The medical profession has been aware that psychosocial issues can lead to physical symptoms at least since the days of Hippocrates about 2500 years ago. Yet diagnosis and treatment for the pain and other symptoms lag far behind nearly every other form of illness. In thinking about this I began to recognize several challenges to improving the quality of care for this condition.
Posts Tagged ‘mental health education’
Stress, Illness and Challenges
Thursday, December 11th, 2014Stress, Illness and Points of View (1)
Monday, September 22nd, 2014In October 2010, while lecturing in Europe, my wife and I spent a few days hiking in the beautiful Lauterbrunnen valley south of Interlaken in Switzerland. Sometimes walking in a beautiful place can get you thinking about the larger picture.
Integrating Medical and Mental Health Care
Sunday, October 30th, 2011I attended the 13th Collaborative Family Healthcare Association (CFHA) meeting in Philadelphia last week. A prominent theme was difficulty gaining acceptance from medical clinicians about the role of mental/behavioral health practitioners in the primary care setting. These practitioners provide skills helping people with complex medication regimens (insulin for example), weight management, smoking cessation, exercise regimens, substance abuse and stress management as well as help with mental health disorders. But these resources are not used nearly as well as they could be.
Stress Illness and Placebos
Thursday, May 19th, 2011In the next edition of The Economist magazine is an article about Edzard Ernst, professor of complementary medicine at Peninsula College of Medicine in Exeter, in southwestern UK. He is retiring after 18 years of studying “alternative” medical remedies which includes acupuncture, chiropractic medicine, Reiki, herbal remedies, Ayurvedic medicine, homeopathy, reflexology and many others. During this time he and his group published over 160 analyses of the research in these fields.
How Physicians View Stress Illness (3)
Friday, April 29th, 2011In the last two posts, we reviewed a quotation from Dr Jerome Groopman that highlighted two common physician errors, the first being to lump together all patients with medically unexplained symptoms and label them hypochondriacs.
Stress Illness and Shared Responsibility (2)
Tuesday, March 29th, 2011As described in the last post, in the future we can teach physicians who practice diagnostic medicine to be aware of Stress Illness and to ask a few key questions. (See the screening questionnaire on the Overview page of this site for examples). When they uncover significant stress, they can offer the patient referral for a Stress Check-Up, where a more detailed evaluation for stress is done by a mental health professional.
Stress, Illness and Primary Care in Arizona
Monday, October 18th, 2010There is a new program at the Phoenix branch of Arizona State University. They are training people with master’s degrees in social work or a mental health field to become Doctors of Behavioral Health. The goal is for them to work closely with physicians, ideally co-located in the same office and collaborating extensively on behavioral and mental health issues as part of primary care. Diagnosis and treatment of Stress Illness would clearly be a significant part of their work.
Psychosocial Context (2)
Monday, September 20th, 2010Continuing from the last post, recall that in my practice a large majority of over 7000 patients with medically unexplained symptoms were referred due to failure to grasp the their psychosocial issues.
Psychosocial Context (1)
Saturday, September 11th, 2010The health care system has a strong bias toward viewing people as purely biological organisms. This approach ignores two critical facts:
Empathy and Stress Illness (3)
Wednesday, May 5th, 2010I had never heard of Mississippi writer Barry Hannah until he died two months ago at age 67. The obituaries quoted many well-known authors who revered him and prominently mentioned his award-winning short story collection Airships (1978). When my writer friend Peter also praised it I put in an order.
