The case against suicide prevention.

Challenges the perspective that suicide is a mental health problem, that mental health practitioners and institutions have a professional duty to try to prevent it, and that it is a legitimate function of the state to empower such professionals and institutions (especially psychiatrists and psychiatric institutions) to impose coercive interventions on persons diagnosed as posing a suicidal risk. Hence, when an individual (formally identified as a patient or client) commits suicide while in the care of mental health clinicians or clinics, the latter may be sued for and found guilty of professional negligence for failing to prevent suicide. A different view of suicide as an act of a moral agent for which that agent himself or herself is ultimately responsible is presented. It is further argued that eschewing suicide prevention and rejecting it as a professional responsibility would not only protect the mental health clinician from being forced into internally conflicting and contradictory roles and the client of mental health services from coercion in the name of suicide prevention, but would also protect the nation from a mental health policy that needlessly undermines the ethic of self-responsibility. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Web pages: Do they meet expectations?

Many practitioners struggle with how best to use Internet technology to market and support their practice. Unfortunately, the empirical literature offers little guidance. This study compared existing mental health clinicians' Web sites to content areas identified as essential and ideal by mental health professionals and prospective consumers. The findings reveal that prospective consumers place a high value on what clinical Web pages may offer, more so than even clinicians themselves. In comparison to clinicians, consumers also have higher expectations for the content of these sites. Only a minority of surveyed clinician Web sites included all of the content endorsed by participants. Results should guide mental health clinicians in the development of their Web pages so that content provided meets consumers' needs and expectations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The creation of partnerships: perspectives and possibilities

This article re-examines access to treatment and care in the current context of fiscal restriction and change in locus of care. Taking the position that the development of partnerships with all parties who work in the mental health area is an important process, this article argues that such processes are infrequently discussed. Further, creating a partnered relationship with the person with mental disorder is also neglected. The authors examine mechanisms of relationship change as care moved from large, total-care institutions to general hospitals and finally, to the community. How professionals, individuals with mental disorder and their families have been affected by this change in terms of how alliances are constituted and maintained is discussed. The authors conclude with two case examples which illustrate the reconciliation and non-reconciliation of differing points of view between all partners which likely affected clinical outcomes.     

Spouses of workaholics: Clinical implications for psychotherapy.

This article examines the impact of work addiction on the family system, particularly spouses of workaholics—an area that has been neglected by social scientists and mental health clinicians. An argument is made for researchers and psychotherapists to pay more attention to this essential area of mental health. Recommendations for how to address this issue in clinical settings are presented along with research considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of a Clinical Guide to Enhance Care for Suicidal Patients.

Suicidal thoughts and behavior are common among mental health patients and are a source of stress for clinicians, who typically receive limited formal training on suicide. The U.S. Air Force initiated a project to enhance care and increase practitioner confidence when working with suicidal patients. A clinical guide was developed containing 18 recommendations for assessing and managing suicidality, strategies for meeting the recommendations, and clinical tools to facilitate quality care. Training opportunities and marketing efforts accompanied distribution of the guide. This initial article reviews the guide's development, content, and evaluation plan as a model that other health care systems, clinics, or training programs can follow to enhance care for suicidal patients. Outcome data will be presented in a follow-up article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Clinical guidelines in cross-cultural mental health.

Reviews the book, Clinical guidelines in cross-cultural mental health edited by Lillian Comas-Diaz and Ezra E. H. Griffith (see record 1988-97772-000). This volume represents the latest work on psychotherapy with ethnic/racial minority populations, and was intended for mental health practitioners as well as academicians. The book is divided into three parts. The first section has six chapters addressing the role of "ethnosociocultural" factors such as ethnicity, family values, language, religion, politics, and race in the cross-cultural delivery of psychotherapeutic care. The second section focuses on clinical practice with specific ethnic/racial groups including Afro-Americans, Mexican-Americans, Puerto Ricans, Cubans, Southeast Asian refugees, and West Indians. A final section of one chapter by Comas-Diaz discusses the "state of the art" in cross-cultural mental health. Three factors set this book apart from previous ones on this topic: 1) devotion of an entire section to core ethnosociocultural factors; 2) use of case vignettes to illustrate important cross-cultural issues in mental health; and 3) provision of specific recommendations for the practitioner. Unfortunately, the effort falls short due to the strong academic approach to clinical issues evident throughout the book. Moreover, there was substantial variability in contributors' use of case material and provision of specific recommendations. This uneven coverage, one of the prime drawbacks of many edited volumes, may limit its appeal to practitioners. This book is an improvement over previous texts in this area, but it is by no means a clinician's guide to cross-cultural mental health because of the pervasive academic influence throughout. Consequently, there is an imbalance in favor of didactic over pragmatic approaches to cross-cultural mental health. Thus this book seems more suitable for clinicians in training than for clinicians in practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How to deal with requests for assisted suicide: Some experiences and practical guidelines from the Netherlands.

In the Netherlands, physician-assisted suicide may be justifiable for patients with physical illness as well as for patients with unbearable mental suffering. Explicit requests for physician-assisted suicide are frequently made, but in psychiatric practice they are infrequently granted. In this contribution, some information on the Dutch practices related to assisted death is presented, with emphasis on assisted suicide in patients with unbearable mental suffering. The aim of this contribution is to demonstrate that the Dutch law and jurisprudence permit clinicians to deal effectively with requests for assisted suicide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Decision Making About Psychopathy and Violence Risk Assessment in Public Sector Mental Health Settings.

Although there has been extensive research on psychopathy, it is unknown how, or whether, clinicians in public sector mental health settings consider the Psychopathy Checklist (PCL) for assessing violence risk. Mental health clinicians (N = 135) from 4 facilities were interviewed by using multiple methods for collecting data on decision making. Participants considered clinical information most often when assessing violence risk, indicating that these data were most readily available. Clinicians perceived formal testing results (e.g., PCL) to be least available and considered testing least often, especially if clinicians had less clinical experience. Participants did not explicitly report using the PCL but did implicitly rely on psychopathy factors when assessing violence risk. Clinicians in crisis settings reported less availability of historical data typically needed for the PCL. The data point to specific ways to improve the clinical practice of violence risk assessment in public mental health settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, mental health, and demographic change: Challenges for psychotherapists.

People are living longer, and in better health, than in any prior point in history, with far-reaching but as yet underrecognized implications for mental health professionals. This phenomenon affects both the developed and the developing world. With greater numbers of older people, mental health professionals will need to develop greater awareness, understanding, and appreciation of gerontology to deliver optimally effective psychotherapy with this population. The nature of psychological issues encountered in clinical practice will also change—for example, intergenerational issues among blended families, increased retirement and leisure time, and expectations of greater health and productivity in later life from baby boomer cohorts. These issues are important for mental health professionals to recognize, as the increased sophistication of the baby boomer generation in terms of health care will lead to higher expectations of mental health care. The authors have chosen to discuss the implications of an ageing population with reference to a cognitive–behavioral perspective, but the issues raised here and practical suggestions contained within this article are not restricted to practitioners of Cognitive–Behavior Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatry and physician-assisted suicide

The psychiatric literature on physician-assisted suicide is scant and almost universally opposed to legalization. This opposition stems from the traditional perspective of suicide as a symptom of mental illness and the tendency of psychiatrists to extend their view of suicide in the medically well to the terminally ill. This article examines the basis for and validity of this opposition and makes recommendations about the role of the psychiatrist in physician-assisted suicide.     

Personality feedback consultation to families in a managed mental health care practice.

This article presents personality assessment as valuable in expediting favorable outcomes in mental health service delivery. The unique role of the examining psychologist is discussed with respect to assessment paradigms, behavior sampling, and eliciting patient "ownership" of solutions. Solution-oriented therapy is presented as promoting client adaptiveness from a customer-oriented point of view. A consultation-feedback model is described, which integrated these themes. Several case examples are offered to illustrate identified principles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health practitioners and HIPAA.

The privacy and security of patients' medical records continue to challenge mental health practitioners in an ever-increasing electronic environment. Although practitioners were to be in compliance of the 1996 Health Insurance Portability and Accountability Act (HIPAA) by April 20, 2006, many practitioners still struggle to understand the nuances of the regulations. This article will cover the areas of HIPAA that relate specifically to the mental health practitioner who treats both adults and children. The article begins with important definitions such as “covered entity,” “individually identified health information,” and “electronic transactions.” Establishing that many mental health practitioners likely meet the definition of covered entities, the article details The Privacy Rule and The Security Rule. Included are issues concerning consents, authorizations, and objections along with enforcement of HIPAA. Also changes in enforcement to HIPAA by the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of the American Recovery and Reinvestment Act of 2009 are discussed. Examples of violations and resulting enforcement will help practitioners better understand the regulations and how best to comply with these regulations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Implementation of a program to improve the continuity of mental health care through Clergy Outreach and Professional Engagement (C.O.P.E.).

There are over 260,000 religious congregations in the United States. They and their clergy are de facto providers of mental health care. Recent models promoting collaboration between clergy and psychologists advocate that shared religious values underlie effective working relationships. This view may impede collaboration with the majority of psychologists, who are not religious, excluding congregants from needed expertise. The Clergy Outreach and Professional Engagement (C.O.P.E.) model was developed and implemented to facilitate continuity of care across a diversity of caregivers. Handouts based on National Institute of Mental Health prevention science categories and case examples illustrate when and how clergy and clinicians would collaborate. The authors introduce and define the term burden reduction to describe a C.O.P.E. outcome. They consider this clinical work religion inclusive rather than faith based. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment issues in genetic mental retardation syndromes.

Because of genetic advances and radical shifts in service delivery, psychologists in community mental health and social service agencies increasingly serve clients with mental retardation syndromes. Persons with specific genetic mental retardation syndromes often differ in their behavioral strengths and weaknesses and in their predispositions to psychiatric disorders. Although genetic breakthroughs are sparking more research on these so-called behavioral phenotypes, researchers have yet to systematically translate phenotypic data into guidelines for therapy and intervention. Using fragile X syndrome, Williams syndrome, and Prader-Willi syndrome as examples, this article shows how the behavioral phenotypes of mental retardation syndromes can inform clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide and depression among college students: A decade later.

Are suicidal thoughts and depression increasing or decreasing among college students? What life circumstances are the most critical to explore with depressed or suicidal college students? This article focuses on the rate of self-assessed depression and suicide among college students and examines contributing factors and help-seeking behavior. Results of the study indicated that 53% of the sample stated that they experienced depression since beginning college, with 9% reporting that they had considered committing suicide since beginning college. Suggestions for college mental health practitioners related to programming, prevention, and psychoeducation are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial Interventions in the Early Phases of Disasters.

Interest in the emerging field of disaster psychology has significantly increased after such events as the Oklahoma City bombing and the September llth (2001) terrorist attacks. Consequently, a massive response has ensued from clinicians seeking to provide mental health services to disaster victims, highlighting the need to ensure timely and clinically effective service provision. The present article is directed toward clinicians and trainees interested in learning more about the disaster mental health field. It describes the impact of disasters on communities and individuals and the most commonly employed interventions. The authors emphasize the distinction between the fields of disaster psychology and traumatology and stress that expertise in treating trauma-related disorders is not sufficient preparation for conducting psychosocial disaster intervention. Finally, information is provided on how to obtain adequate training and experience as a disaster mental health professional. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Third party presence during criminal forensic evaluations: Psychologists' opinions, attitudes, and practices.

If you are a psychologist who conducts forensic evaluations, how would you respond to an attorney's or family member's request to be present or to videotape the evaluation? Your answer may be impacted by legal, professional, ethical, and practical issues as addressed in legal and mental health publications. However, there is a dearth of empirical attention, and even the opinions and practices of psychologists in this arena are unclear. The present article addresses the need for empirical data on third party presence by surveying forensic clinicians' perspectives on the topic. A total of 160 forensic practitioners (41% response rate) provided information on their attitudes and practices pertaining to third parties in an evaluation. Overall, most clinicians believe third party presence can negatively impact an evaluation, yet most have conducted examinations under such conditions. The article concludes with speculation as to the impact of third party presence, a call for research and professional standards, and specific guidelines for psychologists who may struggle with these complex issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)