tag:blogger.com,1999:blog-26666124.post8504995916591533152..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Assorted Frustrations, Plus a Book and TV Series ReviewUnknownnoreply@blogger.comBlogger3125tag:blogger.com,1999:blog-26666124.post-29398096483965339392017-03-01T20:22:21.088-05:002017-03-01T20:22:21.088-05:00Read your column in Feb issue of Clinical Psych Ne...Read your column in Feb issue of Clinical Psych News, yes, it is tough to know when it is correct to force inpatient care. Spend some time at any of the State Inpatient Units, as I have these past near 7 months, and see what court ordered care has wrought for clinically driven providers stuck in forensic dens of punitive, adversarial conditions.<br /><br />It is sad, as I come back 26 years later from my first residency rotation at the same place, and see what it is now, versus taking care of chronically ill patients who needed time and care to attempt to reintegrate into their communities.<br /><br />Now it is just rushed and forced, expecting drugs to make people manageable.<br /><br />Shakespearean tragedy circa 2017...<br /><br />Joel Hassman, MDJoel Hassman, MDhttps://www.blogger.com/profile/18428102819014299270noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-21458348976458930632017-02-12T10:23:03.833-05:002017-02-12T10:23:03.833-05:00as an addendum to the above, this morning going th...as an addendum to the above, this morning going thru old journals I have neglected to review until now, found in an old Psychiatric Annals a short article, "A case review of poor insight in Schizophrenia: How much do we know?", May 2014 volume 44, issue 5.<br /><br />Included as the link here:<br />http://www.healio.com/psychiatry/journals/psycann/2014-5-44-5/%7B1627f248-898e-4ad3-a73c-3338eddcf58a%7D/a-case-review-of-poor-insight-in-schizophrenia-how-much-do-we-know<br /><br />Read the last 3-4 paragraphs of the article, and it notes, unfortunately, that insight can't be simply medicated into effect, and thus for me, reinforces the fine line to when we should be continually psychiatrically hospitalizing patients who just can't, won't, or worst, never will get it.<br /><br />Sorry, it is why we have prisons for some who, for lack of a better term, are terminally ill, and I don't get why colleagues freak out when I have to say that.<br /><br />Every field of medicine has a terminally ill portion, so, I hope you don't just reflexively deny this, but I don't say it to mess with hope and faith. But, hardened realist, yeah, I'll accept that designation.<br /><br />Sincerely,<br />Joel Hassman, MDJoel Hassman, MDhttps://www.blogger.com/profile/18428102819014299270noreply@blogger.comtag:blogger.com,1999:blog-26666124.post-84556281643826372512017-02-11T19:38:33.828-05:002017-02-11T19:38:33.828-05:00Simply this, working briefly at Springfield Hospit...Simply this, working briefly at Springfield Hospital for another month after 1 month already and almost 4 months prior at Finan Center, when does non-compliance repetitively become criminal? When people violate parole and probation limits, they go to jail. So, when people are ordered into conditional release or other court-ordered limits because of their mental health, and then repetitively refuse to be compliant, when do you stop burning mental health professionals who have tried so many ways to maintain compliance and just basically get crapped on both by the court and the patient who refuses to cooperate?<br /><br />It's time for psychiatrists to stop being the lackeys and whipping boys of the courts, as judges are not realizing that we can only do so much, and it's not fair to make psychiatric hospitals jails as much as you rail about jails being psychiatric hospitals!<br /><br />And guess what, I have the right to say it because I am in the trenches right now.Joel Hassman, MDhttps://www.blogger.com/profile/18428102819014299270noreply@blogger.com