In the Public Interest
When does some public good override psychiatric confidentiality? Dinah's post yesterday outlined the recent issue in the Navy's public release of the shooter's psychiatric treatment information. I wrote about this issue before following the release of the expert behavioral analysis panel's report on the suspected anthrax mailer, Dr. Bruce Ivins. In both cases, the rationale for releasing detailed information about the decedent's psychiatric care was cited as being a need to ensure that the government was taking appropriate steps to safeguard public safety. Following release of the EBAP report, the government---without admi...
Source: Shrink Rap - February 1, 2014 Category: Psychiatrists and Psychologists Authors: ClinkShrink Source Type: blogs
The doctor will see you NOW!
Here in Maryland, we have the best laws. And Delegate Robert Costa, a Republican from Anne Arundel County (District 33B), has another Bill proposed:HOUSE BILL 279NOT WITHSTANDING THE PROVISIONS OF SUBSECTION A) OF THIS SECTION, A LICENSED PHYSICIAN MAY PRESENT OR CAUSE TO BE PRESENTED A CLAIM, BILL, OR DEMAND FOR PAYMENT FOR A PROCEDURE PERFORMED DURING AN OFFICE VISIT AT WHICH THE PHYSICIAN DID NOT COMMENCE TREATMENT WITHIN 30 MINUTES AFTER THE TIME SCHEDULED FOR THE OFFICE VISIT.Okay, so if the doctor runs more than 30 minutes late,&nb...
Source: Shrink Rap - January 27, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Insurance (or Not), Flotation Tanks, and Involuntary Committment.
This is an around-the-web post.First, my stuff:Over on Clinical Psychiatry News, I have article up about the survey on "Who are the Mentally Ill?" I talk about how the survey was done and what findings there were, along with a few of my thoughts about those findings. Click Here.My post on Why Psychiatrists Don't Take Insurance is up on KevinMD. Lots of comments on Shrink Rap, feel free to comment to a broader medical audience over there. Click Here.Then Clink's stuff:Over on Clinical Psychiatry News this week, Clink is writing about recreational flotation tanks and their comparison to sensory depriv...
Source: Shrink Rap - January 25, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
It's Official: DSM 5 is a Pissing Contest
First, I want to tell you that I have a conflict of interest when it comes to discussing both Dr. Kupfer and Dr. Frances: they were both my teachers, and they are people I hold in esteem. Dr. Kupfer ran a summer program in psychiatry for college students, the Mellon Fellowship in Psychiatry for Undergraduates, and in the summer of 1983, as a college student aspiring to go to medical and become a psychiatrist, I was one of 8 students from across the country to receive one of these grants. It was an opportunity that opened doors for me and changed my life, and I remember Dr. Kupfer as a warm, kind teacher and I remain ...
Source: Shrink Rap - January 23, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Cardiovascular and Diabetes Outcomes Among Those taking Novel Antipsychotics
I remember from medical school and the early days of my residency when the only medications available to treat psychosis were the neuroleptics. Patients hated taking them: the high potency medicines like Haldol and Prolixin left people rigid; they had pill-rolling movements with their fingers, cogwheeling in their joints, and they walked liked zombies. The lower potency medications like Mellaril left people drooling and sedated. I once heard these medications described as like having molasses poured into your brain. We'd cajole people in to taking them, and like all medications, there were some peop...
Source: Shrink Rap - January 20, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Why Psychiatrists Don't Participate with Insurance Networks
In 2007, I wrote a post called Why Shrinks Don't Take Insurance. The post is a bit dated, the CPT codes have changed since then, and the reasons to not take insurance have increased. Many other doctors don't take insurance now, though psychiatry remains the number one specialty where doctors don't participate in health insurance plans. This is an updated version of that same post.Many psychiatrists in private practice don't participate with insurance insurance panels. They require the to patient pay and then the patient has the option to submit a claim to his health insurance company as an "out-o...
Source: Shrink Rap - January 13, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Please Don't Batter the Shrink
When I was a child, I lived across the street from a neurologist. The neurologist shared his office with a psychiatrist, and I was told that one day, a patient walked into the office and shot the psychiatrist. Last week, in Italy, a psychiatrist was stabbed to death by a patient. We don't think about how dangerous it may be, but being a shrink has some risks. Actually, being a person has some risks, and in Baltimore, fourteen people have already been murdered this year, more than one per day.With that as a prelude, I was on vacation briefly in December; a quick trip to visit family. In...
Source: Shrink Rap - January 12, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Let's Have a Task Force!
I'm going to do a little problem solving here. In the Washington Post yesterday in Virginia Doesn't Need Another Mental Health Task Force, Pete Earley writes:Virginians should be embarrassed and angry that a newly appointed state mental health task force convened Tuesday in Richmond. It is the 16th task force asked to investigate the state’s mental health system. If you click through to hit the link, you'll note that this 16th task force on mental health has 36 members. Politicians love task forces, it's a way to look like something is "being done" without actually doing anything. So now 36 people,...
Source: Shrink Rap - January 11, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Let's Keep Guns Out of the Hands of.....
First, the quote of the day, an explanation to follow:--"I'm a gun owner. It happens."President Obama has renewed his commitment to keeping guns out of "the hands of the mentally ill." See the story in Bloomberg here. In my world, I'd like to keep guns away from most people, but no one asked my opinion. I realize there was a reason for the Second Amendment and that no one is going to go along with a repeal of the right to bear arms, so instead of designating people as targets for legislation based on having received medical treatment for psychiatric disorders, I'd like to talk about who i...
Source: Shrink Rap - January 8, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Things That Make Me Crazy
I sometimes think I live in a tight little fantasy bubble where I want life to make sense and be fair. I want it to be an uncomplicated place where, when resources are limited, we assess the problems and direct the dollars to things we know will efficiently fix the problems. I'd like us to use our public health dollars to feed hungry people, to house those without some place warm to stay, to help those in need learn strategies and get jobs so they can help themselves, and to provide health care to those who are ill. In cases where there are big-picture items that lead to devastating consequences and...
Source: Shrink Rap - January 5, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
The "Mentally Ill" Bucket
Dinah wants me to post more, so she asked me to put up my comment to her post on Results of the Survey on Who are the Mentally Ill. (If you didn't see the original survey, it is here.)So, here's my comment. But I'll begin with the limerick...There once was a man from NantucketWith a thought that was quite a nugget. "The world is round," he exclaimed; Which confirmed he's insane.So they placed him in "the mentally ill" bucket.When I first saw this survey, I told Dinah it was a terrible survey and that she should take it down, because by even asking people 'who are "the mentally ill" ', it lends crede...
Source: Shrink Rap - January 3, 2014 Category: Psychiatrists and Psychologists Authors: Roy Source Type: blogs
Results of the Survey on Who Are the Mentally Ill?
Thank you to everyone who participated!The survey was published on Shrink Rap from December 10, 2013 - December 22, 2013.Respondents were solicited through social media, including blogs, listservs, Facebook, and Twitter. Respondents were not limited to the United States. Please note that the survey was not validated. The data below was pasted directly from the Google "Summary of Responses" with no analysis or interpretation.SummaryAnyone who has seen a therapist is mentally illTrue172%False67698%Anyone who has been in psychotherapy with a psychiatrist is mentally illTrue619%False63091%Anyone who take...
Source: Shrink Rap - January 2, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Depression, the Secret we Share -- A TED Talk by Andrew Solomon
If you've ever been depressed, if you've ever known anyone who has been depressed, if you've ever wondered what it's like to be depressed, or if you just want to listen to a wonderful talk, do listen to Andrew Solomon's TED talk.-----
Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail dot com
Our book is out now. (Source: Shrink Rap)
Source: Shrink Rap - December 30, 2013 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Psychiatry Articles on the Web
There have been a number of articles I've wanted to mention lately.In the New York Times:When the Right To Bear Arms Includes the Mentally IllIn the Wall Street Journal, set in our own Maryland:For the Mentally Ill, Finding Care Grows HarderandRepresentative Tim Murphy Instroduces Mental Health Legislation From the StarTribune:Minnesota Security Hospital: Staff in Crisis Spreads TurmoilIn Atlantic Monthly, a poignant story about one man's battle with anxiety:Surviving AnxietyAnd finally, on Salon, it's from nearly two years ago, but I ran across Linda Gray Sexton's account of being suicidal and found it to be moving:In the...
Source: Shrink Rap - December 29, 2013 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Assisted Outpatient Treatment?
Happy Holidays, everyone. Blogging has been a little slow here at Shrink Rap as the Shrink Rappers overdose on cookies and get caught up in all the usual holiday stresses that get to everyone.===========I've heard rumors that in the coming 2014 Legislative Session in Maryland a bill may be proposed to make Assisted Outpatient Treatment (AOT) part of the landscape. As it stands now, we are one of the few states that does not have AOT, or forced treatment, for outpatients, outside of the forensic system for those on conditional release after having committed a crime (often a violent crime).Since Maryland doesn't ...
Source: Shrink Rap - December 27, 2013 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
