jackie2's Blog

Dr. Jackie's Mental Health Moment


Lewisburg, Pennsylvania, USA
August 01
Clinical Psychologist
Dr. Jacqueline B. Sallade
Only child of holocaust survivors from Eastern and Central Europe, grew up in Phila., Central PA, and NYC (2nd home). Psychologist since 1970 working with children and adults in wide variety of selttings, including schools, hospital, courts, private office, and prisons.

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DECEMBER 19, 2012 6:14PM

Mental Health Systems-Dr. Jackie's Mental Health Moment

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Any one day in a psychologist's professional life can be a testament to the success and failure of our mental health system.

Take the formerly-obese, extremely defiant and violent young man who has been in several instutions throughout his childhood and adolescence. Finally, after years of therapies of all kinds, medications and special education, juvenille detention and probation, he knows that he may be making some progress. He learned the most from a military-style program which included physical fitness activities. He lost weight, got in shape, showed some respect for authority and realized that consequences matter. He understands some of his deficiencies and the concept of anger management is finally within his grasp. Why did it have to take eight years?

Then, look at the middle-aged man who has been trying to find help for forty-some years.  After several brief hospitalizations and scores of therapists and medications, he still doesn't have a consistent diagnosis because none exactly describes his set of symptoms. Most of his coping tactics for his suicidal thoughts developed from his own ingenuity. His combination of brain injury, mood disorder, and post-traumatic stress combine uniquely. He expresses bitterness towards a mental health system which has jerked him around with little understanding and care. His survival is a testimony to his own courage and intelligence.

An easier case is the man with panic disorder. His family doctor prescribed addictive pills. No one suggested counseling. Now, he'll get some and he will face his anxiety directly, learn to feel it and relax, rather than spend more wasted years avoiding malls, stores, restaurants, movies, etc. for fear of panic. This one will be a success story.

I could go on but you get the point. To some extent, the patient has to be ready and determined to change but the mental health profession also needs to be become more streamlined, lass wasteful of time and resources and more real about helping people, not just doing paperwork . One branch of this system needs to communicate with the others, too, instead of someone seeing a family doc, then a psychiatrist, then a counselor or psychologist, then a vocational worker and no coordination among them. What ever happened to teamwork?  What every happened to actually exploring what will work for that particular person, rather than labeling and cookbook , cookie-cutter goals applied, as if the person were an object? I'm frustrated with the system, but nothing compared to the patients themselves.

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It is so interesting to read your posts from inside the mental health care system. Coordinated care, like some city clinics that have medical/dental/social services, everything in one place, would be so great. I give you and all the other caring mental health care professionals so much credit...It takes a very special person to be able to do your work. Thanks so much for sharing your thoughts here!