Do mental health professionals help each other when they're
struggling withdepression' marital problems, alcoholism, and the like?
The good news is that psychiatrists have developed sUpport systems for
their distressed colleagues. The bad news is that psychologists, who
outnumber psychiatrists about three to one, have not gotten the message.
As psychologist Gary Schoener, Ph.D., puts it, "The concept of helping
our own is not there in psychology. We don't even offer each other
`professional courtesy'--physicians often don't charge each other for
services, but we would never adopt such a practice."
What are psychiatrists doing right? All 50 states have treatment
programs for psychiatrists and other physicians, and these programs work
with state licensing boards to ensure that impaired practitioners are
rehabilitated, not simply punished. The American Psychiatric Association
has also taken steps to help their own. "We do workshops and
presentations on illness and impairment," says Harvard psychiatrist
Malkah Notman, M.D., who chairs the association's Committee on Physician
Health, Illness, and Impairment. `"We have videos, articles, papers. We
link Up members who have problems with local organizations [that can help
them]."
Although the official ethical guidelines for psychiatrists do not
actually require them to look out for each other, they do point in the
right direction: "Special consideration should be given to those
psychiatrists who, because of mental illness, jeopardize the welfare of
their patients and their own reputations and practices. It is ethical,
even encouraged, for another psychiatrist to intercede in such
situations."
One of those who intercedes is John Fromson, M.D., director of
Physician Health Services in Massachusetts. His organization's rigorous
program is designed to help drug-addicted psychiatrists get back on
track. "There's drug testing twice a week. Attendance is reqUired at
Alcoholics Anonymous or similar programs three times a week. Regular
meeting are required with our staff. The psychiatrist must also be in
therapy, and his or her professional work is closely monitored. If
participants do not comply, we may report them to the Board of
Registration and Medicine, a very serioUs matter."
The resources available to impaired psychologists are pitiful in
comparison. The problem starts right at the top, with the American
Psychological Association. When I asked APA about services for impaired
psychologists--calling, by the way, as a member of the organization--I
was first told there weren't any. Eventually, I reached the executive
director of APA's clinical arm, who said that, yes, a committee concerned
with impairment exists, But that "it's never issued any reports."
In fact, in 1988 this small, underfunded committee issued an
impressive 250 page manual called Assisting Impaired Psychologists, which
was revised in 1994. However, other than members of the committee, I've
had trouble finding even one psychologist aware of the report's
existence. The former and current committee members I spoke to all
expressed enormous frustration over the organization's lack of interest
in impaired psychologists. Even the committee's name suggests denial and
disinterest: At one time it was the committee on "distressed
psychologists"; then it became the committee on "firm paired
psychologists,; now it's the "Advisory Committee on Colleague
Assistance."
Perhaps 13 state organizations offer limited services to impaired
psychologists. Tennessee's program is one of the best, and California,
which harbors the greatest number of psychotherapists--Lord knows we need
them--has a promising new referral program. Alas, the program only serves
the California Psychological Association's 5,000 paying members--about a
third of the state's clinical psychologists.
According to psychologist Karen Saakvitne, Ph.D., APA's efforts are
"a disgrace." "It's phenomenal," she said, "what we won't look at." Peter
Nathan, an original member of APA's distressing committee, adds, "APA
fiddles while Rome burns."
Tags:
50 states,
apa,
ethical guidelines,
harvard psychiatrist,
health illness,
impaired psychologist,
marital problems,
mental health professionals,
mental illness,
notman,
physician health,
psychiatrist,
reputations,
right direction,
rigorous program,
s committee,
schoener,
state licensing,
therapist
