The Q&A below is transcribed from a phone interview with Dr. James Sullivan, senior vice president and chief medical officer at Butler Hospital, for Honest Conversations.
Why did you choose to practice psychiatry?
I believe in the work we do so passionately. There’s still so much good work that we can do every day. Even with the most tragic set of symptoms that are in front of us in psychiatry, we just don’t give up.
What would you like people to know about mental illness?
This is a science, this is medicine and we need to let people know this is something that can be categorized as sickness, it can be treated with medication and therapy and that people can get better. I think the greatest tragedy is when people don’t get help.
What role do you believe stigma plays in psychiatry?
I think it’s hard to have a conversation about psychiatry without mentioning the word stigma because, unfortunately, it is a barrier that patients face, and in turn, we as clinicians face that as well. Sometimes it’s getting patients and families out there to really understand the benefits of treatment.
I think stigma has to do with lack of education. It’s like prejudice. With prejudice, you don’t understand the other person’s point of view but judgement lives in a whole other ugly place and I think there’s tremendous judgement about people who suffer from brain and behavioral disorders. Unfortunately, until you know someone who has any sort of experience with it themselves or in their family, only then do they really stand up and say, “Oh my goodness, this really is a tragedy.”
So, it’s both the stigma and the judgement. We have to let patients know that they’ll be treated in a way where there is no judgement whatsoever. It’s even the language that patients use. They’ll say, “I have cancer,” or “I have diabetes,” but the difference in terms of the grammar here is that when it comes to mental illness, they say, “I am depressed” and “I am anxious” and “I am psychotic.”
Why is stigma so harmful?
When it comes to the illnesses that we deal with, the challenge is so tremendous because people buy into the fact that it’s not an illness – it’s them, they’re broken. We hear, “I’m not worthy,” and “I don’t need to be in front of you because I’m not important enough.” I think the judgement factor is really key because often by the time people come to us with symptoms, they have been judged many, many times and I think judged by themselves as well. So, it’s a huge lift for them to start to trust and communicate in words that describe what needs to be remedied.
What can be done to combat stigma?
I think one of the most important things we can do is build relationships. That’s always key in my mind. You know you can throw pamphlets and webinars and educational programs at people, but I think we have to build relationships so doctors feel comfortable calling and saying, “Hey, let me run this case by you. I have this individual and I’m thinking they need to see you, what do you think?” Just as I would pick up the phone and call a cardiology colleague to ask about one of my patients.
What else would you like other medical professionals to know?
The truth is that many of our colleagues in medicine do not know what we do at Butler Hospital. They don’t know that we have a full medicine service here, that we have internal medicine doctors who treat the physical aspects of someone’s health. It’s not just from the head up treatment. We treat the whole patient and we treat adolescents through geriatrics.
What’s next for psychiatric medicine?
Here at Butler in the last 10 years, we’ve been developing more of our partial hospital programs, allowing patients to come in and then return home where they can find some comfort. Or, if they return home and find triggers, they can come in and talk to us about it.
We’ve also moved beyond the bricks and mortar of the traditional hospital here at Butler to really understand that people aren’t always going to come to us – we have to go to them. So, we work in affiliation with community partners like The Providence Center to build programs that increase access for patients in the community.
We have an ambulatory detox program for people who are struggling with addiction so they don’t have to be admitted overnight. The can come in during part of the day and get the treatment they need to return to their life and return to work.
What disparities exist between mental illness and other medical conditions?
We all know that anyone of us could be stricken by cancer. We just know that, right? But, I don’t think all of us know that we can be stricken with a brain and behavioral or addiction disorder. We’re not there yet, and I think somehow we have to get people thinking about a different way to take care of themselves and to get more screening tools that are quick and easy.
Symptoms of emotional troubles, emotional disturbance are treatable and they can stand right alongside any other illness in terms of their worthiness to have attention on them, and we need to get people to understand that. They don’t need to suffer needlessly with the pain of emotional and mental illness and addiction.
Butler Hospital’s Programs and Services
Butler Hospital is Rhode Island’s psychiatric hospital focused on treatments, teaching and research for behavioral health. Learn about our inpatient, outpatient and partial hospital programs.View Our Programs