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QUALITATIVE RESEARCH CONSULTANTS ASSOCIATION
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Yale professor William Deresiewicz
writes about in his book,
Excellent Sheep
.
About 20% use mood-altering sub-
stances to manage feelings or to
“self-medicate.” SAMHSA’s 2013 survey
measures the use of illicit drugs at 21.5%
among young adults aged 18 to 25 versus
9.4% for all Americans over age 12.
Marijuana is the most popular and
fastest-growing drug. Because today’s
marijuana plants have been bred to con-
tain levels of THC (marijuana’s main
psychoactive ingredient) 10 times higher
than plants did 20 years ago, mental
health professionals are seeing a rash of
marijuana-induced anxiety and psycho-
ses. We might expect to see some push-
back from health providers as states
expand legalization of marijuana.
Stress, Challenges, and
the Medical Treatment Model
Perspectives on mental health trends
run hot—and in researching underlying
causes and implications, explanations
vary in scope and inflammatory tone.
For example, changes to diagnostic crite-
ria have some parents fearful their chil-
dren will no longer qualify for special
services, while some providers and their
patients worry that only pharmaceutical
solutions will be reimbursable. Here is
how I see it at the moment, but stay
open and I encourage you to draw your
own conclusions.
According to the well-respected
National Alliance of Mental Illness
(NAMI), the percentage of the U.S. pop-
ulation suffering from anxiety disorders
such as PTSD, obsessive-compulsive dis-
order, or specific phobias runs about
18% (or 42 million people last year). Just
under 7% of adults (or 16 million) live
with a major depression, while 6.1 mil-
lion live with bipolar disorder and 2.4
million with schizophrenia.
Two significant challenges in the
industry are:
• Delivering treatment to those in
need.
The majority of those who suffer
do not get treatment. NAMI reports that
close to 60% of affected adults and 50%
of affected children did not receive
mental health treatment in the previous
year. Federal requirements for parity of
coverage with medical and surgical ser-
vices in new healthcare plans should
help increase access to needed mental
health and substance abuse treatment.
• Differential diagnosing.
Diagnostic
manuals such as the DSM-V help clinicians
diagnose by clustering symptoms—not an
easy task when almost every mental health
issue includes anxiety as a symptom.
In a typical medical model, the physi-
cian attempts to promote healing and
cure ailments. For example, she might
set a broken limb or treat an infection
with antibiotics. The treatment model in
mental health is notably different. Here,
physicians and other clinicians use med-
ications and in-office therapies to
improve a patient’s quality of life—they
acknowledge their patients might always
be addicts or might always struggle with
recurring depression, but behavioral
and/or pharmaceutical therapies can
help them manage their symptoms and
lead fulfilled lives.
Indeed, most mental illnesses are not
cured
by pharmaceutical drugs, but the
illnesses can be managed and symptoms
treated. In fact, medical science doesn’t
truly know
how
or
why
many of these
drugs work. In a 2014 report on mental
health medicines under development,
PhRMA (a pharmaceutical advocacy
group) acknowledged that developing
effective treatments for mental disorders
“has been hindered by many factors,
including a limited understanding of
how current treatments work in the
brain.”
Still, exciting advances in neuroscience
research are shedding light on the brain’s
mechanisms for some kinds of depres-
sion, which ultimately may turn into
breakthrough pharmaceutical
approaches. In the meantime, new
understandings about our brain’s neuro-
plasticity coupled with Stephen Porges’
groundbreaking Polyvagal Theory (that
a key part of our central nervous system
serves different evolutionary stress
responses) is leading to alternative treat-
ments of anxiety, depression, trauma,
and autism. These non-pharmaceutical
therapies include yoga, mindfulness,
neurofeedback, and play therapies—
many of which are not yet covered by
health insurance plans.
20 Minute Psychiatric Visits
The relatively low cost and effective-
Yoga & meditation among alternative therapies