According to two independent studies, more Americans are being prescribed multiple psychiatric medications for use at the same time. But most people diagnosed with recent depression don’t get adequate treatment.
In national surveys of more than 15,000 adults, researchers found that 8.3% met the diagnostic criteria for major depression during the previous year. About half those diagnosed received some form of treatment for depression, but less than a quarter were treated using strategies considered effective and used in accordance with American Psychiatric Association practice guidelines.
This is all probably true—but it’s the least of our problems. A bigger problem is that the mental health and medical establishment promotes the idea that emotions and behaviors are determined by brain chemistry. Yes, some may be, but many are not—and most are not exclusively. Most emotional problems are caused by people doing, thinking and feeling things that make little, if any, rational sense.
Another problem is that more people are becoming depressed, in the context of medical care, because doctors no longer work for patients. In most cases,\ doctors work for a third-party abstraction (i.e., insurance companies/Medicare/Medicaid in general) and do not directly purchase fee-for-service. This leads to alienation and depression on the part of patients that would not otherwise exist. I see it every single day, especially in an older population with more medical concerns. On our current course, especially with the passage of Obama”Care,” doctors will be working totally for the government—which Americans will soon learn is even worse than doctors working for third-party, profit-making abstractions.
Connected to all this, and to the findings of the study, is the fact that medical doctors (including psychiatrists) do not talk to their patients about what’s realistic for helping them improve, or what medications are or aren’t doing. Psychiatrists are allotted 15 minutes per patient according to the Medicare/ government standard (used by all insurance companies), but most of them spend only 5 minutes with the patient, as reimbursement rates continue to be cut by Congress/insurance companies. Now, how much psychiatric care can take place in 5-10 minutes per month?
The smarter patients end up concluding, “Maybe it’s not all my brain chemistry” and they seek out someone like a psychotherapist to whom they can talk objectively and work to find solutions. In situations involving depression, this can actually be on a somewhat long-term basis. Those individuals usually do benefit, but they will only go this route if they figure it out for themselves—or have it recommended by that rarest of physician/psychiatrist who acknowledgesthe existence and the benefit of rational, one-on-one talk therapy.
Source: “Studies: Mental Ills Are Often Overtreated, Undertreated,”
By Shirley S. Wang in The Wall Street Journal Online.