Saturday, July 26, 2008

Weekly Psych News Roundup

Puffing for Calm
The Alexza Pharmaceuticals inhaler to treat acute agitation in psychiatric patients is entering its Phase III clinical trial...

"Mad Pride" Sweeps the Nation
It had to happen, sooner or later. "Mad Pride" is a burgeoning movement among folks with mental illness, at least according to the Providence Journal...

Vets & Mental Illness
The VA isn't paying close enough attention to vets with mental illness some say and they point to one Navy man's suicide as a case in point. Meanwhile, the VA is rolling out suicide hotline ads in DC...

George Michael Has Faith in Music
The pop star is emerging victorious after a bout with grief and depression. He credits music as helping him get through...Sphere: Related Content

Friday, July 25, 2008

Deadly Consequences of Negligence

A Double Tragedy Unfolds in Florida
On the evening of July 21, chronic psychiatric patient Mark Rohlman was brought in twice to Fort Walton Beach Medical Center for emergency psychiatric evaluations. Both times, he escaped. How, exactly, no one’s telling just yet, but the story ended tragically for Mark and Sheriff’s Deputy Anthony Forgione.

After his escape from Fort Walton Beach Medical Center, Mark found his way to his deceased father's home where he barricaded himself with a gun. When sheriff's deputies arrived to take Mark back to the hospital, he fired on them. His bullets killed Okaloosa County Deputy Anthony Forgione, a 33-year-old deputy from Niceville. Mark then turned the gun on himself and pulled the trigger.

In these last few days after the tragic series of incidents, politicians and pundits alike have been hammering at Florida’s Baker Act. But do they have the right culprit in their crosshairs?

What is the Baker Act?
Like many other involuntary detention laws across the nation for psychiatric patients, the Baker Act allows that individuals unable to care for themselves or presenting imminent danger can be detained for psychiatric assessment. They are taken to a designated facility where, within 72 hours, they are evaluated. Afterwards, the individual can be released into the community, involuntarily committed to an inpatient psychiatric hospital, or mandated to accept outpatient treatment. Inpatient hospitalization under this law extends up to six months.

The law has multiple patient's rights safeguards built into it, but many are arguing these protections are simply creating a loophole through which potentially dangerous patients can escape.

The Community Outraged
Reporter Tom McLaughlin of the Northwest Florida Daily News wrote a blog post headlined, "In FWB, little is done to secure mental patients. " McLaughlin is one of a growing chorus of understandably outraged citizens suggesting that maybe restraints or seclusion are the best antidote to dangerous psych patients.

On the other extreme, probably laying the groundwork for her hospital's defense, is Fort Walton Beach Medical Center's risk management officer Evelyn Ross. She is quoted in McLaughlin's blog stating, “The Baker Act does give us the opportunity to evaluate the patient even if they don't want to be here, but it does not give us the opportunity to secure them here. You don't restrain people just because they've been Baker Acted." True, but you don't just let them walk off, either. And twice in one day, no less.

Adding his voice to the cacophony was Okaloosa County Sheriff Charlie Morris who said the tragedy "absolutely a wake-up call" to change the Baker Act.

For their part, officials at Fort Walton Beach Medical Center have been mum on the particulars of how Mr. Rohlman escaped. Probably a good idea.

Who's really at fault here?
Vilifying a mentally deranged man who killed one of our finest might make sense of an otherwise senseless crime. Calling for legislative reforms makes better politics and press than examining the mundane details of this incident.

The fact is Fort Walton Beach Medical Center has been notorious for insufficient management of psychiatric patients, put mildly. Really, it’s downright incompetence. As McLaughlin has pointed out, the hospital has placed 45 calls to the Sheriff's Department reporting elopements of Baker act patients since January 1, 2007. They have made 21 such calls this year alone. These are simply staggering statistics for any one hospital.

Any hospital is responsible for their patients and that often means guarding them with one-to-one attention. Could it be that these deaths were needless not because the law is weak but because the hospital bungled the case? That one staff member taking care of the patient could have saved two lives? Right now, it’s too disconcerting to think that way.

But, experience tells me that the real story here is what’s going on at Fort Walton Beach Medical Center, not in Tallahassee.
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Thursday, July 24, 2008

OCD Conference Coming Up Quick!

If you are a clinician who treats OCD and you haven't already registered for the Obsessive-Compulsive Foundation's 15th Annual Conference in Boston, time is running out. The cut-off for online registration is Monday, July 28. The conference runs August 1 – 3, 2008, at Renaissance Waterfront Hotel in Boston, MA.Sphere: Related Content

Tuesday, July 22, 2008

Suzy's Law: Parents Turn Grief Into Action

You've read in this blog last week about Kendra's Law and Laura's Law. Today, I'm writing to raise awareness of a like-titled piece of legislation, Suzy's Law.

Photo by Georgios Wollbrecht
HR 940, as it's officially known, proscribes using interstate commerce to publish suicide promotionals, such as how to kill yourself quickly and effectively, how to write a powerful suicide note, how to get the material means for suicide and how to delay others finding out you're dead.

Who Was Suzy Gonzales?
A resident of Red Bluff, California, a quaint town in the far reaches of Northern California, Suzanne Gonzales was a bright and fun-loving 19-year-old girl with a stellar future ahead of her. She was a national Hispanic scholar finalist and had a full scholarship to Florida State University. To quote the Suzy's Law web site,
"She loved to set her own style and was not afraid to march to her own beat. She was known as the girl wearing glasses with no lenses and hand-painted colorful shoes, and riding a red scooter carrying the stuffed two-headed cat she made herself. She loved polka-dot dresses and ska music, and she was a joy and bright light to be around."
That bright light was about to be tragically extinguished. Suzy became depressed while attending Florida State. She tried to talk to her boyfriend about the increasing thoughts of suicide she experienced, but he told her she needed help.

So Suzy turned to the Internet and found multiple resources encouraging her to kill herself and providing her with the know-how to get the job done. They taught her how to pose as a jeweler to buy potassium cyanide. They gave her instructions on how to send time-delayed emails that would go out after her death. They taught her how to lie to her psychiatrist so she wouldn't get hospitalized. On and on it went.

Finally, on March 23, 2003, Suzy checked into a Florida motel and ingested a lethal dose of potassium cyanide.

Parents Turn Grief Into Action
Mike and Mary Gonzales were devastated by their daughter's suicide, but decided to take action. Suzy's Law was initially introduced in February 2007 by Rep. Wally Herger.

Under the Suzanne Gonzales Suicide Prevention Act of 2007, an individual who uses the Internet or other interstate commerce to teach a suicidal person how to commit suicide or provides them the resources to do it would be guilty of a crime punishable by fines and up to five years in prison. If the recipient actuall suicides, the penalty goes from five years to life in prison.

The bill was referred to the Judiciary Committee's subcommittee on Crime, Terrorism and Homeland Security. It has been in limbo ever since.

So Mike and Mary are going to Washington, DC, this week to bring Suzy's Law out into the daylight for support and, hopefully, action. If you want to get involved, you can read the full text of the law, urge your Congressperson to co-sponsor the bill, and tell your friends.

Here's wishing you the best, Mike and Mary!
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Monday, July 21, 2008

Frank Calloway Keeps On Keepin On

Happy Birthday, Frank Calloway, belated though it is. Frank's birthday was July 2 and he turned a spritely 112, though I never would have known it until reading this AP Feature written by Kate Brumback. This was no how-did-you-live-so-long article, but rather a refreshing tale of surviving schizophrenia.

Born July 2, 1896, in Alabama, Frank entered the mental health system in 1952, diagnosed with schizophrenia. He has lived in that system ever since. Today, he is showing signs of dementia and is spending his days in a nursing home.

All of that aside, Frank is known for his artwork. He creates vivd murals that recall his Alabama youth, glimpses into a world gone by.

As he recounts in the story, Frank was taught early on about drawing and he's been an avid artist ever since. According to staff at the nursing home, Frank is quite happy to just spend his time quietly absorbed in his artwork.

Frank Calloway

This October, the American Visionary Art Museum in Baltimore, MD, will feature 18 of Frank's murals in an exhibit titled, "The Mariage of Art, Science and Philosophy."

Frank had been giving away his artwork or selling it at times for $50. But the nursing home staff has put a stop to that after an appraiser told them Frank's work could be worth thousands. The money will go into a trust so Frank doesn't lose his Medicaid benefits.

Keep on keepin' on, Frank!
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Sunday, July 20, 2008

The Personality Tattoo

Dr. William Cardasis at the Michigan Center for Forensic Psychiatry offered some alarming research findings last week: Tattoos may predict Antisocial Personality Disorder. I have to admit, when I first read this at the LA Times, I thought it must be a joke. But, alas, 'twas not.

Apparently the good doctor and his colleagues studied 36 male inpatients at a maximum-security state psychiatric facility and looked for a correlation between sporting a tattoo and having Antisocial Personality Disorder. In other words, do men with tattoos tend to be psychopaths?

As one might expect, the investigators' question was answered with a resounding yes. Fully 73% of the men with tattoos also had an antisocial diagnosis compared to only a 29% of those without. There is no indication what percentage of these 36 men were sociopaths.

What fails the laugh test in this research are the obvious skews in the pitifully small sample. Well-researched literature pegs sociopaths at about 28% of the prison population, an exponentially higher percentage than among the rest of the population. The fact that they examined men in a prison psychiatry ward only loads the data more. I'm going to guess that a huge number of prisoners have tattoos. I don't know of any data, but anecdotally, people who work in the system estimate from 75% to 90% of inmate have tattoos.

So then, this study makes the leap that of 36 inmates, 10 (28%) have antisocial personality disorder. Within those 10, 7 have tattoos and 3 don't.

What to make of all this? According to Cardasis, we can predict "whether adolescents with tattoos are more likely to have conduct disorder than those without, and what the effect the meaning and subject content of the tattoo has."

With the prevalence of tattoos in our society in general, can we infer much meaning into them anyway? Using tattoos as a predictor of violence is about as meaningful as listening to hip-hop as a barometer of psychopathy.Sphere: Related Content
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