Building referral pathways from medical to mental health professionals will be a key part of relieving stress illness. Here is an example of a letter written by a mental health professional to a medical clinician offering ideas that could help. (The references below will be discussed in more detail in a future post.)
Dear Physician:
Do you see patients whose symptoms can’t be pinned down to a specific organic abnormality? Is their diagnostic evaluation normal even though symptoms persist? Is the illness in some of your patients out of proportion to their underlying condition? If so, you are not alone. In more than half of primary care patients, research* has shown that psychosocial factors, often not fully recognized by the patient, are responsible for the symptoms.
The good news is that these hidden stresses can be uncovered. Once they are revealed, there is almost always effective treatment available. As a mental health professional specializing in treating patients with chronic pain and functional syndromes, I am experienced in helping patients see the connection between their illness and past and present life stresses.
The next time you are evaluating a patient with medically unexplained symptoms, I would be grateful if you would consider a referral for a “stress check-up.” When patients understand that life issues can cause symptoms indistinguishable in severity from those caused by organic disease, and that treating their stresses can relieve physical symptoms, they usually are willing to give this approach a try.
Sincerely,
Friendly Local Mental Health Professional, MA, LMFT, DBH, PsyD, PhD
* Kroenke K., Mangelsdorff AD.; Common symptoms in ambulatory care: incidence, evaluation, therapy, and outcome. Am J Med. 1989 Mar;86(3):262–266
*Smith, R., Dwamena, F.; Classification and Diagnosis of Patients with Medically Unexplained Symptoms. J Gen Intern Med. 2007 May; 22(5): 685–691
Tags: illness, Kroenke, letter, medical interview, mental health education, Smith Dwamena
