Showing posts with label Mental health system. Show all posts
Showing posts with label Mental health system. Show all posts

Tuesday, June 14, 2022

What happened to continuity of care in mental health?

 As has long been observed (e.g., Henry, Sims & Spray, 1972; Holt, 1971; Orlinsky, 2009) there is no single, inclusive and comprehensive profession of psychotherapy. 2 This differs markedly from other established professions such as medicine and law, engineering and accounting, nursing and ministry, and so on. Instead, psychotherapy is practiced as a sub-specialty within several different professions, each of which itself follows no single pattern of practice guided by a generally accepted theoretical framework.

Orlinsky, David E.. How Psychotherapists Live (p. 14). Taylor and Francis. Kindle Edition. 

Psychotherapy is a subspeciality of several professions such as Psychiatry, Psychology, Social Work, Counseling, Nursing, Art Therapy, Music Therapy, Marriage and Family Therapy, Substance Abuse counseling, Occupational therapy, Acupuncture, Naturopathic medicine, etc.

This use of psychotherapy in many mental health professions is called “role diffusion.” Each mental health profession also bring different knowledge bases and skills which is called “role differentiation”. In agencies and health care organizations, mental health services are often provided by a “team.” A mental health team is composed of individuals from different professional disciplines.

In agencies and health care organizations where teams are used to provide services there often is a “primary therapist” assigned who oversees the comprehensive treatment plan and assures continuity of care. In the last few decades with the increasing reliance on revenue from health insurance to pay members of a mental health treatment team, the emphasis by administrators is on the provision of reimbursable procedures rather than patient care and this management system has fractured treatment teams and corrupted the continuity of care leading to poor patient care and demoralization of staff.