I read with great interest this special report on behavioral healthcare presented by Modern Healthcare magazine. When I started representing a large number of drug and alcohol treatment providers in Florida, I had to conduct my own independent “research” to endeavor to understand why this space, including behavioral healthcare generally, was regulated not by state departments of health, but overwhelmingly by social service agencies. It seems to harken back to the days of assigning blame of mental health disorders to personal responsibility, rather than understanding the medicalized nature of this part of the body. This is understandable, for we can autopsy a body and see with our own eyes the ailment or disease. To the contrary, we can open the human brain and it looks the same, diseased or not (excepting physical malignancies such as cancers, of course). Only through modern technologies can we truly map the human brain and be able to “see” the areas of depression or bipolar disorder, or traumas, and then begin to create similar modalities for treatment.
However, unlike fixing a broken arm, the “repair” of the human brain brings along significant medical ethics questions. Would Jeffrey continue to be “Jeffrey” if we were able to remove a long-standing depression and accompanying Substance Use Disorder? Would behavioral modification and counseling still be required? Can this occur in an outpatient setting, or are group homes for behavioral re-programming required? And will insurance pay for any of this until we have significant evidence-based outcomes to demonstrate it is not all “voodoo” science as many within the healthcare field itself quietly continue to believe that psychiatry, psychology, and addiction treatment is?
In any event, I thank and applaud Modern Healthcare for taking on this all-too-important subject, and am hopeful that this will only be the beginning of the push towards the modernization of this healthcare space. One day, I believe we will look back at the early 21st Century, our treatment of persons with behavioral health disorders, and equate it to an earlier time when we used leeches to treat all forms of medical maladies – archaic and un-informed.