Telephone therapy technique brings more Iraq and Afghanistan veterans into mental health treatment

Medicalxpress.com

Originally published July 26, 2012

A brief therapeutic intervention called motivational interviewing, administered over the telephone, was significantly more effective than a simple "check-in" call in getting Iraq and Afghanistan war veterans with mental health diagnoses to begin treatment for their conditions, in a study led by a physician at the San Francisco VA Medical Center and the University of California, San Francisco.

Participants receiving telephone motivational interviewing also were significantly more likely to stay in therapy, and reported reductions in marijuana use and a decreased sense of stigma associated with mental health treatment.

The study was published electronically recently in General Hospital Psychiatry (May 25, 2012).

Lead author Karen Seal, MD, MPH, director of the Integrated Care Clinic at SFVAMC and an associate professor of medicine and psychiatry at UCSF, noted that 52 percent of the approximately half-million Iraq and Afghanistan veterans currently being seen by the VA have one or more mental health diagnoses, including post-traumatic stress disorder, depression, anxiety or other related conditions.

The entire story is here.

Colorado Shooting Suspect Was Getting Psychiatric Care

By Dan Frosch
The New York Times
Originally published July 27, 2012

James E. Holmes, the Colorado man accused of gunning down 12 people at an Aurora movie theater last week, was being treated by a psychiatrist whose research interests include psychotherapy and the neurobiology of schizophrenia, according to court papers filed by Mr. Holmes’s lawyers on Thursday, the first documented glimpse into his mental health condition.

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According to the court papers, Mr. Holmes had sent a package to Dr. Fenton, which was ultimately seized by the police after a search warrant was executed on Monday.

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In September 2004, Dr. Fenton received an admonition from Colorado’s board of medical examiners for prescribing medications — including the allergy medication Claritin, the sleeping pill Ambien, two tranquilizers and the narcotic painkiller Vicodin — for a few colleagues and her husband on several occasions, and failing to keep proper documentation of the prescriptions. The board noted in its admonition letter that Dr. Fenton was no longer writing prescriptions for people who were not her patients.

The entire story is here.

Psychologist's death blamed on sex case worries

BBC News
Originally published July 23, 2012

A clinical psychologist who blamed herself for a decision to release a known sex offender was "visibly upset" before her death, an inquest has heard.

Lisa Derriscott, 33, of Long Eaton, Derbyshire, was found dead in a burned out car near her home on 3 August 2011.

She worked on a Nottinghamshire mental health team that sanctioned the release of sex offender Shaun Tudor, 44, who went on to reoffend.

In a narrative verdict, the Derby coroner said she took her own life.

The entire story is here.

Thanks to Ken Pope for this information.

Sex with patients the biggest no-no for doctors

By Melissa Davey
Health Reporter - The Age
Originally published July 26, 2012

HAVING a sexual relationship with a patient is more likely to see a doctor banned from practising than if they give a patient the wrong operation, miss a diagnosis or breach patient confidentiality, according to new research.

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Of the 79 cases where doctors were guilty of a sexual relationship with a patient, 64 were removed from practice. Although it was far more common for doctors to be found guilty of inappropriate or inadequate treatment, writing inappropriate medical certificates and records, and illegal and unethical prescribing, they were much less likely to be removed.

The entire story is here.

Thanks to Gary Schoener for this article.

When I Kissed the Teacher

Student-Doctor Relationships Can Be Problematic When It Comes to a Teaching Environment

By Guy Rughani
From Student BMJ
Medscape Today News
Originally posted on July 17, 2012

Here is one excerpt:

From the beginning of medical school we are told that doctors should never date their patients. Accusations of preying on the vulnerable, abusing a position of trust, and eroding professional integrity are all persuasive reasons against such relationships. Indeed, in the United Kingdom, the General Medical Council has extensive guidance on the topic, requiring doctors to “maintain a professional boundary between themselves and their patients.” Although some guidance exists for staff about relationships in the workplace (see box), why do we never hear warnings against student-doctor/teacher relationships?

Jonathan Coe is the director of the Clinic for Boundaries Studies, an organisation which supports the victims of professional boundary violations and educates professionals in improving their approaches to prevention. “When we [patients] go to a doctor, we bring with us a level of vulnerability to the relationship,” says Mr Coe. “Implicitly, we are seeking assistance with issues whose solution is outside our knowledge and ability to respond effectively. There is a clear power differential and it is this that means that senior practitioners need to be careful before entering into any kind of personal involvement.”

Mr Coe argues that the guiding ethical principles that underpin the doctor-patient relationship are also relevant in the context of doctor-student matches. “There is a general ethical responsibility to avoid harm [non-maleficence/beneficence] and to respect autonomy,” he says, “both of which are at risk if an intimate relationship [among doctors and students] is started.”

The entire story is here.

Psychology and Social Justice: Why We Do What We Do

By Vasquez, Melba J. T.
American Psychologist, Vol 67(5), Jul-Aug 2012, 337-346. 

Abstract

Much of psychological science and knowledge is significantly relevant to social justice, defined here as the goal to decrease human suffering and to promote human values of equality and justice. A commitment to social justice has evolved as a more important value in the last few decades for psychology, including for the American Psychological Association (APA). The mission, vision, goals, Ethics Code, and strategic plan of APA all provide a rationale for psychologists' involvement in systematic and visible ways of applying our knowledge to social issues. Although psychology has not been immune to the application of psychological knowledge in destructive ways, overall, psychology, many psychologists, and APA have demonstrated a commitment to social justice. This article provides a brief review of the key proponents, debates, and controversies involved in applying psychological science and knowledge to complex societal problems. Psychologists often find themselves in conflict and honest disagreement when the association addresses complex and controversial issues. An important goal is that we continue to find ways to agree or disagree in a respectful manner regardless of where each of us stands on the various positions that APA takes.

The entire story is here and a member benefit of APA.

Psychologist Who Wrote of Abuse Is Punished

By Timothy Williams
The New York Times
Originally published July 30, 2012

A federal health services psychologist who told superiors that an American Indian tribe was ignoring widespread child abuse on a North Dakota reservation has been reprimanded and reassigned, according to federal officials and documents.

The psychologist, Michael R. Tilus, director of behavioral health at the Spirit Lake Health Center on the Spirit Lake Indian reservation, describes himself as a whistle-blower. He wrote in an e-mail to state and federal health officials this spring about an “epidemic” of child abuse on Spirit Lake, which is in a remote area of northeastern North Dakota.

Among the recipients were officials with the Department of Health and Human Services and the Indian Health Service, which oversee most health care on Spirit Lake.  

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Dr. Tilus wrote that instead of being punished, he deserved whistle-blower protection under the Food and Drug Administration Safety and Innovation Act of 2012, which was signed into law by President Obama this month. That law extends military whistle-blower safeguards to federal Public Health Service officers.

The entire story is here.

Social Networking’s ‘Big Impact’ on Medicine

Eric Topol, MD
MedScape Today: The Creative Destruction of Medicine
Originally posted July 17, 2012

Here are some excerpts:

Everybody is familiar with Facebook, which soon will have 1 billion registrants and be second only to China and India as far as a community or population. What isn't so much appreciated by the medical community is that our patients are turning to online health social networking. These are such Websites as PatientsLikeMe, CureTogether, and many others.

Interestingly, patients with like conditions -- often chronic conditions, such as multiple sclerosis, diabetes, or amyotrophic lateral sclerosis (ALS) -- will find patients with the same condition on these networking sites. And these virtual peers will become very much a key guidance source. This is so different from the past, when all information emanated from physicians. In fact, now many of these individuals who use social networks trust their virtual peers more than their physicians, so this is a real change that's taken place. In addition to this, the social networking platforms, which are free, offer an opportunity we haven't seen before.

The entire text and video are here.

Doctor Shortage Likely to Worsen With Health Law

By Annie Lowrey and Robert Pear
The New York Times
Originally published July 28, 2012

In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

The entire story is here.