Mind and Body: When All You Have Is a Hammer, Everything Looks Like a Nail

Posted by Dr. El - May 3, 2011 - Personal Reflections - 5 Comments

When I worked in the psychiatric hospital, the focus of treatment was on the mental health of the patients.  Physical complaints were usually thought of as an expression of mental illness and not reflective of an actual medical problem.  We once sent a patient down to the tiny sub-basement medical clinic after she injured her left hand.  The report came back with a thorough examination of her right hand, which was missing fingers after a self-inflicted gunshot wound ten years prior.  Her left hand was still throbbing.

In nursing homes, I find the opposite situation.  The focus is on medical care, and mental health concerns are “in the sub-basement,” so to speak.  This is despite the intensely stressful experience of nursing home admission, as I’ve written about before: The Stress of Nursing Home Admission.

In her April 30, 2011 New York Times article, Jane Gross, founder of the NYT blog New Old Age, discusses the lack of mental health care in nursing homes.  In Doctor Focuses on the Minds of Elderly, she reports on the work of psychiatrist Dr. Mark E. Agronin, my guest blogger last month.  My favorite quote of the article, which is well worth the read:

Why, Mrs. Sachs asked, “do they send buses of psychologists to a high school every time there’s a tragedy,” but here, where death is constant, “there’s only a brief memorial service and cookies?”