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HCN TURNS 20
What’s Next in Behavioral Health
New Psychiatric Approaches Promise to Better Meet Growing Needs
By Barry Sarvet, M.D.
As a science-fiction fan, I would love to be able to travel in time to see into the future of psychiatry. But, of course,
the future isn’t really knowable and depends in large part on the choices we make. A more useful and realistic approach is for us to envision a pos- sible future based on our awareness of the most urgent needs in the field, and to assume linear progress from the current state of our scientific knowledge and discovery.
In my opinion, the two most compelling needs within the field of psychiatry are the need for more effective, safe, and reliable treatments for the subset of psychiatric patients who don’t respond optimally to current treatments, and the need to make psychiatric care more accessi- ble and equitable for everyone who suffers from mental-health conditions.
Depression is one of the most common psy- chiatric illnesses, affecting 7.1% of all adults and 13.3% of adolescents in the U.S. Severe depres- sion is a potentially deadly illness, and suicide is a leading cause of death in this country. Al-
though we already have a host of effective treat- ments for depression, between 10% and 30% of
depression is repetitive transcranial magnetic stimulation (rTMS). Available at Baystate, rTMS
“Ongoing advances in our understanding of the neurobiology of mental illnesses in recent years have led to a number of novel biological treatments for treatment-resistant depression and other psychiatric conditions.”
patients do not respond favorably to treatment. However, ongoing advances in our understand- ing of the neurobiology of mental illnesses in re- cent years have led to a number of novel biologi- cal treatments for treatment-resistant depression and other psychiatric conditions.
One recently developed treatment that has shown great promise with treatment-resistant
is a non-invasive procedure in which focused pulses of electromagnetic energy are applied to specific regions of the brain resulting in increas- es in blood flow and metabolic activity. rTMS belongs to a branch of psychiatric treatment referred to as psychiatric neuromodulation. We expect to see further development of this branch in coming years, particularly because of the en-
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