Public Psychiatrist Research Articles

Advancing family involvement in collaborative health care: Next steps.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). C. J. Peek has provided us with a masterful integration of Don Bloch's vision of collaborative family health care and the evolution over the past 20 years of the field. The current author was very fortunate to be part of the initial meeting at Wingspread in 1994. As a family systems-oriented community and public health-trained psychiatrist, my primary focus over 30 years has been on families facing chronic illness and disability and collaborative care efforts in specialty, primary, rehabilitation, and palliative care medicine. In my view, the ability of the health care consumer (patient and his or her family members) and professional worlds to collaborate in a more egalitarian and less hierarchical and wary manner remains a significant constraint to progress.

Medical students and public misunderstand psychiatrist role

The role of psychiatrists is misunderstood not only by the public but also by medical students, show the results of a small survey presented to the Royal College of Psychiatrists’ International Congress in Edinburgh last week. Researchers from St George’s University of London surveyed 103 patients at a semi-rural general practice in England …

Patient Kills Virginia Psychiatrist in His Home Office

A public psychiatrist early in his career, Mark Lawrence, M.D., turned to private practice and was active in group and family psychotherapy and imaging work integrating cognitive and affective aspects of therapy.

Transition in care in persons with antidepressant prescription in naturalistic conditions

Few studies have explored transition to psychiatric care in persons treated by antidepressants in primary care. To assess the rates of transition in care after a dispensing of antidepressant and the characteristics associated with transition from primary to psychiatric care. A follow-up study of persons (n = 19 975) starting antidepressant treatment was carried out on a representative sample of the 2005-07 French Social Security Insurance national database. Prescribers were categorized as GPs, hospital practitioners (as a proxy for public psychiatrist), private psychiatrists and other private specialists. Transition in care was defined as a prescription of psychotropic drugs by a prescriber belonging to a category different from that of the index antidepressant prescriber. Eighty per cent of incident antidepressant treatments were initiated by a GP and 28% of persons transited in care. The most frequent pattern was transition from a GP to a hospital practitioner (8%) or to a private psychiatrist (5%). Transition to psychiatric care was independently associated with younger age and markers of illness severity (psychiatric chronic illness status, duration of the index antidepressant treatment >6 months and prescription of other classes of psychotropic drugs). Almost all treatments with antipsychotics or mood stabilizers were initiated after the transition to a specialist. Transition to psychiatric care seemed coherent with distribution of tasks between primary and secondary care according to illness severity. Further studies using detailed clinical information are required to assess not only the clinical appropriateness of psychiatric referral but also lack of referral in antidepressant users.

Loving Warrior, Gentle Rebel: Michael Corry, 1948 – 2010

Dr. Michael Corry died at his home in Clara Vale, Ireland, on February 22, 2010, after a short illness. He was a fearless campaigner for the rights of mental health service users and all those suffering psychological distress, an opponent of biopsychiatry and its reliance on psychopharmacology, an implacable campaigner for the abolition of electroconvulsive therapy (ECT) as a so-called therapy, and a compassionate healer appreciated by thousands of patients. After qualifying in 1973, Michael's career spanned work as a hospital doctor in Uganda in the Amin era before he qualified as a psychiatrist and psychotherapist, work as a public service psychiatrist in St. Brendan's Hospital in Dublin, and private practice. His imagination and desire to get things done powered both his work as director of the European Union (EU)-sponsored Resocialisation Project at St. Brendan's in the early 1980s and as a founder of the privately funded Clane Hospital in Kildare, where he served as consultant psychiatrist from the early days. He was a founder of the Institute of Psychosocial Medicine in Dun Laoghaire, County Dublin, in 1987, which developed from a four-partner practice into an organization with more than 20 practitioners and nationwide renown as a healing center and which also provides training courses and encourages research and advocacy. In June 2004, Michael began a series of articles on depression in the Irish Times that led to the establishment of the monthly Depression Dialogues seminars, which he moderated with his partner, Dr. Aine Tubridy, and to the launch of the depression dialogues Web site on St. Valentine's Day 2005. In 2006, he, together with a number of mental health campaigners who supported his existential approach to the treatment of psychological distress, set up The Wellbeing Foundation to pursue the aim of substituting an experiential, holistic, and compassionate approach to mental health for the drug-based and often dangerous and ineffective approach of conventional psychiatry. The Wellbeing Foundation's successful conference in October 2006, attended by almost 700 people, helped open a public debate on mental health difficulties and on modes of treatment that had previously been virtually absent. The Dialogues, the conference, and continued interventions by Dr. Corry and others were partly responsible for animating a wider patients' movement - or survivors' movement as many former patients prefer - and placing increasing pressure on conventional biopsychiatry, which had enjoyed an easy ride until then. Michael's work in campaigning for an end to electroshock "therapy" led to a private members bill being introduced into the Senate in 2008 that would bar the forced use of ECT - use without informed consent. While the government did not accept the bill as proposed, Minister for Mental Health John Moloney has started a consultation process that may lead to the first steps toward ending this practice. …

Psychiatry in Australia: economic and service delivery aspects

In 1987 there were 1,428 psychiatrists in Australia, 8.8 per 100,000 population (Burvill, 1988), 55% identified as in private practice and 45% in public sector practice. Let us be clear about terms. Public sector practice means that each week you receive a salary from the public purse whether you have seen one or a hundred patients. Private practice means that you are paid on a piece-work basis, also largely from the public purse (national health insurance or Medicare), but the income (at about $100 per hour) depends exactly on the number of hours spent with patients. On average, private psychiatrists in Australia gross about $150,000 per year, out of which they must pay practice expenses. The pay for public sector psychiatrists probably averages $70,000 to which, for the purposes of our calculation, we will add the cost of rooms, telephone and secretary provided by the hospital which at $30,000 brings the cost of a public sector psychiatrist to about $100,000 per year. If 45% of psychiatrists are in public practice then the averaged cost of a psychiatrist in Australia can be calculated as $127,500 per annum, and as there are 8.8 psychiatrists per 100,000 the cost, calculated on this simple basis, is $1.12 million per 100,000 population (Andrews, 1989).