Psychiatry and Urban Anxieties

We appreciate The Times’ focus on psychiatry (Column One, “Window on Psyche of L.A.,” April 27). However, what was left unsaid may be more important than what was said.

Modern psychiatry is part of medicine, and has no relationship to “spiritual” therapies. While psychiatry brings a welcome humanistic viewpoint that emphasizes emotional as well as physical health, it is based on sound scientific principles. The specialty has been transformed by biochemical insights, sophisticated technologies and breakthrough drugs.

On the other hand, neither psychiatry nor medicine as a whole, has the answer for the malaise of suburbia, or the pervasive anxieties of our society. Valuable time and money are spent in physicians’ offices dealing with the effects of minor stress. A few dollars spent on stress reduction programs in our schools and workplaces could reduce these costs.

Unfortunately, there are plenty of serious mental health problems which do require the skilled attention of psychiatrists. What is very distressing is the drastic reduction of psychiatric benefits provided in the health insurance selected by many employers.

Finally, there is a terrible crisis in public mental health in California. In our community we have a large number of chronically mentally ill people. Some are dangerous to themselves or others. They desperately need psychiatric care, and in some cases, long-term hospitalization. Because of county and state budget shortfalls, little is available. They can be found congesting emergency rooms, jails and public shelters. The few psychiatrists who staff the County Department of Mental Health are overwhelmed. If the governor’s new proposal to funnel mental health funds to the county becomes law, we need to be sure that these funds are not used for other purposes.

DAVID CHERNOF, MD

President, L.A. County Medical Assn.