As we reported last week (as did others), antipsychotics are not really a good treatment option for aggressive behavior, based upon the findings from a recently published study in the journal Lancet. Which begs the question: When were they ever?
Sadly, antipsychotics are not the first medications ever to be used to basically sedate people, so they would be more manageable to the individuals and organizations charged with their care. The use of psychiatric and other medications for control of behaviors, rather than treatment of diseases or disorders, has a long history.
Time and time again, research shows that it’s the human relationship we share with one another that have a significant, perhaps the most significant impact, in how we feel. And how we feel has an impact on our treatment and feeling better.
Yet, the first thing we do as a society is to cut the resources and funding for people to help other people. We turn to short-cuts, like medications, to help us do more for less. But in reality, we end up doing less for less, and probably causing more harm to the people we are charged with caring for.
Say you’re a county mental health system. Every year, you’re expected to see more and more people who need care and help for serious mental disorders. But do you get more money or resources to pay for this increasing need? No. In fact, every year for the past 5 or 6 years, government programs like Medicaid and Medicare have actually tried to cut what they’re willing to pay for treatment. Local governments certainly have no more money, at least where I live, as they are constantly cutting back on services.
So what do you do? You look to make do with what you have. And if that means ordering your psychiatrists to prescribe more medications and less psychotherapy or other therapeutic intervention programs because there are no professionals to staff them, then you do it. You do it because otherwise you’d be turning people away. Most people in our field feel that “anything” is better than no treatment at all.
But studies like the Lancet study show that, in fact, no treatment at all is no better than the medications (in this case, for a very specific symptom: aggressive behavior). What seems to have made the difference in the participants’ lives in the study wasn’t the pill they took, but their interaction with another human being. Someone who showed they cared, took the time to listen to the person’s complaints, and talked to them. Like an individual. Like we would all like to be spoken to when we’re stressed out or dealing with the most difficult issues in our lives.
What’s the Answer to Overmedicating?
It’s the same old, same old you’ve heard me say before. Mental health treatment and care in the U.S. needs more funding, more focus, and more facts. We need more funding across the board, not just for more research (as is the common call), but for more services to be provided to those in need and can’t always afford them. We need to fulfill the promise of John F. Kennedy’s vision for community mental health centers, a promise he made over 40 years ago. And one that is sadly still far from a reality in most communities. I believe that if treatment providers had the resources they needed, they would seek to provide the best treatments possible to their patients (and they should be rewarded for doing so). It wouldn’t be hard for me to imagine implementing a program that provided incentives for professionals not to medicate patients (especially for off-label, non-FDA approved uses) to control behaviors.
We need more of a focus of our mental health policy in society. Today it’s all over the place. Our governments — both federal and local — all have their own agenda and it seems they really don’t even talk to one another much. It would be nice to see that change.
Mental health needs to be better understood and written about by the mainstream media. When writing about mental disorders, we need to stick to the facts, and be clear when we’re talking about theories versus what we know as being true today (based upon the scientific literature).
Mental disorders like depression, bipolar disorder and schizophrenia are not simple “brain diseases,” nor are they caused by a chemical imbalance in the brain. It’s time to put those myths to rest once and for all. Let’s publish our real knowledge — that we don’t yet know what causes these disorders — and move on to the more important issues, Here’s how we can help you with this, though. Our knowledge about the cause of mental disorders is limited, but our knowledge of effective treatments for these disorders is extensive.
Studies like the one published last week should be a wake-up call that we shouldn’t be using medications as an alternative to the one-on-one relationships with people who need care and treatment.