USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health Concerns

USA Today Publishes Harmful Prejudice, Misinformation About People with Mental Health ConcernsUSA Today on Thursday published an editorial hopefully entitled, Editorial: Fix broken mental health system. Which would be fine as a stand-alone piece advocating more money, focus and resources for our nation’s patchwork system of mental health and recovery care.

Instead, they — like many well-meaning but apparently brain-dead newspapers — tie the need to fix our mental health care system — something others have been advocating for for decades — to recent headline-news grabbing acts of atrocious violence.

Only buried in this hypocritical, two-faced gutter-piece editorial do you find the truth — “Only the tiniest fraction of the mentally ill ever become violent, and then, usually when they fail to get treatment.” It’s even worse than that — statistically speaking, mental illness is a horrible predictor of violence, and nobody who’s read the research would ever suggest otherwise.

I have no problem with you advocating to help people with mental health concerns. I have a big problem if you’re doing so because of violence in America. The two have little to no connection with one another.

People let to get all riled up and angry when something tragic occurs. It’s one way many of us cope and try to figure out such events. But when we respond to tragic events with action, we’re likely to do so in a way that makes little sense in the overall, broader picture.

The fact is people with mental health conditions are no more likely to be violent than is the general population.
~ Wayne Lindstrom

For instance, every year in America, over 12,000 people a year are murdered — most by some sort of gun. Nobody gets upset at that huge number, or that 30,000+ people a year who take their own lives.

Instead, the thing that USA Today wants us to get motivated by are these horrific acts of violence that barely read in the overall number of deaths per year due to gun violence. USA Today doesn’t seem to care about the 30,000+ people each year who, because of untreated depression or other mental health concerns, choose to end their lives.1

Wayne Lindstrom, the CEO of Mental Health America, on the other hand, gets it right in his response to the crummy piece of what passes for “insightful opinion” at USA Today:

The premise that we can predict or prevent violent acts is unsupported. Even in the case of severe mental illnesses, mental health professionals possess no special knowledge or ability to predict future behavior.

The fact is people with mental health conditions are no more likely to be violent than is the general population. Continuing to link violence and mental illness only stigmatizes people and deters them from seeking care.

We whole-heartedly share and endorse these words. We stand proudly with Mental Health America and other organizations who’ve read the research and know that linking mental illness to violence is like linking terrorism to a specific religion — it’s a feel good strategy imbeciles do to make themselves feel better.

USA Today rues the good ole days, when we could lock up anyone society disagreed with or didn’t like the looks of in a mental hospital (nowadays referred to an inpatient psychiatric hospital): “Many states have become so strict that it is almost impossible to get people committed until they are in deep crisis, or try to commit suicide or harm someone.” Awww, what a shame — we actually have a reasonable, humane standard before trying to take someone’s freedom away from them.

USA Today should be ashamed of itself for publishing an editorial that only reinforces the discrimination, stigma and prejudice against people with mental health concerns. They continue to spread misinformation about the link between mental illness and violence,2 and suggest we have some sort of magical powers of foresight that would allow us to predict these kinds of incidents with such accuracy, it would be like the science-fiction story, “Minority Report” (we don’t have such magical powers, sorry).

 

USA Today crap editorial: Editorial: Fix broken mental health system

Wayne Lindstrom’s response: Opposing view: Don’t link violence with mental illness

Footnotes:

  1. Worse, they cite the example of Seung-Hui Cho — who actually had contact with mental health professionals!
  2. There really isn’t much of one, according to you know, the actual research.

Time to Rethink Separating Out the Psychiatric Record?

Time to Rethink Separating Out the Psychiatric Record?Traditionally, most hospitals have separated out the psychiatric record from a patient’s medical record. This was done historically because of the stigma and discrimination associated with psychiatric concerns — and the serious lack of training in medical school for physicians to understand such information in proper context.

As hospitals move to electronic records, the default behavior has been to simply keep things as they are — so no more processes than necessary have to change at the same time. This means keeping the psychiatric information in the electronic record segregated from a patient’s medical information.

But in an intriguing new study just published — on a very small cohort — researchers found that where hospitals allowed any properly authorized medical staffer to access the patient’s psychiatric information in the electronic health record (EHR), hospital readmissions went down.

Perhaps it’s time to re-evaluate whether opening up the sharing of such information among all doctors on a patient’s treatment team might actually be a good thing.

To get the data, the researchers surveyed 18 hospitals on the 2007 U.S. News and World Report list of the “Best Hospitals in the United States.”

“Of that group, eight hospitals (44 percent) kept most or all of their inpatient psychiatric records electronically, and five (28 percent) let non-psychiatrist physicians see mental health records, including psychiatric admission notes, discharge summaries, notes from the emergency department, and consultation notes.”

Just four hospitals did both. Among this latter group, however, readmission rates for psychiatric patients were substantially lower than at the others on the list. Here’s what they found:

Top teaching hospitals that provided non-psychiatrists with electronic access to inpatient psychiatric records had up to 39% lower rates of readmissions within 7, 14, and 30 days of initial discharge than comparable institutions that did not include inpatient psychiatric notes in their EHRs. Full access also cut 7-day readmission rates by as much as to 27% when compared to hospitals that did not let primary care and emergency physicians see psychiatric records in the EHR

I only have one concern — that non-psychiatrist physicians treat the psychiatric information with the same care they would as if it were their own information. Sometimes doctors are a little too loose with a patient’s medical information when talking to other docs — especially in public places where many others may hear (like an elevator).

I’m also concerned that stigma, discrimination, prejudice and misunderstanding are still fairly rampant among some physicians — especially in certain specialties. Without proper education and training, I worry that some doctors may misuse or inappropriately share information gleaned from a patient’s psychiatric record. Proper education and training could readily solve this concern, however.

Patients, too, ultimately benefit from such increased sharing, as this study — if confirmed by others — demonstrates. If patients are afraid of this development, I usually find information is the best remedy — showing patients exactly what is and isn’t in their medical and psychiatric charts. Patients, of course, have a right to view their medical and psychiatric records in their entirety. In most instances, once a patient sees how little is actually in their psychiatric or mental treatment progress notes (if it’s being properly maintained), they’re usually satisfied.

I’m a big believer in the benefits of transparency and open communication. If giving doctors access to all relevant data of a patient — including their psychiatric history — can help patients receive better care, why not do it?

 

Read the full article: Sharing Psychiatry EHR Data Cuts Readmission Rates