Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum

"Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum

Presented by Ontario Hospital Association

Course name: Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum
Course duration: September 17, 2009 - September 18, 2009
Location: Marriott Eaton Centre Hotel
525 Bay Street
Toronto, Ontario
Canada
Course code: EP 144

Join colleagues from across Canada on September 17 & 18 as the Ontario Hospital Association and the Canadian Patient Safety Institute jointly launch the research paper, “Patient Safety in Mental Health”. The first paper of its kind in Canada defines the patient safety issues unique to mental health and highlights the important opportunities for improving patient safety in mental health.

The Ontario Hospital Association, in partnership with the Canadian Patient Safety Institute, is pleased to present this one-day national conference on patient safety in mental health. This conference will provide participants with the opportunity to hear about current strategies to address some of the critical patient safety issues in mental health from leading experts across Canada and the US.

Topics to be addressed include: the key findings and themes from the research, using evidence and best practice to provide safer care, suicide and risk assessment, transitions of care, and creating safe environments for both patients and staff."

Link: http://www.oha.com/Education/Pages/CalendarofEventDetails.aspx?eventid=EP%20144


We'd like to see a focus on proper physical workups for diagnosis and healing through nutrition. Drugs are a leading cause of dependency, disability, morbidity and mortality.

Remember the Primum - "First, do no harm".

THE EXTRAORDINARY WALKER EXAM helps us understand diagnosis and correction of the real physical causes of mental disorders....



"The following Field Manual was compiled by order of the California legislature. It reveals that 39% of psychiatric patients studied were found to have active medical diseases, many of which caused or worsened their mental condition. The Manual explains the importance of screening patients for disease and lays out a step-by-step process for doing so.
Prepared for theCalifornia Department of Mental Health and Local Mental Health Programs Pursuant to Chapter 376, Statutes of 1988 Assembly Bill

By Lorrin M. Koran, M.D., Department of Psychiatry and Behavioral Sciences,
Stanford University Medical Center
Stanford, California 1991

...The SB 929 Study team performed complete medical evaluations of 476 patients drawn from 24 county mental health programs spread across four Northern California counties and of 53 patients at Napa State Hospital.

The most important findings of that study are: 31,32 para 1. Nearly two out of five patients (39%) had an active, important physical disease.

2. The mental health system had failed to detect these diseases in nearly half (47.5%) of the affected patients.

3. Of all the patients examined, one in six had a physical disease that was related to his or her mental disorder, either causing or exacerbating that disorder.
4. The mental health system had failed to detect one in six physical diseases that were causing a patient’s mental disorder. (Five of 33 cases of physical disease causing a mental disorder had not been detected.)

5. The mental health system had failed to detect more than half of the physical diseases that were exacerbating a patient’s mental disorder. (Twenty-seven of 49 cases of physical disease exacerbating a mental disorder had not been detected.)"
Link - MEDICAL EVALUATION FIELD MANUAL

More on the physical causes of mental symptoms can be found here.

From Blogging against Disablism

From Blogging against Disablism: those lazy, deceiving disabled..why won't they die?
http://elizabethmcclung.blogspot.com/2007/05/blogging-against-disablism-those-lazy.html#links

A group that are lazy, deceivers, liars, take the easy way, always have their hand out, always feel the rules don’t apply to them, unwilling to take responsibility, unwilling to try. No, not just a historic view of the Welsh (“Welshed on a deal”), or Gypsies (“Got gypped”) or Jews, I am talking about the Western attitude toward people with disabilities; in particularly those with sudden or emerging disabilities....

I know two of the people whose government job it is in BC to find the “slackers” and cut them from disability (regardless that the only way to qualify for disability payments is to have less that $3000 in assets to begin with). I have not applied as since my partner makes money, so I do not qualify. However earlier in life, during a period of temporary disability in the UK, even though I was designated as “disabled” I was awarded a monthly supplement assessed income of $0 (but I was exempt from my share of paying garbage tax). After three months I was ordered by letter to come “with two forms of picture ID” to prove to an independent doctor that I was disabled. The entire experience was one in which they dictated that some/many designated disabled people are cheats and liars and that I needed to prove I wasn’t one of them (and prove that I hadn’t sent in a different disabled person to trick them into thinking it was me). The doctor told me, “You have 10 minutes.” I asked if he had my medical records. He opened the folder. It was empty. “You asked my GP for them didn’t you?” I asked.

“You have nine minutes.” He responded.

“I have nine minutes to “prove” I am disabled because you don’t believe I am?”

“Correct”

“Well,” I said, “First I would like you to prove that you are a licensed GP who is qualified to evaluate me. I brought two pieces of Picture ID to verify my identity, all I ask is your Medical Certificate.”

He recoiled as if I had struck him. And was speechless for another minute (now down to 8 minutes). “I don’t have to prove anything to you.”

“Unless you can verify that you actually are a doctor, I will not disclose confidential medical information with you simply for you to decide if I am a liar.” I responded.

“I will be writing the report on you regardless” he threatened, “If you do not give me the information then I will be forced to report on your attitude and you may find your monthly supplement decreased.”

So, now I was not being evaluated on my physical need, but on my “attitude”? I was being threatened for not having the right attitude? Thankfully, half of $0 is still $0, though I clearly remember the humiliation of attending my award ceremony for a Ph.D. in one month and being summoned to a room to prove to some guy who said he was a doctor that I wasn’t a liar and cheat the next. What if my ability to feed or transport myself was on the line instead, or my ability to breathe, to get medical supplies?

Top Ten Noteworthy Lobotomies

Link
Wikipedia entry on lobotomy
We hear that nowadays they use pills instead of icepicks. See "chemical lobotomy".

Lancet, AHRP: Who Beguiled Doctors?

ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full
Disclosure, and Accountability http://www.ahrp.org and
http://ahrp.blogspot.com
FYI
"The current issue of The Lancet, includes a meta-analysis comparing
the efficacy of old and new neuroleptics--a.k.a. first generation
antipsychotics and 'atypical' second generation antipsychotics. The
findings corroborate the fact that the new drugs are no better than
the old antipsychotics.
See:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)617...
A Commentary in the same issue, "The Spurious Advance of Antipsychotic
Drug Therapy," by Dr. Peter Tyrer, professor of community psychiatry,
Imperial College, London, and Tim Kendal, MD, co-director of the
Royal College of Psychiatrists' national collaborating centre for
mental health, leads one to conclude that doctors have been 'conned'
by drug manufacturers:
"The new generation of drugs, known as atypicals, were heralded as
safer and more effective than the earlier antipsychotics, and for
the past 20 years doctors have been bbeguiledb into thinking they
were superior."
'The spurious invention of the atypicals can now be regarded as
invention only, cleverly manipulated by the drug industry for
marketing purposes and only now being exposed.' (Source: Lancet,
2009; 373: 4-5; 31-41).
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)617...
We would beg to disagree: given the active (duplicitous) role of
prominent academic psychiatrists, as well the major professional
associations in psychiatrybthe American Psychiatric Association,
the American College of Neuropsychopharmacology, the American Academy
of Child and Adolescent Psychiatry, et al in promoting the second
generation antipsychotics, it is unfair to lay blame entirely on
the pharmaceutical industry...."
Continue reading here.

When the Cure is Worse than the Disease

"Mary wonders why the new young doctor she visited recently says to nearly every patient, after examining their throat, that it looks like their esophagus is being eroded by stomach acid and they need to start taking acid-blocking pills. He hands patients free samples provided by pharmaceutical companies. The patients are oblivious to the fact that if they begin using the drug, they may never be able to stop taking it without experiencing an excruciatingly painful bout of rebound heartburn."

One way to build an income in private medical practice is to hook patients on drugs that continually require re-examination, testing and prescription renewal. Article here.

Tranquilizer Addiction Rampant in the UK: Daily Mail

"It's thought that between three and seven million Britons are affected, with antidepressants, tranquillisers, sleeping pills and pain-killers the main culprits.

A recent report by the United Nations' International Narcotics Control Board predicted that the scale of the problem of addiction to legal drugs will soon overtake addiction to banned substances.

Yet despite this, few patients receive any effective help - meanwhile, millions of pounds are spent helping those addicted to illegal drugs. In fact, the problem of prescription addiction has, for years, been ignored or denied by drug companies and successive governments."

Story here.

Video - Money Talks: Profit Before Patient Safety

This 50-minute documentary was created to give an in-depth, academic perspective on the questionable marketing tactics of the pharmaceutical industry, and features the commentary of investigative journalists and medical professionals including Dr. John Abramson, author of Overdosed America, and Prescription Access Litigation Project Director, Alex Sugerman-Brozan. Other notable interviewees include Dr. Bob Goodman of Columbia University, founder of the 'No Free Lunch' program, and Dr. Jerome Hoffman of UCLA Medical School.

But these day may be numbered. Pharma may soon have to disclose its contacts. Read more here.

Blind Faith

BLIND FAITH
What happens when drugs, science and money mix?
"Our investigation discovered complex, seemingly ubiquitous, financial relationships between giant pharmaceutical companies and the scientific community tasked with establishing the safety of our drugs.
And the financial entanglements are not just pervasive, they are oftentimes virtually invisible.
Blind Faith also reveals a frightening escalation in the number of unsafe drugs being pulled from Canadian store shelves, an astounding number of medications that are routinely prescribed for unapproved uses and a federal bureaucracy that seems ill-equipped to offer Canadians the safeguards they deserve.
Much of our investigation focuses on McMaster University and the researchers who work there. You'll learn that in recent years the amount of money the pharmaceutical industry pours into McMaster and its teaching hospitals has almost quadrupled.
For many at McMaster, that explosion in funding is a source of genuine pride, emblematic of the university's stature in the scientific community.
Fair enough.
But that explosion has also exacerbated the very real concerns many have about the uneasy relationship that sometimes exists between scientists and the people who pay for their research.
Initially, we focused our attention on Mac simply because it's in our back yard.
But what we discovered over the course of our investigation is that the university's outstanding success in attracting private funding has brought into particularly sharp focus many of the ethical issues such funding raises.
Universities across North America face increasing scrutiny in this area, and the scientific community is, itself, debating the implications of the increasingly cosy relationship it has with the pharmaceutical world. In Blind Faith, you'll come to understand why that is a conversation in which we should all participate."

Lyme Disease: Antitrust probe spurs disease review

Lyme Disease can be wongly diagnosed as mental illness, causing further harm by delaying proper treatment. Read articles here and here

NYT: Merck wrote studies for doctors to sign

Great cartoon from Jabberwock via Veracare/AHRP, with thanks.


April 16, 2008
Merck Wrote Drug Studies for Doctors

By STEPHANIE SAUL
The drug maker Merck drafted dozens of research studies for a best-selling drug, then lined up prestigious doctors to put their names on the reports before publication, according to an article to be published Wednesday in a leading medical journal.

The article, based on documents unearthed in lawsuits over the pain drug Vioxx, provides a rare, detailed look in the industry practice of ghostwriting medical research studies that are then published in academic journals.

The article cited one draft of a Vioxx research study that was still in want of a big-name researcher, identifying the lead writer only as “External author?”

Vioxx was a best-selling drug before Merck took it off the market in 2004 over evidence linking it to heart attacks. Last fall, the company agreed to a $4.85 billion settlement to resolve tens of thousands of lawsuits filed by former Vioxx patients or their families.

The lead author of Wednesday’s article, Dr. Joseph S. Ross of the Mount Sinai School of Medicine in New York, said a close look at the Merck documents raised broad questions about the validity of much of the drug industry’s published research, because the ghostwriting practice appears to be widespread.

“It almost calls into question all legitimate research that’s been conducted by the pharmaceutical industry with the academic physician,” said Dr. Ross, whose article, written with colleagues, was published Wednesday in JAMA, The Journal of the American Medical Association. and posted Tuesday on the journal’s Web site.

Merck acknowledged on Tuesday that it sometimes hired outside medical writers to draft research reports before handing them over to the doctors whose names eventually appear on the publication. But the company disputed the article’s conclusion that the authors do little of the actual research or analysis.

Read the article here


Ghost Writers in the Sky

Salon: Doctors Without Orders

Now they want to put dog tags on us to monitor when we take our meds. What next?

Doctors Without Orders
THE MYSTERY OF PATIENTS WHO FAIL TO FOLLOW PRESCRIPTIONS.
By Jessica Wapner
Posted Friday, March 21, 2008, at 10:21 AM ET

Many patients do not take medicine as prescribed
Earlier this month, scientists at Georgia Tech announced their invention of a necklace that records the date and time at which a person swallows his prescription medicine. The device (which looks more like a dog collar than jewelry) responds to a tiny magnet in the pill as it travels down the esophagus. Other recently developed similar technologies include a drug-filled prosthetic tooth that slowly drips medicine into the mouth and a pill bottle that sends a wireless message to your pharmacist every time it's opened.
Are we so bad at taking medicine that we need false teeth to do it for us and pill bottles that tattle on us when we don't?