Where are we in Psychiatry? What is the future for mental health?
Come join us with Dr. Scott Shannon as he talks about Integrative Psychiatry: Past, Present and Future.
Not to be too morose on this, but I think, you know, we don’t want to dismiss all the advances and scientific underpinnings that have been developed, and how far we’ve come. But I think we really need to be able to see that history has something to teach us. And basically, one of the things that teaches us is that because the brain is so complex, and so difficult to understand and manage, that we will develop these ideas about how we can approach mental illness that makes sense to some degree and give us some comfort.
Where are we in Mental Health?
Number one, neuro psychiatric disorders are contributing most to morbidity in the modern world in the United States. As of 2020, depression is the number one disabling condition worldwide according to the World Health Organization, medical spending, if we look at medical spending, both institutionalized active duty military and civilian, we see that mental disorders at far outpaced the next competition and and this spending is accelerating. So in 10, or 15 years, probably the spending for mental disorders will be twice that of the next most impairing condition.
As we understand the profound, lifelong implications of early life trauma, this becomes something that could shift and potentially dramatically change should shift and potentially dramatically change our approach to all mental illness. If you go into a community mental health center, it seems unusual to find someone who doesn’t have an ACE score over five. And this is one of the great flaws the problem. And the reason why the DSM is not built more centrally around trauma, is because it creates a shift that moves us from a biological perspective, that there is a chemical imbalance that we and we alone can master and treat to an understanding that people’s life experience changes and alters their trajectory. And that it’s incumbent upon us to not only relate to them and their life experience and trauma, but also to figure out ways to prevent it. And I think we’re doing horrifically, in both of those.
Here is what we have: Our medications place us in a fight with homeostasis.
We’re losing ground in mental health, our culture is toxic and debilitating. And I think as psychiatrists and mental health professionals, we need to be advocates for that type of change. We have no interest in defining what the health and mental health is. And as such, we have little ability to practice prevention, talk therapy works, but has little true support or philosophical inclusion. And our medications place us in a fight with homeostasis. So that basically, when you introduce a neuroleptic in someone, their body and their brain does its best to create more dopamine and more dopamine receptors.
Our Future: The Body is Impportant
So I think the future for mental health is understanding that the body is damn important. And I mean, this should not be a revolutionary insight. And the fact that if inflammation is going on in the body, it affects the brain. If gut function is impaired, it affects the brain, you know that if diet is poor, it affects the brain, that if our water is polluted, and our air is polluted, it affects the brain. So this is important, and this is crucial. And this seems like sort of common sense. our grandmothers could have told us this, but we’re going to discover it psychiatry is on that path to discovering it. And that new paradigm is opening up from here, I think this new paradigm is going to be one that honors the psyche in ways and it’s going to be a paradigm that moved from a model of suppressing the psyche, with antidepressants, anti psychotics, and medications, that blunt awareness and blunt capacity to a new model that is an evocative model that calls through and respects and honors all that we are an all that we can be as colleagues and collaborators for the people that we’re working with.