Re: "Diagnosis: Human" — Letters that should have been in the new york times

To the editor:  

Ted Gup (Diagnosis: Human; 4/3/13) poignantly highlights the potentially fatal consequences of colluding with 'a system that devalues talk therapy'. Evidence abounds to support his view about therapy: A recent study found that 1.2% of the general U.S. population receives antidepressant medication despite displaying symptoms of only mild severity for which drugs are not indicated. Another study found that less than 11% of psychiatrists in the U.S. are providing psychotherapy. Furthermore, insurance companies continue to aggressively move to control costs by preferentially reimbursing and supporting drug therapy over talk therapy,   These trends have not evolved overnight and will take time and effort to reverse. Medication, when correctly prescribed, can be lifesaving for many individuals. Psychotherapy, while more labor intensive and costly in the short run, can also have profound and enduring therapeutic effects. Clearly we are living at a time where cost control is a major and legitimate consideration for the delivery of health care. Gup highlights the less conspicuous but heartbreaking cost of a system that devalues talk therapy.   

Respectfully,  

Larry S. Sandberg MD