What the Wall Street Journal Got Wrong About Mental Health Care
Primary care doctors can play a key role in helping people find the help they need
In a recent piece in the Wall Street Journal, Gurpreet Dhaliwal, MD, argues that generalist physicians are so pressed for time they should not be called upon to consider the mental health of their patients. His position that there "isn't enough time in the current system for generalist physicians to address complex psychiatric conditions" is true, but it misses a critical opportunity.
In the 12 minutes most primary care doctors spend with a patient at each appointment, they would be remiss if they neglected to screen for health risk factors, such as smoking or high blood pressure, even though doing so might require specialist care that's beyond a generalist's scope. Screening for mental illness is just as significant.
Depression is more common than AIDS, cancer, and diabetes combined, and nearly 400,000 people attempt suicide in the United States every year.
A dichotomy between mental and physical health stigmatizes those suffering from mental health issues, when in fact a simple screening and referral from a trusted generalist might be the very key to providing necessary care and relief.
We completely agree with Dr. Dhaliwal that the key to quality mental health care is an abundance of well-trained providers. But even if referral options are not as robust as they should be, primary care providers must not wait to ask about a patient's mental health until that ideal becomes a reality.
In fact, there has been an increasing awareness of the value of primary care screening for mental health issues; a number of states have recently passed mental health screening legislation compelling, for instance, OBGYN and pediatricians to screen new mothers for postpartum depression.
No one is asking generalists to be psychiatrists, just as we do not expect them to be oncologists or cardiologists. But what we need is a willingness to undertake the same screening “first steps” to safeguard the health of our community.
Seleni is one of only a few organizations in the United States offering specialized training in treating perinatal mood and anxiety disorders (PMADs), and it's the only training that includes in-depth instruction on treating perinatal loss.
At the Seleni Institute, we focus on destigmatizing mental illness. And, because 90% of those who die by suicide have a mental illness that has not been diagnosed or that has not been adequately treated, it is imperative that we understand and support all, including mothers, who are suffering with suicidal ideation.
Building bridges with others can be transformative and restorative and can remind a new mother that she is not alone. And, these affective connections can strengthen her understanding that she can be cherished, loved, and soothed and, therefore, that she can cherish, love, and soothe.
Pediatricians are in a powerful position to strengthen the mental health of the whole family.
Novel medication could provide faster – and better – relief than antidepressants
Professional treatment helps and women should be supported in seeking it
Many insurance plans will be required to cover perinatal depression screening
Let's all join this critical conversation
Women deserve complete information to make these important medical decisions
New law will increase screening for PPD and other postpartum mood disorders