The War on SSRIs Part 2: What we need is better access to care.

The systems in place are failing.

A patient wants to quit smoking, has tried all the over-the-counter options he can think of. We send a prescription that WITH insurance, is still $150 per month. He can’t afford to pick it up, loses hope, and continues smoking. Wouldn’t it have been wise for insurance to cover this? However, this is the system. Patients lose, providers’ hands are tied. 

If we truly want fewer people taking psychiatric medication, then we should build a healthcare system where they have meaningful alternatives. Make therapy affordable and expand the mental health workforce. We need easier access to higher levels of care like PHP, IOP, and residential before things become dire. (I have patients who will go bankrupt getting the care they need. That just shouldn’t be the case.)

What we need is for our system to support prevention, while continuing to fund crisis response.

Until then, asking people to reject medication without giving them another evidence-based path is asking for worsening outcomes and feels an awful lot like abandoning them.

Medication should never be a substitute for comprehensive mental health care (alongside sleep, water, and sunshine). But for many people today, it is the only evidence-based treatment they can realistically access. That's not a failure of patients or clinicians. It's a failure of the system we've built.

We don't need less psychiatry. We need better psychiatry. We need access to resources and to continue to remove the stigma from those accessing these resources. 

For now, we work within the system we have and vote for change because our lives and those we love depend on it. Vote to fund mental health care. 

-Katy Goggins, PMHNP