Some of the closed threads

[whopper]

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Nancysinatra & I discussed this over private mail.

If someone comes to this forum and inappropriately asks for help from us mental health professionals, we should politely inform them that we cannot help them in that manner, then direct them to possible sources that can. I emphasize the word politely.

We've had a few people come on the board quite angry with their experiences with other mental health profesionals, and vent that anger onto us. This in turn made us angry, and fire back. While this is a common response to be expected by anyone, we are supposed to be professionals. We should aspire to a higher standard.

I also would like to remind all of you that several of us have encountered other people in the profession who did not practice up to their professional obligations. Its realistic to find someone who may have been mistreated by another mental health professional. While its not correct for them to blame us, it is understandable for these people to vent their anger, and this is quite consistent with what we know of defense mechanisms.

No we can't give them therapy over the net, but we can direct them to the right people who can help them in a manner in the same standards of our profession.

 

[notdeadyet]

It's kind of outside the scope of SDN though, isn't it?

A patient in need of treatment makes a post on SDN outlining their condition and what they're looking for. The professionals on SDN's psych forum make recommendations of where to look for treatment or how to go about finding it. Makes sense.

But it would be a pretty big departure for SDN to serve as a resource for patients. And it would have to change the flavor of the Psych forum as well. I personally would definitely be less frank about my comments/concerns/gripes about Psychiatry, techniques, residency programs, hospitals, etc. if more patients started using it as a resource.

Answering requests for treatment with referrals is still answering requests for treatment and it encourages patients to use the forum. I don't necessarily think it's a bad idea, but I'd recommend folks really do some navel gazing if that's a new direction they want the forum to take.

 

[Thorazine]

i agree with notdeadyet. im not on the clock or here to give out consultations (which would be worthless anyway being a lowly intern!). this is a forum for professionals but not necessarily a professional forum. we should be allowed to vent as well.

 

[sunlioness]

I don't think Whopper was saying that we're not allowed to vent. Just that even when someone shows up with an obvious chip on their shoulder, we still treat them politely.

 

[billypilgrim37]

Our night ED attending frequently tells patients, "Hey, I didn't show up in your living room in the middle of the night. You showed up in mine."

Just saying.

 

[nancysinatra]

I don't think Whopper was saying that we're not allowed to vent. Just that even when someone shows up with an obvious chip on their shoulder, we still treat them politely.

I don't think the point was that we're here to offer consults either. Just to be tactful when people show up who appear to be suffering in some way or other, rather than overtly kicking someone who is down.

 

[notdeadyet]

I don't think the point was that we're here to offer consults either. Just to be tactful when people show up who appear to be suffering in some way or other, rather than overtly kicking someone who is down.

I think I tend to tune out the threads of people seeking medical advice. Are folks really treating the help-seekers poorly? That's really unfortunate.

I wholeheartedly agree that we should treat everyone with kindness. I'm just uncomfortable with the idea of offering recommendations or any other kind of treatment.

I think we should treat with folks looking for medical advice the same way all the other forums on SDN do. Someone replying with "Sorry, it is against the TOS of SDN for anyone to give medical advice" and lock the thread.

 

[BabyPsychDoc]

I think I tend to tune out the threads of people seeking medical advice. Are folks really treating the help-seekers poorly? That's really unfortunate.

I wholeheartedly agree that we should treat everyone with kindness. I'm just uncomfortable with the idea of offering recommendations or any other kind of treatment.

I think we should treat with folks looking for medical advice the same way all the other forums on SDN do. Someone replying with "Sorry, it is against the TOS of SDN for anyone to give medical advice" and lock the thread.

I would tend to agree with this standpoint. At best, we could put together a list of patient info websites and direct such posters to that list if they are interested. Anything more than that, they should really discuss with a mental health professional in person.

I do agree though that we need to behave professionally ESPECIALLY towards such posters, since they are those that tend to have loudest voices when it comes to criticising psychiatry - why give them another (valid) reason to complain?

 

[whopper]

I don't think Whopper was saying that we're not allowed to vent. Just that even when someone shows up with an obvious chip on their shoulder, we still treat them politely.

That's what I meant. In any field, colleagues need to vent, rant, share stories, & ask advice.

We shouldn't be giving people treatment over the net. That would be a violation of the standard of care, and create a doctor patient relationship between that person & us--thus making us legally responsible for that person, and we haven't even seen that person in person, done labs, had time to do a mental status exam etc.

It appears that at least once every 1-2 months we get someone asking for treatment advice. It appears that once every 3-6 months we get someone who is extremely upset at their treating psychiatrist.

From my own experiences, I've seen plenty of doctors (from all fields) I would not recommend my friends, family & loved ones see as their treating doctor. I've seen too many doctors make very strange treatment actions. (E.g. a doctor I know told someone suffering from migraines to tape a spoon to his leg to treat the headaches, I know of a case where a psychiatrist was having sex with patients, etc). For that reason, I do think that some of the people with a chip on their shoulders may truly have had a bad experience with a past psychiatrist. Some of these people may be down. We shouldn't be kicking them while they're down.

 

[notdeadyet]

At best, we could put together a list of patient info websites and direct such posters to that list if they are interested.

Good idea. Maybe create a sticky "Resources for the prospective patient" or somesuch with links to 12 step program finders, NAMI, etc.? Then when we have patients inquire about treatment, give a nice response about the TOS concerning giving treatment advice, wish them well, supply the link to the sticky, and close the thread?

 

[Still Kickin]

Good idea. Maybe create a sticky "Resources for the prospective patient" or somesuch with links to 12 step program finders, NAMI, etc.? Then when we have patients inquire about treatment, give a nice response about the TOS concerning giving treatment advice, wish them well, supply the link to the sticky, and close the thread?

Just curious:
(And I'm not necessarily saying I think notdeadyet's idea is a bad one, in fact I think it is a very kind and caring idea and may also help *us* in that we would have a nice consolidated list of resources we might pass along to our patients...)

But, by making such a list are we not implicity setting this forum up (at least in that little tiny way) as a *patient* resource? I don't think this is a forum for patients, it's a forum for *us*.

Also, I don't know if any of the search engines (google, etc.) pick up SDN threads if one types in the right keywords. (Does anyone know?) If in fact they do, having a sticky about "resources for the psychiatric patient" or whatever might sort of "backfire" by actually INCREASING patient traffic to this website. (Hmm, I guess if we do come up on google searches, I may have caused just the effect I'm speculating about through the words I've used in the above post...)

But I definitely agree we should be *polite* to those who may enter this forum looking for help or a place to vent...

 

[kugel]

Also, I don't know if any of the search engines (google, etc.) pick up SDN threads if one types in the right keywords. (Does anyone know?)

that's how I found SDN.

My thought would be to simply lock the thread with a simple statement to the effect of "SDN is not designed, and not capable, of providing medical/psychiatric advice nor appropriate referrals, since it is not possible for us to adequately know the situation or the community. We recommend you contact a local mental health agency or local referral service for information on where/how you can receive appropriate assistance. We wish you the best of luck."

And leave it at that.
Anything else just gets us in deeper.

Also, I would lay off the teasing as we await lock from a moderator. Things like "In before the lock," or "Lock in 3...2...1..."
Just report to the moderators and let it be.

Just my 2 cents.

 

[nancysinatra]

I think the operative words are "be polite." I think this might be coming up because of the nature of what sometimes gets said to these types of posters (advice seekers or complainers), not necessarily because of the frequency. Complainers are probably the most frustrating to deal with, but a little tact and compassion can go a long ways, is all. I think the point has been made--we probably don't need a sticky or anything official about treatment.