Reflections on the State of Public Mental Health Treatment

As my year-long intenship is wrapping up at a public community mental health clinic, I thought it would be an appropriate time to offer some reflections about the quality of mental health care people are receiving in this country. Starting in two weeks I’ll be transitioning to begin a post-doc at a private psychiatric hospital. The transition will be quite an adjustment. Currently, the majority of the patients I am seeing are on Medicaid or Medicare. Many of them are also being treated by psychiatrists for “medication management” and some are also in a community psychiatric program where they are paired with a community support specialist who attempts to promote the patient’s adjustment to the community by providing resources. The critiques I will lay out on this post are not directed towards any of the social workers, psychologists or psychiatrists who valiantly provide mental health care to the severely “mentally ill” who are serviced in community mental health clinics (CMHCs). These workers are vastly underpaid and unappreciated. The pay that psychologists receive is a complete insult. Of course, the pay is dictated by Medicaid’s cheap reimbursement for psychotherapy and psychological testing. Many psychologists opt to go into private practice or enter private hospitals or clinics where they are more adequately compensated for their services. Along with the wonderful training I will be receiving during my post-doc, the benefits and pay certainly played a significant role in my reluctant decision to transition from a public to private setting.

First, psychotherapy is undervalued and disrespected. Read the rest of this entry »

Sexual Violence: An American Problem

The Steubenville rape case along with the horrific gang rape in India has brought sexual violence to the media’s attention. Of course, we had GOP politicians who felt compelled by some ungodly force to speak about rape victims in demeaning and bizarre ways during the previous election. I know that my posts over the last six months have centered on the terribly depressing topic of sexual violence but I find that I am up to my ears in sexual violence as a soon-to-be-psychologist working in a public mental health setting. Last week I led a group with some women who had recently experienced sexual violence and they asked me a simple question: “Jeremy, you’re a guy. Do you know why guys think it’s OK to rape women?” This is a very difficult question and one that I had trouble answering. I responded with some vague statements about the ways in which our culture makes men feel entitled to have sex with women.

Read the rest of this entry »

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