The Confusion of Mental Health

There might be no other recognized discipline in life that is more inconsistent and confusing than mental health.  Those professionally involved do a great and immense disservice by not recognizing this very fact.  Let me change my mind right here, the mental health confusion takes second place to that of religion.  Religion is the most confusing and complex.  I would agree that religion makes the same arrogant claim.

Is there anything more controversial than faith?  Yet, if you walk into a specific church, they act like there is no confusion at all.  Outside of their doors is chaos, inside certainty.  How can this be?

The only clear reason I can come up with is certain people have an ability to grab hold of something and never let go.  It might be the truth (by truth in the religious sense I refer to THE truth).  In the mental health profession there is more flexibility, but with the same “religious” certainty to their particular philosophy and methods.

Certain schools that train have overview courses.  This is very interesting but highly impracticable.  In practice, you must have a specific method of application.  Once you graduate and get hired someplace, you need to adopt that philosophy.  Somehow in the process of education, you become convinced a particular method is the best to follow.  Most people shut off all other methods of thinking in order to feel certain and confident. 

Whatever "group" or "company" you work for expects you to follow through their their thinking.  Venture outside of this and you are a malcontent.  If you expressed a philosophy that was more expansive during the interview, you probably wouldn't get hired in the first place.  But some personalities continue to think and grow, and in the process of their careers challenge the status quo.  Those individuals either have to keep quiet or move on.

The same is true in education, but most teachers are not very “religious” and simply follow the path before them.  A few, after they have taught for years, stretch out and seek a better method.  Most are security oriented and because of family and financial responsibilities never look outside their own school district, much less a different method of education.  The simple reason is this upsets the cart.  Who wants to upset the environment they work in and have to be the "bad guy" with those they work with?

In the mental health profession there are two great divides that is so glaring I am stunned those in this profession cannot even recognize this great confusion.

If you are in need of mental health, you either see a psychiatrist or a psychologist/licensed counselor.  One will give you medications before you leave and the other wants to talk and/or suggests medication(s) and then you need to see a psychiatrist.

The TV show Frasier is not true.  Frasier acts like a psychologist but calls himself a psychiatrist.  Almost all psychiatrists suggest and manage medications.  After the initial visit, you have follow up visits to adjust your medications.  This is usually a 15 minute visit summed up as; up, down, the same, or change according to your current prescription.  See you next meeting. A psychologist can want to talk to a patent for years!  A psychiatrist only manages medications.

Those are the two camps, one can give medications and the other cannot.  But in the psychologist camp of talking therapy, we have many hybrids.  This is similar to the Christian faith.  Drive down the street in any major city and you will see a variety of churches--Baptist, Methodist, Lutheran, Catholic, Church of Christ, Pentecostal all claiming to be Christianity.  Confusing yes?  All believe they have THE WAY!

In mental health, we have counselors who claim to specialize in a variety of issues.  Go to the Psychology Today website, search for a specific issue and you will get a list of mental health professionals with 20-30 bullet points of what they specialize in.  This is one of the greatest frauds ever.  No one person can be a specialist in all those specific areas, but they claim to be. 

To anyone seeking help, this is the message: that particular counselor or psychologist treats all the listed issues to the right of your computer monitor.  WOW...looks impressive.  Reality is a great disappointment!  This is false advertising in the mental health profession where there might be no other profession where a relationship of trust is more crucial!  Talk about starting off a new relationship on the wrong foot!  Yet go look at any page on the Psychology Today list of professional mental health workers--they all look like this!

When you meet with one of these professionals, you will realize they have a very narrow approach adopted from wherever they were trained.  In truth, if you see a specific counselor it is highly likely you will get diagnosed with one of five disorders.  The easiest is depression, anxiety, some type of fear or phobia disorder and then a specific diagnosis--ADD, OCD, bipolar, paranoid schizophrenic.  Many will stay ambiguous however because a specific diagnosis means a specific medication.  Some of these professional psychologists in the psychological community do not even believe medications are needed.  Talk about confusion and disconnection to their counterpart, the psychiatrist!  It actually seems like these people never communicate with one another.  This appears much like those in the profession of religion, churches sit next to each other yet pastors or church leaders never speak to one another.

It gets more complex (similar to the church).  Walk into a Baptist church and you will get an interpretation of the bible that says one thing.  Walk into a Pentecostal church and there will be another.  If you are going to sit under these denominations, you are going to apply truth according to their methods and interpretations.  That means you might commit years before you realize this isn’t for you or that they are not as competent as they claim to be.  Many simply give up and just go with the flow.

Walk into the office of Counselor Bob and he treats depression one way.  Across the street, Counselor Wendy treats depression another way.  Psychiatrist Steve diagnosis' a patient with bipolar and across the street Psychiatrist Lisa says you are OCD.  If you are not aware of any of these inconsistencies to this very soft science, you simply accept that these professionals know what they are doing.  Ignorance is indeed bliss!

After being in the “system” for some time, I am stunned at the arrogance of both the church and mental health profession.  Many people in the mental health profession are not religious, but in truth, they are really much the same as the very organizations they rebel against!  They just don’t see it!

Imagine seeing a mental health professional who started out your time by saying;
Life can be very confusing.  Many people are claiming they have the best way or the truth to life and mental health, but we must be open.  I try to not get locked into a system, but at the same time have worked very hard at trying to narrow down some methods to help my patients.  I work with a team of other professionals to get feedback in order to diagnose a patient before treatment, especially before any medications that will have a major influence on a patient’s life!  Over the next several sessions, I will be trying to piece together your story, asking questions and developing trust.

Guess what?  That type of treatment costs a lot of money!  You will not get that level of integrity through a low-cost service.  I have found in large part that you get what you pay for in mental health!  If you do get this type of integrity, it is usually from a new professional, idealistic about their career.  They have the proper heart attitude, but not the experience.  There usually is a huge difference from a sliding scale session compared to one costing $250 for 50 minutes of time!  Low-cost treatment usually means meeting with an intern getting their licensing time logged under supervision.

In the end, a mental health professional cannot impart what they do not possess.  They are very limited to how healthy they are as a person.  If you took music lessons, a guitar instructor can only take a student as far as they have gone musically, after that they have to jump to their head to teach what they cannot play.

Most mental health professionals start from their head.  They have no idea what it is to live with bipolar, so they have to work through the intellect.  This comes down to training.  Yet I am shocked how someone who says they specialize in a particular area of mental health does not attend groups listening to actual stories of people battling a particular illness like bipolar.  This would be like being an addiction counselor who never attends an AA meeting!  How arrogant is that?  Yet, many psychiatrists never get outside of their office!  There are exceptions to this.  Some community group meetings do have a psychiatrist of psychologist who attends on occasion.  My only concern here is this modifies the interaction, especially if this is your mental health professional.  When the doctor is in the room, many people capitulate and never say what is really on their hearts and minds.  These professionals hold a tremendous amount of power in a patents life.  Many will never challenge them because it is their only source of hope! 

If what I have heard in internet forums and small groups are consistent in others, then much of the discussion is on two areas; the relationship one has with their mental health professional and the other is medications.  There is a lot of talk about medication!  All mental health professionals must listen to what patients say on both issues, especially medication.

It is very irresponsible and tragic to go into a mental health forum and hear what actual patients say about their psychiatrists or psychologists/counselors.  The Internet has shot a hole in this profession because now we can get a collective look at what people are really dealing with.  Up to the Internet age, there was only a small group that could gather and share.  This allowed the mental health profession to appear more powerful and successful than they really are!

People go to these forums for support, not to gather and complain.  Their lives are hanging in the balance.  Yet the psychiatrist has no clue and does not have the integrity to LISTEN to what patients are struggling with!  Maybe if they did they would get confused.  They would have to admit they do not really know something.  How different is this from the pastor or religious leader disconnected form the very people they claim to love and serve.  That is not love!  That is self-protection and arrogance!  That is someone who wants to feel in control!  They get paid well for their time, so they need to walk in integrity.  The accountability in this profession is much like the church--they have free rein unless there is a tragedy.  Then they come under the microscope.

We live in a world of “commercial.”  Every TV commercial makes their product sound like the best product.  Most spend little time with the actual product, but use manipulations to tease the senses.  Rather than discuss why a Subaru is a good vehicle, they try to associate a Subaru with falling in love with someone.  That is why I need a car, to fall in love and get married.  Wow…Subaru’s are vehicles with magical powers.  Why go on a dating website that claims to have the best method to fall in love, all we need to do is buy a Subaru!  Welcome to America--the land of manipulation!

Sadly, this is part of almost all professions.  When I need to buy a car, I can overlook this nonsense, but when I need mental health care, this type of manipulation is very serious, especially when someone gets put on powerful medications!

There are very competent mental health professionals.  We usually see them on C-Span or a TV show, or they write great articles in journals or respectable websites, but I cannot stress this more--they cost a lot of money!  Unless you have a great health care plan, you are screwed to the lower level services.  Yet, even in the best of care, we still have the same conflicts between psychiatrist and psychologist.  Those who actually work together in tandem cost the most money.  This level of care can cost someone well over $100k!  That is over one-hundred thousand dollars!  Treatment programs average a thousand dollars a day!  A typical program for 30 days costs $30k!  Many times these programs are no more than a day-care center.  Gloried housing and three square meals a day.  This is another topic in itself!

The mental health profession is ripe with much confusion.  People get hit hard when they do not know what they are getting into.  Arrogance by these professionals is appalling.  It says a lot about the soft science of this profession.  There needs to be great humility by those professionals dealing with the most vulnerable in our society, especially those who administer powerful medications that can have a radical impact on one's life.  The side-effects of most medications in itself can be a full-time job trying to understand and cope with!  Yet, many psychiatrists are so cut off from this reality, they give out medications with the same integrity of the ice cream man selling candy at a park. 

It is worthy to note that the opiod epidemic started with doctors totally unaware of these medications.  That proves my point exclusively!  Where were the doctors who said they need to be educated on what these medications will do to patients?  How can those in positions of so much power be so naive?  They were that naive, now we have thousands of deaths associated with doctors who acted like drug dealers.  Yet these doctors are still well paid and are taking their vacations in Europe while their patients lie six feet under!