Saturday, December 27, 2008

72-Hour Observations

Weekend News

Army to establish mental health board
Since 2003, 15 Army recuiters have committed suicide, prompting the armed service to form a suicide prevention board. Their task will be to study the mental health of recruiters, one of the Army's most stressed-out job classes. Read more about it at The Fayetteville Observer.

Insurance and mental health
A study published in the December 24/31 issue of the Journal of the American Medical Association found that psychiatric patients who insurance with a lower share of cost tended to get treatment more frequently. Read more about it the Washington Post.

But if they were in Afghanistan...
Mental health patients in that country are numerous, according to experts, but treatment is hard to come by. So Afghanistan sends its mentally ill to feed on bread, water and pepper at shrines, or chains them to trees. Read more at Related Content

Friday, December 26, 2008

Some mental health patients remain invisible

Violations of the human rights of psychiatric patients may not be as uncommon as I'd like to imagine them. On December 23, the Associated Press ran an item "Mental patients isolated for years despite laws" on the MSNBC web site. Virginia, Connecticut, Florida, California, Pennsylvania, Oregon, Massachusetts and Maryland were among the states listed to have put patients into long-term seclusion for lack of any other treatment alternatives.
Typically the patients are chronically violent. For instance, the story refers to Cesar Chumil, who has been in a three-room "containment suite" since 1993. He had 300 incidents of assaulting staff and another 100 of assaulting patients before going into confinement.
Simple isolation was not the most egregious encroachment on patients’ rights cited. Others involved long-term restraint: one man strapped to a bed for 2½ years in Florida, another tied to a bed for over a year in Connecticut.
The AP story opens up a Pandora’s Box of questions about behavioral management, staff biases, and physician perception.
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Wednesday, December 24, 2008

Missouri shows how it's done

Probably every one of us in the mental health profession can produce a (hopefully) short roster of psychiatrists whose prescribing practices are flawed. Some of them would like to squeeze their patient’s symptom presentations into formulaic drug regimens whereas others would under- or overprescribe.
Five years ago, the state of Missouri’s Behavioral Pharmacy Management Program began an ambitious educational outreach to those physicians operating on the edges of psychiatry. The program paid off well this year when the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded them one of their highly-regarded Science and Service Awards for 2008.
This innovative and voluntary program provides physicians with suggested prescribing strategies as well as clinical considerations. Physicians who continue to experience the same issues are offered per consultation.
"This is a model on how states can increase the quality of care that Medicaid residents with severe mental illnesses receive while encouraging more efficient use of taxpayer dollars," said Joseph Parks, M.D., Medical Director of Missouri's Department of Mental Health. "Through this project, many opportunities for coordination of care have been identified, resulting in improved quality of care and enhanced quality of life for persons with mental illness."
You can read more about this innovative program on the SAMHSA website.
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Thinning wallets and bulging waists

News Item
The global financial crisis of the past year has hurt Americans and Canadians in more than just their wallets. Trends show that as a result of increased stress, many are eating more than usual and losing their battle against the bulge even as they try harder to diet.
"I've been seeing nearly three new patients a day for months, and 90 percent of them have stress-related eating issues," said Dr. Penny Kendall-Reed, a world-famous naturopathic physician and author who treats patients on how to utilize the brain and holistic measures for controlling food cravings without the unpleasant side-effects normally associated with dieting.
According to Dr. Kendall-Reed, as many people become more stressed about work stability and the economic downturn, they compulsively turn to food.
"Stress stimulates the hunger center in the brain, destabilizes our blood sugar, makes us resistant to our anti-hunger messengers, and reduces our levels of 'happy hormone' serotonin, all of which trigger cravings that inevitably lead to weight gain," said Dr. Kendall-Reed.
Dr. Kendall-Reed should know; her revolutionary, research-based No-Crave Diet concept, co-authored with her husband Dr. Stephen Reed, helps people take back control of their weight by teaching them how to counter the biological process that makes us crave the wrong foods, effectively silencing the craving urge fueled by stress.
"A standard complaint I get from patients at a time like this is that their diets are not working," said Dr. Kendall-Reed. "That's simply because stress promotes storage of calories, particularly around the midsection, which is the most dangerous place to gain weight and the hardest to remove."
Monitoring about 90 percent of her patients on the No-Crave Diet for six to eight weeks prior to when the financial crisis worsened in mid-October, Dr. Kendall-Reed noticed that they have continued to lose weight and report no recurrence of cravings.
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Tuesday, December 23, 2008

Young schizophrenic man shot in Florida

In Hallandale Beach, Florida, on Wednesday, December 17, an 18-year-old schizophrenic male named Johnny Mario Silfrain was shot in the leg by a Broward County Sheriff’s Deputy, according to the South Florida Sun-Sentinel. Mr. Silfrain had led police on a brief chase in a hearse he stole from a funeral he was attending. At the end of the pursuit, he attempted to run over deputies, leading them to open fire. Now, Silfrain has been undergoing evaluation at Memorial Regional Hospital in Hollywood, Florida.
Just the day before this incident, deputies had been called to the apartment Silfrain shares with this mother. He had become increasingly agitated, she told them, but by the time officers arrived, Silfrain had calmed down and was no longer judged to be dangerous, so the authorities left him at home. According to his mother, Silfrain was quite paranoid, believing people were watching and following him.
Prior to his first psychotic break, the young Silfrain was football player and a student in Advanced Placement classes.
While there aren’t enough details available at this time, it appears this crisis may present an opportunity for examining what systemic failures may have occurred in this case.
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