Psychiatric Care for Adult Mental Health Patients
Mental illness in adults can present itself in a myriad of ways. There are several factors to consider such as age, gender, and social environment. Since the start of the pandemic, these challenges have compounded to create a situation where mental health care is more visible than ever. People are struggling with depression and anxiety caused by long periods of isolation. There are more acute cases than before the pandemic started. Those with chronic conditions have also suffered. To treat mental illnesses in adults, it’s important to understand what causes them.
Understanding Mental Illness
Mental illness is mainly caused by chemicals in the brain being out of balance. Certain medications such as antipsychotics, SSRIs, and mood stabilizers are meant to bring the brain back to a state of balance. However, not all illnesses require medication and not all patients will accept treatment with medication.
Dr. Nicolas Sikaczowski with Peace Behavioral Health says, “Treatment varies depending on severity, condition, location, access to specialist care. Most mental health conditions can benefit from both medication and evidence-based psychotherapy, though specific treatments should be tailored to the patient’s severity and desires.” Common mental health struggles include depression, anxiety, and bipolar disorder.
Depression can be acute or chronic. An example of an acute condition is postpartum depression while chronic depression generally lasts all of a patient’s life. People who struggle with it may feel a sense of numbness and/or deep sadness. They may also reject activities they used to enjoy. Depression is typically treated by a combination of SSRIs and therapy.
Anxiety is often comorbid with other conditions such as depression. Those who struggle with anxiety may suffer from debilitating worry and even panic attacks. Like depression, anxiety can be treated with medication and therapy.
People with bipolar may experience manic highs and depressive lows. There are two types of bipolar: type 1 and type 2. Bipolar 1 includes episodes of severe mania while bipolar 2 includes episodes of less severe hypomania. Those with untreated bipolar may feel like they’re on a rollercoaster.
Behaviors can be classified as low-level, mid-level, and high-level. Low-level behaviors include “avoiding appointments or late-cancellations, not following-through on recommendations, placing blame on others, and not allowing the therapist to talk or make suggestions,” says Dr. Kyle Zrenchik, PhD, ACS, LMFT, “Mid-level includes arguing with or undermining their therapist, bullying their spouse or child (if it is couples or family therapy), being unwilling to take accountability, allowing themselves to stay hopeless without trying the interventions suggested. Lastly, high-level behaviors include calling their therapist names or being verbally abusive, threatening behaviors, active and intentional manipulation.” If any of these behaviors are exhibited, therapists should work with clients to address them individually.
Fortunately, there is help. “Psychotherapy is generally a gradual process, it takes time to develop insight into current thoughts, feelings, and behaviors, and to decide on a course for change, additionally practicing these new thoughts and behaviors so they can be utilized when emotions are high can take some time,” says Dr. Sikaczowski, “I think setting expectations early and establishing a comfortable space for feedback from the patient is important. Providing proven, well studied, evidence-based treatments such as Cognitive Behavioral Therapy statistically improves outcomes.”
Challenges Faced by Providers
Adult care requires a multi-faceted approach. “Working with adults brings about its own set of challenges because the clients have experienced so much up to the point of treatment,” says Jessy Pucker, LMSW at Refresh Psychotherapy NYC. However, even if an illness is not recognized and treated during childhood, there is still hope for adults living with these conditions.
With the advent of COVID-19, several providers have faced numerous challenges such as having to rely solely on telehealth for patient appointments. “We rely on each other,” says Dr. Zrenchik, “It’s super important that all therapists have a good team around them, either in their clinic or in their professional circles. We need to be able to collaborate, vent, and feel validated with others.” Having strategies for managing stress are also an important part of the job.
In-patient care is sometimes necessary when outpatient care is ineffective. Mental health providers working in hospitals are struggling to manage clients. Many patients choose not to wear masks or stay socially distanced. However, health care workers still want to provide a safe environment for patients. Resolving these issues will take time.
Challenges for Patients
While providers incur a number of obstacles when it comes to providing client care, people living with mental health conditions also face certain obstacles. “It is challenging for many mental health patients today because many health care providers are only doing telehealth sessions right now due to the pandemic,” says Iris Waichler, Patient Advocate and author of Role Reversal, How to Take Care of Yourself and Your Aging Parents. These telehealth sessions can be beneficial for some patients.
Additionally, over the course of the pandemic, several clients struggling with mental illness have seen their conditions worsen due to isolation and a lack of in-person support. Some patients require face-to-face sessions in order to feel seen and heard. As the pandemic fades, it seems like telehealth is here to stay.
How to Find the Right Provider
Unlike children and adolescents, adults with mental health conditions must take their treatment into their own hands. This means being proactive by reaching out to providers that can fulfill their needs. When searching for the right provider, it’s important to ensure they have experience treating a person’s condition. For example, a veteran who suffers from PTSD would want to find a therapist specializing in that kind of care. It may be necessary to call and email around until the right provider is found.
Conclusion
People who struggle with mental illness have imbalanced chemicals in the brain. There are several challenges faced by patients and providers, especially amidst the pandemic. For patients, finding the right provider is a crucial step toward achieving the care they need. Psychiatric care should be comprehensive and accessible to all who need it.
