This article was written (above) in the Guardian UK and there was another one written prior to this in the NY Times. I think however the average person who is making the choice between the two is confused about what the article is saying. I would like to give my take on it here.
A psychiatrist is a doctor. If you need medication then you would see them for that. A psychotherapist is a combination of several licenses and degrees, social work, professional counselor and marriage and family therapist. The latter only requires a master’s degree and therefore cannot prescribe medication. So a psychotherapists role is to work with a client in a holistic manner by helping them through their crisis in what is known as “talk therapy.” Whereas a psychiatrists role is not really that of a psychotherapists, though the articles are stating that they should be. I agree with the above article because while it is essential to have a psychiatrist for obvious reasons that some – note that I am saying “some” clients do require psychotropic drugs (or medication for mental illness). Unfortunately more people are prescribed psychotropics than really need them. A psychiatrist who is prescribing needs to have more time talking with the client to figure out what they believe the client really needs. Often doctors will spend approximately 15 minutes sizing you up. Some will give you about 30 minutes for the first time only. Psychotherapists are required to size up a client for insurance companies in the first session. Unfortunately it takes a lot more than one session of 30-50 minutes to figure out an accurate diagnosis. As a result most professionals are forced to take feedback from others, previous diagnosis from another doctor or psychotherapist and later on they may take the time to change the information provided to the insurance company. Not all do though because this takes a lot of work to tell them you made a mistake the first time around.
I have experience with adult clients but mostly child clients in foster care. If there is ever a case for psychiatrists taking advantage of their title and abusing the system of vulnerable people it is in the child welfare system. Since I mainly dealt with the most difficult cases in foster care, I saw children on more medications than the average adult. They did not need them. What they needed was a treatment team designed to work with them and help them to succeed or transition into adulthood. Instead, they had the psychiatrists listed in the UK article above who listened to para-professionals who had undergraduate degrees or no degrees at all – who had no knowledge of medications or psychology, rather than listen to the experienced professionals who did understand the situation at hand.
Psychiatrists dealing with children in foster care were overwhelmed by the amount of people begging them to give the child drugs to “settle them down.” Teachers, group home workers, case managers, all who work with severely emotionally disturbed children are overworked and underpaid. When a new child shows up on their doorstep, they are already at a disadvantage because they are labeled from day one. If you have the title SED on your IEP, or if you are sent to a group home, you automatically have a bad reputation with the para-professional. They are without realizing it, looking for you to screw up the minute they meet you. When a person has filtered glasses on, they tend to make judgements that are not realistic and as I have said unreliable because they are not properly trained in making these decisions. I worked with other programs where medication was not the main focus and these children were on less medications and did better than the ones who were in the heavily medicated programs. Why? Because often medication is not the answer to the problem. The answer is having a good psychotherapist who understands how to work with mental illness and not allowing anyone in the room with a psychiatrist who is not a psychological professional. The judges in the county I worked for wouldn’t even allow anyone to review a psychological evaluation unless they were a psychological professional. The reason being, if you do not have a graduate degree or above in psychology then you are not trained adequately enough in understanding the diagnosis or the information presented on an evaluation. So you are most certainly not appropriate for deciding whether they should have medication.
How did we get here? How did we come to a place where para-professionals are deciding the fate of children and whether they should be on medications? How did we get to a society where the average person is telling their doctor that they need to be on medication? What happened to good old-fashioned, home-made remedies and holistic thinking?
Television. Teachers, group home/foster home providers, parents, case managers are sitting behind television sets much too often in an effort to calm themselves down from the end of a long hard-working day. What is on that television are a bunch of reality shows with a lot of nuts on there who humiliate themselves and do things the average person would only do drunk. In between these ridiculous programs are advertisements for every medication imaginable. It is subliminal messages because the brain is not even completely in action during television programs and this has been proven by research. So while you are watching “reality” television and taking in all the medications being sold to you, somewhere along the line you are also making judgements about yourself and the clients you work with. The television has succeeded in making you belive you are mentally ill, are having a heart attack, could be in danger of restless legs, might have COPD, and of course the purple pill or the pink one or “just one a month is all you need,” is all you require to feel better and “be happy again.”
Meanwhile, the pharmaceutical companies are wining and dining your psychiatrists with fancy vacations, elaborate meals with all you can eat lobster and champagne. I’ve seen the advertisements at work for the dinners and talked to people who attended them. I’ve seen the fancy salesmen and women who show up at doctor’s offices with gifts for everyone in the office. I am also aware of the billing department for every non-profit and for profit in the mental health industry who is clamoring to get paid by insurance. Mental illness diagnosis pays higher and requires medications if the insurance company is going to buy your argument that the patient is mentally ill. If you don’t prescribe than you can’t diagnose, plain and simple. If they don’t require medications than they should have a diagnosis that does not require one. The lesser the diagnosis, the lower amount of sessions will be paid for. The business has to survive.
Do you really need medications? Does your child really need them? Probably not. However, now that you are addicted to them you’d be hard pressed to take the step forward in finding out. I could share quite a few stories of children who I was successful in getting off all the medications, got them in the correct placements and maybe on one medication and who were happier healthier children as a result. It takes a lot of work: the cooperation of the child welfare system, the judicial system, the placement and the school. You have to be dedicated and of course you also have to have a child who trusts you and is also not dedicated to be on drugs the rest of their life (which actually I rarely met a child who wanted to be on drugs – except teens who were already addicted to their anti-depressant or other psychotropic which they favored).
With adults, you hold the keys. You don’t require courtrooms and child welfare systems, teachers and placements. If you are in an adult placement than you probably do require one or two medications. The problem though is that as an adult, you don’t have the social worker to protect you like my kids did. You don’t have all those heavies in the court room who are interested in looking good in regards to your case. The public is concerned about the welfare of children, they don’t care about that of an adult. An adult is supposed to know better. But when you are unwell and require the support of professionals, it is hard to know who to trust. When you are already sold on the medications you are taking, it is hard to imagine how life would be without them.
As an adult, in order to find out if you are mis-diagnosed, on too much medication, it would require a lot of money to start over again. You’d have to do a lot of research on finding the right psychiatrist, psychotherapist, medical doctor, and other alternative practitioners who probably won’t be funded by your insurance company. Why? Because insurance companies don’t care about preventative maintenance. They WANT you to take drugs because they are funded by pharmaceutical companies as well. But if you the adult are already on all this medication than chances are it would be very difficult for you to focus on research. Your mind is being sent in several directions in order to keep up with all the drugs you are on. Multiple medications counteract each other and so the brain is so confused and often you see zombie like people. This is not the type of person who is going to be capable of researching and trying to find the right person who can clean them up and start over. It is quite the conundrum. It is also a very sad situation that many Americans are facing. It is part of why we have an obesity problem in this country (they never mention this on the television documentaries that many types of medications cause weight gain). This is because the commercials in between the journalists talking to you about obesity are medication advertisements.
Face it, we are an addicted country with many people in our population on some type of psychotropic drugs. Making the brave effort to ditch the drugs (with professional support) is no different from an addict on the streets trying to get off illegal substances. Addictions are addictions whether they are illegal or legal. It is these articles that brandish the psychiatrist as none other than a dope dealer which force people to think. Just because someone has a license or the initials, doesn’t make them ethical or willing to practice legally. This is the reason why people with a license or those initials must carry malpractice insurance. There are just too many people violating the trust of the average American each and every day.
If you have yet to get on medications for some type of mental health diagnosis, research this ahead of time. Get more than one opinion. Research alternative practitioners, aka holistic treatment providers and find out what their methods are and what type of results they have. You can go to any Whole Foods grocers or health food store and talk to them about holistic treatments and unless you buy something, it is free advice. Try alternative practices first. Wait until you find professionals in psychotherapy that you really feel is helping you. Put your television control on mute during the commercials (or try taking up a hobby to relax in the evening rather than TV). Drugs should be the very, very last resort and your own well-being the first. If you know you have a mental illness that is one thing, but then do you really? Who was the first person to make this decision? Was it when you were a child? Take your life seriously, consciously, take care of your mind, body and soul. It is all you have to live. Be happy and healthy, stay away from any type of drugs if at all possible.