“Can we Talk”, was comedienne Joan Rivers catchphrase.
In recent years, our culture has begun to talk about a subject heretofore pushed off to the quiet corners of “polite society,” mental health.
That talk has turned into action. A week ago the U.S. Senate passed the first major mental health legislation in nearly a decade, sending the 21st Century Cures Act, which included that legislation, to President Obama for his signature.
Connecticut Sen. Chris Murphy, a Democrat, worked with Sen. Bill Cassidy, R-La., a physician, to achieve this landmark legislation that will provide states with additional funding and grants to address the challenges of mental health.
“I’d seen up close the heartbreak and frustration that families suffered trying to find care for a loved one — care that seemed impossible to find and even harder to pay for,” Murphy said.
Although this is welcome news, the greater utilization of mental health professionals, ubiquitously referred to as “counselor” or “therapist,” brings new challenges.
The growth of counselors in Connecticut between 1998 and 2014, according to the Connecticut Department of Public Health, is significant. Psychologists increased 45 percent, clinical social workers, 75 percent, and marital and family therapists, 99 percent. With such growth, has not come commensurate state oversight.
In seeking out a mental health professional it is assumed that they have no agenda or pre-conceived notion of you and your past. When we walk into a therapist office, we are not in a good way.
Whether for marriage counseling, grief counseling, substance abuse counseling, etc., if you are going to a therapist things are bad.
Walking into a therapist’s office, as I have done in my life, your mind and physical state is confused and exhausted. Most of all you walk into the office vulnerable. This vulnerable state is cause for concern because the decisions made, advice and counsel given, will have a dramatic impact on not just the person seeking counsel but many around them.
As a society, we are too casual with choosing and understanding the roles, responsibilities, and accountability of this important and increasingly utilized segment of our health care system. The public is unaware that each of these disciplines — psychologists, clinical social workers and marital and family therapists — offers a difference in approach, methodology, and ethical guidelines.
More concerning is a lack of informed consent for patients who walk into a therapist’s office.
According to information received from the Connecticut Office of Legislative Research, when asked, “What are licensed clinical social workers, psychologists, and marital and family therapists required to provide clients during an initial meeting (e.g., license, CV, accreditation, etc.)?” The response was, “We found no laws or regulations that require these health professionals to provide clients during an initial meeting with documentation pertaining to licensure or professional qualifications.”
Providing patients with an informed consent document, explaining for both patients and therapists, the expectations and responsibilities of all parties involved is a prudent measure.
In response to an inquiry about how the public can review a counselor’s effectiveness, the OLR stated, “The state does not evaluate these health care professionals’ effectiveness.” This lack of objective analysis needs to change. Without a form of measurement, how can effectiveness be assessed?
There needs to be greater engagement by mental health professionals in communicating with clients who they are and what patients can expect. Assessment of the effectiveness of mental health professionals and the dissemination of such information to the public can only enhance choices made by patients and the practice of therapists.
The responsibilities and authority conferred on therapists — their influence on whether a family stays intact; in determining if a person is suffering from a clinical mental disease requiring powerful medications or hospitalization; or in helping a child through the horrors of abuse — cannot be overstated.
Those who decide to become a therapist see it as a calling. Therapists are part of “first responders” to horrific events such as the Sandy Hook shootings. These are individuals who step into the darkest corners of our culture with the mission of providing some light.
Our mental health professionals need to be treated with the rigor and oversight that is commensurate with their critical role in our health care system.
Ben Davol, is a freelance writer and an occasional contributor to The Day, lives in Stonington. His email address is firstname.lastname@example.org. His writing can be found at DromanaStrategies.