In a new viewpoint published in JAMA Psychiatry, researchers from Indiana University and the University of Washington assert that fewer than 30% of psychiatric hospitals in the United States employ psychologists.
This gap leaves patients without access to therapy, behavioral interventions, and comprehensive psychological assessment during a time of vulnerability. The authors contend that integrating clinical psychologists into inpatient care could reduce coercive practices, improve patient outcomes, and even lower costs.
The authors—Alexandra Moussa-Tooks, Adam Kuczynski, Leah Gilbertson, and Sarah L. Kopelovich—write that many U.S. hospitals still omit psychologists from staffing models, despite rising demand, chronic underfunding, and overreliance on medication in crisis care.
“Our current models, which rely heavily on pharmacologic symptom stabilization while neglecting the psychosocial drivers of crisis, often fail to address the conditions that precipitate hospitalization,” they write. “Worse still, such care has been reported by service users to entrench mistrust in mental health systems and, perhaps counterintuitively, has been shown to be associated with increased suicide risk after discharge.”
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Eww, how dare you, MIA? Inpatient care is not something that needs “saving”. Psychologists are just psychiatrists with even less “science”. Psychology as a field is a huge part of why we ended up with the problems we have now.
Why would you think anyone here cares about what JAMA Psychiatry thinks? I’m continually amazed at the republican levels of constituent-abusing ignorant hypocrisy on this website. This is a website neither about science nor social justice, it’s literally just doctors and psychiatrists talking about the latest psychiatry research like it’s anything resembling a science.
I would say this site were a joke if it were funny. This site makes ME feel like a joke. This pro-psychiatry atmosphere feels like a cruel mockery of all the damage psychiatry causes.
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Agree 100%
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I have been a patient of psychiatry, locked up and drugged against my will, but I would say I quite like psychology. I think talking about issues and understanding issues can help a person to improve their mental health. Of course it should be the patient’s choice though.
Perhaps you think that involuntary inpatient psychiatric care should just be completely ended. I am tempted to think that, having been through it. I doubt it will be ended any time soon though. I hope that involuntary drugging might end at some point, but involuntarily detaining some people who are potentially dangerous might have to continue, for the safety of everybody.
If patients have more access to psychology, on a voluntary basis, then I think that’s a good step forward. If they don’t want to engage with psychologists then they shouldn’t have to, but I think it would be good to give patients the option.
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Why would you want to engage with people who believe in the DSM?
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Anonymous, since the great majority of psychologists rely on the bogus categories of the DSM in making diagnoses and administering therapy, your faith in their intellectual integrity and competence is misplaced. What do they provide to clients that cannot be offered, at far less expense and perhaps with more insight, by a support group of intelligent peers with relevant life experience?
As for the need to detain potentially dangerous individuals, ideally that should be a matter for law enforcement agencies and the judicial system. Unfortunately, in the current profit-driven economic system, those who end up in prisons tend to be street criminals from the urban underclass, not wealthy well-connected corporate sociopaths who knowingly contaminate the environment and produce or sell addictive toxic foods. It’s the latter who are far more dangerous to public health and welfare. So, if you’re concerned about “the safety of everybody,” wouldn’t it be better to focus attention on the greater threat?
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Kelli, Have you ever heard of Fritz Redl( When We Deal with Children) ( actually the late Wayne Dryer studied under him) or the concept of therapeutic milieu? The sense of not having psychologists is an almost red herring depending on the proscribed role. Testing or clinical work such as groups and family therapy. Both aspects of the profession were once used.Irving Yalims work on groups essential.
The idea is relevant but missing so so so much more! There is music therapy and therapists, there is horticultural therapy and therapists, there is art therapy and therapists, there is dance therapy and dancers, there is recreational therapy and therapists, there is poetry therapy and therapists, there is drama therapy and actors, there is pet therapy and animals!
To just have an article on psychologists is vastly missing the point.
Child Life Therapists should also be Adult Life Therapists. One needs to look into the work of Emma Plank as well as medical social work abd therapists work of Mary Richmond and Ida Cannkn.
Folks are anti psychiatry because it has been horrific for at least two decades and throughout the so called profession sometimes of light and more than times of deep and dark vastness.
Do something abd expand your vision. To help means to be helped by others. And learning what is not in your syllabus and talking to the elders as well as the survivors essential. JAMA put on its art covers at the suggestion of I think Dr Arthur Sackler. Marketing and Advertsing and profit versus care and compassion and actual help for those in crisis and their families.
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Mary, the field of psychiatry has been “horrific” for far longer than two decades. I can cite, among numerous examples, the participation of psychiatrists in implementing the Nazi T-4 program and the Holocaust, in the forced hospitalization and drugging of dissidents in the Soviet Union and other communist countries, and in the widespread lobotomizing and coma therapy of homosexuals and other “deviants” in the 1940s and thereafter, not to mention the sterilization of those considered bearers of defective genes. Peter Breggin and Jeffrey Masson have written extensively about the sordid history of psychiatry if you’d like to delve more deeply into this subject.
In short, there are valid reasons for abhorring the “science of lies,” to use Thomas Szasz’s apt expression.
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Joel I know!!!! I can write a book on it!
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Also there are so many complex layers of history. So just take the deaf community. Finding language was used abd the assessor only was aware of the strict AzSL and no slang or dialect. Some e sane Coukd be scared insane. Same with every immigrant or migrant because standard language many times is not ever standard in various locations. Even with English there can be huge problems. An elite assessor who has no understand big another country may see things through that narrow view without knowing what they don’t know.
Germany sent people to research Jim Crow before WWII even started before the program you mentioned. Eugenics was a big thing in the United States and other places why Disability Studies do so do important. Check out Nelly Bly’s work undercover. I had hopes of doing something but it seems not able to get around life. Take Care.
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Without a doubt. My own horror is over 4 decades old now. Oh, yes there was even “art therapy” and “music therapy” and no, those things didn’t make the authoritarian abuse any more palatable nor was it “healing” in any sense of the word.
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Well under a psych unit with a administration most units even with other therapies Coukd be brutal especially after 200 though also before depending on what time period Annie. So the moral treatment was helpful to many but not all. They stopped doing moral treatment because some folks didn’t get better . Some people running the units were okay some were not. It all depends on who what when where and why yes?
And many therapies in community not just onsite in unit.
Also military WWI abd even more so WWII fir a brief time extensive treatment groups but because of money and funding sources and the amensia of any trauma important knowledge gets forgotten so then after that period Family Thersoy. Murray Bowen, Jay Haley, Carl Whittaker , Cloe Mendez and others then they had big time issues with each other and funding. Then after that Loren Misher abd Soteria among others. There needs to be a timeline so everyone can be in the same page in terms of knowing the timeline. It makes dialogue easier because this is all so complex and hard.
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Yes, Mary, it is complex and very hard and there are no easy answers, nor was my experience , everyone’s experience.
And I am ok with places such as Soteria House if is truly a respite and voluntary- emphasis on voluntary. Perhaps we do need something available for the distressed to turn to, but it just such ideas never seem to be able to survive.
It takes money, so people must be categorized into diagnoses that can be charged and paid for, and then these human beings are turned into money fodder for the greedy. From the Dickensian work houses to the present, the real problem is the profit of off the vulnerable, and we will not rid the world of the types of people who do this type of thing- they seem to be quite abundant. That is just a harsh reality of the world.
What is really needed is laws that protect the civil rights of people who find themselves in these unfortunate circumstances.
Laws that would allow for the criminalization of medical professionals who detain, diagnose and drug individuals who should not be. This by itself, would go a long way in cleaning up this awful mess. As of now, the is no accountability whatsoever.
We need a society who questions authority and so – called experts instead of trusting with compliance and without scrutiny.
We need a lot, but these three things are a doable start.
Don’t make any other profession a part of a failed and corrupted industry.
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This article serves us yet another portion of medicalized language: “patients” (i.e. people in emotional distress) and “symptoms” (their understandable responses to the harrowing circumstances in which they find themselves).
The mistrust of “service users” (Orwellian newspeak for victims, often disproportionately from marginalized or impoverished social groups and ethnic minorities) toward psychiatric institutions seems to me entirely justified, given the degrading conditions that prevail therein.
And is it really “counterintuitive” to discover that the suicide rate of those who have the misfortune to pass through the mental health system turns out to be shockingly high?
I question the view that increasing the number of clinical psychologists (the great majority of whom base their diagnoses and therapies on the scientifically invalid DSM) to participate in such a corrupt, inhumane system would effect any substantive reform.
The problems that lead to widespread alienation, emotional suffering and suicidal despair among the population lie far deeper and are much more intractable than this facile solution assumes.
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People in emotional crisis don’t need “diagnoses”, “medications”, or “treatment”. They need advocates they feel safe with who’ll listen to them without judging them.
Turning empathy into a commodity spells the end of the human race.
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“Turning empathy into a commodity spells the end of the human race.”
This is the heaviest truth that people will not recognize until it’s already too late. It already is.
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Your comment reminds me of a Russian literary essay I translated many years ago, in which the author remarked: “Man has died, only his pants remain” (referring to the hypersexualization of artistic imagery and culture in general).
I would paraphrase this observation as follows: “Man has died, only his pocketbook remains.” Capitalist commodification leads not only to the destruction of the environment but to the destruction of all human values beyond the mad scramble for wealth, status, and power.
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Yes, but it’s a mistake to blame capitalism.
Blame psychiatry and psychology for using it.
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Spot on Birdsong
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I blame both. Capitalism is an economic and political system in which a commodified health care industry intertwined with Big Pharma and insurers, among other colluding players, finds a hospitable and highly profitable environment.
Ralph Nader has produced many excellent podcasts that expose this corrupt nexus of wealth, power, and privilege.
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Thank you so much, AnnieOakely 🙂
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“This is the heaviest truth that people will not recognize until it’s already too late. It already is.”
I hope not. But you may be right.
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Seems pretty obvious, really. Of course people in psychological distress need psychological support. That this needs to be stated is a pretty telling sign of the dysfunction within the medical system.
I also find it interesting how the word “care” is used to refer to medical intervention, even when those medical interventions are acknowledged to be inappropriate and harmful. The medical profession seems to view itself as fundamentally “caring”, and it seems to be a core part of professional’s self-image. It seems to make it difficult for them to consider or acknowledge the harms their actions can cause. Although, that’s just one factor of many.
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You make a very good point.
It’s remarkable how mental health practitioners who administer a range of severe brain-disabling treatments to “service users” can take pride in being members of so-called helping professions.
Human beings seem to have an infinite capacity to rationalize their actions as genuine, benevolent concern for other people’s welfare. The mental health field is no exception to this hypocritical, self-seeking behavior.
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“Can More Psychologists Save Inpatient Psychiatry?” What a disgusting question. Why would anyone want to save inpatient psychiatry? And why should all the money that goes to psychology and psychologists not go directly to “patients,” so that they can improve their material conditions rather than prop up the pretense that the problem is in their heads?
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Because bloated egos and greed are what run the circus called “psychiatry”.
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As a psychologist utilising an open dialogue approach I was met at the doors to the inpatient ward by the psychiatric nurses who blocked my entry. I was able to get approval for my approach from a few “enlightened” psychiatrists, but the nurses were a different kettle of fish. Amongst their senior members were the policy writers, who blocked what I wanted to do. I continued to work outside of the inpatient units through seeing the families, but even with “advanced directives” (legal papers expressing their wishes if they ever got admitted to an inpatient unit) they could be over-ridden by the committal laws. Industrially it is something of a “closed shop” these days run by a union of psychiatric nurses.
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The bards of the comment section- those who have survived the horrors of psychiatry and might I add, many who have also escaped therapists who have caused suffering following the dictates of psychiatry – these fellow human beings speak over and over of the problems and abuses in the industry and yet those whose incomes depend on the industry for a living seem simply to ignore the cries and write more proposals, while ignoring the problems that have been clearly delineated. I have to ask- tongue in cheek- is there a diagnosis for this behavior?
But more to the point, what can we, the survivors, actually do to help those ensnared in psychiatry’s clutches ? It seems so hopeless troubling a deaf heaven with our bootless cries. What can we do besides write these comments just in case a fellow sojourner happens to read our thoughts. I think about this every time I write.
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“What can we do besides write these comments just in case a fellow sojourner happens to read out thoughts. I think about this every time I write.”
So do I. But saving just one soul is worth it.
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I agree- I wish I had such people writing their thoughts long ago.
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I wish the same thing. However, other wishes of mine have come true:
I long suspected psychiatry was a huge lie, but I also dreamt of finding others who not only shared my point of view, but that somehow, somewhere, there’d be a way of letting the wider world learn the truth about it.
MIA has fulfilled this wish.
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Yes, you are right, we are no longer holding the truth by ourselves, and that is a beautiful thing Miss Birdsong. Glad to know that there are others.
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🙂
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