Genesis of 360 Mental Health Services

As an adult, child, and adolescent psychiatrist I evaluate and treat patients of all ages with serious (and sometimes not so serious) mental health problems on a daily basis.  Many of these patients have previously suffered serious consequences following a misdiagnosis, such as being prescribed the wrong type of medication or receiving improper psychotherapy.  Since I am also a forensic psychiatrist, I am often the person called upon by the Court to explain how a diagnosis was missed or a treatment plan failed.  Such failures range from adverse drug reactions to tragedies such as preventable suicides or even homicides.

During my forensics training at the University of Rochester, New York I learned the value of spending many hours devoted to a single forensic evaluation. I have since adopted this method not only in forensic cases, but in evaluating and treating my patients as well.  I understand that your loved one is important to you.  Unfortunately, I often see patients who have failed to make progress during treatment despite seeing numerous mental health specialists.  I have found that a lack of treatment progress usually boils down to a single common denominator:  a misdiagnosis.

According to reputable publications, 50% of patients currently being treated for a mental illness do not in fact have one (click here for more information on this).  So why are so many patients misdiagnosed?  In my opinion, there are many reasons, each including the word failure.  Here are some of the more common reasons I have seen in my practice:

Failure to…

-Thoroughly review previous medical and psychiatric records

-Perform an adequate interview with the patient and family members

-Gather collateral information from other sources such as teachers, friends or acquaintances

-Order the appropriate medical tests, including blood work or brain scans

-Obtain the proper psychometric or psychological tests

-Consult with other mental health or medical professionals when something just doesn’t add up

-Take the time to put the pieces together to arrive at the correct diagnosis

A 360-degree approach minimizes these errors.  No diagnostic system is perfect, and even with a systematic and thorough approach a misdiagnosis is still possible.  Earlier, I cited publications that 50% of all patients treated for psychiatric diagnoses do not actually have one.  If other mental health clinicians followed my thorough 360-degree approach, I believe this 50% misdiagnosis statistic would be dramatically reduced.

So why don’t more clinicians utilize a thorough 360-degree approach?  If I had to make an educated guess, it would be that “time is money!”  It literally takes hours to review all of the relevant medical records, complete a thorough interview of the patient and other related individuals, order and interpret medical tests, and obtain psychometric or psychological testing.  In my experience, insurance companies do not routinely reimburse doctors or other professionals for all of this work the insurance company deems "medically unnecessary". At 360 Mental Health Services, we do not allow insurance companies or managed care organizations to define what is or is not "medical necessity". Rather, we tailor each evaluation to best suit you or your loved one's needs. The critical, unmet need of providing such evaluation is what led to the genesis of 360 Mental Health Services, and I firmly believe this approach is going to benefit those who seek out our services.

--Dr. Tim