20 years after finishing a psychiatry residency, and what do I have to show for it?  Being marginalized into just writing scripts for people who as a sizeable majority have no interest or clue to pursue a level of care that is most efficacious.  Since I stopped doing Locum Tenens work about 2 years ago and went back to trying to combine community mental health and private practice, I just seem to be treating more addicts, Axis 2 “treatment resistant” mood and thought disorders, solely socioeconomic problems, and people with tertiary care presentations coming to a primary psychiatric source without any resources to effectively diagnose such complicated cases.

This is what mental health has degenerated into?  Fix multifactorial problems with a single intervention in a tablet/capsule, and then be harassed by others who don’t want to hear what is the realistic treatment plan of psychotherapy, psychosocial change, medications where warranted, and reassessing coping skills while maximizing insight and judgment?

I am taking the week off for the first time in 6 months, and really don’t know what I will be willing to come back to in July.  I do know this:  I have been resilient to make it this far, so I think I can continue.  What I don’t get it is how all these people who work in mental health show up and do the job with the way it is today.  How do many of you live with yourselves accepting this disgusting lie that has been propagated by so many in positions of power and authority in the multiple disciplines in the field?

I mean, forget psychiatry as one element for a moment.  Psychology thinks they can be psychiatrists without the medical training to be able to prescribe, Social Work thinks they can be therapists without really learning true psychotherapy skills as a whole, people can be licensed as “therapists” without legitimate training program access, and administrative officials throughout the various levels of mental health care can maximize billing while minimizing time of services, this is what the system has deteriorated into?

It goes back to my 100th posting when I wrote “I have seen things you people would not believe”.  I have participated in mental health care settings that redefine the term “travesty”, and some of these programs still exist today.  Incredible, and what people as patients have been willing and complicit to put up with that gives the illusion they are receiving at the very least adequate care is just absurd.

People reading this post probably don’t know what to make of what I am writing, and believe me when I tell you, I just don’t get it either.  I am convinced that if there really is a higher power, it is the prankster that the Al Pacino character in “The Devil’s Advocate” tells Keanu Reeves.  Look but don’t touch, touch but don’t taste, taste but don’t swallow.  How do people with caring and invested souls survive as practitioners when so many people who are our alleged leaders and policy makers are just whores and cowards?

Sort of goes along with my political posts I make here too:  what do you do when our leadership is devoid of compassion and representation?  We have so much characterological pathology running amok in so many elements of society, we really do not know what is right or wrong anymore.

Well, I reread what I wrote above and will stick with printing it.  Some of you will laugh, some will be perplexed, some will just think I am clueless, and maybe some of you will think I am trying to make sense of the senseless shit that is consuming mental health care.

My mistake, I went into this pursuit to be a doctor and psychiatrist because I genuinely care and want to help people help themselves.  I just can’t do it the way the system has corrupted things to where this “care” has degraded into.

Do I have a choice?  You always hope you do!  Feel free to comment, I probably won’t print any until the end of the month, I am only going to my email every so many days.

Talk amongst yourselves!