WomaninGreen Is it about underfunding or is it that mental health services will always operate in a certain way?
I think (this is a pub, yeh? I can lean on the bar and say "I reckon..." without having conducted a sociological study?
) that attitudes, at least of individual professionals, are gradually changing. Probably just as a result of time passing and the general societal attitude to emotions and experiences changing, a sort of general awareness of psychological factors even if pop psychology. But there's no services to offer, the whole system is just fire-fighting crises.
However so much about the whole system, the whole conceptualistaion of "mental illness" is messed up! And I really think (um, surely there's psychological evidence for this?!) that people in general sort of take the path of least resistance. So it's easier to believe someone doesn't really need help/go along with other professionals unpleasant views in order to dismiss someone, if it takes a patient off your (impossibly huge) caseload. Actually, there's a thing, they call it "splitting" - supposedly a manipulative act of behalf of the patient who divides staff which causes problems with the staff team. In practice IME this seems to be that some staff have compassion and want to help whilst others are punitive and blaming, and the two can't agree on how to treat the patient... (Read a great blog on this from an ex social worker, who was given all the "difficult" patients but found that treating them humanely and relating to them made them not difficult... and apparently their unflattering views of other staff members were surprisingly perceptive!)
... it was only about ten years afterwards that I started to see studies being done into that problem, often people were being advised to do it when it made them worse, but it takes X amount of time for enough experiences to inform studies and build data etc.
I've had the same issue with mindfulness. Apparently not good for people who've suffered trauma. (Also hate this assumption that people must be thinking wrong/not capable of reflecting on stuff/not trying hard enough. That's how I ended up with incredulous staff baffled that I "have insight" and am fairly sensible about thoughts/reasoning/decisions - "But why are you still not ok?" !!!) I suspect it's the same process at work as that which dismisses women's health issues - the patient is seen as being difficult/making a fuss if something doesn't work.
But, the main problem seems to be that services are simply not designed or run from a psychologically informed perspective. There's stacks of evidence - including really basic stuff about human interaction - that is just ignored. "Psychology" is the remit of psychologists, that patients are sent off to see... other staff range from fairly informed (off their own backs and interest) to glorified prison guards who appear to have had their humanity removed as part of the training. (Which raises another question about the seemingly common psychotic delusion that agents of the state are monitoring the person and poisioning them..!)
Read a great article, but I can't seem to find it now... It explained the problem with needing empirical evidence that a treatment is effective to justify funding it. Say you've invented a new therapy for depression - you have to test it on a large number of patients who have "pure" depression, no complicating factors (potential confounding variables) like other mental health diagnoses, self-harm, being in an abusive relationship... think they have to take into account socioeconomic group as well. And the therapy has to be delivered in such a way that it's the same for everyone in the trial. So therapies that are very concrete and manualised have an advantage over those that take into account circumstances and are more individualised, and a therapy CBT may appear very successful for this unusual subgroup of patients with a specific clear issue and non-complicated lives, but doesn't necessarily translate to the real world.