Stress Illness and Psychiatry (2)

Remarkably, mental health practitioners (MHP) are largely uninvolved with the largest single group of people with mental health issues.  This is because those issues are manifesting most prominently as physical symptoms.  These patients find it difficult to imagine  that their illness is stress-related.  They seek help from medical clinicians, few of whom have formal training in stress illness diagnosis and so usually don’t refer to MHPs.  Even when patients are referred, few MHPs have much experience with what to look for in a patient complaining of physical symptoms.  It is uncommon for MHPs to know that they can relieve these symptoms using their usual techniques augmented by a Stress History.

The solution to this is two-fold.  First, the public will need to learn that stress can cause real symptoms of virtually any severity in almost any body location.  Ideally, in the future when a person develops persistent symptoms they will consider stress as one possible cause.  Second, the public, medical clinicians and mental health professionals will need to know that a Stress Check-Up should be done when the cause of a symptom is not found by diagnostic tests.  The Stress Check-Up may begin with screening questions (as described in recent blog posts) followed by a more detailed Stress History (click on the tag below to see other posts about this).

Ideally, mental health clinicians integrated into a primary care medical office would conduct most of the Stress Check-Up.  Their daily interaction with medical clinicians would enable each type of practitioner to learn from the other.  Improved clinical outcomes would follow and encourage greater use of this approach.  When that resource is not available, the traditional model of referral to a MHP will be facilitated when the patient learns they are to have a Stress Check-Up and not a Psychiatric Evaluation.

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