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Meeting the Challenges of Mental Illness Through Integrative Mental Health Care

  • James H. Lake
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Abstract

Circumstances that have led to a crisis in mental health care in the USA and globally are discussed. Limited effectiveness, safety problems, and high costs of many psychotropic medications have resulted in an urgent mandate for safer, more effective, and more affordable treatments of mental illness. The conventional Western model of mental health care delivery is limited in its capacity to alleviate the root causes of mental illness because its theories and methods address only some of the complex causes of symptoms. Trends driving increasing acceptance of complementary and alternative medicine (CAM) by the general public, patients, and health care providers are reviewed. Western medicine is being influenced by increasing openness to non-Western healing traditions and growing demand for more personalized care. In industrialized world regions there is a trend toward eclectic training among mental health care providers many of whom use or recommend CAM modalities in their clinical practice. Individuals who report a mental health problem are significantly more likely to use CAM compared to the general population and individuals with more severe symptoms are more likely to combine Western medical treatments and CAM. Integrative mental health care incorporating validated CAM modalities into mainstream treatment is an emerging paradigm that more adequately addresses the complex causes of mental illness than current mainstream treatments and models of care while resulting in significant potential cost savings. By combining select conventional and CAM treatments on a case-by-case basis integrative mental health care offers more advantages compared to any particular conventional or CAM modality or any single system of medicine.

Keywords

Conventional mental health care CAM Integrative mental health care Clinical guidelines 

References

  1. Astin, J., Marie, A., Pelletier, K. I., Hansen, E., & Haskell, W. L. (1998). A review of the incorporation of complementary and alternative medicine by mainstream physicians. Archives of Internal Medicine, 158, 2303–2310.CrossRefGoogle Scholar
  2. Barbato, A. (1998). Schizophrenia and public health [Internet]. Geneva: Division of Mental Health and Prevention of Substance Abuse, World Health Organization.Google Scholar
  3. Barnes, P. M., Bloom, B., & Nahin, R. L. (2008, December 10). Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Reports, (12), 1–23.Google Scholar
  4. Beck, A., Crain, A. L., Solberg, L. I., Unützer, J., Glasgow, R. E., Maciosek, M. V., et al. (2011, July–August). Severity of depression and magnitude of productivity loss. Annals of Family Medicine, 9(4), 305–311.CrossRefGoogle Scholar
  5. Davis, M. A., & Weeks, W. B. (2012, September–October). The concentration of out-of-pocket expenditures on complementary and alternative medicine in the United States. Alternative Therapies in Health and Medicine, 18(5), 36–42.Google Scholar
  6. De Jonge, P., Wardenaar, K. J., Hoenders, H. R., Evans-Lacko, S., Kovess-Masfety, V., Aguilar-Gaxiola, S., et al. (2017, December). Complementary and alternative medicine contacts by persons with mental disorders in 25 countries: Results from the World Mental Health Surveys. Epidemiology and Psychiatric Sciences, 28, 1–16.Google Scholar
  7. Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., et al. (2004, June 2). WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590.Google Scholar
  8. Denys, D., & de Haan, L. (2008). [25 years antipsychotics: Back to the future?] [Article in Dutch]. Tijdschr Psychiatr, 50(Spec no.), 105–109.Google Scholar
  9. Depression: Fact sheet [Internet]. (2017). Geneva: World Health Organization; updated 2017 February.Google Scholar
  10. Eardley, S., Bishop, F., Prescott, P., Cardini, F., Brinkhaus, B., Santos-Rey, K., et al. (2012). A systematic literature review of complementary and alternative medicine prevalence in EU. Forschende Komplementärmedizin, 19(Suppl. 2), 18–28.PubMedGoogle Scholar
  11. Eisenberg, D., Davis, R., Ettner, S., Appel, S., Wilkey, S., Van Rompay, M., et al. (1998). Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. Journal of the American Medical Association, 280(18), 1569–1575.CrossRefGoogle Scholar
  12. Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., et al. (2010, January 6). Antidepressant drug effects and depression severity: A patient-level meta-analysis. JAMA, 303(1), 47–53.CrossRefGoogle Scholar
  13. Frank, R., Conti, R., & Goldman, H. (2005, June). Mental health policy and psychotropic drugs. Milbank Quarterly, 83(2), 271–298.Google Scholar
  14. Harris, P. E., Cooper, K. L., Relton, C., & Thomas, K. J. (2012, October). Prevalence of complementary and alternative medicine (CAM) use by the general population: A systematic review and update. International Journal of Clinical Practice, 66(10), 924–939.Google Scholar
  15. Hartling, L., Abu-Setta, A. M., Dursun, S., Mousavi, S. S., Pasichnyk, D., & Newton, A. S. (2012, October 2). Antipsychotics in adults with schizophrenia: Comparative effectiveness of first-generation versus second-generation medications: A systematic review and meta-analysis. Annals of Internal Medicine, 157(7), 498–511.Google Scholar
  16. Hawryluk, M. (2016, August 11). Supply of psychiatrists shrinks: Lack of doctors creates access problems in U.S., Oregon [Internet]. Bend, OR: The Bulletin.Google Scholar
  17. Henderson, D. C. (2008, February). Managing weight gain and metabolic issues in patients treated with atypical antipsychotics. The Journal of Clinical Psychiatry, 69(2), e04.CrossRefGoogle Scholar
  18. Herman, P. M., Craig, B. M., & Caspi, O. (2005, June 2). Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complementary and Alternative Medicine, 5, 11.Google Scholar
  19. Herman, P. M., Poindexter, B. L., Witt, C. M., & Eisenberg, D. M. (2012, September 3). Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations. BMJ Open, 2(5), e001046.Google Scholar
  20. Herrmann, N., Chau, S. A., Kircanski, I., & Lanctôt, K. L. (2011). Current and emerging drug treatment options for Alzheimer’s disease: A systematic review. Drugs, 71(15), 2031–2065.CrossRefGoogle Scholar
  21. Horrigan, B., Lewis, S., Abrams, D., & Pechura, C. (2012, February). Integrative medicine in America: How integrative medicine is being practiced in clinical centers across the United States. Tucson, AZ: The Bravewell Collaborative.Google Scholar
  22. John M. Eisenberg Center for Clinical Decisions and Communications Science. (2016, September 13). Nonpharmacological versus pharmacological treatment for patients with major depressive disorder: Current state of the evidence [Internet]. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  23. Kelley, J. (2010, March 2). Antidepressants: Do they “work” or don’t they? [Internet]. New York, NY: Scientific American.Google Scholar
  24. Kemper, K. J., Gardiner, P., & Birdee, G. S. (2013, November–December). Use of complementary and alternative medical therapies among youth with mental health concerns. Academic Pediatrics, 13(6), 540–545.Google Scholar
  25. Kessler, R. C. (2012, March). The costs of depression. The Psychiatric Clinics of North America, 35(1), 1–14.CrossRefGoogle Scholar
  26. Kessler, R., Soukup, J., Davis, R., Foster, D. F., Wilkey, S. A., Van Rompay, M. I., et al. (2001). The use of complementary and alternative therapies to treat anxiety and depression in the United States. American Journal of Psychiatry, 158, 289–294.CrossRefGoogle Scholar
  27. Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5(2), e45.CrossRefGoogle Scholar
  28. Kurtz, M., Nolan, R., & Rittinger, W. (2004). Primary care physicians’ attitudes and practices regarding complementary and alternative medicine. The Journal of the American Osteopathic Association, 103(12), 597–602.Google Scholar
  29. Laxman, K. E., Lovibond, K. S., & Hassan, M. K. (2008, November). Impact of bipolar disorder in employed populations. The American Journal of Managed Care, 14(11), 757–764.Google Scholar
  30. Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., et al. (2010, August). Poverty and common mental disorders in low and middle income countries: A systematic review. Social Science & Medicine, 71(3), 517–528.CrossRefGoogle Scholar
  31. Mathers, C., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), e442.CrossRefGoogle Scholar
  32. Mental Health Action Plan 2013–2020 [Internet]. (2013). Geneva, Switzerland: World Health Organization.Google Scholar
  33. Milden, S., & Stokols, D. (2004). Physicians’ attitudes and practices regarding complementary and alternative medicine. Behavioral Medicine, 30(2), 73–82.CrossRefGoogle Scholar
  34. Nguyen, T., & Davis, K. (2017). The state of mental health in America 2017 [Internet]. Alexandria, VA: Mental Health America.Google Scholar
  35. Pelletier, K. R., Herman, P. M., Metz, R. D., & Nelson, C. F. (2010, March–April). Health and medical economics applied to integrative medicine. Explore (NY), 6(2), 86–99.Google Scholar
  36. Pirotta, M., Kotsirilos, V., Brown, J., Adams, J., Morgan, T., & Williamson, M. (2010, December). Complementary medicine in general practice - a national survey of GP attitudes and knowledge. Australian Family Physician, 39(12), 946–950.Google Scholar
  37. Posadzki, P., Alotaibi, A., & Ernst, E. (2012, December). Prevalence of use of complementary and alternative medicine (CAM) by physicians in the UK: A systematic review of surveys. Clinical Medicine (London), 12(6), 505–512.Google Scholar
  38. Posadzki, P., Watson, L., Alotaibi, A., & Ernst, E., (2013, April). Prevalence of use of complementary and alternative medicine (CAM) by patients/consumers in the UK: Systematic review of surveys. Clinical Medicine (London), 13(2), 126–131.Google Scholar
  39. Purohit, M. P., Zafonte, R. D., Sherman, L. M., Davis, R. B., Giwerc, M. Y., Shenton, M. E., et al. (2015, July). Neuropsychiatric symptoms and expenditure on complementary and alternative medicine. The Journal of Clinical Psychiatry, 76(7), e870–e876.CrossRefGoogle Scholar
  40. Rhee, T. G., Evans, R. L., McAlpine, D. D., & Johnson, P. J. (2017, April). Racial/ethnic differences in the use of complementary and alternative medicine in US adults with moderate mental distress. Journal of Primary Care & Community Health, 8(2), 43–54.Google Scholar
  41. Shoaib, M., & Khaliq, M., (2017, June 27). Physicians’ attitude, belief and practice of complementary and alternative medicine use. Patient Prefer Adherence, 11, 1091–1092.Google Scholar
  42. Stafford, M. R., Mayo-Wilson, E., Loucas, C. E., James, A., Hollis, C., Birchwood, M., et al. (2015, February 11). Efficacy and safety of pharmacological and psychological interventions for the treatment of psychosis and schizophrenia in children, adolescents and young adults: A systematic review and meta-analysis. PLoS One, 10(2), e0117166.CrossRefGoogle Scholar
  43. Thase, M. E. (2007, December). STEP-BD and bipolar depression: What have we learned? Current Psychiatry Reports, 9(6), 497–503.CrossRefGoogle Scholar
  44. Tindle, H. A., Davis, R. B., Phillips, R. S., & Eisenberg, D. M. (2005). Trends in use of complementary and alternative medicine by U.S. Adults: 1997-2002. Alternative Therapies in Health and Medicine, 11(1), 42–49.PubMedGoogle Scholar
  45. Unützer, J., Katon, W., Callahan, C. M., Williams, J. W., Jr., Hunkeler, E., Harpole, L., et al. (2002, December 11). IMPACT Investigators. Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial. JAMA, 288(22), 2836–2845.Google Scholar
  46. Unutzer, J., Klap, R., Sturm, R., Young, A. S., Marmon, T., Shatkin, J., et al. (2000). Mental disorders and the use of alternative medicine: Results from a national survey. American Journal of Psychiatry, 157, 1851–1857.CrossRefGoogle Scholar
  47. Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., et al. (2009). Expert Consensus Panel on Adherence Problems in Serious and Persistent Mental Illness. The expert consensus guideline series: Adherence problems in patients with serious and persistent mental illness. Journal of Clinical Psychiatry, 70(Suppl 4), 1–46.PubMedGoogle Scholar
  48. von Ammon, K., Frei-Erb, M., Cardini, F., Daig, U., Dragan, S., Hegyi, G., et al. (2012). Complementary and alternative medicine provision in Europe—First results approaching reality in an unclear field of practices. Forschende Komplementärmedizin, 19(Suppl 2), 37–43.CrossRefGoogle Scholar
  49. Walsh, R., & Vaughan, F. (Eds.). (1993). The quest for wholeness: Transpersonal therapies (section 7) in: Paths beyond ego: The transpersonal vision. New York, NY: Jeremy P. Tarcher/Putnam.Google Scholar
  50. Wilber, K. (2000). Integral psychology: Consciousness, spirit, psychology, therapy. Boston, MA: Shambhala Publications.Google Scholar
  51. Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., et al. (2011, September). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(9), 655–679.CrossRefGoogle Scholar
  52. Wright, J., & Potter, P. (2003). Psyche and Soma: Physicians and metaphysicians on the mind-body problem from antiquity to enlightenment. Oxford: Clarendon Press.Google Scholar
  53. Wu, P., Fuller, C., Liu, X., Lee, H. C., Fan, B., Hoven, C. W., et al. (2007, March). Use of complementary and alternative medicine among women with depression: Results of a national survey Psychiatric Services, 58(3), 349–56.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • James H. Lake
    • 1
  1. 1.Center for Integrative MedicineUniversity of Arizona College of MedicineTucsonUSA

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