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Recovery Plus 28 Feb 2016 Integrate treatment for complex patients Until recently, mental illness triggered little public discussion. It was often kept quiet and regarded as “a private family matter”. Despite a growing body of scientific evidence, many failed to recognise the disease states of depression or addiction as illnesses. Now people are talking. Why? According to the National Institute of Mental Health, depression is the leading cause of disability in the US. About 20% percent of americans suffer with diagnosable mental illness each year and 17.5% of adults with psychiatric illness have co-occurring chemical dependency. In the UK, anxiety and depression are the most common mental disorder, and about 25% of the population will experience a mental-health problem each year. Co-existing mental health and substance use problems – ‘dual diagnosis’ – is estimated to affect 30-70% of patients in health and social care settings The statistics are clear; clinicians should not ignore suffering and its detrimental impact. The conversation is on. It is imperative to discuss mental illness and deliver mental health in order to circumvent the occurrence of tragedy affecting us privately in small numbers while causing detriment to the safety of our communities and of our world as a whole. Society has made some advances in understanding depression as a “brain disease” but misconceptions of addiction as a weakness, moral failing, or personal shortcoming persist. As the scientific study of addiction advances, so too, one hopes, will public understanding and support for patients. A significant number of patients are “dually diagnosed”, meaning they suffer from both addiction and psychiatric illness such as depression or anxiety. Similar to a patient with cardiovascular disease and comorbid diabetes, patients with co-occurring disorders pose complex challenges, all of which must be addressed if the individual is to achieve optimal mental health. An integrative model of treatment affords the comprehensive care necessary for success. What is integrative medicine? The answer varies according to the responder. In my professional opinion, integrative medicine, much like psychiatric illness, has garnered little public interest – but thankfully that is changing also. The American Board of Integrative Holistic Medicine describes five basic pillars on which integrative medicine rests, as below. 1. The relationship between the practitioner and patient is paramount. The practitioner and patient work as partners, in tandem to foster the patient’s health. As a team, the patient and provider continue to address acute illness, but make prevention of disease the relationship’s primary goal. Bilateral education is a key component: the patient gives information about lifestyle, health and goals, while the healthcare practitioner informs the patient about the disease and treatment options. 2. Integrative medicine addresses the whole person. This view moves us away from the “Cartesian split” of mind-body duality and the reductive view of patients being a bundle of pathologies. 3. Treatment is informed by evidence. In every discipline, physicians seek a balance between By the end of this presentation at Recovery Plus 2016, delegates will be able to: 1) cite statistics to assess prevalence of mental-health disorders and accompanying substance-use problems 2) list and discuss the 5 pillars on which integrative medicine rests 3) apply an integrative approach to their practice 4) more effectively establish a reparative relationship to meet complex patients’ needs. Click for presentation Click


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