As a young premed, I saw my future doctor-self as someone who would figure out what is wrong with the patient and suggest the right next steps. I suspect that’s the reason healthcare professionals go into the mental health space. But it’s the alternative mental health care space that is unique and is booming.
As a country with a lot of resources and the ability to print our own money and carry an obscene amount of national debt, we have neglected the mental health of our society.
There will eventually be a tipping point that will affect all of us. In the meantime, I have seen the most amount of progress in this subspecialty of clinical issues.
When I chose to become a doctor I assumed there would be a great deal of ownership on the part of the patient. That they would come to me only after they have tried certain things themselves and that their visit with me signaled readiness to change.
Though a small percentage of patients fall into this category I see a growing number of individuals who associate healthcare with health. They go to their doctor in order to be healthy and they are looking for western medical solutions in order to ease their suffering.
We don’t often view mental health as a part of the clinical workflows. In fact, it is the mother of all medical conditions. You can’t avoid mental health care when discussing STD’s, pregnancy, obesity, or malignancies.
In fact, diabetes, our biggest failure in western medicine, is a good example of how mental health care has to take precedence if our ultimate goal is being disease-free.
If our goal is diagnosing as many diseases as possible and prescribing as many medications as possible, as is the case in current medical trends, we are leading with diabetes.
The Mental Health Space
The mental health space is in a very unique place in time. There are very few psychiatrists and for all but the most severe mental health conditions we don’t need a psychiatrist.
There is the psychiatry space but because many of gone the way of insurance reimbursement there is very little traction there. The work is difficult, the income isn’t great, and burnout is high.
Then there is alternative mental health space. This is where non-psychologists and non-psychiatrists are stepping in and helping patients based on their own experiences or based on certain methods and teaching, like mindfulness.
Professional Distinction in Mental Health Care
Wiki has a good page on this topic. There are lots of ways to get into the mental health care space, from psychiatry to social work.
As a psychiatrist, you prescribe medications and do some psychotherapy as well. You’re often dealing with insurance companies and it’s rare that you’ll specialize.
As a psychologist, you’ll rely on insurance as well. The majority of the work is psychotherapy and your patient population doesn’t often self-refer. Meaning, you’re seeing patients who are lower on the “Stages of Change” scale. Often in the pre-contemplation or contemplation.
The Alternative Mental Health Care Space
Then there are the Dr. Phil’s, Byron Katie’s, Eckhart Tolle’s, and Jim Dethmer’s. These are individuals who are working on people’s behaviors and mental health without working in the traditional mental health care space.
In fact, their success, often enormous success, stems from the fact that they have sidestepped the traditional mental health care space.
There are many more like them. Tara Brach, Tom Compton, Jack Kornfield, Thich Nhat Hanh, Michael A. Singer, Pema Chödrön, Sharon Salzberg, Trudy Goodman. Some are less well-known individuals but they have a strong following and they are making a real difference in people’s lives.
Each of these individuals brings a lot of experience to the table. They learn even more from seeing more patients. And their cumulative experience is a gamechanger for those who are suffering from mental health issues.
The Engaged Consumer
The people I mentioned above work with engaged consumers. This means that they aren’t relying on whomever the insurance company sends their way. Well, and they couldn’t, they aren’t licensed mental health experts.
It’s because of that lack of licensure that they have their success. Their patients are individuals who found them because they were searching.
They may have tried or already have their own mental health experts. But they also realized that mainstream mental health care wasn’t working for them.
It’s always better to work with the engaged consumer. It’s more challenging in some ways and to me, it feels more intimidating. But you eventually get the hang of it and you’ll enjoy higher-quality interactions.
The Career Model of Alternative Mental Health
I am a family medicine doctor so I know a lot about mental health. I have had my own bouts with it as well and know what works and what doesn’t. My binge eating was one of the toughest things to overcome. Not to mention the depression and low self-esteem I experienced in medical school.
If you’re reading this as a student or a physician it’s important to understand that there are a lot of individuals who don’t feel that their mental health is adequately addressed through western medicine.
This is the room and opportunity for those of you who want to work outside of the highly regulated, litigious mental health space. Whether you’re going to build your own methodology or piggyback off of what already exists you’ll never run out of clients.
Non-Traditional Mental Health Care
The reason the non-traditional mental health care community exists is that western models or more mainstream thinking based around the DSM-V have let patients down.
There is a strong place for western medicine in the mental health care space, no doubt. But trying to force the peg into the mold is far more obvious in mental health than in traditional western medicine.
Patients are already suffering emotionally and psychologically. They don’t want to be labeled as having some axis disorder and lose the little autonomy they have.
This is how this alternative mental health space has shaped up.
Mental Health Care is Growing
Emotional support and mental health interventions are ever more necessary. Partly because our society is becoming more structured which adds more stress and tension in people’s lives.
People are also becoming aware that they don’t have to suffer – they know that there are alternative ways of living. Because of social media and the free information age they know of someone somewhere who has taken charge of their mental health.
The Alternative Mental Health Space
The alternative mental health space is of course best populated with those who have structured training. But there are just as many effective individuals without ever opening the DSM-V.
For those of us who suffer emotionally or deal with some psychiatric issues, we need someone to hold space for us in the alternative mental health model.
We need someone who will listen and help us dive into our thoughts and beliefs. The non-traditional mental health care space brings such experts to those who need it.
The patient discovers their soothing voice on a podcast or watches their video on YouTube and they recognize the value of being in the presence of such a person.
It’s like back in medical school – you’d have that one attending whose voice alone dropped all your anxiety by 80%. Their demeanor, the way they thoughts, their attitude. I just never thought back then that I could emulate them.
Career Opportunity for the Physician
As a doctor, you’ve gone through some tough times to get to where you are. You’ve also counseled a lot of your patients and been there for family members.
In the alternative mental health space, you can offer a lot of value to patients. Often with nothing more than being present for them which the cool kids call mindfulness.
You don’t need a fancy degree and you don’t have to get a board certification or a PsyD license. You just have to make yourself known in the community. This last part, getting your name out there, is perhaps the most intimidating but that’s what I’m really good at and the content on this site should help you accomplish the same.
Find a Niche You Love
You don’t have to compete with everyone else. Maybe you’re interested in working with men, teenagers, single mothers, minorities.
You might want to help the adult with ADHD or the single mom with self-worth issues. Or you might like working with young professional women who are grappling with romantic concepts ingrained in them since childhood.
You read, you write, you speak. That’s how you become proficient in a new space. Clients will find you and you’ll gain your confidence and voice as time passes.
One reply on “The Alternative Mental Health Care Space”
I’m interested to see what credentials will be required for folks interested in being involved with psychedelic assisted therapy as Oregon hashes out the details over the next 2 years of its legalization of psilocybin.