Tom Cloyd 
Member since May 7, 2014


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Re: “Far and Away: Idaho is Rural and Underfunded, with a High Incidence of Mental Illness.

A remarkably thorough and detailed article. As someone who's practiced for years in rural areas, I recognize all the problems it outlines. It's good to see that real efforts are being made to improve the situation.

However, there is glaring problem revealed in the article which is not identified as such: the emphasis on providing access to psychiatrists is about medication, not psychotherapy.
Few psychiatrists do psychotherapy anymore, and in any case they are by far the most expensive providers of such services when they do. What psychiatry is about these days is medication, and almost nothing else.

Then, the described exclusion of Masters level professionals from Medicare reimbursement is a huge mistake. There absolutely NO evidence-based consensus that PhDs provide better service than people with Masters degrees. None. Zip.

In fact, a recent multidisciplinary assessment of treatment models for PTSD, done in Australia by a team of clinical, research, and academic professionals, concluded that there is no basis at all for recommending one sort of psychotherapy provider over another.

So, good new, bad news. We need to keep working on this very real problem.

Tom Cloyd, MS MA (LMHC, WA State)

16 likes, 0 dislikes
Posted by Tom Cloyd on 05/07/2014 at 8:59 AM

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