In the United States, Canada, Europe, and other industrialized world regions, increasing numbers of patients are using nonconventional approaches to treat both medical and psychiatric disorders. Most people who use nonconventional treatments are well educated, committed to personal growth, satisfied with the conventional medical care provided by their family physician, and use both prescription medications and nonconventional treatments for the same problems. Psychiatrists and psychologists commonly refer patients to nonconventional medical practitioners, including acupuncturists, homeopaths, herbalists, massage therapists, naturopaths, and chiropractors. Because nonconventional treatments are widely used in mental health care, it is important to carefully examine the evidence to determine when it is reasonable and appropriate to recommend these nonpharmacological modalities to patients.

Despite increasing acceptance of nonconventional approaches in mental health care, the effectiveness of most nonconventional treatments has not been established. Nevertheless, the majority of individuals who receive nonconventional treatments for mental health problems believe that they are as effective as conventional medications. Although research findings confirm the efficacy of certain nonconventional treatments, the evidence for most nonpharmacological treatments is not strong. Emerging evidence for nonconventional treatments in the context of unresolved concerns about conventional pharmacological treatments has resulted in the use of nonconventional biological, mind–body, and so-called energy healing modalities by increasing numbers of patients and growing interest in these approaches among psychiatrists and psychologists. Increasing use of nonpharmacological treatments is taking place in the context of recent systematic review findings of studies on conventional pharmacological treatments that point to significant placebo effects and are raising concerns about serious unresolved safety issues. Although certain medicinal herbs and acupuncture have been used for millennia to treat symptoms of mental illness, for the most part, their use is supported by anecdotal evidence. Because the majority of nonconventional treatments are not supported by compelling evidence, they are often dismissed by Western medicine before outcomes studies are done.

Students should study Table 28.1 and the questions and answers below for a useful review of this field.