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Over the last 30 years, the psychiatric profession has made progress in integrating the best of the traditional “medical model” of care with an evolving “recovery model” considering the individual’s holistic needs and their goals. The combination offers patients the best chance at the most favorable outcomes.
This is a sharp contrast to the era in which I grew up. At that time, societal norms led to the topic of mental illness being swept under the carpet, which I experienced in my own family.
My dad was a fun, charismatic, loving and generous man who had bipolar disorder. Back in the day, no one talked about his obvious problems and erratic behaviors, which I later learned were classic symptoms of mania with psychosis. When my dad was away for months in the state hospital, no one brought flowers or casseroles. We didn’t speak of it, even inside in my family. We were alone.
I decided to become a psychiatrist to find answers to my questions about my dad and his illness—to help him, my family and other families. When I announced to my family I was applying to medical school, they were initially thrilled. However, they would have preferred I be a surgeon or a cardiologist, rather than go into psychiatry. For decades, Dad held out hope that I would change my specialty. He loved me deeply, but he didn’t want this path for me; it was just too close to his deepest source of shame.
In my psychiatry residency application essay, I wrote about my dad’s illness and my quest to help him. I was surprised that it wasn’t seen as a legitimate motivation for entering the profession and seemed to violate an unwritten rule. One person at a prestigious hospital told me my reason was a “terrible” one. An interest in neurobiology or behavioral change was then the norm. He told me it might have been acceptable if my father was a psychiatrist himself and not just a patient. Fortunately, we’re making progress in this area, with an increased recognition that integrating personal experiences with professional ones is another way to learn.
Many years into my journey as both a psychiatrist and caregiver, I encountered the National Alliance on Mental Illness. I am currently the chief medical officer, but I started 20 years ago as its medical director. Over the years, I’ve listened to countless people share their stories and noticed reoccurring patterns about patients caring and advocating for themselves, and the value of their problem-solving skills.
My work with NAMI has been the best part of my professional life. It’s given me the opportunity to help as many people as possible by combining my experience as a family member with my training as a psychiatrist. One of the biggest insights I’ve seen is the incredible growth of families accepting mental illness and learning to communicate in ways I could only have dreamed of as a boy. I’ve encountered wisdom from patients and their loved ones I didn’t have the chance to acquire during psychiatric residency.
NAMI values the peer as an expert, given their own mental health journey, and believes that sharing their stories can help others know they aren’t alone. Their stories poignantly convey that common and serious mental health conditions are something we need to talk about openly, and that medical professionals can problem-solve together with individuals and their loved ones.
NAMI Provider is a unique educational program for healthcare professionals and those in training, offering a collaborative, person-centered approach to engaging people with mental illness and family members in treatment. The Des Moines University College of Osteopathic Medicine has been our national champion to incorporate the program into the required curriculum for medical students. Based on their success, NAMI is focused on expanding the program’s academic reach for all healthcare providers. Our goal is to help providers recognize the importance of including their patients and families in all aspects of the treatment process to improve outcomes.
As we all know, there’s a critical shortage of mental health professionals right now. At the same time, individuals and their families are experts in this journey. We need to further integrate professional knowledge with the lived expertise of others to achieve the best outcomes for people living with mental health conditions.
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