I have always been fascinated by mirror to mirror image, as close to infinity you will ever be able to grasp tangibly. Anyway, this post I wrote a while ago is still fitting, so you can read and digest.
The post as written:
The title of this picture is “a bitter pill to swallow”, and that is not only fitting, but the metaphor of what mental health care has been simplified and trivialized into these past 10 years. Let’s have a brutal and candid moment of honesty and reality folks, patients aren’t interested in expending the time, money, and energy to truly problem solve their mental health issues and needs any more. No, they want and demand the quick fix, the simple solution, the easy out. And I say give it to them!
So, I advise every state in this country that runs mental health clinics to let go of 50% of the therapists at the state clinics by the end of the year and just have psychiatrists treat about 80% of the patients alone, and allow the doctors to provide some amount of therapy along with the predominate medication management visits that go on now for at least 50% of the billable care provided anyway.
Why do I suggest this today? Come on, we all know that the majority of therapists aren’t providing real psychotherapy at Community Mental Health Clinics these days, no, they are just holding hands, writing treatment plans, and trying to be psychiatrists without the training nor expertise. What happened yesterday to motivate this post?
First, the patient who has enough psychosocial crap going on that could keep the patient busy for at least every week visits for honest and dedicated therapy care, if not even 2 a week attendance, but after not showing up for a therapy visit for almost 4 months, the patient shows up for a visit and just after 15 freakin’ minutes in the office, the therapist is at my door asking me to change the meds I started 10 DAMN DAYS AGO!!! Yeah, thanks for that effort, COLLEAGUE!
Then, about 2 hours later, a patient who is a bit complicated with probably both mood and psychotic issues, comes in after a therapy visit just prior to meeting with me, and tells me what meds the patient needs as the therapist spent much of the therapy visit discussing the meds this patient needs to think about changing to in order to be stable. Yeah, that homelessness and lack of support in the community will really dissipate quickly with a med change. At least the patient admitted it was ridiculous for the therapist to be suggesting medication changes without any specifics nor knowledge of side effects or risks in changing the current meds.
THIS IS WHAT IS GOING ON IN THERAPY OFFICES THESE DAYS AT LEAST 50% OF THE FREAKIN’ TIME, BOTH IN CMHC AND EVEN IN PRIVATE PRACTICE OFFICES THESE DAYS, PEOPLE! Therapists by in large aren’t interested in providing appropriate therapy interventions, they have bought and sold the biochemical model, and if the patient is in any way difficult or not invested, then the therapists want the patient drugged and out the door.
So, to all those bureaucracies out there trying to save money and maximize health care interventions, unload those non MD staff as much as able, and let those who are invested and trained to provide care the way it is intended to be the providers. And this is not sarcasm or a joke, this is what mental health care is today.
To all those “therapists” out there who want to collect a pay check and do the least you can do, don’t let the door hit you on the ass when you are escorted out. Frankly, if some of these patients could get appropriate legal representation, suing some providers would reinforce the message to administrations out there who want to avoid the publicity in the first place!
And when the quick fix fails, as it will as many psychiatrists will do just 15 minute med checks onwards anyway, maybe some of these joker asshole MDs will also face some malpractice consequences as well. Hey, time to touch the stove, folks.
Me, I am ready to provide the compliment of care I was trained to do in residency. This god damn compartmentalization by insurers and administrators and false equivalent non psychiatrists, well, good luck with your agendas as currently in place!
Oh, there will be more about this matter in days to come, COUNT ON IT!!!
So there you have it, nothing new, but well said in my opinion.
Oh yeah, that is my opinion. Kinda like that mirror at the top…