The Marriage of Mental Health and Medicine: Practice Success

by Barbara L. Kersey, Ph.D. 

The year was 1986. I had earned a Ph.D. in Marriage and Family Therapy in 1984 and was in my first post-graduate position, “in the trenches” of a local mental health agency. I was ready for a change, having become rundown and somewhat disheartened about the difficulties of agency work. I received a call from Jon Crockford, an OB/GYN physician, asking if I would be interested in coming to work in a medical setting.  I was more than interested and couldn’t wait to talk with him.

We chatted for a few minutes and made an appointment to speak face to face in Dr. Crockford’s office.  After that meeting, he arranged for me to meet with all the physicians (at that time, six males) at one of their 7am Thursday meetings. We discussed the possibilities; I knew it made intuitive sense. Women who are seen by their OB/GYN and are in need of mental health care for depression, postpartum issues, marital problems, premenstrual distress, infertility, or hormonal challenges would be much more likely to follow up with a referral to an in-house therapist than to seek help in a psychiatric practice elsewhere. And a practice that specializes in addressing the needs of women would be well served to address their mental health needs as well.

We started off with a series of free seminars informing the public and our patients about our new counseling services. On four separate occasions, one of the physicians and I offered loss, women and relationships, and depression.

One of the groups of patients we wanted to reach was those who experience pregnancy loss. In addition to our free seminar, I drafted a letter of condolence that went out to patients who experience loss, expressing our concern and letting them know that the practice had expanded its services to include counseling. In addition, I sent a booklet on grief that let patients and their husbands and families know what to expect emotionally in the weeks and months following loss. These booklets have now become routine and a part of the medical protocol.

Our counseling services were well received. Within six months of coming on board, I was busy fulltime.  Now, 18 years later the practice includes nine physicians (with four females). The counseling services have been expanded to include a sub-specialty in work with infertile couples and a consulting relationship with both the Jones Institute for Reproductive Medicine and the New Hope Center for Reproductive Medicine. My caseload remains full and now is only open to physician referral. The marriage of mental health care in this medical setting has been a practice success. I feel fortunate to have had the opportunity to do this exciting work.