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Too Healthy to Treat?


In theory health insurance pays for treating illness, but when someone who cannot pay and falls short of diagnostic criteria in DSM or ICD asks you for help do you turn them away or “treat” them and fudge the diagnosis? Have you ever sought help from a psychiatrist or psychotherapist who said, “There’s nothing wrong with you; you don’t need help; go away.”?

DSM criteria at least seem almost bottomless, that is, they seem intended to include almost anyone who wants psychiatric help. But some people must be just mentally healthy and still want to change something about themselves.

Does it all depend on what treatment tools you have to offer? Might a psychoanalyst accept a patient turned away by a cognitive behavior therapist? Family psychotherapists may bill for treatment of an “identified patient,” but work with significant others who have no diagnosis.

Are the “worried well,” well, not really well?