Despite challenges, mental health care has bright outlook

Key takeaways:

• For Mental Health Awareness Month, an expert discusses the state of mental health care.
• The outlook for the mental health field is bright despite the current challenges.

In recognition of Mental Health Awareness Month, Jeffrey A. Lieberman, MD, highlighted several points about the field of mental health as it stands today.

First, now is the best time in history for those with mental health disorders because the base of knowledge about these disorders is the biggest it has ever been, according to Lieberman, who is the Lawrence C. Kolb professor of psychiatry at Columbia University Medical Center in New York and a Healio Psychiatry Peer Perspective Board Member. However, he said it is important to recognize that there are issues with the accessibility and quality of mental health resources, as well as the stigma associated with them.

Specifically, policy and legislation play a role in making mental health care inaccessible to some, Lieberman said.

“Our knowledge base allows us to treat a whole variety of conditions, ranging from schizophrenia and anxiety disorders to substance abuse to dementias, effectively,” Lieberman told Healio. “But it’s difficult for people to gain access to good treatment, and that’s because the clinical infrastructure is not sufficiently developed, and the workforce isn’t adequately trained, sized and deployed.”

However, Lieberman said that economics are the “secret sauce” that can help address this through cost containment.

Furthermore, people in the general population do not have as extensive of an understanding of mental health disorders as they do about other common medical conditions such as heart disease, diabetes, cancer and asthma, Lieberman said.

“People can recognize the symptoms [of other conditions] and they know where to go to have it evaluated and treated, even if it’s just beginning with their general practitioner,” Lieberman told Healio. “When somebody has a mental disorder, they’re not necessarily sure if it’s a disorder or they’re just having a bad day or something else. If they do think they need to see somebody for distress, they’re not sure who to go to — what discipline. Do [they] need a psychiatrist, a psychologist, a social worker, a therapist, a clergyman, a counselor, a new age retreat or some other type of new age or holistic remedy?”

To address this, Lieberman said patients should do independent research and talk to others, like they would for other medical conditions, to ensure they are seeking care in the right places.

Finally, Lieberman highlighted the recent revival of interest in psychedelics for the treatment of mental health disorders.

When the first synthetic psychedelic, LSD, was created in 1938, “research was done at the time that seemed very promising at potentially being able to reveal mechanisms of the mind and brain, but also to treat conditions like addiction, eating disorders, sexual dysfunction and personality disorders,” Lieberman said. “But it was all brought to a screeching halt in 1970 when, for political reasons, psychedelics were prohibited from being developed, and research stopped for roughly 30-plus years. They’ve come back now because advocates have stayed the course and tried to make the case that they can be useful and revived research in this area.”

However, Lieberman expressed concern that “the real goal is to have access to legally marketable substances,” especially as much of the recent research on these drugs is being done by “newcomers to the pharmaceutical industry” rather than established companies.

“It’s not because I’m against them — I’m an avid advocate for researching this unique class of substances for seeing what they can teach us and how they can help us — but it has to be done in a deliberate and scientifically rigorous way,” he said.

Despite these concerns, Lieberman said the outlook for mental health care, as a whole, is bright.

“While there are many frustrations that we have over limitations in terms of the quality of care, the availability of care and the second-class status that mental health care in many instances seems to have relative to other disciplines of medicine, and the stigma that still remains associated, we have a lot to be proud of,” he said. “We have tremendous ability to help people with mental disorders, and I’m very confident that the best is yet to come.”