In a previous article, I noted that psychology is the redheaded stepchild of the healthcare profession. (See “Respect Psychology and We All Win”.) At least two incidents recently made me realize that what I said was a vast understatement.
The first occurred when I watched Jennifer Siebel Newsom’s documentary, MissRepresentation. Their website describes it as a film that “exposes how American youth are being sold the concept that women’s and girls’ value lies in their youth, beauty and sexuality.” It is a really wonderful and enlightening film that everyone should check out, but there was one glaring omission: there were no psychologists.
The film utilized a number of people to emphasize and discuss the message they were portraying. These experts included lawyers, 
activists, politicians, media personalities, authors, presidents of non-profit organizations, historians and professors. The professors were from the fields of political science, journalism, communication and government. There were no professors of psychology. Although the film referenced at least three separate reports from the American Psychological Association and the National Institute for Mental Health, they interviewed no one with background in psychology. It was left to the professor of political science to talk about such mental health concerns as depression and self-esteem. Don’t get me wrong, she did a great job, but why in the world were there no mental health professionals present in a film examining gender, self-esteem, self-confidence, leadership, prejudice and the effects of sexism? Was Mary Pipher (of Reviving Ophelia fame) busy?
The second incident was from my own practice. Several of my new patients last week were families struggling with the fallout from high conflict divorces. These are extremely tough patients to deal with because the emotionality is so high, money is involved, and the legal profession has made the conflict extremely adversarial. The necessity for psychology to intervene in these situations deserves its own article, so I won’t go into it here but the issue last week was in trying to get some of the parents to understand why their children needed to be in counseling. They were not convinced of the efficacy of counseling nor did they seem to realize the mental health consequences of high conflict divorces.
With all the research out there detailing the mind/body connection, the effects of stress on the body, the consequences of inadequate emotional intimacy, the poor outcomes for kids dealing with divorce and the reasons why people turn to alcohol, drugs and even suicide (just to name a few), how in the world are people still questioning the need for counseling and psychology? Really, my mind is blown. How is it that the field of psychology is still so poorly understood when we have all this evidence in our favor?
But it gets worse. As those of us who are direct service providers in the United States know, mental health is not only fragmented from the physical health arena, but we are paid at much lower rates and not given nearly as much respect from physicians themselves. It’s frequently a battle to get some physicians to include mental health professionals in treatment planning, and I’ve had several physicians question my ability to call myself doctor because, as a PhD, apparently my doctor title is not as real as theirs.
While the lack of respect is annoying, it’s the fragmentation and lower reimbursement that is at the heart of this issue. Before all the research showing that mental health is inextricably linked to physical health, I could understand shoving us aside. We didn’t know better. But now we do and, what’s more, patients realize it too (“No one puts psychology in a corner!”).
In a recent survey by the National Alliance on Mental Illness, 83% of parents stated that they wanted to discuss mental health issues with their child’s primary care physician even if they saw no evidence of problems; about half said they didn’t believe their physicians were knowledgeable about mental illness. No kidding. Medical doctors frequently have minimal, if any, training in mental health issues and many disregard them as unimportant. I’m hopeful that if we move toward a more holistic form of healthcare, this will change. If psychologists and mental health professionals become active team players, then maybe our reimbursement levels will increase as well. As we all know, we pay for what we value in this society.
So, what is it that we can do to help increase our visibility and public worth? Psychologists should be front and center in the movement toward helping our society heal itself and I have several ideas about we can do this. First, we need a prominent face for psychology. Much like Gloria Steinum is the face of feminism, we need someone well-known to advocate for psychology. In short, we need a psychology rock star. That way when documentaries are being filmed, they will have someone to call.
Second, we have to change the public perception about healthcare. Right now much of it is centered on what is called the Medical Model. It is an illness-focused model whose primary emphasis is on treatment. Yes, of course, treatment is a necessary part of healthcare, but never forget: if you need treatment then you’re already sick. I’d like to see us transition to a Social Model.
In a Social Model, emphasis is on cultural and lifestyle changes that can make the population healthier. Environmental groups and people in public health programs are already operating under this model and psychology should as well. We have a lot to offer. We can work with hospitals, physicians and schools to help people prepare for major life transitions, like birth and death. We can teach couples how to get along and parents how to discipline effectively. We can help motivate people to make healthy lifestyle choices (like brushing their teeth, eating nutritious food and exercising) and teach them ways to decrease stress and anxiety. We can work with the courts to demonstrate appropriate conflict management. Businesses could utilize our know-how in increasing productivity and providing family friendly environments. We could work with groups like government, churches or volunteer organizations to help educate them on reaching consensus and other good decision making skills. Don’t you think Congress needs us?
We need to start working on this shift right now, and everyone can help! Just like Occupy Wall Street made a difference using the voices of regular people, psychology can do the same. (In fact, there’s even a movement called Occupy Healthcare.) We can start talking to physicians, hospitals, churches, groups, schools and other places about bringing in psychologists and other mental health professionals to help with some of the issues mentioned above. If the market hears a roar, it seeks to satisfy the demand. So start roaring!