As we shift from treating disease and toward supporting health, medication is merely one possible intervention in a spectrum of possible ones.
By leveraging the value of physiological assessment, we move closer to the promise of a psychiatry grounded in pathophysiology. The benefits that accrue in the practice of integrative child, adolescent, and adult psychiatry are both professional and personal. View the slides in PDF format. Related content: Integrating Biomedicine and Asian Medicine: Challenges and Opportunities.
Fact: Integrative psychiatrists consider both symptom presentation and methods for prevention. This specialty helps psychiatrists search for barriers to health and factors that can support a return to health. Practitioners push deeper into the testing of metabolic, gut, and brain features, which seems more fitting, given our role as physicians. The explosion of findings in the realms of inflammation, microbiome, neuroplasticity, pediatric acute-onset neuropsychiatric syndrome/pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANS/PANDAS), population nutrition, and epigenetics augurs well as these key areas are targeted for more exploration.
Fact: A wide range of non-pharmacological tools support the notion that psychiatric care is more than medication dispensement. Health, healing, and mental health form the bedrock of integrative psychiatry. It is from this ground-level vantage that we can begin to see our treatments, our tools, our tasks, and our patients in a light that fosters healing rather than the absence of symptoms. Integrative medicine seeks first to do no harm. Above all else, we want to protect the mind, body, and spirit of our patients. With proper support and the alleviation of obstacles, the mind, body, or spirit can often heal itself. This is one of the obvious though often overlooked facts of health, especially in the territory of the brain-that care comes best as a support mechanism, not an intervention.
Fact: Integrative psychiatry is not anti-medication. By shifting the treatment model away from treating disease and toward supporting health, it understands medication as merely one possible intervention in a spectrum of possible interventions. This means every intervention must be evaluated according to an assessment of health vs illness and safety vs effectiveness. And all too often medications cause some damage in the search for long-term health.
Fact: Assessment explores the mind, body, and spirit of each patient. Some believe that no single tool possesses more power to transform our genetic expression than diet and nutrition. For example, our brains are made up of the molecules we ingest, yet you will not find a mention of diet, food, or nutrition in any psychiatric textbook. Integrative medicine prefers-or is willing to try-health-empowering interventions over the introduction of treatments that might increase dependency or offer only brief, symptomatic relief. For instance, an integrative psychiatrist might offer a patient struggling with anxiety meditation, yoga, or inositol, before benzodiazepines or SSRIs are discussed.
Fact: Patients and their families want options. The operative word is “options.” The work of integrative psychiatry offers a deeper and richer connection with each family member, as we listen, assess, and care, while working to foster health in growth and development. Integrative psychiatry embraces, at its core, this central clinical task. It is an effective complement for much of what we do now and a challenge to do better in the future.
Fact: The rewards are many-for the patient, as well as for the physician (eg, burnout prevention). The production-oriented, pharmaceutically driven delivery system in the US feels increasingly heartless; it is frustrating and unrewarding for many practitioners. The unfortunate truths have been most widely documented in adult patients, but the gaps in research and questions about treatment are most challenging among children, adolescents, and young adults, whose developing nervous systems have become a canary in a coal mine. Integrative psychiatry emerged and developed in direct response to some of these growing imbalances.
For more information, see The Premise, Practice, and Promise of Integrative Child and Adolescent Psychiatry by Scott Shannon, MD, on which this slideshow is based.
Editor's note: This article was originally published on April 7, 2017, and has since been updated.