The numbers that boil behind F-699

Enticing title, no?

Here’s the skinny. According to data from Statista, approximately 39.89 million prescriptions for sertraline were written in the United States in 2022. Let’s call that 40 million just to make it easy. Math is not my strongest suit.

The research is pretty clear that exercise is a viable treatment option. It’s also clear that deep relationships like those formed in Interpersonal Psychotherapy is too. Let’s imagine that 20 million people chose exercise and relationship over medication.

“But what’s wrong with medication?” you protest. Maybe a lot. Older adults are vulnerable to idiosyncratic interactions among medications, which can make things look worse to everyone.

It’s got to be purchased (what if the price goes sky high?). Someone has to manage it. Who notices or really hears--when someone on medication doesn’t like it, or its effects? While there some people who must take meds, a lot of people take them because it’s easier and more convenient. It takes less time to be seen for med checks. There’s an efficiency that can work.

And remember: 40 million prescriptions for only one of many psychotropic meds and the number of prescriptions is rising every year.

Those 20 million people who (safely and slowly) come off sertraline (Zoloft) who choose therapy (and exercise)? the research is pretty clear that for most people, four sessions a month for the first few months is best. Can we just assume that to make the numbers easier?

For 20 million people, that’s 80 million sessions.

Clinicians become clinicians after about ten years of school, supervision, and the licensure process. Each clinician can see maybe 20 clients a week and keep the paperwork caught up. Burnout is high and there are multiple factors driving turnover. And, many professionals only stay in the field 7-8 years.

One drug. 80 million sessions a month. 20 clients per clinician per week. Do the math.

If you need treatment plans for every resident with an issue for which psychotherapy is indicated, and they are able to participate? Good luck finding a clinician. Good luck with the waiting and the “easy” answer of polypharmacy.

The gap will never close. Now what? Keep digging the same hole?

More next week. Of course, if you just can’t wait to read what’s next, call me. My calendar is at https://elizabethpower.com/calendar. I’d love to have virtual coffee with you.