Attorney and mental health reform advocate Ellen Lubensky discussed the importance of informed consent and transparency in psychiatric medication prescriptions during a recent episode of the Health Policy Podcast.
Lubensky, who graduated from Stanford University and Rutgers Law School, said that both patients and healthcare providers need better education about the risks associated with psychiatric medications.
She said that most psychiatrists are given only 15-minute appointments to medicate patients, which she believes is insufficient for discussing the risks and benefits of treatment. "Most doctors, most psychiatrists are given 15-minute appointments in which to medicate people. This is not enough time to discuss the risks and benefits of treatment," she said. She also attributed this issue to pharmaceutical industry influence, stating, "I firmly believe that this is because of big pharma. Doctors should have transparency when they're prescribing medications."
Drawing from her own experiences with psychiatric medications, Lubensky explained that she was not adequately informed about potential risks before starting treatment. "I did not have a sit down with my psychiatrist telling me what the risks would be. If I had known about the risks, I would never have ingested them in the first place," she said.
Lubensky defined informed consent as ensuring patients understand both the risks and possible outcomes of their treatment.
"Informed consent means telling you the risks, telling you what may happen if you ingest psychiatric medications,” she said. “Doctors have a duty to speak openly about whether the 'may' will happen to you."
She encouraged patients to advocate for themselves by asking questions during appointments and seeking other providers if their concerns are not addressed.
"If your psychiatrist does not give you the time to ask questions, then you should find another psychiatrist," she advised.
She also addressed rising mental health spending in light of Medicaid expansion but expressed concern that increased funding has not necessarily improved patient outcomes.
"This is almost a hundred percent preventable with information,” Lubensky said. “Doctors need to speak openly about these issues."
Lubensky advocated for therapy as a first line of treatment before considering medication.
"Medications should never be the first resort."
She called for more funding so psychiatrists can spend more time with each patient.
Regarding mental health parity regulations, Lubensky noted progress but highlighted ongoing disparities between coverage for mental versus physical health conditions.
"There should be no differentiation between people who are struggling with mental health issues and physical issues," she said.
Lubensky concluded by urging listeners to seek information about their treatments and not feel ashamed about addressing mental health issues.
"You can ask questions. If somebody does not have time to ask questions, you find somebody else... This is not something that you live in shame over. It is not something that should be disguised."
