Medication expectations in mental health care

The article below is part of an educational series to help the community better understand Behavioral Health Services (BHS) available to them in Gillette, Wyoming.

Prescription medication can be part of your services when you seek help with a mental health challenge. Now, let me say right at the start: I am not a doctor, and I will not be talking about specific medications or how/why they work. I will not be talking about expectations. I will, however, talk about how not staying on top of your regimen can be cause for your provider to terminate your relationship with them.

Imagine being prescribed insulin for your newly diagnosed diabetes. Type I Diabetes, to date, is not something curable but is successfully managed through the use of insulin. Now also imagine that once you begin your medication use and begin feeling better you quit using it. Now, because you are feeling bad, you go to your doctor and complain that you do not feel good. How many times will you go back to your doctor before he/she decides that you are not invested in staying healthy and terminates your relationship? Well, my example is someone simplistic but you get the point.

In mental health there are many powerful drugs used to manage mental conditions. One size does not fit all and what works for one person may not work for another. Also, there are some classes of medications that doctors can prescribe that are highly regulated and should only be prescribed by highly trained professionals—such as a psychiatrist, physician assistant or nurse practitioner. If misused, these medications can cause a tremendous amount of harm.

Unfortunately, from what I have seen in my many years in managing mental health services, there are people who seem to not be concerned with evidence based mental health care. This thought process has many problems attached to it, including:

• It jams the system up for those that want true help.
• It could cause legal issues for the patient, the doctor or the organization.
• Many drugs have alternatives that work just as well without nasty side effects, like addiction.
• Drugs interact with each other. You want a professional to make those determinations.
• If doctors at mental health facilities are just giving out meds without professional forethought, they are not helping the patient or their community, and they are going to do more harm than good.
• Most people go to their respective family doctor for initial mental health issues. They also receive their first prescriptions from this person. In my opinion, this is often a mistake. I’m not saying that they are bad doctors or that they want to harm their patient. But, I believe that it is best for these medications to be prescribed from a doctor who pursued specialized training in mental health. One should ask questions when they get to a mental health provider who then switches the medications.

Do you remember the singer-songwriter Prince? If you did not love his music, I’m willing to bet that you could certainly recognize his talent. There have been several high profile deaths like Prince’s that have lead our government to start really looking at what doctors are prescribing and why. With the street values of some drugs sky rocketing, it is no wonder some people are looking to get their hands on them.

If you are suffering with what you believe to be a mental health issue I would guess you want your provider to do what is best for your situation, is evidence based quality care, and is not endangering you. I’m also willing to bet that you’d want to get an appointment without the system being clogged with others who might not have your best interest in mind.

Jeff Rice is the director of Behavioral Health Services at Campbell County Memorial Hospital. BHS provides professional mental health and substance abuse services to the community through prevention, education, advocacy and treatment for all ages in the community. Appointments are available Monday–Friday from 8 am–5 pm. Call 307.688.5000. Learn more at www.cchwyo.org/BHS.