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While the psychiatric/behavioral health community cries for equal funding and “parity” with other medical conditions, unlike the medical field, psychiatry has never been required to practice under equal standards.  Specifically, the mental health industry has never been required to provide an exit plan from its alleged drug “treatments.”

For example, when a person breaks a leg, an X-ray is taken of the suspected broken bone, the broken bone is set, and a cast is worn for six weeks.  A follow-up X-ray reveals that the bone has healed, and the cast is removed.  A cast is not worn for months, years, or life.  Or in the case of cancer, chemotherapy or radiation may be provided, and the tumor is regularly checked for reduction.  Chemotherapy and radiation are not provided for life.

In medicine, treatment plans are discussed with patients when the illness is first diagnosed.  There are expected results within expected time frames.  Healing will occur, or alternative treatment will be discussed.  The point is to get the patient well and provide an exit plan from medical treatment.

A similar treatment exit plan should be expected of psychiatric treatment.

Currently, in the United States, nearly 77 million Americans are taking at least one psychiatric, mind-altering drug, with millions under the age of 18 and as young as one year old.  And, according to a White House paper on mental health, as of 2022, “people with psychiatric disabilities were the largest contributor to growth in Social Security Disability Insurance (SSDI) rolls … with 18 percent of SSDI beneficiaries, or 1.4 million individuals in current payment status, suffering from depression, bipolar or psychotic disorders.”  The report further explains, “The mental disorder category accounted for 29 percent of beneficiaries in 2020, or 2.4 million people — a share larger than beneficiaries who cannot work due to injuries, cancer, or diseases of the circulatory and nervous systems, combined.”

Further, the federal government is the largest payer of mental health services, with around $280 billion being spent through state Medicaid programs.  And, despite hundreds of billions of dollars of taxpayer funds being utilized by the mental health community, nowhere does the federal government provide standards in the form of an exit plan for tapering off the commonly prescribed mental health drug “treatments.”  Why?

Why is it accepted practice to write prescriptions for years or life for mental health patients?  Is there no measure of wellness?  Of course, the answer is no.  There is no measure of wellness when it comes to mental health treatment.  Short of the patient verbally explaining how he is feeling, there is no test known to man that will reveal an abnormality that is the psychiatric diagnosis, nor when the alleged psychiatric disorder has been successfully treated.  Currently, there simply is no test that would reveal that the patient has recovered from the alleged psychiatric diagnosis.

But could there be some standardized exit plan from the go-to psychiatric drug “treatment?” Yes.

The exit plan from psychiatric drug “treatment” would look very similar to the diagnosing symptoms tests.  In other words, to obtain a psychiatric diagnosis, the patient merely talks to the doctor about his feelings.  The doctor considers the patient’s complaint, and, based on criteria provided by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM), a diagnosis is provided.  More often than not, a psychiatric drug “treatment” is prescribed.

It seems logical that there would be federal mandates about the length of time psychiatric patients are permitted to be drugged.  After all, in real medicine, a doctor would be laughed out of business for suggesting wearing a cast for life.

An exit plan might look like this.  With each psychiatric drug prescription written, the physician must provide a written “treatment” timeframe, including a start date and an end date with specific expectations.  At the end of the allotted prescription drug treatment, the patient must return to the physician for careful review.  If the patient is feeling “better,” then the patient must be provided a detailed drug withdrawal plan to wean off the prescribed drug.

As it stands today, receiving a psychiatric diagnosis and drug “treatment” has become a life sentence.  Yearly, the number of prescriptions being written for psychiatric drug treatments increases, leaving one to wonder why no one is getting better.  It seems doubtful that this type of endless unchecked prescribing of drugs would be acceptable among the other medical professions.  It should not be for the psychiatric/mental health industry, either.

Obviously, it would behoove some smart person within the federal government to consider: if no one is getting better, and the mental health data seem to support that conclusion, then something in mental health treatment isn’t working.  Given that the go-to “treatment” is mind-altering drugs, maybe the length of prescribing needs to be reviewed and exit plan standards adopted.

An exit plan provided at the first doctor appointment and prescription written is not a lot to ask if the mental health industry is really interested in getting the patient “better.”  Advising a patient about the length of time that is anticipated for a drug to “work” should be standard procedure and a definite schedule for review provided.  Of course, one must wonder: if the drug is “working,” and the patient feels “better,” why wouldn’t the physician want to wean the patient from the drug?  Isn’t that the definition of successful treatment — no longer needing treatment?

If the patient isn’t “better” at the end of the prescription drug “treatment,” there should be standards as to the length of time and number of drugs that may be utilized.  At some point, one must understand that drug “treatment” isn’t working, and alternative treatment must be sought.  Endlessly supplying random cocktails of mind-numbing prescription psychiatric drugs and hoping for a different outcome becomes experimentation, not treatment.

At the end of the day, psychiatry can never be on par with other medical professions because there is no known abnormality in the brain that is any psychiatric disorder.  But if the mental health community demands to be treated like other medical professions, it must adhere to equal medical standards.  Setting strict universal psychiatric drug exit plan standards is a good place to start.

Who knows?  With solid standard exit plans in place for psychiatric drugging, people may start getting better.  Why not dedicate a portion of the federal funding of Medicaid for mental health treatment exit plan information, made available to the public?

<p><em>Image: Chris Dodds via <a href=Flickr, CC BY-SA 2.0.

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Image: Chris Dodds via Flickr, CC BY-SA 2.0.