A Psychiatrists’s Lens into Mental Health Disorders and Substance Abuse

“I think psychiatry is much more diverse than people understand. They think it is rich people going to see a therapist for years, when it is really more diverse than that—inpatient, outpatient, community psychiatry—it is not all just private practice.”

Psychiatry is “ the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders” (“What is Psychiatry?”) 

Dr. Dan Medeiros is a psychiatrist based in New York, where he has spent his life working with adolescents who faced anxiety, depression, ADHD, and eating disorders, among other traumas and difficulties. After completing four years of medical school, five years of residency, and passing Medical Boards, a test that measures a doctor’s ability to provide care in a medical specialty, (“How Can I…”), Dr. Medeiros was able to begin practicing medicine. 

Upon completing residency training in New York City, Dr. Mederios began working in a hospital in Newington Connecticut, in which he ran an inpatient child psychiatry unit. He was responsible for admitting children, between ages five to thirteen, doing psychiatric evaluations, prescribing medication, and running community meetings that discussed the activities and issues of the previous day. The children primarily dealt with problems involving depression, anxiety, behavior disorders, post traumatic stress disorder, and psychosis.

Three years later, after moving back to New York City, Dr. Mederios began working at St. Luke’s Roosevelt Hospital, where he ran the outpatient clinic and soon began treating adolescents who spent the day receiving schooling mixed with therapy for their substance abuse issues. Dr. Mederios’s work with this program led him to become certified in Addiction Psychiatry, in addition to his certification in General Psychiatry and Child Psychiatry. 

Transitioning to the Mount Sinai Adolescent Health Center, Dr. Mederios oversaw four mental health teams—a primary care team, an eating disorder team, a team for children with HIV or who had family with HIV, and a traditional mental health team. 

Since the health center was a medical clinic, Dr. Mederios saw adolescents (ages fourteen to twenty-one) who wouldn’t normally attend a mental health center. There were children who were transgender and sought to transition—the center provided hormones to such adolescents so they did not obtain dangerous street hormones—as well as children with eating disorders. Dr. Mederios helped the adolescents before their disorders became advanced, such as anorexia nervosa (unwilling to eat food) or bulimia (uncontrollable eating, followed by purging). In addition to facing such mental health issues, many of these children also “live in poverty, dangerous neighborhoods, and experience violence, among other difficulties,” and are predominantly from underserved black or latino communities.

Returning back to St. Luke’s Roosevelt, Dan worked with adolescents who were extremely anxious and often skipped school to take drugs. He described that “the hardest part for me was when I was doing a lot of psychiatric evaluation…almost every girl…had some history of sexual abuse, assault, rape, etc. That was probably the time where things were getting emotionally overwhelming. When you hear these things so often, you have to find a way of resolving them yourself.” 

While Dan worked at the Comprehensive Adolescent Rehabilitation and Education Service (CARES), he constantly saw children who faced traumatic issues. He said, “you are a witness for them…just being there and being able to listen..” However he pointed to the importance of not becoming too analytical as “you can lose the ability to see the whole child…if you just focus on the problems, you are missing the entire kid.” The children had talents, such as singing, dancing, and creating artwork—they just wanted to be normal and live without their problems. 

Yet despite working to alleviate children and adolescents of their disorders and issues, Dr. Mederios explained that psychiatry is often seen as “the step-child of medicine,” and is often undervalued. It would greatly benefit patients if it were better integrated into primary care. For the future of psychiatry, Dan sees the need for increased training of psychiatrists in substance abuse issues, as addiction becomes more prominent in today’s world. According to the National Survey on Drug Use and Health, in 2017, 19.7 million Americans aged 12 and older fought a substance abuse disorder. The survey also found that about 992,000 or 1 in 25 teens, aged 12 to 17, dealt with a substance abuse disorder (Scot, Thomas). 

Psychiatry is vital in aiding those, not only with addiction, but also with mental health difficulties and illnesses. Hopefully, more people, like Dan, will see the value of psychiatry and utilize their skills to help treat today’s youth.

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