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Search for county medical director, psychiatrist mirror national trends

Essex County Board of Supervisors

Essex County Board of Supervisors Photo by Keith Lobdell.

— Essex County has been without a full-time medical director and staff psychiatrist since the mental health department’s medical director, Dr. Kausar Chaudhry, resigned last December.

Chaudhry was a staff psychiatrist who served as the department’s medical director.

Patients are still receiving care, said Mental Health Services Director Stephen Valley, and residents are not being discharged.

“When a patient comes, they have a primary counselor who works with them,” explained Valley. “Some, not all, also see a prescriber. The vast majority are still coming to the clinic and receiving their counseling services.”

Lorna Jewell, the office’s psychiatric nurse practitioner — a registered nurse with additional training in psychology who is allowed to write prescriptions — has increased her workload from one to two days per week, said Valley, and is handling many of Dr. Chaudhry’s former patients.

Jewell cannot accommodate all of them, however, so the balance has been transferred to local primary care physicians for the purpose of prescribing their psychotropic medications.

“The general consensus for good treatment in mental health treatment is to combine therapy with medication,” said Valley, whose office is designed to provide, according to their mission statement, county residents with opportunities to improve their psychological well-being through therapeutic partnerships with mental health professionals.

County residents tend to require the same mental health services as the rest of the nation: treatment for mood disorders and depression are common, said Valley, and tend to be comorbid with substance abuse problems.

But shuttling them over to primary care physicians, while not detrimental to the patient, is just a quick fix to the staffing problem and isn’t a permanent solution to patient care, say officials.

Local impact

“While a primary care physician can write a prescription, they don’t have the training to really offer counseling,” said Valley. “If you have a heart problem, you go to the cardiologist. Raising the bar for primary physicians to care for those who don’t have a psychiatrist available concerns me greatly.”

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