Sure, let’s talk about treatment decisions, but without the rancor.
Sure, let’s talk about it, without the rancor
Confounding is the only way to describe Paul John Scott’s commentary “Mental illness: Want to talk about it?” (Dec. 8). Many of the elements were accurate but presented with rancor. Why attack organizations made up of individuals with mental illness and their family members? It’s true that mental illness is more complicated than sometimes portrayed, and certainly Big Pharma has much to answer for. As a psychologist, I wholeheartedly would underscore the importance of emphasizing a comprehensive approach to the understanding and treatment of mental illness. But the battle against stigma is far from over, and to put down organizations that work tirelessly to make a broad range of treatments and supports available is counterproductive.
DR. TRISHA A. STARK, Minneapolis
The writer is a licensed psychologist.
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Scott is right to argue against a purely “biocentric” model of psychiatric illness, or any simplistic “chemical imbalance” theory of mental illness. The most serious psychiatric disorders — schizophrenia, bipolar disorder, and major depression — represent the interaction of biological, social and psychological factors. But we should not underestimate the biological component of these disorders, as Scott implicitly acknowledges when he cites “genetic vulnerability” as a factor. Our genes make proteins, and proteins affect brain function. Social and psychological factors then interact with our genetic-biological makeup to produce psychiatric disorders.
And while “talk therapy” is often preferable to medication for many psychiatric disorders, some conditions — like schizophrenia and bipolar disorder — require medication in the vast majority of cases. The issue is not whether these medications restore a “normal” state to the brain, as Scott implies, but whether, on the whole, medications help those with the most serious psychiatric illnesses live relatively normal and productive lives. I believe they do, when they are properly prescribed, carefully monitored, and provided with the informed consent of the patient.
DR. RONALD PIES, Lexington, Mass.
The writer is a professor of psychiatry and SUNY Upstate Medical University and Tufts University.
Even sports lovers have to wonder
An institution’s priorities are sometimes revealed in the most surprising places. A full-page ad congratulating the Gopher football team on Dec. 8 listed about 120 players and 35 coaches.
Closer study convinced me that only about 15 or so of the 35 are actually involved in coaching, although I reflected at length before deciding not to place the offensive and defensive “quality control” specialists in the coaches’ category, as I presumed that their job is merely to inform the offensive and defensive “coordinators” as to whether the offense and defense are “under” or “out of” control.
Thus, there is one coach for every eight players. I wonder what percentage of undergraduate classes have such a wonderful professor-to-student ratio. Very low, I’ll bet.
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