Is Psychiatry Monolithic? Can You Rule Out Mental Illness By Reading Someone's Journal/Sketchbook? And, The Murphy Bill Returns
A few things from around the web:
In The Myth of Monolithic Psychiatry, Dr. George Dawson takes on the question of "Is Psychiatry Monolithic?" I didn't know what that even meant, but now I do, and this is a terrific piece and well worth the read.
Over on the Marshall Report, former APA president Jeffrey Lieberman gives his opinion on the notebook the Aurora shooter mailed to his student counseling center psychiatrist before he killed innocent people in a movie theater. Based on his review of the notebook, Lieberman was able to conclude:
His chief complaint and reason for seeking help at the university health center was related to interpersonal issues and anxiety. He does not reveal what would be considered psychotic symptoms. The major issues are his alienation, disaffection, isolation, fear and anger. No mental disorder is clearly apparent.
Wait, do psychiatrists do that -- rule out the presence of a mental illness -- without so much as meeting the patient? I guess I missed that part of training. I'd also like to add as an aside that while I have no idea if the shooter had a psychotic illness or was responsible for his actions (alas, I've never met him), I do think that intense psychic pain should fall under the rubric of what psychiatrists treat even if the symptoms don't add up to meet the DSM Chinese menu criteria for a specific mental disorder.
And the text for the 2015 version of the Helping Families in Mental Health Crisis came out on Thursday. The text of the new congressional act is 173 pages long, nearly 40 pages longer than the last version. Pete Early did a stand up job of getting right on it and comparing the new bill to the 2013 text in Murphy Introduces Revamped Bill. Outpatient Commitment is apparently no longer required, but states who adopt it will get extra funds, which I guess I find less objectionable, sort of. And there are some limitations on ending privacy rights for psychiatric patients which I think might do a better job of serving the intent of loosening these requirements. I'm still not a fan of singling out psychiatric patients as the only people who can't instruct a doctor not to release information about their care. And finally, I'm not sure how Murphy is planning to make more psychiatrists -- our field is already in a shortage situation, and psychiatrists are aging out of the field, with the majority of psychiatrists who are currently in practice now being over age 55. Personally, I think the only way to get more people into the field is to subsidize medical school for those who go into the field. As it stands now, many medical students just can't take on the astronomical educational debt and still manage on a psychiatrist's pay.
I'm still not sure I support the new version (Oh, I haven't read it and don't know if I will) but this does seem better. Do check out Pete's post.
And to those who've commented on our decreased rate of blogging, rest assured that we're making good progress with our upcoming book on involuntary psychiatric treatment.