my ideal....

[Psyclops]

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I figure the northeasterners will be familiar with this place, but have a look see everyone and let me know your thoughts...

http://www.austenriggs.org/

....don't get too used to it though. It will make the MH system reality that much harder to bear.

 

[Doc Samson]

I figure the northeasterners will be familiar with this place, but have a look see everyone and let me know your thoughts...

http://www.austenriggs.org/

....don't get too used to it though. It will make the MH system reality that much harder to bear.

It's a very nice place, but the patient population is quite homogenous.

 

[Psyclops]

BPD x 70?

 

[Doc Samson]

BPD x 70?

Wealthy caucasian BPD x 70

Fees

 

[Psyclops]

Hmmmm....I'm trying to think of pts with BPD that didn't fit that profile...

 

[Psyclops]

...I can't....not from my experience at least.....DSM is no help either.

 

[Doc Samson]

Hmmmm....I'm trying to think of pts with BPD that didn't fit that profile...

The ones here:

Mass Mental

 

[Psyclops]

THe fees weren't that surprising to me, I've worked at two private hospitals and that was exactly our quoted rate. The only thing was our average length of stay wasn't 4-6 weeks. We also accepted the Ms and would generally end treatement when the third party payer told us to (I didn't work in UR, not that I would have done anything different). It was much more the "stabilization and goodbye" model.

 

[Psyclops]

I'm sure there is a much more diverse population at MMHC. BUt, when it comes to BPD, in your experience, do the patients tend to be homogenous?

 

[Doc Samson]

I'm sure there is a much more diverse population at MMHC. BUt, when it comes to BPD, in your experience, do the patients tend to be homogenous?

No, but unless you're working at a state facility, you won't see that. Poor borderlines burn their bridges at private hospitals very quickly.

 

[Psyclops]

I wasn't talking about SES I was talking about ethnicity. I'm familiar with plenty of poor borderlines.

 

[Poety]

Admit me there DS, look so nice, I can just live it up for a while ,get some therapy, relax, eat good food - mmmm sounds like a nice place to vaca

 

[Doc Samson]

I wasn't talking about SES I was talking about ethnicity. I'm familiar with plenty of poor borderlines.

Oh, sorry. But, no, in my experience it's not an ethnically homogenous group either.

 

[Doc Samson]

Admit me there DS, look so nice, I can just live it up for a while ,get some therapy, relax, eat good food - mmmm sounds like a nice place to vaca

If you think that looks nice, take a look at this:

McLean Pavillion

High chance you'll be in group therapy with a celebrity!

 

[Doc Samson]

...or if you wanted to avoid examining your dynamic conflicts, and wanted a CBT vacation:

Brattleboro Retreat

 

[Psyclops]

Hmmm, you know, one hospital I worked in was in a rural setting, population wasn't homogenous on any measure except for diagnosis. But, most recently I worked at a hospital that, although private, was located in a large northeastern city and received a broad range of populations. But when it came to the BPD criteria, I didn't often see them in non-caucasians.

 

[Psyclops]

...or if you wanted to avoid examining your dynamic conflicts, and wanted a CBT vacation:

Brattleboro Retreat

Damn.....what can I say, I want in.

 

[Doc Samson]

...or if you wanted to avoid examining your dynamic conflicts, and wanted a CBT vacation:

Brattleboro Retreat

...or if you prefer New York to New England:

Four Winds

...or if you want to detox in the desert:

Sierra Tucson

 

[Doc Samson]

Hmmm, you know, one hospital I worked in was in a rural setting, population wasn't homogenous on any measure except for diagnosis. But, most recently I worked at a hospital that, although private, was located in a large northeastern city and received a broad range of populations. But when it came to the BPD criteria, I didn't often see them in non-caucasians.

OK, I'm going to hypothesize here, so bear with me. Just off the top of my head, no evidence to support any of this:

I think MMHC might've provided me with a broader population view of BPD because it specializes in a) psychosis, and b) BPD, with triage focused on whether the pt should enter the CBT program or the DBT program. I wonder if other, less specialized facilities might tend to label non-white borderlines as "psychotic". There is strong epidemiological evidence (the kind of evidence I actually trust) that psychosis is overdiagnosed in black men with depression, so I wonder if a similar mechanism might be in play here. Another epidemiological concern might be that non-white borderlines might be more likely to be sent to jail as a result of violent acting-out, rather than to treatment, so treaters end up seeing a biased sampling of the population.

 

[OldPsychDoc]

I figure the northeasterners will be familiar with this place, but have a look see everyone and let me know your thoughts...

http://www.austenriggs.org/

....don't get too used to it though. It will make the MH system reality that much harder to bear.

I've got that beat! 😀

I think that rehabbing here would make the hard work of being an addict worthwhile! 😎
And for a mere $17,000 per month!

(I wonder if they need a board-certified addiction psychiatrist?)

 

[Doc Samson]

I've got that beat! 😀

I think that rehabbing here would make the hard work of being an addict worthwhile! 😎
And for a mere $17,000 per month!

We have a winner!

 

[Milo]

We have a winner!

17K? Chump change 🙂


http://www.timesonline.co.uk/article/0,,2-1802846,00.html

http://www.themeadows.org/meadows-treatment.html

 

[Psyclops]

I think MMHC might've provided me with a broader population view of BPD because it specializes in a) psychosis, and b) BPD, with triage focused on whether the pt should enter the CBT program or the DBT program. I wonder if other, less specialized facilities might tend to label non-white borderlines as "psychotic". There is strong epidemiological evidence (the kind of evidence I actually trust) that psychosis is overdiagnosed in black men with depression, so I wonder if a similar mechanism might be in play here. Another epidemiological concern might be that non-white borderlines might be more likely to be sent to jail as a result of violent acting-out, rather than to treatment, so treaters end up seeing a biased sampling of the population.

I think those are good points. And I do think that is the case, sadly. Or at least that is the case with psychosis. I don't know about borderlines. I'm just hypothesizing here too, so don't shoot me but, I think that cultural effects might mask or muddy the waters when trying to tease apart BPD in some non-white samples. I mean, I imagine that the diagnosis is based on white norms from predominantly white culture. Basing the diagnosis on patients with another cultural background might either over endorse the BPD pathology or under endorse it, depending on how it presents and the features of the culture. This is something I would have to think about.

As for the diagnoses that Pts would get at the facilities I have worked at, often Axis II was just defered, even if everyone would agree that the pathology was present. THere wasn't much time spent on assessment.