I have practiced community mental health in Fayetteville, NC for 12 years and have observed every point Dr. Nasrallah made in “A skeptical view of ‘progress’ in psychiatry” (From the Editor, Current Psychiatry, June 2011, p. 18-19). As psychiatrists, we share a great deal of the blame. We handed over leadership of community mental health centers to social workers and allowed ourselves to be “carved out” of community hospitals. State hospitals are dysfunctional at best.
Dr. Nasrallah is correct in asking who is the “genius” behind these decisions. Many new psychiatric practices are based on family practice models of herding 60 to 80 patients per day. I’m not sure I will even recognize the practice of psychiatry in 10 to 20 years. Perhaps with obstinate rigor we can restore what we’ve lost.
Mark Chandler, MD
Medical Director
Cumberland County Mental Health Center
Fayetteville, NC