The Mental Health System: Missing Standards
24th November 2011 | By Mary Miller
In the field of physical medicine, there are standards that are used in determining any treatment of choice. While, clearly, there are cases where these standards are overlooked or ignored, the general idea is to find an effective treatment for any given condition. The standards involve, among other things, repeatability, reliability and effectiveness. For example, penicillin is a well-known antibiotic used in the treatment of certain Gram-positive infections.
Recognizing that there is a down-side to the use of antibiotics, this medication is used because it has proven itself to be consistently effective with a broad spectrum of patients in the treatment of certain bacterial infections. The results are first, repeatable. Repeatability means that a treatment has shown itself to be effective in a significant number of patients who exhibit similar symptoms. If a treatment works once or twice, it might be of interest. But for a treatment to have wide scale value, it must be effective with a hundred or a thousand or more patients with similar conditions. Repeatability means that a treatment results will be replicated or duplicated when applied to a patient population with similar conditions.
Reliability is another significant indicator. Reliability means that a treatment is dependable and consistent. A treatment might be repeatable in a patient population but limited in its repeatability. If penicillin was only effective in 50% of the patients who used it for Gram-positive infections, it would have some repeatability but lack reliability. A treatment has to be consistent and trustworthy to merit its use.
The third and perhaps most obvious indicator is effectiveness. In simple terms, it has to work to alleviate the presenting problem. In the field of physical medicine, these parameters or standards are generally well-understood and serve as guidelines for treatment procedures. In the field of mental health, however, no such standards exist. There are no guidelines, no government regulations that state that a therapist must be effective at alleviating a client's presenting problem. There are no required records of success rates or demonstration of long-term effective outcomes.
Make me laugh
Before going any further, please know that I am not against counselling or therapy under certain conditions. Talking in the form of counselling or therapy can be very helpful and supportive during difficult times especially if the client and therapist like each other. Eric Berne MD, author of Games People Play, used to say that the therapist should be able to make the client laugh and that this was a sign of a good connection between the two people. This is probably the sign of a good connection in almost any relationship but particularly so in the world of counselling and therapy. Having someone in your life that likes you and listens to you might be very helpful from time to time.
However, if you are talking with someone who does not like you and invests nothing in your well-being, there is a good chance you are repeating something that happened to you when you were a child. There is a good chance you are repeating a situation involving someone whose approval was important to you such as a parent but who also did not like you. Only now, you are paying someone to relive those old patterns with you. If you want someone to talk to, you might want to check out your friends and family members. If you do go to therapy, it is important to find someone who enjoys your company and likes spending time with you.
Who should you listen (talk) to?
It is also important to find a therapist who is mentally healthy. There are no standards governing the mental health of psychotherapists. This means that anyone can go to school, obtain a degree, become a therapist and hang out a shingle. Nowhere in the training of psychotherapists is there a requirement that a student should pass a battery of standardized psychological tests. Any therapist is free to bring his or her problems into his or her practice and possibly inflict those difficulties on clients who seek their help.
In the world of mental health, it is possible to stay in practice and never have to produce repeatable, effective results. In the world of mental health, one hundred people can go to atherapist with a problem and not know whether or not that therapist has any record of helping people with that problem.
For example, let's say we have a population of one hundred people who suffer from anxiety every time they go to get on an airplane. All one hundred choose the same therapist. Each of those one hundred people may or may not be helped. The reason for that is that each one of these people has a unique consciousness and unique energetic wiring. Each person’s fear is driven by a different event or experience or set of events and experiences.
In the world of eastern medicine, each person’s anxiety would be seen as a function of an imbalance in his or her circuitry that needed to be corrected. And, again those imbalances are unique to each individual with no singular, predictable source.
Western mental health practices assume that talking about one's fear of flying will be enough to repair the imbalance at its source within the energetic structure. It is also assume that talking will lead the person to the exact source of the anxiety which may or may not happen. Mental health practices assume that through awareness of the precipitating event, the person will be released from his or her fears. This is a bit like sitting with your car and talking to your car about its flat tire and hoping that, through your conversation, you will discover the source of the flat tire and that revelation will cause the tire to fix itself.
Imagine what would happen in the world of auto mechanics, if one hundred people brought their cars in with worn brake pads. All the mechanics could do is to sit and talk with each car trying to find the source of the myriad of ways in which the brake pads had become worn down. Imagine expecting that the revelations about how the brake pads had become worn would be enough to fix the condition. How many cars do you think would get fixed? And, how long do you think those mechanics would stay in business?
The missing standard
If we had one hundred patients with Gram-positive infections and we gave them each a random medication in hopes of solving the infection, what do you think would happen? Mental health practices here in the west, have limited capacity to be of help because they are built on a limited body of knowledge.
These practices do not produce repeatable and reliable results. Outcomes are still random. This is not good enough. We expect our mechanics to fix our cars. We should also expect mental health systems and methods to fix our problems. Maybe some of us think we deserve the problem in the first place and do not deserve to have it fixed. I disagree.
As you might imagine, there are some in the world of mental health who find my opinions a bit harsh. I think if you look honestly at our mental health system, you will see that there is much truth and accuracy in what I have said.
I recently gave a talk at a Health Freedom Conference and said some of what I have written here. A psychiatrist came up to me and told me that he was relieved by my words. He told me that he has longed to hear someone tell the truth about mental health practices and that, ten years ago, he himself had stopped practicing as a traditional psychiatrist. He said that medicating people's problems away was not good enough for him.
Taking the "mechanics" approach
Again, I am not against the practice of therapy. I am for an expansion in our knowledge base that explores the principles of eastern medicine. I am for exploring new and unchartered pathways to emotional well-being. I am for therapists taking a “mechanic’s” view of mental health difficulties. We do not bring our cars to our mechanics to have them comforted or to teach them to cope with or adapt to their problems.
We bring our cars to our mechanics with the expectation they will be fixed. When we have emotional difficulties and behavior patterns that take us to the same painful outcomes, we do not need to be soothed into adapting and coping with those patterns. We need to be fixed. We do not need to spend one or five or ten years talking and trying to locate the source of those problems with the hope that such revelations will release us from our difficulties. In fact such revelations, even accurate revelations, may cause us to feel even more stuck with our problems.
If you are looking to transform your life, look for systems that are proven to be repeatable, reliable and effective. Expect no less. Random outcomes are not good enough.
