Press Trivializes the Treatment Process and Devalues the Suffering

I read this morning that Casey Johnson, heiress to the Johnson & Johnson fortune, died alone in her Los Angeles apartment after a well-publicized life of drugs and partying. I feel sad to hear yet another story of a celebrity who succumbs to addiction after cycling in and out of a series of boutique rehabs.

If you follow the news the story is familiar. Train wrecks of pop check into posh $100,000-a-month beachfront rehabs, where they demand - and appear to receive - special indulgence. In my mind this kind of press trivializes the treatment process and devalues the suffering that I see every day as a therapist at Cottonwood Tucson. In the morning paper I read of the rich and famous going to treatment to save face and then go to work and treat less famous patients who struggle to save their lives. Too often, the news media leave general public with the notion that treatment doesn't work.

I know better. As an "in the trenches" clinician, I see overwhelming evidence that treatment does in fact work. While miracles can be hard to quantify, the Substance Abuse and Mental Health Administration's National Outcome Measures show that treatment results in improvement in every life domain, including: abstinence from alcohol and other drugs, decreased symptoms of mental disorders and improved functioning in all major areas. The same study reports that those who have completed treatment also have decreased involvement with the justice system and are better able to find and keep safe and stable housing for their families.

That's what miracles sound like when measured in the dry, public sector language of the National Institute on Drug Abuse. For a more personal take on the value of treatment, please consider the words of a grateful mother who recently sent a thank-you note to one of the family therapists at Cottonwood:

"We are still floating. None of us will ever be the same.
Our son is doing great - happy and clean out in
California. He told me the other day that he had gotten
a sponsor. The sound of his laughter has returned to us.
We have gotten a miracle."

I wish you could have had one too, Casey.

Jeffrey C. Friedman, LISAC
Primary Therapist
Cottonwood Tucson

Adolescents, Mental Health Treatment and Disparity

I have been thinking lately about the disparity between the need for adolescent mental health services and the relative lack of available treatment programs to address our current situation. We spend a lot of money on pediatric medical services for children and adolescents. We build Children's Hospitals, Children's Service in general hospitals, Cancer Centers, and Burn Centers. Many non profit organizations raise tremendous amounts of money for pediatric research and treatments. This is fantastic and has allowed more and more children and adolescents to have advanced state of the art treatment. We have made great strides in reducing morbidity and mortality from infectious diseases, cancers, heart problems, genetic diseases, neurologic diseases, and others. But the fact remains that we ignore the most widespread problems that are faced in this age group.

Morbidity and mortality from disorders that have a mental and behavioral component outweigh that of all other causes combined. The three major causes of death in pediatrics are accidents, murders, and suicide all of which have behavioral aspects. Complications of child abuse, substance abuse, and depression are more widespread than any other pediatric diseases. Sexually transmitted diseases and teen pregnancies are the two main gynecologic problems for our young people. What a disparity between the needs and the services available! In Tucson all funding for both inpatient and outpatient treatment programs have been cut and each year there are less available treatment options than the year before. There are fewer major non profit organizations that are raising money for more research and treatment as there are for other medical illnesses.

What is the answer? I don't know but I believe that we must bring more awareness to our society about this great disparity before we will make any changes. I hope that the Mental Health Parity Act that was recently signed into law will help move us in the right direction.

Thought for the day

Our children are our future.