Why if We Don’t Work Together, We All Fail Alone
Hey, have you seen the most recent Newsweek article by Sharon Begley? It seems antidepressants don’t work. Apparently, 82% of the improvement people feel is placebo effect. If you are a mental health professional, you know this, whether or not we want to admit it.
Let’s face facts, folks. When it comes to curing mental illness, we are in the dark ages. We have NO IDEA what we are doing. It’s not our fault. The brain is just so stinking complex! But we have this need to say we know stuff that we don’t. I know we get pressure from our clients/patients, other professionals for an easy answer, a quick fix, the little sad blue pill that turns yellow and happy after taking Prozac (remember those commercials?). It seems good marketing trumped good science but we all wanted to believe it was that simple. And yet, in the face of the evidence,people treat the researchers like criminals and they are labeled as anti-science.
Again I ask: How does this help people? How does it improve lives? If we KNOW something is not working, why hold on to the fallacy that we are “doing good” by perpetuating a non-effective intervention? I’m sure money is a motivator, so is laziness and fear. But I don’t want to talk about that, because looking for a scapegoat or a cause of the issue doesn’t solve the problem we have in front of us.
How do we help people with depression?
Let’s start thinking about collaborating vs. going solo. If psychiatrists, therapists, and researchers all got together and worked together on how to address the complexities of depression we could come to a better answer. But now, we have therapists saying therapy is the answer (and they seem to be right, but can’t agree on what approach is most effective-CBT or psychodyanamic), psychiatrists saying medication is the answer (and this is a weaker argument by the day), and researchers saying they don’t have an answer, but know what doesn’t work (but will tell the public it does because a placebo effect, is better than just doing nothing.)
What a mess.
And the truth is, we are failing people who need our support. The more the evidence surfaces that we are at a loss on how the brain works and how to improve people’s mental health, the more the public sees us like the man behind the curtain in the Wizard of Oz. Because we claim to have answers we don’t have.
We are failing alone, publicly.
What if someone put a grant together to pull researchers, physicians and psychotherapists to tackle these issues? What if part of the grant was to bring in a good PR person (who understands social media) and opened the doors to the progress being made? And what if participants in the studies were recruited via social media, doctors’ and therapsits’ offices? Do you think we’d be able to find enough volunteers to help solve this really big problem? Do you think we could get an article in Newsweek talking about the collaboration and the progress? Do you think working together we’d learn more and generate knowledge faster than we are working alone and in isolation?
What do you think?
Hi there,
I appreciate your maintaining this site, but must take exception to one statement you make: “When it comes to curing mental illness, we are in the dark ages. We have NO IDEA what we are doing.” I’m going to have to beg to differ here. Many psychological conditions, as you likely know, are responsive to specific psychotherapy interventions. We’ve learned this through decades of well done research (and some less well-done research). While it’s true there are some conditions where therapy and medications are both less effective than we’d like, characterizing mental health care practitioners as woefully ignorant does patients and providers a real disservice in my opinion.
Paul, I appreciate your comments here. I think we need to be aware that the media is beating up mental health right now because we make claims that we “have the answers” when we don’t. Yes, some of what we do is effective, but we don’t know WHY. We really don’t. I think consumers need us to be open and honest about what works and what does not. We can’t “cure” mental illness (which is the focus of my original statement).
But now, the average person sees articles on psychologists not using science and antidepressants being no more effective than placebo. Then there is the ever-present psychodynamic vs CBT debate. Consumers see this already, so being honest that we are not all on the same page because we don’t have clear answers may encourage more trust. When we say, “we are doing the best that we can with the knowledge we have,”"this intervention has been found to work best with this condition,” we can be seen as trustworthy health care providers. But we have no “cures” and we have no definitive answers.
My point is we need to give up these useless debates of what is “right,” and instead pull together in an interdisciplinary way to broaden our understanding and develop more effective treatments.
And I in no way suggested we are “woefully ignorant.” But we have a long way to go. Again, we have no cures. We have no clear connection between organic mental illness and the treatment we provide.
Black and white thinking and rhetoric are no longer useful to the profession. We need to pull together to do teh hard work that needs to be done to better help those in need of our expertise.
I agree with the general idea that mental health providers of all stripes need to work together to address complex problems such as depression. I am a clinical psychologist in a multispecialty clinic, with psychiatrists, mental health nurses, and social workers all working together to treat our clients. It is a wonderful place to work, and clients really get better using multi-systemic modes of treatment. The best part is, it is also savvy business – when there is no competition between schools of thought, everyone can apply their skills to the best of their ability and collaborate to ensure quality care.
I do take issue with the whole idea that psychologists are all about therapy and psychiatrists are all about medication – for example, many of our psychiatrists are wonderful therapists – and I believe this sort of thinking just perpetuates unhelpful stereotypes which makes collaboration all the more difficult.
@Greg, I’m so happy to hear you work at such an integrated site. And I have to say I’m surprised you have psychiatrists on staff who do therapy. In all my years I have not yet met one psychiatrist who does actual therapy. In our area psychiatrist do only medication, with little bits of therapeutic advice thrown in. So my outline here is my experience, not a stereotype (at least in my corner of the world). Where is your clinic located?