What can finally end the American mental health crisis

The Americans have lived with the mental health crisis as long as most of us can remember it. And always, medicine was warned of urgent repairs.

First, the system must produce more psychiatrists.¹ Second, medical education Primary care doctors – who provide 75 percent of all mental health care – must be prepared for recognition and management Psychiatry illness.² None of them happened. Almost no one pressed what, in my opinion, is the third main reform: weave psychology and other mental health professionals in the fabric of medicine.

The consequences of this failure are amazing. Initial care and other doctors, who are not trained in mental health, have written most of the opioid prescriptions that nourished more than 200,000 deaths in an overdose in the opioid epidemic.³ Of the 48,000 suicide cases annually, 40-45 percent of patients see their doctor in weeks before 2-4 weeks-suicide cases that can be prevented significantly if doctors are trained on a global and appropriate level.^4,5

Unfortunately, many doctors ignore or manage the wrong treatments depressionand anxietyAnd drug In hundreds of millions of patients – reading the divorce that can be avoided, job failure, school dropouts, addiction, displacement, and prison.² But do not blame them, we are often told; They were not trained.

Why did the medicine not change?

Two powers stand in the way of real device, the device in this field.

The first barrier is my thought. Modern medicine grew from the scientific revolution in the sixteenth and seventeenth century, which attracted a sharp line between the body and the mind, today called “the division of the body”.⁶ This model focused exclusively on physical illness and leaving the mental and social problems of the church or society.

I worked with unparalleled benefits.⁷ The average life expectancy doubled in the last century.⁸ But when people lived for a longer period, mental disorders became the most common health problems, as they outperform heart disease and cancer combined.⁹

However, medical education still reflects the division. Students and residents spend more than seven years immersed in identifying physical disease. Less than 2 percent of the training time addresses mental health and other psychological and social features such as sympathy, lifestyle and social medicine.^10,11 The result is the generation of the generation of doctors who are mainly trained in physical disease.

It doubles the rare exposure to the issues of the mind, doctors and other doctors are not trained to think “outside the box.” Medical education usually focuses on learning strong facts (usually about physical diseases), and thus interfering in identifying the problems of informal diseases – nothing about the knowledge that is diagnosed and treated.

It is not only practitioners who show this. Doctors ’leaders – in medical education, research, and clinical care – carry the same training. Many leaders have not realized the need for better training and care for a more common health problem in medicine. We do not know any mental health care more than we have done more than 100 years ago. In clinical care, we have a deterioration crisis.

The second barrier is economical. By the middle of the twentieth century, the success of medicine led to a strong medical industrial complex (MIC), with hospitals, insurance companies, pharmaceutical companies and medical equipment manufacturers between the main players. Initially, these institutions advanced medicine Altruism Objective: Better care for everyone.

But the profit soon is the purpose of the purpose.^12-15 Since the regulations were weak and huge financial incentives, the microphone flourished by doubling the physical removal of medicine. Today, doctors who control 5 trillion dollars have been spent annually on health care, or nearly half of the hospitals alone.¹⁶ And with the profits related to maintaining the current situation, there is little appetite For change.

I claim that these twin forces-intellectual stagnation and economic self-interest-outperform the reason for the lack of medicine despite decades of warnings. Medicine is very firm in its outdated model for the leadership of reform. Meanwhile, the microphone flourishes financially and has no incentive to endanger this success. Both institutions are allowed to work with the least censorship.^12-15

Political philosopher Hana Arndt has warned that science, like medicine, should be under general control, or that it risks serious deviation.¹⁷ Mental health care is an example of a textbook of what is happening without this censorship.

History also shows that resistance institutions rarely reform voluntarily. Civil rights, women’s rights and the end of the Vietnam War – were not goodwill from the established forces. They came because ordinary citizens became angry enough to demand change. The activity of the consumer has similarly dropped the industries that determine the profit for safety, from Ralph Nader Uninterrupted To Rachel Carson Silent spring.^18,19

Health care, in contrast, escaped from this account. The Americans are probably Grateful For real developments in physical medicine, they have greatly trusted that the system also serves its interest in mental health.

I Fearful Their confidence is in its place.²⁰ Behind the curtain lies a widespread negligence, the amazing loss of man, and trillions of dollars wasted every year.

The truth is blatant. In my opinion, the American health crisis will not be treated from within medicine.²⁰ This will only change when the public demands this – when citizens insist on accountability, when they refuse to accept preventive deaths and their broken lives as the current situation.

The risks are painfully clear. Until anger becomes a work, the American mental health crisis will grind. But if history teaches us anything, the angry audience can do what the medicine will not do: Impose our mental health system to change on desperate.