A recent post by Beyond Medications reported that psychiatric medications sent over 90,000 people to the ER. Let me preface this by saying that I enjoy Beyond Medications. They highlight the need for other creative interventions and foster critical thinking about the use of medications. I also am deeply concerned about the overuse of psychotropic drugs but they certainly have their place in psychiatric treatment. Something about the tone of this article about psychiatrists and doctors CAUSING ER visits and deaths rubbed me the wrong way.
My gut reaction is to think about how many ER visits there are because of lack of proper access to psychiatric medications. My experience as a psych ER social worker is that the LACK of psychiatric medications can be more dangerous. I think we have to think carefully about assertion of CAUSE in this article. I would think there were a lot of comorbid factors that led people to have medication problems beyond bad doctors. These visits in the ER could have be unexpected side effects, comorbid medical problems, not taking mediations as prescribed, and overdoses. Before we assert that psychiatric medications CAUSE ER visits lets think carefully about this.
Psychiatric MD’s and NPP’s (and other MD’s) are faced with difficult decisions. They are often presented with dangerous or risky cases and are giving the charge to treat dangerous and risky people. People treated are often a danger to themselves and others. The tools at psychiatrists’ disposal sometimes carry risks as well. It is balancing the risk versus reward that is the key for implementing psychiatric medications as part of a treatment plan.
Are there doctors out there that are negligent and don’t think carefully? I am sure there are, but in my ten years of practice I have not run into one. Technology such as Electronic PDR’s are used refrequently to look at side effects, contra-indications, withdrawl protocols, and Guidelines for titration. New York State has implemented a program to cut down on poly-pharmacy and medication errors (Psyckeys).
Since I will continue to always focus on solutions, Beyond Medicine’s post Medical compliance? Adherence? No. My MDs are my PARTNERS is an excellent piece or work. Both the consumer and the MD need to have the conversation about risk versus reward. If you are a consumer ask questions, if you are MD take the time to educate consumers. As a social worker I believe in the right of consumers to make their own choices, choices presented in a well informed manner.
