“Lost in Medication”

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Psychiatrist Sarah Mourra writes, in The Atlantic; “This isn’t to say that people don’t need to be on medication — but this psychopharmacological myopia is dangerous in that most psychiatrists of my generation pay lip service to the “psychosocial” part of the biopsychosocial treatment model while failing to put it into practice. This is no fault of our own. I come from a generation of psychiatrists who will never see someone come into a hospital, be taken off all medications, and get better. And for many in my generation, if you don’t see it, you won’t believe it’s possible.”

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5 COMMENTS

  1. “And for many in my generation, if you don’t see it, you won’t believe it’s possible.”

    But they shouldn’t be so stupid as to not realize that they don’t see it because they don’t look and they don’t look because they don’t want to have to face a fact that would hurt the bottom line for their profession.

  2. One of the commentators mentioned he was doing very well with CBT to deal with his depression but unfortunately, when his therapist asked for more time, the insurance company said he needed to be on medication.

    Supposedly, that is an attempt to save money but actually, that ended up being a costly endeavor since it sounds like he went through “medication hell” and become non functional.

    My question is how do we convince the insurance companies that demanding that people be on medication is actually more expensive to their bottom line or is this a useless endeavor?

    Jeffrey C, your points about doctors not looking for successes off of meds is a great one. They also don’t look for successes because it would destroy their entire belief system about psychiatry which would be too threatening.

  3. “My question is how do we convince the insurance companies that demanding that people be on medication is actually more expensive to their bottom line or is this a useless endeavor?”

    That’s exactly right AA, exactly right! I’ve been trying to make this point in Ohio for some time now. In Ohio and other States there is a treatmet model de jur called “Health Homes” Jack Carney has blogged on this here at MIA.

    Health Homes are designed to treat both “mental illnesses” and primary care issues (real illnesses) at the same time by the same team of staff. What’s driving this model, in many states, is the desire to bring down costs (both mental health and primary health) for persons diagnosed with “severe mental illnesses.” For many, the primary health problems are the RESULT of psychiatric drug interventions. The weight gain, lethargy, amotivation, tardive dys, etc. All the drug effects mentioned quickly at the end of those adverts on TV.

    So we’ve created a whole new approach to dealing with an issue, without really dealing with the issue. Now that’s madness!

    Insurance companies and other payors should be a receptive audience to the messages of MIA. Stop using/paying for “illnesess” based on an invalid classification method (DSM); stopy paying for interventions (Drugs) that will cause long-term outcomes to be far worse (and expensive) than non-drug interventions (which are far cheaper in the long-term).

    Best,
    D

  4. Hi David,

    I found the blog entry by Jack on the “Health Homes”. Argh!

    Have you had any luck in making your point in Ohio about meds being more expensive in the long run? If you want to point me to a previous blog entry of yours, that is fine.

    • “Argh!” Could mean so many things 😉

      I’ve not written a blog on my efforts in Ohio around this issues as yet. Primarily because most people I talk to about it look at my funny and what to know what I county I work for again. That’s why I was so excited about your comment. Anytime I run across someone else who “gets it” on this topic, I feel affirmed!

      I think time, will help in being successful in Ohio and hopefully in other states. We just continue to try to educate the community about the impacts on recovery of approaches including drugs vs. not. The one and only Courtenay Harding has agreed to speak at a regional conference we host this year. Her work on the Vermont Longitudinal Study is a classic and will hopefully persuade some folks.

      The implementation of the Affordable Care Act might also offer a chance to speak directly to managed care entities in way we’ve never had before.

      I’ll certainly try to keep everyone posted on my successes and failures as I try to learn from both!

      Thanks,
      David