Health

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In situations where there are not enough psychiatrists, psychologist and counselors available, it can be incredibly frustrating and challenging to get the help and support needed for mental health concerns. When it's impossible to secure an appointment or obtain prescription refills, it can exacerbate existing issues and lead to feelings of helplessness and despair. It's essential to explore alternative options for managing mental health, such as seeking therapy from other mental health professionals like psychologists or licensed counselors, joining support groups, practicing self-care techniques, and utilizing online resources for mental health support. Additionally, reaching out to primary care providers for interim help or exploring telehealth options may provide temporary relief.

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It's crucial to prioritize mental health and continue advocating for improved access to psychiatric care for all individuals in need. In situations where mental health services are scarce, individuals may face significant barriers in accessing the help they need. This can lead to a sense of frustration and isolation, amplifying the challenges of managing mental health concerns. Exploring alternative avenues of support, such as connecting with therapists, engaging in self-care practices, and utilizing online resources, can offer valuable assistance during these times of limited psychiatric availability. Additionally, seeking interim support from primary care providers or considering telehealth options can provide temporary relief while waiting for more specialized care. By prioritizing mental health and advocating for improved access to psychiatric services, individuals can work towards creating a more inclusive and supportive system for those in need.

Can AI chatbots be used to address the shortage of psychiatrists, psychologists, and counselors?

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AI chatbots have the potential to help address the shortage of mental health professionals such as psychiatrists, psychologists, and counselors by providing a cost-effective and easily accessible form of support. These chatbots can offer immediate responses to individuals in need, providing them with resources, guidance, and coping strategies. They can also monitor patients' progress over time and alert human professionals when intervention is needed. Additionally, AI chatbots can help reduce the stigma associated with seeking mental health support, as some individuals may feel more comfortable confiding in a non-judgmental virtual assistant. However, it's important to note that AI chatbots cannot replace the level of care and empathy that trained mental health professionals can provide. They should be seen as a complement to traditional therapy rather than a replacement.

Proper training and oversight are necessary to ensure the effectiveness and ethical use of AI chatbots in mental health care. AI chatbots have the potential to revolutionize mental health care by reaching a larger population in need of support. Their 24/7 availability and anonymity can be particularly beneficial for those who may struggle to seek help through traditional means. By offering immediate responses and personalized resources, AI chatbots can empower individuals to take control of their mental well-being and access help when they need it most. However, it is crucial to integrate these chatbots into a comprehensive mental health care system that includes human professionals for more complex and nuanced issues that require deeper emotional understanding and empathy. Thus, the collaboration between AI technology and human expertise can pave the way for a more inclusive and effective mental health support network.

People who are poor, under-insured, minorities, without transportation or internet connection, and other access issues are as affected or even more so impacted by the overall lack of psych providers.

Individuals who are experiencing poverty, lack adequate insurance coverage, belong to minority groups, face challenges with transportation and internet access, or encounter other barriers to care, are significantly affected by the shortage of mental health providers, if not more so. These vulnerable populations not only have limited access to mental health providers, but they often face stigma and discrimination when seeking help. This further exacerbates their struggles in receiving the support and services they desperately need. The shortage of mental health providers also disproportionately impacts rural communities, where access to care is already limited due to geographical barriers and lack of resources. This creates a cycle of unmet mental health needs, leading to worsened mental health outcomes and increased rates of mental health crises among the most underserved populations.

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Efforts to address the shortage of mental health providers should focus on expanding access to care in underserved areas, increasing funding for mental health services, and implementing programs to recruit and retain providers from diverse backgrounds. It is crucial to recognize the intersectionality of barriers that individuals facing poverty, discrimination, and other challenges may experience in accessing mental health support. By addressing these systemic issues and working towards a more inclusive and equitable mental health system, we can better support those who are disproportionately affected by the shortage of mental health providers.As always, your comments and feedback are welcome.

Certainly! Mental health chatbots have emerged as a valuable resource for individuals seeking support and guidance. Let’s explore a few of them:

• Woebot:

• Developed by Woebot Labs in San Francisco, Woebot is a fully automated conversational agent.

• It engages users in conversations, offering support and guidance.

• Woebot uses cognitive behavioral therapy (CBT), an evidence-based approach to treatment.

• Users can discuss their thoughts and emotions, and Woebot helps identify and challenge distorted thinking patterns.

• It’s user-friendly, has a sense of humor, and provides reminders about confidentiality and emergency situations1.

• Wysa:

• Wysa is an AI chatbot designed to provide emotional support.

• It offers coping strategies, mood tracking, and relaxation techniques.

• Users can discuss their feelings, and Wysa provides evidence-based interventions.

• It’s available 24/7 and can be a helpful companion during difficult moments.

• Youper:

• Youper combines AI with human expertise.

• It engages users in conversations, helping them explore their emotions and thoughts.

• Youper uses techniques from CBT, acceptance and commitment therapy (ACT), and other therapeutic approaches.

• It’s interactive, personalized, and aims to improve emotional well-being.

• Kintsugi:

• Kintsugi focuses on resilience and growth.

• It encourages users to embrace their imperfections and learn from challenges.

• Kintsugi provides mindfulness exercises, self-compassion practices, and positive affirmations.

Remember that while chatbots can be supportive, they are not a replacement for professional therapy. If you’re experiencing severe distress, consider reaching out to a licensed mental health professional.

Is voting for Nikki Haley equivalent to voting for Donald Trump?

by Donald H Marks, physician scientist

https://docs.google.com/document/d/1v62Wn5NwEsSx4axk_CnVte-_z8iV0VeIKIKCbokJ-Gc/edit?usp=drivesdk

With Nikki Haley moving up in the polls, many have asked whether there is any difference between Nikki and the Donald. In the past, Nikki has definitely said that there is no difference, no daylight between her opinions and those of the Donald. Yet, there are IMO some major differences between Nikki Haley and TFG in terms of political views and style. Here are some examples:

- Haley has directly criticized Trump for his involvement in the US Capitol riot on January 6, 2021, and said he has no future in the GOP⁶. She also said that Trump's actions since Election Day "will be judged harshly by history" and that he "let us down" as a party and a country⁶.

- Haley has slammed Trump for his recent comments on Hezbollah, a militant group that is designated as a terrorist organization by the US and many other countries⁵. She said that Trump's praise for Hezbollah's leader Hassan Nasrallah was "a betrayal of our ally Israel and a gift to our enemy Iran"⁵. She also said that Trump's remarks showed that he has lost sight of who America's friends and enemies are⁵.

- Haley has a more conventional Republican message than Trump, who has often deviated from the party's orthodoxy on issues such as trade, immigration, foreign policy, and social issues⁴. Haley has emphasized her conservative credentials on fiscal responsibility, national security, pro-life, and pro-Israel stances⁴. She has also tried to appeal to a broader base of voters, including women, minorities, and moderates⁴.

These are just some of the differences between Nikki Haley and Donald Trump, so yes there is a difference and a point to be made when voting for one versus the other.

Source: Conversation with Bing, 11/30/2023

(1) Nikki Haley criticizes Trump and says he has no future in the GOP. https://www.cnn.com/2021/02/12/politics/nikki-haley-donald-trump-gop/index.html.

(2) ‘These are not good or smart people’: Haley slams Trump ... - POLITICO. https://www.politico.com/news/2023/10/28/these-are-not-good-or-smart-people-haley-slams-trump-on-praise-for-u-s-adversaries-00124102.

(3) Opinion | Why Nikki Haley Might Become Donald Trump’s Biggest Rival .... https://www.politico.com/news/magazine/2023/11/02/mag-lowry-nikki-haley-00124866.

(4) Trump slams JPMorgan CEO Jamie Dimon for praising Nikki Haley. https://www.msn.com/en-us/news/politics/trump-slams-jpmorgan-ceo-jamie-dimon-for-praising-nikki-haley/ar-AA1kMY4p.

(5) Donald Trump Melts Down Over Support for Nikki Haley. https://www.msn.com/en-us/news/other/donald-trump-melts-down-over-support-for-nikki-haley/ar-AA1kNwhV.

(6) One Response at Nikki Haley Event That's a Warning Sign for Trump. https://www.msn.com/en-us/news/politics/one-response-at-nikki-haley-event-thats-a-warning-sign-for-trump/ar-AA1kNfWx.

(7) Getty Images. https://www.gettyimages.com/detail/news-photo/nikki-haley-in-conversation-with-all-due-respect-at-92nd-news-photo/1187294330.

by Donald H. Marks M.D. Ph.D. FACP

New or worsening (psychiatric) symptoms can represent adverse effects of prescribed medications, rather than a progression of the underlying disease state. Patients and their families should be informed and warned, as I have urged (cited ref below).

The treating/prescribing physician of medications that Can cause CNS adverse events should perform an adequate medical and psychiatric history and evaluation to ascertain the risk for using these medications in each patient. Professional help should be sought from psychiatrists with a good knowledge of psychopharmacology and substance-induced mood disorder (SIMD). Consideration should be given to the consequences in each patient of inducing increased anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, or suicidal or homicidal ideation.  IMO all patients who receive psych drugs, and their immediate family and caregivers, must receive specific warning about potential induction of CNS adverse events, including: anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, suicidal or homicidal ideation. (Marks et al 2008)

Patients receiving these listed medications should be queried at regular intervals for the development of CNS adverse events, and appropriate follow-up should be performed. If a person receiving these medications develops new or heightened homicidal thoughts, it is important for the treating/prescribing physician to determine whether the medication should be discontinued. Patients developing CNS adverse events should be questioned concerning their degree of risk to themselves and others, and they should be requested to notify anyone who may be at risk from their actions. Professional psychiatric input should be considered. All these actions should be documented in the medical records.

References

Marks DH, Breggin PR. Braslow D. Homicidal Ideation Causally Related to Therapeutic Medications https://bit.ly/3x7yjtw  Ethical Human Psychology and Psychiatry, Volume 10, Number 3, 2008

Some Suggested Guidelines to Prescribing Anti-psychotics 

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Full disclosure, I am a medical doctor, and many of my patients have psych disorders like anxiety depression, PTSD and manic-like illness. While I do occasionally treat psych disorders, I am not a psychiatrist. But many of these patients who need or could benefit from medication and psychotherapy simply can not afford it, or don't have access to care.

Here is the good news and the hope. There are apps specifically designed to help individuals cope with PTSD anxiety and depression symptoms. These apps, and more are coming, can provide tools for managing anxiety, stress, and triggers, as well as offering resources for relaxation, mindfulness, and grounding techniques. Some apps also offer cognitive behavioral therapy exercises, guided meditations, and mood-tracking features to help users better understand and manage their symptoms.

While apps can be a helpful supplement to traditional therapy and medication, it's important to remember that they are not a replacement for professional medical advice. It's always recommended to consult with a healthcare provider before making any changes to your treatment plan, including reducing or stopping medication.

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Ultimately, whether or not an app can help someone get off medications for PTSD anxiety depression will depend on the individual's unique circumstances and the severity of their symptoms. It's crucial to approach treatment holistically and work closely with healthcare professionals to determine the most effective and safe approach. It's essential to view these apps as tools to complement existing treatment strategies rather than a cure-all solution. Building a comprehensive support system that includes professional guidance, self-care practices, and possibly app-based tools can enhance overall well-being. Each person's journey with PTSD is unique, so it's vital to personalize the treatment approach with a healthcare provider's guidance and supervision.

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In navigating the possibility of reducing medication use, it's crucial to prioritize safety and well-being. Collaboration with healthcare professionals can help individuals make informed decisions about their treatment plan, considering factors like symptom management, potential risks, and overall progress. Finding the right balance between medication, therapy, self-care practices, and technological tools can empower individuals in their healing process and promote advocate for improved healthcare access.

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