I am having a debate in my head as to who deserves/needs most help

Is it the person who experiences acute periods of crisis punctuated by frequent good spells of functioning ,or is it the person who doesn’t experience crisis but functions less well overall?
I guess if we had a mental health service fit for purpose this wouldn’t be an issue.

I guess if we had a mental health service fit for purpose this wouldn’t be an issue.
Ie if we had a mental health service that wasn’t increasingly becoming a crisis intervention service.
Ultimately I think there needs to be parity of esteem for those acutely and chronically ill.

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It’s a difficult question, also because what counts as ‘more’ help may not be that clear… Like, in a crisis, the patient may receive much attention and care, very intensively, multiple people concerning themselves with the patient almost continuously, but for a short period. The, in one sense, less extreme, yet persistent problems of the chronic patient may get treated less intensively, idk, maybe he’d see a therapist every few weeks or have a social worker drop by for half an hour every other week or so. One way to think of ‘the amount’ of help a patient receives could be to break it down into man-hours of received care over the stretch of one’s life. Then it would depend on the number of crises which patient recieves the most help.

Idk, I am inclined to think that an ‘equal share’ of hours of received help is missing the point. I would incline to think it is about the outcome rather than the means towards that. Some baseline of quality of life is to be achieved.

Then I guess that would point to more help needing to be given to the chronically ill person who has longer periods of poor functioning which results in the greater likelihood of a low/inadequate quality of life.

However if you argue from that position what happens to the need to adequately support those who are a danger to self or others? Obviously acute implies a relatively short period of time but in that time quality of life could be seen to be greatly impaired .

Yes so in this very general sense I think it makes sense how things are currently arranged, obviously taking into account that there are limited resources available. Such that the intensity/duration of care mimics the intensity/duration of health problems.

I think we always put the burning fires out before we deal with nagging structural issues. I think I’m mainly your second scenario - generally lower functioning but not awful, with diminished quality of life. And the occasional crisis.

It’s only the crises that really get attention, though how much of that is on my treatment team and how much is on me is debatable. I tend to drag myself along, telling everyone I’m okay, when in truth I’m not doing all that well. I’m not sure I’ve given my treatment team a fair shot at letting me down :smile_cat:

I imagine they would have a crisis eventually, although it might not look the same as the acute crisis sorts. When you have chronic struggle to function, your crisis usually entails losing your home and dying on the streets. It’s just that the rest of society doesn’t see that as a crisis. Some ways of dying are more acceptable than others.

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The mental health system is so overburdened that it is hard for them to find the best fit for every patient. Even when case loads are light not every case is easily understandable to them.

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It is the person who happens to be me, obviously.

15 15 15.


I suppose both situations need help, the most I don’t know, people need immediate help in situations of crisis and need continuous help in situations of chronic illness.

In my country, there’s immediate help and coordinated help for non acute cases. It’s a good balance.

I would say the acute crisis individual needs the care.