Oct 25, 2014

Separated Orphan Twins

In 2014 my work focused on addiction, specifically on the heroin epidemic claiming so many lives across the U.S. My new book SHARP Stop Heroin and Rescue People reflects that work.

That work helped me to focus more on the question of integrated care. Poor social choices and bad public policy have caused mental health and addiction care to develop like separated orphan twins.

Mental health and addiction are both biopsychosocial, with biological, psychological, and social aspects that continuously reinforce each other and cannot be easily separated, but the treatment systems are separated. Over the course of decades, each system figured out how to emphasize and advocate for its particular service delivery style, treatment philosophy, and culture of care.

This has caused clinicians to develop blind spots. People come away with a different diagnosis and different treatment depending on the system they walk into.

The separation has affected the overall health of the population using mental health and addiction services. We see this in the resistance of addiction treatment systems to medicine-assisted addiction treatment. We also see this in the tendency to overmedicate people in the mental health system.

The separation from mainstream healthcare also allows for a certain amount of medical shunning. People with mental health and addiction problems can be self-destructive, edgy, difficult, noncompliant, willful or just plain strange. Separated systems make it easy for medical doctors to minimize their own accountability, and kick responsibility over to someone else.

The mainstream medical system is not some add-on or accessory to psychiatric care or addiction treatment. It’s the other way around.

1 comment:

sickness said...

Withdrawing from family life and social activities that had been previously enjoyed by the individual is one such symptom.