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Mental Health Courts
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.
QTc Prolongation and Psychotropic Medications
Psychiatrists and other clinicians frequently prescribe psychotropic drugs that may prolong cardiac repolarization, thereby increasing the risk for torsades de pointes (TdP). The corrected QT interval (QTc) is the most widely used and accepted marker of TdP risk. This resource document was created in response to the paucity of strong evidence to guide clinicians in best practice prescription and monitoring of psychotropic medications that may increase risk of TdP.
Risk Management and Liability Issues in Integrated Care Models
Upon full implementation of the Affordable Care Act, it is estimated that more than 32 million Americans will become insured and gain access to mental health and substance abuse services at parity (1). Despite considerable gains in the number of medical school graduates entering the field of psychiatry over the past ten years, it has become clear that the workforce of psychiatrists is not large enough, acting alone, to meet the needs of patients (2,3).
Peer review of expert testimony
The American legal system seeks justice through the adversarial process. The adversarial process, by its very nature, tends to highly polarize ideas. At times psychiatrists who testify as expert witnesses in court or similar settings have been perceived in the popular, legal and medical literature as either deficient in knowledge or to have knowingly behaved in an unethical manner to advance the cause of the party who hired them.(1-6) Sometimes these perceptions are not accurate. Other times the
Psychiatrists' responses to requests for psychiatric information in federal personnel investigations
Psychiatrists routinely receive and respond to patient authorizations to release information to third parties. However, a security clearance-related request for information differs from an ordinary release of information generally encountered in clinical practice. An ordinary release specifies records, notes, admission or discharge summaries, or other information generated in the course of clinical care. Most often, the information is to be released to another provider or facility for use in a
Mental Health Issues Pertaining to Restoring Access to Firearms
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.
Interacting with Caregivers
In this document, we address ethical and legal issues related to involving caregivers in the treatment of patients and provide a comprehensive approach to the engagement of caregivers in the treatment process. This approach revolves around the development and implementation of a caregiver plan (CGP). It is important to note that the development of a formal CGP does not reflect current practice in the field. The discussion of a CGP in this document is for education: to describe a potentia
Mandatory outpatient treatment
Mandatory outpatient treatment refers to court-ordered outpatient treatment for patients who suffer from severe mental illness and who are unlikely to be compliant with such treatment without a court order. Mandatory outpatient treatment is a preventative treatment for those who do not presently meet criteria for inpatient commitment. It should be used for patients who need treatment in order to prevent relapse or deterioration that would predictably lead to their meeting the inpatie
College Mental Health and Confidentiality
College homicides and suicides often precipitate reviews of regulations, statutes and case law governing treatment and confidentiality.1 In April 2007, for example, a college senior at Virginia Polytechnic Institute and State University killed 32 students and faculty, wounded many others and then killed himself. The review panel appointed by the Governor found significant confusion among university officials about the Family Educational Rights and Privacy Act (FERPA)2, the federal law governing
Religious/spiritual commitments and psychiatric practice
Psychiatrists should maintain respect for their patients' commitments (values, beliefs and worldviews). a. It is useful for clinicians to obtain information on the religious/spiritual commitments of their patients so that they may properly attend to them in the course of assessment, formulation, and treatment. b. Empathy for the patient's sensibilities and particular commitments is essential. Conflicts, either within the patient or within the clinician-patient relationship should be handled with
Developing a Global Mental Health Curriculum in Psychiatry Residency Programs
As the importance and centrality of mental health becomes apparent within and beyond the health care sector, so will opportunities for psychiatrists to apply their knowledge and skills to meet the growing needs. Through careful attention to the moral imperatives and explanatory models among cultures that differ from their own, psychiatrists have been very successful in engaging local entities and establishing partnerships that incorporate trust, credibility, transparency, and accountability to a