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writing for godot

The End of Psychotherapy?

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Written by Cindy Perlin   
Wednesday, 20 March 2013 21:58

A happy, popular 12 year old girl was prescribed an antidepressant after being referred to a psychiatrist for test anxiety. Soon after, she committed suicide by hanging herself.

A young father of four, described by his wife as "a man who would run into a burning building to save his children" complained to his primary care physician about stress at work. He was given a prescription antidepressant. Shortly thereafter, he stabbed two of his children to death.

A young man in his 20s who was experiencing anxiety over a period of a few weeks was given an antidepressant by his primary care physician. A few weeks later he jumped off a building to his death.

What all of these individuals have in common is that they were given drugs with potentially lethal consequences instead of being referred for safer and more effective psychotherapy treatment. They were not warned of the potential for harm.

Why these tragedies happenned and continue to happen is no mystery. They are the result of decades of disinformation and funding restrictions designed to benefit certain powerful interests.

In the early ‘80s, faced with competition for patients from psychologists and social workers, the American Psychiatric Association began colluding with pharmaceutical companies to eliminate the competition for their mutual economic benefit. Specifically, they began promoting a theory that had, and still has, no basis in science, that mental illness is the result of a chemical imbalance in the brain that can be corrected by the administration of drugs. This fraudulent theory was used as justification to limit the use of psychotherapy.

Health insurance companies joined in this effort by severely restricting the number and frequency of psychotherapy sessions, imposing higher co-pays and burdensome preauthorization requirements. Despite the passage of federal mental health parity legislation in 2008 which outlawed these practices, most health insurance companies continue to require preauthorization of mental health care and to limit access to treatment in violation of the law.

In addition, most insurance companies have not increased the fees paid to psychotherapy providers in over 30 years, which has resulted in an inflation-adjusted reduction in fees of more than 70%. This has forced many psychotherapy providers to go out of business, discouraged new providers from entering the field and eroded the quality of care.

The latest assault against psychotherapy has come as a result of procedure code billing changes implemented by the American Medical Association for psychotherapy services that took effect on January 1, 2013. There are between 8000 and 9000 billing codes for medical procedures and changes are made every year. Now, insurance companies are claiming that changes to 30 psychotherapy billing codes are beyond the capacity of their computer systems to handle and it may take up to six months to fix the problem and pay providers. Many mental health providers will be forced to go out of business if they are not paid for months. In addition, insurance companies are using the changes in procedure codes to further reduce fees for psychotherapy.

As of 2000, over half of the counties in the U.S. did not have a single mental health provider of any kind. Other areas have severe shortages. As a result, many people in great emotional distress due to trauma or overwhelming life circumstances get prescriptions for pills instead of the compassionate help they need to develop effective coping strategies.

The Newtown massacre has prompted many to be concerned about the inadequate treatment of the mentally ill. The emphasis on drugs rather than psychotherapy as a treatment modality actually has made some mentally ill people more dangerous. Many of the most widely prescribed psychiatric drugs, including antidepressants, antipsychotics and stimulants, increase the chances of violence and suicide, according to recent studies. Numerous studies also show that the benefits of long term psychotherapy far exceed the benefits of medication and that psychiatric medication increases the likelihood that a mental illness will become chronic. Psychiatric illnesses are the leading cause of disability and reduced productivity in the U.S and worldwide.

Studies have also shown that about 90% of visits to doctors’ offices are related to stress. Studies in the 1950s showed that emotionally distressed patients could be identified by the weight of their medical chart and that even one targeted session of psychotherapy could reduce medical utilization for up to five years. Many subsequent studies have shown that psychotherapy is cost effective in that it reduces medical utilization and overall medical costs. And, unlike many medications used to treat chronic pain, high blood pressure, migraine headaches, ulcers and other stress related medical conditions, psychotherapy has no negative side effects. Reduced psychotherapy services have been one of the driving forces behind the huge increases in medical costs.

I've started a petition "Congress and President Obama: End the war against psychotherapy and expand mental health services" to inform policy makers about these issues and demand action. Please help by signing it now.

Here's the link:
http://www.change.org/petitions/congress-and-president-obama-end-the-war-against-psychotherapy-and-expand-mental-health-services

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