Ending Treatment

Peter Forster About GPS

We have a short list of rules and Gateway Psychiatric, and one of those rules may seem a little bit odd to people when they first come in for treatment. We ask people to agree to “say goodbye in person.” What do we mean by this?

We don’t mean that when someone who has been seeing us for a while decides to stop treatment that we want to harangue them, or coerce them, or even strongly encourage them to continue in treatment. Everybody gets to make their own decisions and the purpose of our rule is really to help someone make that change in the best possible way.

If someone has decided to see another mental health practitioner we want to help make the transition as smooth as possible: get a copy of our records to the new provider, answer any questions about the transition, make sure that they have the medications that they need, etceetera.

If someone is taking a break from treatment we want to talk about when they might want to resume treatment, how and why they might want to make that decision and, once again, to answer any questions they may have about their care.

Finally, over the fifteen years that we have been running this clinic we have seen that the very few former patients who have had severely negative outcomes, including two former patients who, we later learned, committed suicide have all happened when someone “disappears” or drops out of treatment without a final visit.

Because sometimes people don’t come in for care precisely because they do feel so badly, and so the clinically appropriate intervention is to try to get them to come in for that needed session. And there is no way of knowing whether or not that is the case without having a final in person visit.