FROM THE PRESIDENT
Gray and White Matter Matters
BY SETH M . BARNES , MD , FACP PRESIDENT , ARKANSAS MEDICAL SOCIETY
It happens in every office and hospital every day . No specialty is immune to matters of mental health . No doubt the recent social issues associated with the pandemic have brought a lot of these diagnoses to the forefront , but isolation and social interruptions have taken somewhat stable patients with mental health issues and caused dramatic exacerbations . I ’ ve been concerned with my own patients ’ loneliness and how this can destabilize otherwise stable medical conditions .
HERE ARE JUST A FEW EXAMPLES FROM RECENT CLINIC VISITS .
The elderly couple living alone with one spouse suffering from dementia . Medical concerns are addressed and that is usually straightforward , but what about the mental side of the case ? Safety concerns are a significant issue , not only for the patient , but for the caregiver . As we all know , the caregiver slowly becomes a live-in nurse and social worker quickly progressing to a 24 / 7 / 365 tour of duty . How exhausting for the caregiver . There are gero-psychiatric units available for inpatient treatment , but this is for extreme cases and offers no real help for the outpatient . What support is there for this situation ? Where do we turn for help ? How do we provide for both the patient and caregiver to treat both with kindness and dignity ? Are their affairs set up to provide for progressive disability for both of them ( powers of attorney , asset protection , etc )?
A young man with severe anxiety , with depression also playing a role . Medications are prescribed , but he still has significant issues with job performance , social engagements , family , and personal relationships . What other avenues of help are there for him ?
A nurse with emotional fatigue and burn out symptoms from many , many extra shifts and Covid 19 patients . Job performance is an issue . Where can we get her the best help ?
And what about us - the doctor ? Where do we turn when we have reached our limit with stress , anxiety , and possible burnout ? Most of us put up a facade and carry on but is this healthy ?
Obviously , many more questions than answers are here in these few examples , these issues are faced daily by physicians of all specialties .
I ’ ve been concerned with my own patient ’ s loneliness and
We need more investment in mental health . Much more needs to be done to help support these types of patients and their attending physicians . Once again legislation is the key . Without appropriate funding , programs cannot be put into place to improve mental health care . Our government is happy to invest in all sorts of things ; what about a call to invest in mental health ? For far too long , a stigma has been associated with mental health conditions . Shouldn ’ t the safety and welfare of the population be at the forefront of legislative efforts ?
This issue of the Journal hopefully will shed some light on these matters and provide some guidance as where we need to start . ■
how this can destabilize otherwise stable medical conditions .
The veteran suffering from PTSD . He ’ s trying to cope but now has resorted to heavy alcohol use and some illicit drug use . Where is the safety net for him ?
A new mom with severe postpartum depression who is taking care of a young child at home alone . Sure medications can be prescribed , but what else is there to support her and allow her to be the best mother she can be ?
36 THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY