For the mental health crisis of care, quality is as much of a problem as quantity.
Most people who seek mental health care for the first time are baffled by how to find a clinician. I know what many parents felt. When my daughter, Lara, finished her first semester at Oberlin, she returned home to Atlanta thin and exhausted. I was excited to have her back home and entirely clueless about her desperate struggle with anorexia. In fact, as I learned later, she had been driven by obsessions about her weight and her appearance for over a year by that point. As was true of Amy, her perfectionism and her shame at not being perfect kept her from sharing this struggle. And now, in a crisis after a year of anguish, she was asking for help. As a professor of psychiatry at the university, I should have noticed her serious mental illness, and yet I missed it. At least, now that Lara was asking for help, I should know where to find the best care. But the university had no resources specifically for eating disorders, and I could not find a center for her treatment any better than Amy’s parents had. Fortunately, Lara, ever the problem solver, found an intensive outpatient program with a superb therapist and began a long, successful road to recovery. But even as a professional in this space, I found it difficult to navigate the maze of care. The first issue is that there are so many different types of professionals: social workers, marriage and family counselors, clinical psychologists, professional psychologists, psychiatrists —and they all call themselves therapists. The choice really matters, because what you receive depends largely on whom you see.
This is not true for cancer or asthma or heart disease, but in mental health care, there is little consensus among the various care providers as to how to approach even the most common forms of mental illness. [Read more…] about From “Eminence-based” to Evidence-based mental healthcare: Time to focus on quality and accountability