Psychiatric Care in Ineffective

At least when we are talking about depressed acutely suicidal patients. We know that the method of committing someone to an inpatient facility, setting an arbitrary length of stay, and starting the standard medications does not work.

We do have some evidencebased methods, but they are currently not used or used infrequently.

We are talking about eskatamine Spravoto and ECT. Eskatmaine was approved in 2020 for MDD with acute suicidal ideation or behavior. Why isn’t it used. I’ve asked the same question on my unit, and it seems that there is no payment structure in place for delivering the treatment on an inpatient basis. We are withholding a potentially lifesaving treatment because of money.

ECT on the other had is sometimes done and I do many of those treatments myself. However, most patients who would benefit are not interested. Stigma and barriers such as transportation prevent people for trying this life saving treatment.

We do have treatments that work and we are clearly not doing them but for two very different reasons.