I’m a big believer that integrating primary care and treatment is important to improving recovery rates. The feds have recently reached the same conclusion and this had me very excited…until I attended a NIATx/SAAS conference. At the conference, it became clear that the federal government’s enthusiasm for pharmacology leads to a vision of primary care integration that would looks something like what we’ve seen in the treatment of mood disorders. That is, primary care physicans prescribe medications, increasing access to pharmacological treatments while access to other treatment decreases.
Jonah Lehrer provides some of the recent history in the care of depression:
In this blog post, I’d like to focus instead on one of the troubling data points in this most recent medical survey, which is that the percentage of depressed subjects seeking psychotherapy for treatment declined dramatically between 1998 and 2007, from 53.6 percent to 43.1 percent. (This drop has come despite the fact that a majority of subjects say talk therapy is their preferred method of treatment.) Needless to say, pills have taken the place of therapists, as more than 75 percent of depressed patients are now treated with anti-depressants, which has led to a dramatic increase in medical spending on the disorder. Between 1998 and 2007, Medicare expenditures for depression increased from $0.52 billion (1998) to $2.25 billion (2007).