A few months back, I was dispensing an antibiotic for a young child. I was counselling the child’s Father, who happened to be a family physician. I could tell right away, he was a nice guy, a caring Father and well-spoken. We chatted after discussing his son’s medication. I asked him about his clinical practice, and his thoughts on the current trends in mental health. His response below left me bewildered and frustrated. (Note: we chatted for about 10 minutes, this quote stayed with me, and I wrote it down right after our conversation).
“Mental health is my bread and butter. A patient comes to me and asks for dopamine. I let them have it. I tell them to play Lotto 649. They ask for Zoloft, Lorazepam, Quetiapine, I let them have it.”
From our entire conversation, it was clear that this man was intelligent and thoughtful. It was evident he spends time with his patients, hears them out and listens to their ordeals. After all, he is their physician, and it’s difficult to argue against giving in to patient requests or desires, especially when you may be providing them with a “solution” to their problems. I can’t help but think, is this the best we can do?
After he left the pharmacy, I felt a bit helpless in the fight against the mental health epidemic ravaging our communities. It’s disheartening to know there are some healthcare providers propagating and facilitating instant gratification. Instead of encouraging behaviour changes and mindfulness or physical activity, we instead put our patients on prescribing cascades and hedonic treadmills. Is this the best we can do?
Changing the status quo
It’s difficult to witness the declining quality of care plaguing our healthcare system. Up until this point, I’ve been an accomplice in this negative transformation. For every prescription I’d see for antidepressants or anxiolytics, I followed the protocol. Counselled on adverse effects, drug interactions, and compliance. the usual. I thought I was making a difference. But I see more and more patients falling into the traps of static care. Instead of healing, we hide the symptoms and numb the pain.
It’s time we shift our collective thinking about how we approach mental health care. Rather than relying solely on the prescription pad, it’s time we do our part as healthcare providers to educate and promote non-pharmacological options in addition to medication. Physical activity. Mindfulness. Sleep hygiene. Practicing self-compassion and empathy for others. Mental health is not my bread and butter. Instead, it’s a fire in my belly; the crisis gives me fuel to inspire real change in my community. To my friend, the physician, I invite you to put down the bread and join the cause.
