In a widely-emailed article about depression, Judith Warner, a former columnist at the New York Times, writes:
This is the big picture of mental health care in America: not perfectly healthy people popping pills for no reason, but people with real illnesses lacking access to care; facing barriers like ignorance, stigma and high prices; or finding care that is ineffective.
When Atul Gawande fails to mention prevention in a discussion of how to improve American health care . . . well, he’s a surgeon. Of course he has gatekeeper syndrome. What’s Judith Warner’s excuse? Judging from this article, the notion that depression might be prevented has not occurred to her.
Judith Warner refers to a study which purportedly demonstrates that antidepressants work for severely depressed patients. I haven’t seen the study, but I have my doubts about that conclusion. Based on the evidence I’ve seen, I don’t think the drugs work for anyone (that is, they don’t work any better than a placebo). See, for example:
https://www.spring.org.uk/2008/02/new-study-ssri-antidepressants-dont.php
For anyone who has an interest in psychopharmacology, I recommend a book called, Blaming the Brain: The Truth About Drugs and Mental Health by Elliot Valenstein:
https://www.amazon.com/Blaming-Brain-Truth-Mental-Health/dp/0743237870/
Valenstein is respected neuroscientist based at the University of Michigan (actually, he may be retired now). In this book, he debunks the fashionable but simplistic “chemical imbalance” theories that are so popular these days, especially among psychiatrists and pharmaceutical companies.
(And, no, neither I nor Valenstein are Scientologists.)
I was glad that she noted the lack of quality psychotherapy, rather than arguing for more prescriptions:
“In 2008, a team of psychologists brought this point home in blunt terms in the journal Psychological Science in the Public Interest. “Despite the availability of highly effective interventions,” they wrote, “relatively few psychologists learn or practice these interventions.”
I think it is worth reporting both the lack of efficacy of psychopharmaceuticals for much of what they are prescribed for, as well as the need for higher quality psychotherapeutic interventions.