Letters: Therapists seek to help, not harm
Residents can safely dispose of expired or unused medications during an event of the “Shed the Meds” program on Sunday, Sept. 15, 2012. (April 21, 2005) Credit: Newsday File/David L. Pokress
As a psychotherapist practicing on Long Island, I strongly disagree with Daniel Akst's column suggesting that mental health professionals are profit-hungry drug-pushers ["Overdiagnosis is enough to make you crazy," Opinion, Jan. 23].
Responsible therapists do not suggest medication as a knee-jerk reaction to a patient who reports that he or she is depressed or anxious. A vast majority of patients do not need or ask to be medicated. We may meet with the patient, sometimes for weeks or months, before mentioning medication, and even then it is a conversation, not a directive.
I can assure you, when patients do require medication, it is the drug company and insurance company making money off the deal. Those of us who work in a psychodynamic way are helping patients begin to talk about their emotional distress, not getting them dosed up.
Akst also mentions the DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders, fifth edition), which is "being prepared in secret." Since February 2010, the public has been able to go to the website www.dsm5.org and take a look at the changes being made.
Some of us only use the DSM because insurance companies require a diagnosis in order to reimburse the treatment. Rarely does a patient fit the exact criteria for one diagnosis and some do not fit any. Patients who are in emotional pain do not care if I come up with a fancy diagnosis; they want me to help.
Megan O'Rourke-Schutta, Long Beach
Daniel Akst has joined the many who have written irresponsibly about psychiatric disorders. If anything, psychiatric disorders are underdiagnosed in the general population, as study after study has shown.
For example, many individuals with mood and anxiety disorders who see their primary care physicians don't have the proper diagnosis or treatment prescribed, because it is very easy to overlook these problems. Fairly high rates of mental illness in the general population have been found repeatedly over the decades in careful epidemiological studies.
Akst need not worry -- most of these people will not find their way into the clutches of mental health professionals who he believes are looking to make a buck. Uninformed attitudes like his, coupled with restricted access to mental health professionals, have taken care of that.
The issue that mental health professionals working on the DSM-5 are grappling with is not whether a mental disorder is present, but rather how to properly classify these conditions so that a better understanding of their underlying physiological causes can be gained, and more specific and effective treatments can be devised. Having a more precise diagnostic classification system is not the same as creating more mental illness; the size of the pie remains the same.
Dr. Michael Schwartz, Stony Brook
Editor's note: The writer is an associate professor of clinical psychiatry at Stony Brook University.
