Sad situation

[OldPsychDoc]

---

Members do not see this ad.

Thought this update would be of interest.

http://news.yahoo.com/s/ap/20061109/ap_on_re_us/new_orleans_psychiatric_care_5

 

[Anasazi23]

Unfortunately (and there's no way to tell), it's difficult to sort the legitimate cases from the homeless "admit me or I'll kill myself" 'patients.'

We expected a disaster of this proportion post-Katrina. It's not a consolation per se, but the entire medical system is in shambles there...not just psychiatry.

A semi-misleading statement at the end:

There are one full-time, board certified psychiatrist, and two part-time psychiatrists to treat 2,000 inmates.

Not all those inmates are psychiatric patients (unless I misread it).
At their statistic of 11.3% mentally ill in the city, approximately 226 inmates are mentally ill (yes, I know that there is a higher incidence in jail). At this rate, that's two full time psychiatrist equivalents for 226 patients. That's lighter than my caseload will be next year, and more than manageable.

Even if you presume 30% mentally ill of 2000, the number comes to 600, which for 2 full time psychiatrists, is do-able at 300 patients each.

If the number 2000 are considered 100% psychiatric patients, then yes, it is overburdened.

 

[lloyd braun]

Unfortunately (and there's no way to tell), it's difficult to sort the legitimate cases from the homeless "admit me or I'll kill myself" 'patients.'

We expected a disaster of this proportion post-Katrina. It's not a consolation per se, but the entire medical system is in shambles there...not just psychiatry.

A semi-misleading statement at the end:


Not all those inmates are psychiatric patients (unless I misread it).
At their statistic of 11.3% mentally ill in the city, approximately 226 inmates are mentally ill (yes, I know that there is a higher incidence in jail). At this rate, that's two full time psychiatrist equivalents for 226 patients. That's lighter than my caseload will be next year, and more than manageable.

Even if you presume 30% mentally ill of 2000, the number comes to 600, which for 2 full time psychiatrists, is do-able at 300 patients each.

If the number 2000 are considered 100% psychiatric patients, then yes, it is overburdened.

Let's not forget that treating inmates is not the same as treating patients in the outpatient setting, a hospital, or even other community settings. There are issues of overcrowding, violence, rampant HIV, TB, hepatitis C, etc. that can make the job a lot more stressful and difficult to manage in comparison to other psychiatrists' jobs. Yes, the caseload might be lighter in number, but the complexity of providing comprehensive care in a setting designed to punish can be quite challenging. Furthermore, I think as a whole, these patients will be a lot sicker and seeing them every 3 months or so simply would not fly.

 

[whopper]

Unfortunately (and there's no way to tell), it's difficult to sort the legitimate cases from the homeless "admit me or I'll kill myself" 'patients.'

Agree---Once you see a patient pull the same bullcrap several times, then see that patient in the inpt unit--avoid all groups, start hitting on other patients, and have a smile on their face the second they get into the hospital--you know they're full of dung.

Problem is after that, when you've figured out they're a BS artist, and refuse to let them in, some of them are willing to pull some stunt, such as superfically cut their wrist because they know that while in the hospital, where they'll get immediately treated & its enough to override you.

Or some of these con artists then just move to a hospital in a different area. One guy I knew would pull his stunt in Atlantic City. Once he wore his welcome, he moved on to the Camden hospitals. Then from there Philadelphia. Then he'd cycle back to Atlantic City. He'd be able to get away with his crap for about a month each per hospital. When he got to the new hospital, they hadn't seen him for a few months so they're willing to give him another chance.

One guy I didn't want to admit-but was forced to admit because my attending had a soft spot conducted a drug deal over the phone in the inpt unit with a big smile on his face. Then he started saying stuff like "yeah these dopes, they got me free housing so long as I say I'm suicidal". Yeah well good thing the inpt attending wasn't a wimp, and kicked that guy out within the hour. He then told the guy if he continued with his bogus suicidal threats-he'd call the police and charge the guy with making terroristic threats.

Well, at least if I decide to become a homeless parasite on society, I know a way to get free hospital stay continuously and get away with it.

Sometimes I wish there was a real life Punisher (the Marvel Comics guy) who'd teach these guys a lesson.