President Trump’s pick to run federal mental health services has called for a bold reordering of priorities — shifting money away from education and support services and toward a more aggressive treatment of patients with severe psychiatric disorders.
The proposal has some psychiatrists — a generally liberal bunch — cheering despite their distrust of the Trump administration.
But it’s also sparked concern among other health professionals, who worry that the administration will put too much emphasis on medicating and hospitalizing patients, and remove supports that might help them integrate successfully into society.
It would seem that there is plenty of room to discuss whether efforts to deinstitutionalize mental health have left us without some of the care we need. (For example, there’s a persistent shortage of psychiatric beds.) On the other hand,
She will be the first to assume the title of assistant secretary for mental health and substance abuse — a near-cabinet position which reports directly to Health and Human Services Secretary Tom Price. Congress created the post to bring order to a scattered system; this is the first time mental health and substance abuse have received such a weighty emphasis in D.C.
“We’ve never had someone coordinating the fragmented mental health services in this country,” said clinical psychologist Xavier Amador, who has written several books for patients with mental illness. . . .
McCance-Katz, a psychiatrist who specializes in opioid abuse, hasn’t spoken publicly since her nomination, and declined to talk to STAT. But she has had a long career in mental health, and her writings — as well as a fact sheet put out by the Department of Health and Human Services — give insight into her priorities. Among them:
Increase the number of inpatient beds for patients experiencing serious psychiatric symptoms.
Reconfigure health privacy laws to give families access to information about patients who are severely mentally ill.
Reevaluate federal funding for suicide hotlines and programs that train patients with psychiatric disorders to help their peers.
The article does a good job providing an overview of the politics involved, including criticism from politicians and the recovery vs. medical model tensions.
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