INTERVIEW WITH
DR. RAHN BAILEY
Rahn K. Bailey, M. D. is the Assistant Dean of Clinical Education at Charles R. Drew University and Chief Medical Officer of Kedren Health Systems Inc. He received his medical degree from the University of Texas Medical Branch at Galveston. He served as the 113th President of the National Medical Association.
You have practiced psychiatry in a variety of regions in the nation. Are there commonalities that you can cite in the life experience of patients in the various geographic sectors that lead them to seek treatment?
Yes, I have found more similarities than dissimilarities in the practice of psychiatry. I have been in every region of the country. Went to college in Charlotte and Atlanta; trained in Connecticut; worked in Houston, Nashville, Louisiana, and now in Los Angeles.
People with mental illnesses usually get mistreated, even in places with adequate resources. Not all the rules work in the best interests of the patient. Challenges accumulate if patients are not managed well initially, because they end up in other sources of governmental support such as jail / prison, emergency rooms and hospital settings. We need to do a better job of providing mental health care early which will lead to better outcomes for persons with brain illnesses.
As a general rule, is there a pronounced difference in the issues and conditions that affect low income clients, middle class clients, and upper income clients that cause them to seek treatment? To what extent does culture play a role? Economics?
In general, if a person does not have resources, they are not able to acquire adequate healthcare. This is more profound in patients with psychiatric difficulties. For example, copays are expensive, higher lifetime caps, difficulties getting an initial visit. I have spent decades fighting this battle against states that seem to want patients to fail before they get the optimal treatment they need.
For example, if a patient needed an anti-psychotic medication, the state would not sponsor a newer form of the medication initially. When this treatment failed, only then could we prescribe the newer and more appropriate medicine based on empirical data. That is not done in any other area of medicine. All data in psychiatry indicate you want to manage an illness early and try to eliminate them until omission from the inception of care. So, we are disadvantaged and incur additional adversity managing brain illnesses whether they have full income or whether they’ re on limited income.
What are some of the variables that affect how you treat clients in a private practice setting versus in an institutional setting? How do elements such as stigma and family support factor as variables in each treatment setting?
Patients are treated the same. I was a chairman of two departments of a private hospital. I have also worked in the public sector setting. Currently, I run a County-funded innercity psychiatric hospital in Los Angeles here at Kedren. I do think that outside influences may certainly change. Some are governmentally funded either by Medicaid / Medicare, or privately funded with Aetna or Kaiser. Individuals might have additional barriers with private care.
Given the general community reaction to COVID-19, the social change initiatives such as Black Lives Matter, and the contentious political climate in DC, is there a burden on local healthcare leadership to maintain a sense of equilibrium and avoid widespread panic?
For all Americans, the challenges of civil unrest are real. Police brutality unfortunately is not a new issue, it has been around for a long time. It is worse in the African American community. Hopefully now we can have an active, open, and
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