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couraging observations of clinical effectiveness and safety of this type of treatment for patients whose conditions have not responded to conventional medications.
Other biological psychiatry ad- vancements on the horizon include the development of medications targeting receptors for neurotrans- mitter systems (such as glutamate and NMDA) which have recently been implicated in the patho- physiology of depression and other psychiatric illnesses. We are also seeing a renaissance of research ac- tivity studying the use of so-called psychedelic drugs in combination with talk therapy to induce states of consciousness in which patients
“Currently, a majority of patients with mental illness do not receive any treatment at all, and for many more, treatment is delayed.”
may find it easier to change well- worn patterns of thinking associ- ated with psychiatric illnesses such as PTSD, anxiety, and depression.
Lastly, on the biological front, advances in the understanding of genetic variability in metabolism and responsiveness of the nervous system to psychiatric medications promise to usher in an era of per- sonalized medicine in psychiatry, allowing psychiatric clinicians
to select effective and tolerable medication treatments for patients without having to go through a trial-and-error process.
Even more important than advances in biological psychiatry
is the need for progress in making psychiatric treatment more ac- cessible to everyone who needs it. Currently, a majority of patients with mental illness do not receive any treatment at all, and for many more, treatment is delayed. In
fact, many patients with untreated mental illness, disproportionately persons of color, end up in the criminal-justice system because of a lack of access to care.
In recent years, we have seen steady reduction in stigma sur-
rounding mental illness and increased acknowledgment of the importance of mental health across society. Baystate’s recently an- nounced plan for the development of a new, state-of-the-art psychiat- ric hospital facility for our region reflects the growing recognition of the importance of improving access to behavioral healthcare.
This new facility is just one com- ponent of a comprehensive strategy which needs to be executed in part-
nership with the whole community to improve access to all levels of mental healthcare and address persistent racial and socioeconomic disparities in access to care. Some of the components of this strategy includes work we have been doing at Baystate to embed mental-health services into our primary-care ser- vices. In addition, our development of new training programs for psy- chiatrists and child and adolescent psychiatrists have established a
pipeline for enhancing the psychi- atric workforce in our region.
We also will see continued use and improvement in telehealth models of psychiatric practice, which, of course, have dramatically grown in response to the pandemic, and have proven to be an impor- tant tool in reducing geographic barriers to access to care. v
Dr. Barry Sarvet chairs the Department of Psychiatry at Baystate Health.
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