Sunday, September 11, 2005

"Call for More Therapists to End Prozac Nation"

Since moving from academics to being a part-time outpatient general internist in a private practice, I have found that it is still not easy to get our patients the mental health care they deserve. Getting them access to good psychiatrists and counselors is always challenging. My experience, of course, is just a microcosm of a larger problem.
Thus I liked this headline, "Call for more therapists to end Prozac nation." This news report summarized a talk to be given tomorrow at the Sainsbury Centre for Mental Health about continuing "gaps for the provision of mental health." A survey to be released tomorrow showed that only 40% of patients had "any access to talking therapies over the past 10 months." Professor Richard Layard noted "Many people do not get treated at all [for depression] because they don't want drugs. There is a huge demand for therapy because people want to understand what is wrong with them. We have such a heavy prescription of drugs because there is no choice."
I would have suggested that this is yet another example of a dysfunctional US health care system which puts cost-cutting on the back of primary care and cognitive practitioners (including specifically those who practice cognitive therapies, in this case, for a bad pun, I suppose), seemingly in order to pay lavishly for expensive drugs, high-tech devices, and invasive treatments.
However, the problem is broader than that. The clue is in the spelling of "Centre" above. The story is from the Manchester Guardian, and the talk will be given in the UK, and is about the UK National Health Service.
This mismanaged priorities we see in the US are similar to those in many other countries, and hence cannot be blamed, as we often do here, specifically on our mixed up system of financing health care.
In my humble opinion, the problem of bad health care leadership is global, not dependent on an individual country's system of financing health care, and will not be fixed by changing how health care is financed.

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