Comments on: Why if We Don’t Work Together, We All Fail Alone

By: Susan

Susan — Fri, 19 Mar 2010 00:15:45 +0000

@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?

By: Greg

Greg — Thu, 18 Mar 2010 21:22:52 +0000

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.

By: Susan

Susan — Sun, 07 Feb 2010 18:41:27 +0000

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.

By: Paul Greene

Paul Greene — Sun, 07 Feb 2010 00:14:53 +0000

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.