Many Psychiatrists Unaware of Community Mental Health

Nov. 2, 1999 (New Orleans) -- A surprisingly high number of psychiatrists are unaware of community mental health services and often fail to refer their patients in the right direction when they leave the hospital. That gloomy revelation was presented this week at the American Psychiatric Association's 51st Institute on Psychiatric Services.

Babak Mirin-Babazadeghan, MD, a psychiatric resident, did a survey in June of psychiatrists at the State University of New York, Health Sciences Center in Brooklyn. The hospital is well known for its large psychiatric inpatient services. Fifty-seven psychiatrists participated in the survey.

Based on the survey, Mirin-Babazadeghan found few psychiatrists were aware of community mental health services. In fact, he says, the results of the study were shocking. Thirty percent of the psychiatrists surveyed did not know the meaning or purpose of community psychiatry. About one-quarter didn't refer patients to self-help groups.

Mirin-Babazadeghan concludes that psychiatrists are poorly trained in the use of community psychiatric resources. These resources can often make a difference between a patient's success or likelihood of relapse. "What is more striking, about 76% did not even know, or they did not refer anybody to, NAMI, the National Alliance for the Mentally Ill, which is the biggest [support group] for our patients," Mirin-Babazadeghan tells WebMD.

The prevailing institutional culture is that patients get medication, and they feel better and are discharged. "But now we have to help them to stay in the community," says Mirin-Babazadeghan.

"The psychiatric training [program] has not adjusted to the shift of inpatient to outpatient training, and I think they have to include some standardized model of training in community psychiatry as a baseline, as a necessity. It's optional at this time," says Mirin-Babazadeghan.

The problem is that many doctors refer their patients to social workers and assume that the transition to the community will be completed by them. Mirin-Babazadeghan wants to see doctors more involved with the social workers. Doctors should help with outpatient treatment planning and make sure that patients are enrolled in the needed mental health services in their community.

For instance, he says, community services could be anything from an Alcoholics Anonymous group in Beverly Hills to a church in the inner city, but the connection needs to be made for the patient prior to leaving the hospital.