Psych drug pipeline is just one part of a complex set of challenges

The Globe editorial on psychotropic drug research (“ ‘Unsticking’ psych drug research,’’ April 1) rightly points to the slow pace of innovative development in this critical area. One 2014 review concluded that “the psychotropic pipeline is slim and that the majority of drugs presently in Phase III trials are not very innovative.’’

However, this problem has little to do with rare cases of violence carried out by people with severe, inadequately treated mental illness. As your editorial points out, most people with mental illness are not violent; indeed, they are more often victims than perpetrators of violence.

Even though our current antipsychotic medications can have significant side effects, they are effective for acute psychosis and can also reduce the risk of psychotic relapse. Unfortunately, limited community resources and poor adherence to treatment often nullify the benefits of any medication. Assisted outpatient treatment, or “outpatient commitment,’’ as discussed in the Globe’s 2016 Spotlight series, ought to be a high priority in Massachusetts.

Ronald W. Pies

Lexington

The writer is a psychiatrist affiliated with Tufts University School of Medicine.

Comprehensive, multifaceted course of treatment is called for

We applaud the Globe’s ongoing effort to highlight the psychiatric needs in our communities but contend that the recent editorial “ ‘Unsticking’ psych drug research’’ oversimplifies the treatment of serious mental illnesses such as schizophrenia by focusing only on the inadequacies of medication treatment. As physicians dedicated to helping those with these types of illnesses achieve meaningful recovery, we urge a more comprehensive approach to this issue.

Decades of research in the United States and elsewhere demonstrate that medication treatment is only one avenue for improving outcomes for such individuals. Interventions that address housing, food security, education, employment, social skills, self-advocacy, integrated addiction treatment, and family and community supports also have been found to alter the course of illness.

Many people experience a dysfunction in awareness of the illness itself; it may take clinicians several years of efforts before individuals accept treatment and achieve improvement in symptoms.

Addressing the needs of people with serious mental illness will require creative and multifaceted approaches to using existing public funds and services, leveraging legal mechanisms to support treatment, improving collaboration across systems, and stimulating dialogue to reduce stigma and invigorate investment in comprehensive solutions.

Dr. Hannah Larsen

Lynn

Dr. Miriam Tepper

Somerville