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01.04.2014

Mental health help near me, how to sleep teenage insomnia - PDF Review

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Assisted living facilities for those with mental disabilities offer some unique advantages that can dramatically improve one's life. It can be emotionally and physically exhausting to try to convince a loved one with mental disabilities that an assisted living facility is best for them. I recall discussions, fifteen years ago, among members of my internal-medicine group about whether it was ethical for us to prescribe antidepressants when we practiced in a hospital with dozens of mental-health professionals on staff. Demand by patients for mental-health care has increased such that if primary-care doctors didn’t offer it, many people would go without it. Some argue that the increased demand is artificial, driven by overdiagnosis of mental illness and overuse of psychiatric medications. Regardless, access to psychiatric care is nowhere near large enough to meet the growing demand.


But even in Boston, where I practice, primary-care doctors are treating more mental illness. Some patients don’t have adequate insurance to obtain specialized mental-health care, despite legislative efforts, including the Affordable Care Act, to create parity between mental-health coverage and coverage for other medical conditions. In its initial phases, it will place mental-health workers in six Boston-area primary-care clinics and target the treatment of depression. If she met the criteria for depression set by the PHQ-9, her name would be entered in a registry of patients in my practice who were assigned follow-up care with a psychiatric nurse, social worker, or other mental-health professional on my medical team. A 2013 review of several programs in which patients received psychiatric evaluation and counselling by phone, e-mail, or video showed that telemedicine can improve symptoms, reduce length of hospital stays, and help people adhere to medication as well as face-to-face psychiatric care. A few generations ago, the family doctor was a one-stop resource for health care and emotional support.


Psychiatric drugs and conditions can affect physical health, and drugs for medical conditions, as well as the medical conditions themselves, have psychological effects. And people with mental illness are two to four times as likely to die from their medical conditions as people without mental illness. Several studies have shown that when primary-care doctors team up with mental-health workers, their patients’ physical health improves.
The key to making team-based medical care work, Phillips said, is helping the patient feel that his or her relationship with the primary-care provider is at its center.



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