facebook twitter twitter tiktok   donate

HELPLINE NUMBERS

24-HOUR TOLL-FREE EMERGENCY HELPLINES

Suicide Crisis Helpline
0800 567 567

Department of Social Development Substance Abuse Helpline
0800 12 13 14
SMS 32312

Cipla Mental Health Helpline
0800 456 789
SMS 31393

NPOwer SA Helpline
0800 515 515
SMS 43010

Healthcare Workers Care Network Helpline
0800 21 21 21
SMS 43001

UFS #Fair Kitchens Chefs Helpline
0800 006 333

8AM-8PM TOLL-FREE HELPLINES

Dr Reddy’s Mental Health Helpline
0800 21 22 23

Adcock Ingram Depression & Anxiety Helpline
0800 70 80 90

ADHD Helpline
0800 55 44 33

Pharma Dynamics Police & Trauma Helpline
0800 20 50 26

8AM-8PM SADAG OFFICE NUMBER

SADAG
011 234 4837

WHATSAPP NUMBERS

8AM – 5PM

Cipla Mental Health
076 882 2775

Maybelline BraveTogether
087 163 2030

Ke Moja Substance Abuse
087 163 2025

Have Hope Chat Line
087 163 2050

FOUNDER ZANE WILSON

Contact Founder: Zane@sadag.org

Click Here

UNIVERSITY LINES

student shaming

EMERGENCY Contact Numbers for Students in South Africa - Click here

REQUEST A CALLBACK

counsellor button

Request a Callback from a Counsellor
Click here

SUPPORT GROUPS

Website_Button.png

SADAG has over 160 free Support Groups. To find out more about joining or starting a Support Group click here.

Mental Health Calendar 2024

2023 Mental Health Calendar

To view our Mental Health Calendar
click here

QUESTIONNAIRES

questionnaire infographic

Do You want to check your Mental Health?

Click here for questionnaires

Are psychiatrists rushed, uncaring, and in it only for the money?

by Dinah Miller, MD |

Perhaps you’ve heard the news: psychiatrists no longer have time to listen to their patients. It’s all about writing prescriptions for medications and the days of “tell me about your mother” are long gone, or so we’re told. The current perception is that large volume practices where patients are seen in a matter of minutes are now standard and acceptable in psychiatry; that it’s how many — if not most — psychiatrists practice, and that medications and psychotherapy are either/or treatments, rather than complementary.

Is it true that psychiatrists are rushed, uncaring, uninterested, and in it only for the money? Has it all become about how fast a prescription can be written, as if the practice of psychopharmacology is something that can be done quickly, thoughtlessly, and without even knowing the patient? As a past president of the Maryland Psychiatric Society, a former community mental health center medical director, and a general extrovert, I know a lot of psychiatrists. I was curious, and with some help, I put together a How We Practice survey and had the Maryland Psychiatric Society send it out to the members who have email addresses on file.

Psychiatrists were asked how many people they typically see on their busiest day of the week — please note that this survey was not validated, and data were not collected: it was merely a question we asked in an email survey. The most common answer was 8 to 11 patients. Of the 16% of respondents who report they see more than 21 patients in a day, several noted that they work in settings other than outpatient practices: hospitals, group homes, addiction centers, schools, and settings where patients are seen in groups or with the help of a multi-disciplinary team. Only 10 psychiatrists saw more than 30 patients on their busiest days. We concluded that in Maryland, few psychiatrists have very high volume outpatient practices, or perhaps those who do are too busy to take a survey.

Some patients do very well seeing a psychiatrist for 15 minutes a season (once every three months) and psychotherapy is not necessary. That’s not always the case and we know that many patients do better with a combination of psychotherapy and medications. There are patients who may do better seeing a single psychiatrist rather than dividing their care between mental health professionals. Sadly, the insurance industry reimburses best if patients are placed on a conveyor belt to see their psychiatrist. That doesn’t make it good medicine, and even when patients get better, some are dissatisfied and angry.

There are several reasons why psychiatrists may practice outpatient psychiatry in a rapid-care model. Participating with insurance plans is a socially responsible thing to do and there are regions of the country where there are very few psychiatrists and restricting practice size is just not feasible. Also, it pays well. That doesn’t make it good medicine, nor does it mean that everyone’s doing it. There is no one-size-fits-all psychiatry.

Many psychiatrists (70%– per Mojtabai and Olfson in the Archives of General Psychiatry) see patients for psychotherapy — if not all their patients, then at least some of them. And often psychiatrists who don’t practice psychotherapy still listen and evaluate a patient’s symptoms within the context of what is happening in their lives, then take the time to answer questions and explain their treatment recommendations.

Converyor-belt psychiatry works for some, but not for others, and it gives psychiatry a bad name. It is simply not true that all psychiatrists practice this way, that psychiatry has given up on psychotherapy, and that it’s all about the medicines. In a field that is hampered by stigma, this portrayal is both wrong and irresponsible, and discourages people from seeking treatment. If that’s not bad enough, it also discourages doctors from pursuing careers in psychiatry, and that only worsens the problem.

Dinah Miller is a psychiatrist who blogs at Shrink Rap and co-author of Shrink Rap: Three Psychiatrists Explain Their Work.

 

Our Partners