Virginia Tech gunman's records point to systemic inadequacies

The mental health records of Virginia Tech gunman Seung-Hui Cho were released this afternoon to much fanfare. The records, however, revealed little in terms of clinical substance, as the Washington Post indicated today.Sphere: Related Content
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New York's assisted outpatient treatment revisited

The publication of a Duke University Study on assisted outpatient treatment in New York, known as Kendra's Law, and the June 30 report from the New York Office of Mental Health (OMH) has put the law back in the spotlight. WSJ blogger Shirley Wang tackled the issue today, asking "Does Court-Ordered Treatment for Mental Health Work?" So does it?
The answer, from Duke Univerity researchers and New York's official report, is a resounding yes. The OMH reported that the process resulted in a "substantial reduction in the number of psychiatric hospitalizations and in days in the hospital if a person is hospitalized." Their report also found that, "AOT reduces the likelihood of being arrested."
The New York report also found, "AOT recipients are far more likely to consistently receive psychotropic medications appropriate to their psychiatric conditions. Case managers of AOT recipients also report subjective improvements in many areas of personal functioning, such as managing appointments, medications, and self-care tasks."
One emotionally charged issue has been the racial disparities between blacks and whites in court-ordered treatment. In 2005, New York Lawyers for the Public Interest presented demographic data which demonstrated that African Americans were overrepresented in the AOT program. The OMH report acknowedged this, stating, "We find that the overrepresentation of African Americans in the AOT Program is a function of African Americans’ higher likelihood of being poor, higher likelihood of being uninsured, higher likelihood of being treated by the public mental health system (rather than by private mental health professionals), and higher likelihood of having a history of psychiatric hospitalization."Sphere: Related Content
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Feds want Medicaid money back

When needing mental health treatment, many of the nation's poor have been turned away at the door. A new move by the federal government may lock them out entirely, at least in Texas.
According to a story in today's Houston Chronicle, the feds have required the state to repay them $1.67 million in Medicaid reimbursements for inpatient psychiatric care. Medicaid does not provide for adults living in psychiatric institutions.
About 200 psychiatrists and institutions in the state received notices from the Texas Health and Human Services Commission in June requesting the return of reimbursements from 2001 to 2007. A few individual practitioners received bills for $40,000 and one medical group was hit with a $130,000 demand, according to the article.
Will other states be next?Sphere: Related Content
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Münchausen mother convicted of murder

On June 19, a St. Louis circuit court jury convicted Judy Pickens of second-degree murder and five other felony counts in the poisoning of her children, underscoring that Münchausen by Proxy is, at least for now, not a viable legal defense.

The case began when Pickens' three-year-old son Mikal died in October 2004. Her lawyer sent a letter threatening to sue St. Louis Children's Hospital for his death. Ironically, Pickens' daughter Kheematah was in the hospital days after the letter was received.
Hospital workers were suspicious and an aide was assigned to the room. One staff member reported seeing Pickens putting a substance in her daughter's drink. Another reporter seeing her tamper with her intravenous tube and throw an empty syringe in the trash.
Pickens was ultimately charged with crushing her blood pressure pills and feeding them to her son and trying to poison her daughter.
A psychologist testified that her behavior fit the criteria for Münchausen by Proxy, a disorder in which someone deliberately makes another sick to command attention, often from doctors or other care providers.
Even though her actions may be the result of a mental disorder, Michael Armour, a forensic psychologist, testified that, "In my opinion, these are rational and deliberate behaviors." Münchausen by Proxy "would not exclude someone from taking responsibility for their actions."
See STLtoday.com for the full story.Sphere: Related Content
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"Death in slow motion": A Scientology exposé

The death of Lisa McPherson, is the subject of today's St. Petersburg Times' series on the Church of Scientology.
Titled "Death in Slow Motion," this second in a three-part series on Scientology explores how the church's "counseling" services may have led to the death of this 36-year-old follower.Sphere: Related Content
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