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The doctor is (not always) in

“I need to see the doctor right away!”

“Someone please call a doctor!”

“Is there a doctor in the house?”

I’m sure many of you have been on the giving end of these exclamations and I have certainly been on the receiving end of them more than once.

For many years, it was the conventional wisdom that if one was ill, one went to the doctor. Simple as that.

The doctor was the only person trained and possessed of the knowledge that could allow him (and of course, it was always a him at that time, though no more) to listen to your complaints, make a valid diagnosis and prescribe a life-saving treatment.

As I wa l ked past t he Vietnam, Korean War and World War II memorials in Washington, D.C., recently, it occurred to me that the great struggles of those conflicts were not entered into by individuals. Success was not for the most part gained, ground was not held and battles were not gloriously won by individuals who thought that they were the only ones who could save their buddies, much less their countries.

These conflicts were entered into, prosecuted and dealt with by teams of well trained people who worked together, had each others’ backs and complemented the skills of their compatriots with their own to form a highly specialized, effective team.

May is Mental Health Month.

At the Aiken-Barnwell Mental Health Center and in most mental health facilities around our country, teams of dedicated professionals work long hours and give of themselves to make sure that those with mental illnesses receive the excellent treatment they need and deserve.

These teams may or may not be lead by a physician. They consist of MDs, PhDs, nurse practitioners, physician assistants, nurses, care coordinators, administrative professionals, social workers, and other therapists who together make up a highly trained team of caring people with the best interest of their clients in mind.

When I asked about the titles and credentials of the many people I work with at our local MHC, I found that we had at least one of each of the following clinical staff members: MD, RN, advanced practice nurse (nurse practitioner), Master of Science in Psychology, licensed professional counselor supervisor, master addiction counselor, Master of Counseling and Psychology, Master’s level LPC, LMSW, LISW-CP and LPC.

Now, as I have written before, the client always defines the emergency. If someone is in need and feels that they need immediate assessment or treatment, this is taken at face value by the provider. That person often states quite explicitly, “I need to see the doctor today!” That is all well and good, but sometimes the doctor is not in or is otherwise engaged.

Does that make the perceived emergency any less important? Absolutely not. Does it still make timely assessment and intervention important? Absolutely yes!

Much as in the Vietnam conf lict, the Korean War or World War II, response by highly trained teams is important and in some severe cases may mean the difference between life and death. Melodramatic, you say? I think not. Make no mistake my friends, when it comes to the devastating effects of mental illness and substance abuse in this country today, we are indeed at war. We are fighting an enemy who is elusive, cunning and deadly. It will take all the knowledge, skill and determination we can muster to find him, engage him and eradicate him.

When it comes to responding to the needs of our clients, I am very proud to be serving in this conflict and to be engaged in these actions, with a fine group of people who are every bit as dedicated and knowledgable as I can ever hope to be. We know different things. We are trained in different ways and we have different skills. We complement each other and we make the response to mental illness in this area that much stronger by both our numbers and our collective will.

Together we assess, we diagnose, we plan, and we provide counseling, medications, family interventions, school based treatments, and referrals to other professionals who can provide services that we cannot.

The doctor may not always be in, but someone from the corps of mental health providers will be.

May is Mental Health Month. If you need help, find it without delay.

Gregory E. Smith, MD, serves as Chief of Psychiatric Services at Aiken Barnwell Mental Health Center. He has been practicing psychiatry for 30 years since he finished a residency in psychiatry at the Medical College of Georgia in Augusta.


Mind Matters

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