Here, a doctor is always in

Sanity: The affluent, progressive town has one of the state's highest concentration of therapists - and they stay busy.

October 29, 2001|By Laura Vozzella | Laura Vozzella,SUN STAFF

Just as Washington is wall-to-wall lawyers and Los Angeles has a glut of out-of-work actors, Columbia is up to its well-examined head in shrinks.

Howard County has about 270 psychologists, most of them in Columbia. That's one for every 920 residents -- more per capita than any other county in the state.

The county also has about 90 psychiatrists -- about 12 times the number needed for a community its size, about 248,000 residents, according to minimums set by federal health officials.

"There's certainly a lot of therapists per square inch here," said Harold Ziesat, a clinical psychologist and director of the Anxiety Treatment Program of Columbia.

It's not that Columbians are an unusually unstable lot, experts say, though they face extra stresses. They say the town's progressive attitude and affluence make residents about as willing and able as Woody Allen to seek professional help.

"A little bit of it might be income, but it's more philosophic," said Columbia psychologist Marv A. Hoss, past president of the Maryland Psychological Association. "Right down the street is the Acupuncture Institute and David's [Natural Food] Market. This is who we are. This is the Marin County of Maryland."

The Maryland Psychological Association, a statewide professional group, is based in Columbia. So is Magellan Health Services, which manages the mental health care benefits of about 70 million Americans.

Then there's Kittamaqundi Community -- a Town Center church whose mission and membership are so bound up in mental heath care that it runs support groups for people who run support groups.

The nondenominational church seeks to blend spirituality with psychology in services that are something like group therapy sessions. Members sit in a large circle and share stories about their troubled teen-ager or forthcoming mastectomy, sometimes relating their problems to Scripture.

Of the 100 active members, more than 10 are mental health professionals.

Many of the other members found the church because they are clients of those therapists, said Carol Lobell, a psychotherapist who belongs to the church along with her husband, John, a retired pastoral counselor.

"I think people in Columbia are just willing to ask for help and maybe have the money to afford it, too," she said. "I was always surprised when I'd visit relatives or friends elsewhere who'd say, `Oh, I would never tell anyone if I was in counseling.' There was such a taboo. I'd say in Columbia they're happy to say they're in counseling because they're working on their issues."

Columbia takes some good-natured ribbing from folks who know it as psychiatry central.

"I'm not moving there," joked Dr. Sheldon Horowitz, associate vice president of the American Board of Medical Specialties. "My condolences to the community."

But the distinction probably says more about the area's economics than its mental health, Horowitz and others said. Howard boasts the state's highest median household income, at $75,500. Montgomery County's is $68,100.

Montgomery comes closest to Howard's ratio of one psychologist for every 920 residents, with a 1-to-1,055 ratio. Compare that with a region like Washington County, where median income is $32,590 and there's one psychologist for every 32,981 residents.

"There's a very strong economic component to all of health care, and it's particularly strong in mental heath care," said Dr. Richard Cooper, director of the Health Policy Institute for the Medical College of Wisconsin in Milwaukee.

That's because mental health care often comes with "higher co-pays, shorter duration of benefits," he said. "It clicks into your own pocket sooner."

Many mental health professionals say school officials are quicker to refer students for treatment in Columbia and adults are more likely to seek help for problems that in other places might be worked out within the family or with clergy.

"I think that people here in Columbia and Howard County tend to rely on psychologists and psychiatrists to solve some of the problems of everyday living," said Jean Leslie, an administrator with the county affiliate of the National Alliance for the Mentally Ill. "We have affluence to do that."

Perhaps even more important than Columbia's economics is its outlook, experts say. Columbia is, after all, a town whose physical design was supposed to root out racism and religious intolerance, a place where problems of all sorts are expected to get solved.

The residents who first settled in the new town in the late 1960s tended to be people open to new ideas, new experiences -- precisely the type of people willing to look to psychology to solve problems large and small, experts say.

"I think it's a pretty psychologically minded population, partly as an artifact of the high education level," said Ziesat of the Anxiety Treatment Program of Columbia. Columbians are "more likely to accept [help] without as much of a stigma."

Ziesat treats people with phobias, panic disorders, obsessive-compulsive disorder and other problems. He said those and other troubles, such as marital difficulties, can be exacerbated by the stressful lifestyles led by many Columbians.

As a relatively new community situated between two large cities, Ziesat and other experts said, Columbia has extra stresses: long commutes into Baltimore and Washington; lots of dual-career couples and latchkey kids; expensive housing; high academic pressure on kids; and a large transient population lacking the support of extended family.

"They come here for careers, and in some ways it's a pretty hectic lifestyle," he said. "I do see a lot of stressed people."

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