NHPR’s Rewind: How Mental Health is Treated

Jul 24, 2017

Medical scholars have long researched and debated the best methods to treat people with mental health problems. A recent Exchange episode explored how the philosophy of wilderness therapy – the idea that camping in a natural setting can be a treatment for patients struggling with mental health problems. But when gauging the benefits of wilderness therapy, it may be useful to examine the success of more common methods used to treat mental health: medication and talk therapy.

In 2010, The Exchange’s Laura Knoy and psychiatrist Daniel Carlat discussed changes in mental health treatment and the use of medication and talk therapy for people struggling with depression, behaviour disorders, ADHD, and more. 

Carlat asserted that medication was seen as an easy way out for treating mental health. For patients, medication made them feel better and more in control. Doctors found it easier to prescribe medication rather than schedule a talk therapy. And for health insurers, medication was seen as a money maker.

But Carlat, author of the book Unhinged: the Trouble with Psychiatry - A Doctor’s Revelations about a Profession in Crisis, argued that the heavy emphasis on medication caused his profession to go astray. Rather than taking the time to explore why patients experience problems, psychiatry focused on the biochemistry of mental health and the ever-growing number of drugs promising cures. This led to the issue of patients being treated for their symptoms through medication, while root problems were often overlooked.

Indeed, studies over the last 20 to 30 years (from when this Exchange episode aired) found that while medication was very effective in the short term, some talk therapy techniques were actually more effective in the long term because they gave patients the psychological tools they needed to ward off future problems in response to stresses that occurred in their lives. Carlat goes further into detail on the debate between the effectiveness of medication and talk therapy and addressed questions.

This Exchange episode brought to light concerns that many people continue to have regarding mental health treatment and its effectiveness. Carlat heavily advocated for strong communication and collaboration between a patient’s practitioners, so that they are all on the same page in terms of how the patient is being treated. He suggested a healthy balance between drugs and talk therapy is the best way to address mental health problems. Furthermore, he noted that we still have a long way to go in terms of understanding how the brain works in association with mental health.