In the common goodness and grace of God the twentieth century brought real advance in the area of psychiatry. New drugs were discovered and various schools of counseling were developed as knowledge increased regarding the human body and how the mind actually works. But a recent trend does not bode well for patients with psychotic and emotional needs. Health insurance plans show an increasing unwillingness to pay for real counseling. The result is that more psychiatrists are prescribing medications without therapy.
A recent study showed that in more than 14,000 sessions, the percentage of visits that involved actual therapy fell to 28.9% in 2005, down from 44.4% in 1996. The use of medication rose to 83.8% of all cases, up from the earlier number of 68.6%. Authors of a recent study based on these numbers suggest there is no hard evidence yet that this has harmed patients, but they are generally agreed that drugs and therapy should be kept together. The two approaches work “synergistically,” noted one physician.
The problem is in the health plans themselves. Some plans make it much more lucrative for doctors to prescribe medications, and alternative practices and methods are always slow to get coverage. This I have found out first hand in dealing with a chronic illness that the medical community took many years to even recognize.
More and more psychiatrists are majoring in medication management, not in counseling. This could be a good news and bad news story. Some therapies are questionable for sure, but prescribing drugs without working on very real human psycho-social problems is not the answer either.