There are dozens of empirically proven treatments for a wide range of mental disorders. Drugs. Psychotherapy. Self-help books and support groups. Other stuff. It all works, and it works even better when you combine it together. This isn’t so much rocket science any more as “common sense.”

So you’d think every family doctor and general physician out there wouldn’t just be prescribing the latest psychiatric medication to the patients who ask for it — they’d tell them they need a complete treatment program that includes a referral to an experienced mental health professional for proper diagnosis and treatment.

And, as is so often the case here on World of Psychology, you’d be wrong.

Maggie Mahar over at Health Beat has an interesting blog entry about how mental health treatment options take a back seat, entitled Evidence-Based Mental Health Treatments: Lost in Translation.

In one survey published in 2002 on depression patients, for example, prescriptions were up and people who said they went to psychotherapy went down 11%. But the survey was conducted during two specific periods of time 1987 — before the advent of modern antidepressants like Prozac — and 1997, after such antidepressants were widely prescribed. So its results may be reflective of a particular unique point in time. It’ll be interesting to see if this survey was replicated in 2007, and what those results show; I suspect we’ll see an increase once again in psychotherapy, but prescriptions keeping even pace.

This is a problem I’ve long noted — that every time a drug gets released or new research is published about it, the drug company makes sure you and everyone else knows about it. Through press releases, news brief, and numerous other strategies, drug companies’ profits depend on you getting the news.

No such incentive is in place for any type of effective psychotherapy, like cognitive-behavioral therapy. No company is making more money if you go see your therapist more often (although your individual therapist might enjoy the increase!). And while organizations like the American Psychological Association (and folks like us) try to get out the news on new psychological treatments, their marketing budget doesn’t compare to that of a dozen pharmaceutical companies’ budgets.

Sadly, given the amount of effort on a patient’s part in order to make psychotherapy work, this situation isn’t likely to change any time soon. It’s not simply about money and pharmaceutical budgets, it’s also about effort and the desire for change. Psychotherapy requires hard work, and it generally takes more time than medications do to kick in. And in America, hard work isn’t something a lot of us want to do when it comes to our mental health (I mean, don’t we work hard enough at our jobs, relationships, with our kids, etc.?!?).

Given the choice between a pill and months of hard work, most people will opt for the pill and a “wait and see” attitude when it comes to the psychotherapy. And doctors regularly reinforce this choice by not only not pushing psychotherapy as an important component of effective treatment for their mental health concerns, but also sometimes not even mentioning it.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 23 Apr 2008
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