Why do we treat psychiatric illness different from other illness?

I recently had the opportunity to be the informal medical navigator for a friend with an acute psychiatric crisis. This previously “normal” friend lives alone, is a high-functioning professional and was unable to sleep, to eat, to finish a coherent thought or to carry on his business for several weeks. I was called to help after an embarrassing public meltdown. The first problem was finding a doctor who would deal with the situation. After all, even if patients have a primary care provider (and not all do), this PCP is usually not a psychiatric expert. In general, we want to run in the opposite direction when we encounter people with mental health issues other than mild anxiety or depression. So, a trip to the ER and assessment by physicians and social workers who do not know the patient is routine. By the grace of God and connections, this patient’s PCP facilitated admission to the inpatient hospitalist service for medical evaluation to rule out stroke, tumor, drug intoxication or metabolic disorders. After exclusion of these conditions, a psychiatric consult was obtained. An inpatient psychiatric stay was offered to the patient, who refused, and the patient was placed on escalating doses of antipsychotics and sedatives. These drugs slowed the manifestations of the mania (loud, pressured, often inappropriate speech) but had no effect on the disordered thoughts. I won’t address the thorny ethical question of whether it is appropriate to allow a psychotic patient to ac...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Emergency Medicine Psychiatry Source Type: blogs