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Psychiatry's Past Can Be Psychiatry's Future.
1Clinical Pharmacology, Drug Design and Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, Maryland; and Aristea Translational Medicine Corporation, Park City, Utah.
The Journal of Nervous and Mental Disease
|December 16, 2020
Summary
Psychiatry has lost essential resources for unhindered practice since the late 20th century, impacting care for the severely mentally ill. Revisiting past community-based models can help address current mental health challenges.
Area of Science:
- Psychiatry and Mental Health Policy
- History of Medicine
Background:
- The late 20th century saw significant erosion of conditions necessary for unhindered psychiatric practice.
- Historical analysis reveals a shift away from comprehensive, community-based mental health services.
Observation:
- A decline in community mental health services, interdisciplinary teams, and preventive social consultations is noted.
- Reimbursement structures favoring brief, 15-minute visits limit individualized patient diagnosis and treatment time.
- The neglect of severely mentally ill individuals reflects a broader loss of resources and support systems.
Findings:
- 20th-century changes in psychiatric practice have diminished resources and impacted patient care.
- Loss of community-based services and adequate physician time hinders personalized treatment.
Implications:
- Current psychiatric challenges, exacerbated by epidemics and social issues, necessitate a return to historical, resource-rich models.
- Reintegrating past successful strategies can inform 21st-century mental health care and improve well-being.
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