Physician’s Weekly, along with Linda Girgis, MD, co-hosted the second installment of the #PWChat series focusing on the current status of mental healthcare in the United States. Check out our recap of PART I.

Topics discussed in the second half of our live, interactive chat included: how the public can be better educated on how to address emergency situations among patients with mental disorders, why some feel that mental illness is often treated as less important than physical illness and how that thinking can be changed, how to address patients who aren’t willing to accept that they might have a mental disorder, and much more!

View our upcoming schedule, or read our other #PWChat recaps here.

Below are the highlights from the chat. You can read the full transcript here.

 

 

Question 1

Q1: How can the public be better educated on how to address emergency situations among patients with mental disorders?#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

A1. More information needs to be discussed in schools about mental health disorders, esp. in view of recent school shootings. Crisis numbers need to be readily visible and available. People need to know there is someone to call for help if they know someone needs it. #PWchat https://t.co/MfKf90krZl

— Linda Girgis, MD (@DrLindaMD) April 24, 2018

A1: We need a multifaceted approach, with community-level outreach and funding for emergency #mentalhealth management (something like @MHFirstAidUSA). Schools offer a great opportunity to introduce these concepts, perhaps as part of social-emotional learning curriculum.#PWChat https://t.co/9dtt2SV7ez

— Rie Lopez, MPH (@RieOfLetters) April 24, 2018

#PWchat
There has to be a portal where people can constantly go and express themselves. Social media has been credited for many things harmful in society, but look at the great things it is doing with MH. We should use #socialmedia to our advantage @DrLindaMD

— Ravikumar MD., MPH (@Chockalingam_Ra) April 24, 2018

 


Question 2

Q2: Why do you feel that mental illness is often treated as less important than physical illness? How can that thinking be changed?#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

A2. Mental health disorders are diagnosed and treated based on subjective symptoms. We cannot measure it, like we can a blood pressure to see if it is getting better. People cannot see the damage these diseases cause. Many believe patients can just will themselves better. #PWchat https://t.co/k4cWz2l7J4

— Linda Girgis, MD (@DrLindaMD) April 24, 2018

As orthopedic surgeon, I see daily, the profound impact mental illness (mild anxiety–>severe forms) has on so many patients’ physical ailments (including degree of symptoms, response to treatment & healthcare costs) yet we physicians are ill prepared to manage (pts not open too) pic..com/H95oGGGqVt

— Nicholas DiNubile MD (@drnickUSA) April 24, 2018

Q2 Mainly, imo, because they view the mind as being fully under personal control, and anxiety, depression, etc being a moral failing.

Also, visible injury is more “believable” than something unseen#PWchat

— Matthew Loxton (@mloxton) April 24, 2018

 


Question 3

Q3: How do you address patients who aren’t willing to accept that they might have a mental disorder?#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

My goal as a Psychiatrist is not to ensure nor indulge in getting my patient to accept his/her mental illness. The fact that he/she has had the courage to come seek help is COMMENDABLE. My goal is to validate and reinforce it could be better and thats my ONLY GOAL #PWChat

— Ravikumar MD., MPH (@Chockalingam_Ra) April 24, 2018

 


Question 4

Q4: Why do you think health insurance companies differentiate mental health disorders from others, and how can that mentality be changed?#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

I think this is largely an issue of numbers. I dont want to offend anyone, but the unfortunate reality in the US is the elevation of insurance providers as a stake holder in the life of a consumer of mental health. This is an absolute conflict of interest. #PWchat

— Ravikumar MD., MPH (@Chockalingam_Ra) April 24, 2018

Q4 Because insurance is a business model. Mental health can’t be valued like physical units of care. Insurers don’t want to manage MH or provide access, they want to collect premiums & make money for shareholders. It’s that simple & that complicated #pwchat pic..com/pMpANPOLPB

— ShereeseM, MS/MBA (@ShereesePubHlth) April 24, 2018

 


Question 5

Q5: When a patient who needs specialized care from a psychiatrist and/or psychologist is left waiting for months, what can their primary care provider do to help? What can others do?#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

Q5 ugh.
So at that point you are talking plugging a dam wall that is cracked and gushing.

Almost anything but ignoring them would help, but really what we need is comprehensive care and integrated PC and MH.

Not something the physician can solve#PWchat

— Matthew Loxton (@mloxton) April 24, 2018

Q5 Some towns have crisis clinics. I dealt with this recently with a neighbor. His family and I discussed things and they ended with an intervention and crisis care. But, the crisis clinic had nowhere to send him because he was uninsured. SMH #PWChat https://t.co/Ahg0EkZWBX

— Becky Brandt RN (@bbhomebody) April 24, 2018

Exactly! I see this often. Where are these patients supposed to go when no one takes their insurance? You may have averted a crisis but happens next week and the week after? #PWchat https://t.co/VRbJT6Uy9t

— Linda Girgis, MD (@DrLindaMD) April 24, 2018

 


Question 6

Q6: What steps must be taken on the state and/or national level to increase access to mental healthcare? How do we increase psychiatrist/psychologist numbers? How do we get them to accept more insurance types again? Etc…#PWChat

— Physician’s Weekly (@physicianswkly) April 24, 2018

Q6 a Congress whose thinking wasn’t stuck in the 1700’s would be a good start.

It would help to increase the payment rates for psy clinicians, add PFA to training, and to train first responders in PFA.#PWchat

— Matthew Loxton (@mloxton) April 24, 2018

#PWchat
Multipronged approach.

Increasing access is through systematic investments in training, infrastructure, human resources across primary, secondary and tertiary domains of mental health. Ease off reimbursement should improve and providers should uphold the Hippocratic oath

— Ravikumar MD., MPH (@Chockalingam_Ra) April 24, 2018

Q6: For complex diseases, we miss opportunities for mental health support for caregivers (esp. in peds.). Develop multidisciplinary teams with pt and caregivers in mind at diagnosis. #pwchat

— Heidi Grabenstatter (@PatientIntv) April 24, 2018