What Mental Health Parity Has Wrought
Psychiatrists now practice like primary care physicians: short meetings and a prescription pad:
Dr. Levin, 68, first established a private practice in 1972, when talk therapy was in its heyday… Then, like many psychiatrists, he treated 50 to 60 patients in once- or twice-weekly talk-therapy sessions of 45 minutes each. Now, like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names. Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional.
It was a dumb idea all along.
The best analysis by far of mental health parity has appeared at the NCPA web site. Everyone else has been asleep at the wheel on this issue.
It has produced craziness. No pun intended.
Even more worrying, many of the meds haven’t been around long enough for us to understand the possible side affects. Without any sort of cognitive behavioral therapy, patients learn to believe that a pill is their only option.
When there is ‘talk therapy,’ it seems it is isolated from the medication-prescribing psychiatrist, i.e. it is done by psychologists or family therapists.
This story laments the demise of talk therapy by psychiatrists — which has repeatedly been found to be about equally effective with drug therapy. Yet, psychiatrists argue that the greatest advance in the treatment of mental health over the past few decades has been the ability to adjust brain chemistry with pharmacology rather than costly, time consuming talk therapy.
There are still practitioners of talk therapy. But many are clinical psychologists and or practitioners with a Masters Degree in Counseling. The demise of talk therapy by physiatrists may be because psychiatrists themselves don’t consider it rewarding. It requires a special kind of person to sit all day long and listen to patients talk about their problems without suffering burnout.