The Price of Doing Nothing

Written by craig

 A couple of days ago I sent off a rather radical suggestion to the president of our corporation . . . one that, if followed, could get me laid off. 

In a nutshell, I made an argument to fold our mental health clinic under the larger medical clinic. The savings would immediately be a half-million dollars a year, and the same services could be provided with less than half the staff. From a business perspective it made perfect sense, and the only significant downside (not one usually a show-stopper for administration) would be the laying off of most of the psychotherapists and half of the prescribers. 

So, why knowingly make a suggestion that would put my job and those of some of my closest friends at risk? I mean, if were to do nothing, just ignoring the recent changes in regulations that made my suggestion possible, what would be the harm? 

Well, putting services under the regular clinic would mean that people struggling with depression wouldn't have to go over to a separate building, get admitted, get diagnosed and labelled, and then get trapped in the system with no easy exit. You see, public mental health clinics in my state are kind of like roach motels: people check in but they can't check out. 

Let me explain. If our mental health clinic does what it is supposed to do (and it will almost every time), the people get stable on medication and the psychotherapy helps them through the rough parts. One would think that it would be a matter of simply getting with the patient's doctor and having her/him pick up the task of writing any continuing prescriptions.

Wrong! It just doesn't happen. Eighty percent of the prescriptions written in the US for antidepressants are written by the primary care physicians, but when you start at a mental health clinic, you stay in a mental health clinic.

So, people who want to avoid the stigma will stay away from the clinic all together to keep from being forever labelled as crazy, and . . . well, they come up with other alternatives, like suicide.

That, my friend, is the cost of doing nothing.