What it Means to Receive Psychiatric Treatment
Several acquaintances of mine who are undergoing psychiatric treatment all say the same thing: “I take the medicine, but in the end, I’m the one who has to do the actual improving alone.” This isn’t just an emotional grievance; it is the lived reality of those who have attended clinics for a long time. No one deceived them; it is simply how the system is designed. The average psychiatric outpatient appointment lasts about ten minutes. In that time, the patient reports their status, the doctor asks a few questions, and adjusts the medication. That is all. Counseling must be booked separately, and since it is often not covered by insurance, the cost is substantial. Consequently, most patients return home with nothing but a prescription, left to regulate themselves as they survive.
Who is the Healer?
In this structure, I am forced to ask: Is the psychiatrist truly the “healer”? In reality, those who induce emotional change through intervention and help reconstruct life conditions are different people entirely—psychological counselors, behavioral therapists, and sometimes the people nearby who remain by one’s side for a long time. Nevertheless, the authority for diagnosis, hospitalization decisions, prescriptions, and official records lies solely with the psychiatrist. They monopolize the title of “healer” while performing only the role of a judge, not a practitioner of care.
The Asymmetry of the Structure
Psychiatrists often say they “help the patient recover,” but the process of recovery is left almost entirely to the patient. True intervention is delegated to other professions, while the doctor remains a systematic decision-maker. An even greater problem is that responsibility for these decisions is ambiguous. Even if a grave outcome occurs, such as a misdiagnosis or suicide, it is rare for a doctor to bear practical responsibility. The responsibility is blurred, while the authority is crystal clear.
A Proposal: Redefine the Roles
My most simple and rational proposal is this: leave the diagnosis to the doctors and the treatment to the healers. While psychiatrists should continue to classify illnesses and make legal or administrative judgments, the core of therapeutic intervention should be delegated to those who actually aid recovery, such as psychological counselors and behavioral therapists. The system must be overhauled so these practitioners receive fair compensation within the insurance framework, ensuring that from the moment a patient enters a clinic, counseling and life-based interventions are provided alongside medication.
Why Does This Structure Not Change?
The problem is neither technology nor the design of the system. The core issue is vested interests. Compared to other departments, psychiatry has maintained high profitability through a relatively non-interventional structure. One can handle many patients in a short time, and because drug therapy is standardized, the risk is low. It is a structure that has successfully maintained diagnostic authority and prestige while offloading the actual substance of “treatment” to external parties. The likelihood of the medical community voluntarily giving up this structure is low. However, the logic of the market is cold. Outdated methods are eventually weeded out, and medicine is no exception. If they wish to remain “healers,” they must accept the labor and responsibility of healing. Otherwise, it is only right that they remain “diagnosticians.”
Shifting Toward a Recovery-Centered Structure
The goal of mental health is not a prescription for a diagnosis, but the recovery of a life. That recovery is not achieved simply through taking medicine or receiving a medical certificate. The psychiatric system must be reorganized to be far more intervention-centered, relationship-centered, and patient-centered than it is now. Diagnosis is still important, but it is merely the starting point, not the destination. If psychiatry wishes to function as true medicine, it must no longer treat the title of “healer” as a mere nameplate. If one is a healer, one must naturally endure the labor of healing. If not, that name should be laid down.
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