This resource document provides an overview of the clinical, ethical, and legal considerations that a psychiatrist should consider when asked to write an emotional support animal (ESA) letter for a patient.
Suicide is a leading cause of death in the United States. Research demonstrates that how media reports on suicide and suicide attempts may either increase contagion risk or decrease the risk of future suicide attempts, rendering the issue a matter of public health and safety.
This resource document focuses on several of the ethical and practical issues surrounding psychedelics in their current investigational stage, and also discusses issues for psychiatrists to consider if psychedelics one day become available for broad clinical use.
Thousands of Haitians are traveling to the U.S.-Mexico border to seek asylum in the U.S., with many settling in camps after being denied entry. The U.S. government is responding with the deportations of thousands to Haiti. These deportations put Haitians at risk of violence, being unhoused, and even death amid Haiti’s political, economic, and environmental crises.
This resource document seeks to lay out the major issues involved in formulating the rules governing the psychiatric hospitalization of minors so that psychiatrists can be better informed when rendering their judgment in particular cases. Admission for substance use treatment raises somewhat different concerns that are not addressed in this document.
According to the office of the United States Surgeon General, syringe exchange programs are an effective public health intervention strategy that reduces the transmission of HIV and hepatitis. Syringe exchange programs do not encourage the use of illegal drugs, but seek to prevent the harm caused by unsafe drug use.
Racial injustices have long contributed to mental health disparities for minority and underserved populations. More than 50 years ago, Dr. Melvin Sabshin and colleagues documented the “structured pattern of racism” in psychiatry in a series of articles in the American Journal of Psychiatry. Insufficient progress has been made in eradicating institutionalized racism in psychiatry. Race-based disparities in psychiatric care and mental & behavioral health reflect this lack of progress and reproduce racial inequities that span all sectors of our society.
This document provides an overview of contemporary approaches to youth in mental health crises with practical, solution-oriented recommendations. It provides developmental considerations when dealing with youth in crisis, the continuum of existing response models and encourages readers to understand their role in advocacy through clinical vignettes. The resource document emphasizes de-escalation and rapid linkage to clinical evaluation services and supports the APA’s goal of ensuring young people in mental health crises and their families receive support by first responders who are appropriately trained to address their needs. This document provides an overview of contemporary approaches to youth in mental health crises with practical, solution-oriented recommendations. It provides developmental considerations when dealing with youth in crisis, the continuum of existing response models and encourages readers to understand their role in advocacy through clinical vignettes. The resource document emphasizes de-escalation and rapid linkage to clinical evaluation services and supports the APA’s goal of ensuring young people in mental health crises and their families receive support by first responders who are appropriately trained to address their needs.
Historically, psychiatry has had a fraught relationship with religion. One example can be found in the writings of Sigmund Freud, who was dismissive of religion and viewed it as a form of mental illness, drawing parallels between the rituals of obsessional patients and those of very religious people (Breakey 2001). However, there are also works throughout history demonstrating the harmonious relationship between psychiatry and religion, suggesting that the notion of an adversarial relationship between the two may not be a complete picture (Frankl 1975, Meissner 1984, Meissner 1987).
In 2019, there were nearly 72,000 U.S. overdose deaths, a new record high. Most of these overdose deaths involved opioids, with rising involvement of fentanyl and fentanyl analogues, which are increasingly found in street heroin and other opioids and often without the knowledge of the user. Even more concerning, it appears that the coronavirus pandemic is further worsening the overdose crisis.1 In the context of this ongoing crisis, psychiatrists must be aware of the full range of policy, organizational, and public health strategies impacting the lives of people who use drugs (PWUD). This document aims to inform psychiatrists about one such strategy: Safe Consumption Facilities (SCFs, also known as “supervised consumption sites”), an approach that has long been a feature of harm reduction efforts in certain countries and that has attracted increasing attention in the United States.
This document supports the APA’s goal of addressing structural racism in clinical practice by linking existing literature on the impact of race on patients’ lives with race as experienced in the clinical encounter. It provides psychiatrists with the necessary tools to speak with patients about race in a sensitive and professional manner using clinical vignettes. Incorporating these tools should increase understanding of how race and racism impact patients’ lives, decrease bias and enhance the therapeutic relationship. This document also encourages readers to seek to understand patients’ cultural and linguistic backgrounds as the beginning of any conversation about race, racism and discrimination. The authors believe this is the bedrock of culturally competent care, whether with a French speaking African immigrant, a Spanish speaking Latinx, or a Black teenager raised in the American South now living in the Northeast, as reflected in the included vignettes. The authors also acknowledge that racial groups are not homogeneous and that the focus on culture and language is intended to help psychiatrists focus on the unique aspects of an individual’s experiences in addition to talking about racial discrimination and bias.
Mental health courts (MHCs) are one of a range of “problem-solving courts” operated on the premise that the criminal law can be used to therapeutic ends to the benefit of both individual defendants and society as a whole, a concept known as therapeutic jurisprudence (Winick 2003). Other examples of problem-solving courts include homelessness courts, veterans’ treatment courts, and domestic violence courts. Many psychiatrists are unfamiliar with MHCs despite their rapid expansion in recent years. The purpose of this resource document is to describe the concepts behind and operations of MHCs and review their role and effectiveness.