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Monday, November 12, 2012

NHBMP #12: I Call B.S.!

1:46 PM Posted by Tiffany Taft , , ,
Today's NHBPM topic is an extra fun one:  Call B.S. on something.  A few things come to mind, but the over-arching theme is the lack of attention that is paid to mental health in the context of physical illness.  Has it gained some recognition in the past decade? Yes.  But we are so far from where we need to be.  Many factors contribute to this slow progress, and I'm going to call out a few here.  I'm also going to comment on the "Functional/Organic" illness divide that I've seen in medicine, and how these conditions are often perceived by others.

It's B.S. for many physicians to dismiss the psychological and social issues that go hand-in-hand with a chronic medical diagnosis as less important.  Not all do, and there are some who embrace this relationship.  But in my experience it's not yet the norm.  Yes, it's beyond the scope of their training, it's uncomfortable to talk about, and it can push them over the small 15-minute window they have for appointments.  I get that, but there are resources out there that physicians can use (points thumb at myself).  If they partner with a mental health professional who is skilled in working with these clients, it'll reduce their patients' healthcare utilization and improve medical outcomes.  The research supports this over and over again.  Yet so many don't understand the value in this multidisciplinary approach enough to routinely think about it.

It's B.S. for insurance companies not to cover mental health services on the same level as medical services.  I dedicated an entire blog entry to this, so I won't go on here.  I've had so many people reach out to us for discounted or free treatment because they don't have insurance or they do but no mental health coverage.  I usually have to refer them to community mental health centers, with long waits for appointments and over-worked staff.  Steph and I do offer a limited number of discounted slots, but we also run a business.  I would love to be able to see everyone for free.  Once I win the lottery.

It's B.S. for people to dismiss "functional" illnesses such as Irritable Bowel Syndrome, Fibromyalgia, and Chronic Fatigue Syndrome as lesser conditions, or worse - all in the person's head.  I started my research life creating a questionnaire to measure stigma perceptions in patients with IBS, which I extended to IBD for my doctoral dissertation.  Both groups experience stigma, but the IBS group reported more especially from health care providers.  I've reviewed (and rejected) research manuscripts that my peers have submitted because of their derogatory language toward those with IBS.  Just because an illness doesn't show up on traditional diagnostic testing doesn't mean the symptoms aren't equally as real and equally as debilitating.

The previous statement is also true for people who have an "organic" disease but their tests are coming back clean, yet they still have symptoms.

It's B.S. for anyone to be thought of as weak for seeing a therapist.

Dr. Phil is B.S. (Now I'm just getting off on a tangent)