New Year's Resolutions to Help Our Patients

Article excerpt

Most new Year's resolutions have a self-oriented, narcissistic flavor: "I will--(lose weight to look better; exercise to become healthier; stop smoking to live longer; travel to an exotic location; make more money than last year so I can buy that sports car I've always wanted; etc.)."

As psychiatrists, we are particularly attuned to the human condition around us, so perhaps we can transcend our personal desires and resolve to do something to help seriously mentally ill patients. Our stressful lives as toiling psychiatrists pale when compared with the lifelong anguish, stigma, disability, loneliness, and poverty faced by many of our chronically ill patients. Beyond providing them with good evidence-based care, I can think of several meaningful resolutions to improve mentally ill persons' quality of life. Imagine the impact we could have if we collectively adopted these resolutions for 2010:

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* The 40,000 readers of CURRENT PSYCHIATRY can resolve to send e-mails to leaders of the U.S. Senate and House of Representatives as well as President Obama, urging them to make sure mental illness is covered as well as cancer or heart disease in any health reform act.

* Lobby our states to stop closing long-term psychiatric hospitals and to build some new ones. A subset of seriously mentally ill patients simply cannot take care of themselves in the community and need to be permanently housed and managed in institutions staffed by mental health professionals. Such institutions are "psychological wheelchairs," analogous to the assistance required by persons unable to walk because of neurologic diseases.

* Raise our collective voice to protest the criminalization of mentally ill persons that has transformed them from hospitalized patients to imprisoned felons. Consider this eye-popping statistic: one-half of prison and jail inmates have symptoms that meet criteria for mania, major depression, or a psychotic disorder (705,600 in state prisons, 70,200 in federal prisons, and 479,900 in local jails in 2006 (1)). So much for the notions of de-institutionalization and "the least-restrictive environment."

* Let's all e-mail the Health and Human Services Secretary (kathleen.sebelius@HHS.gov) and National Institutes of Health Director (francis.collins@nih.gov) to advocate for increased funding of research to discover the pathophysiology of mental disorders. Our patients need more effective biologic treatments to replace current agents that control symptoms but do not restore health. The enormous cost of mental disorders and addictions in the United States--hundreds of billions of dollars--justifies substantially increasing the National Institute of Mental Health budget. …