scholarly journals A National Analysis of Medical Licensure Applications

2008 ◽  
Vol 94 (4) ◽  
pp. 11-16 ◽  
Author(s):  
Sarah J. Polfliet
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Americans With Disabilities Act ◽  
Case Law ◽  
Professional Organizations ◽  
Medical Board ◽  
Medical Licensing ◽  
Application Data ◽  
National Analysis

ABSTRACT The 1990 enactment of the Americans with Disabilities Act (ADA) and subsequent case law have established that medical board screening of physician licensure applicants for histories of mental illness or substance use may constitute discrimination. This study examines how physician licensure questionnaires have evolved since the enactment of the ADA. Specifically, we requested medical licensure applications in 2006 from all U.S. affiliated medical licensing boards (n=54) and analyzed their mental health and substance use inquiries comparatively with application data from 1993, 1996 and 1998. Response rates were 96 percent (n=52) for initial registration applications and 93 percent (n=50) for renewal applications. Our results indicate that applicants in 2006, compared with applicants in the 1990s, were questioned more about past, rather than current, histories of mental illness and substance use. These findings revealed medical board practices that seem to run counter to existing court interpretations of the ADA, as well as licensure guidelines established by several professional organizations.

scholarly journals Substance Use, Homelessness, Mental Illness and Medicaid Coverage: A Set-up for High Emergency Department Utilization

2018 ◽  
Vol 19 (6) ◽  
pp. 902-906 ◽  
Author(s):  
Aimee Moulin ◽  
Ethan Evans ◽  
Guido Xing ◽  
Joy Melnikow
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Health Planning ◽  
Private Insurance ◽  
Mental Healthcare ◽  
Emergency Department Utilization ◽  
Public Healthcare ◽  
Frequent Users ◽  
Ed Visits

Introduction: Frequent users of emergency departments (ED) account for 21–28% of all ED visits nationwide. The objective of our study was to identify characteristics unique to patients with psychiatric illness who are frequent ED users for mental health care. Understanding unique features of this population could lead to better care and lower healthcare costs. Methods: This retrospective analysis of adult ED visits for mental healthcare from all acute care hospitals in California from 2009–2014 used patient-level data from California’s Office of Statewide Health Planning and Development. We calculated patient demographic and visit characteristics for patients with a primary diagnosis of a mental health disorder as a percentage of total adult ED visits. Frequent ED users were defined as patients with more than four visits in a 12-month period. We calculated adjusted rate ratios (aRR) to assess the association between classification as an ED frequent user and patient age, sex, payer, homelessness, and substance use disorder. Results: In the study period, 846,867 ED visits for mental healthcare occurred including 238,892 (28.2%) visits by frequent users. Patients with a primary mental health diagnosis and a co-occurring substance use diagnosis in the prior 12 months (77% vs. 37%, aRR [4.02], 95% confidence interval [CI] [3.92-4.12]), homelessness (2.9% vs 1.1%, odds ratio [1.35], 95% [CI] [1.27-1.43]) were more likely to be frequent users. Those covered by Medicare (aRR [3.37], 95% CI [3.20-3.55]) or the state’s Medicaid program Medi-Cal (aRR [3.10], 95% CI [2.94-3.25]) were also more likely to be frequent users compared with those with private insurance coverage. Conclusion: Patients with substance use disorders, homelessness and public healthcare coverage are more likely to be frequent users of EDs for mental illness. Substance use and housing needs are important factors to address in this population.

scholarly journals Physician-Friendly States for Mental Health: A Comparison of Medical Licensing Boards

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Pamela Wible ◽  
Arianna Palermini
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Illness Experience ◽  
Medical Licensing ◽  
Physician Mental Health ◽  
Confidentiality And Privacy

Do medical boards undermine physician mental health by breaching physician confidentiality and privacy? We analyze the initial medical licensing process in each state to determine if qualified applicants who report mental illness experience discrimination. We then identify the most favorable states for physician mental health.  

scholarly journals Suicidal ideation in patients with mental illness and concurrent substance use: analyses of national census data in Norway

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Helle Wessel Andersson ◽  
Solfrid E. Lilleeng ◽  
Torleif Ruud ◽  
Solveig Osborg Ose
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Census Data ◽  
Current Treatment ◽  
Cross Sectional ◽  
Specialized Mental Health

Abstract Background Suicidal ideation may signal potential risk for future suicidal behaviors and death. We examined the prevalence of recent suicidal ideation in patients with mental illness and concurrent substance use and explored the clinical and sociodemographic factors associated with suicidal ideation in this patient subgroup, which represents a particular risk group for adverse psychiatric outcomes. Methods We used national cross-sectional census data in Norway collected from 25,525 patients in specialized mental health services. The analytic sample comprised 3,842 patients with concurrent substance use, defined as having a co-morbid substance use disorder or who reported recent regular alcohol use/occasional illicit drug use. Data included suicidal ideation measured in relation to the current treatment episode, sociodemographic characteristics and ICD-10 diagnoses. Bivariate and multivariate analyses were used to examine differential characteristics between patients with and without suicidal ideation. Results The prevalence of suicidal ideation was 25.8%. The suicidal ideation rates were particularly high for those with personality disorders, posttraumatic stress disorder, and depression, and for alcohol and sedatives compared with other substances. Patients with suicidal ideation were characterized by being younger, having single marital status, and having poorly perceived social relationships with family and friends. Conclusion Suicidal ideation in patients with mental illness and concurrent substance use was associated with a number of distinct characteristics. These results might help contribute to an increased focus on a subgroup of individuals at particular risk for suicidality and support suicide prevention efforts in specialized mental health services.

Psychiatric Rehabilitation Outcomes Among Hispanics with Co-Occurring Serious Mental Illness and Substance Use Disorders: A Systematic Review

2017 ◽  
Vol 48 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Jennifer Sánchez ◽  
Veronica Muller ◽  
Magdalena E. Garcia ◽  
Stephany N. Martinez ◽  
Scott T. Cool ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Serious Mental Illness ◽  
Psychiatric Rehabilitation ◽  
Treatment Strategies ◽  
Rehabilitation Outcomes ◽  
Psychiatric Hospitalizations ◽  
Evidenced Based

Purpose: To conduct a systematic literature review relating to psychiatric rehabilitation (PsyR) outcomes of Hispanics with co-occurring serious mental illness (SMI) and substance use disorder (SUD) and to identify the most appropriate evidenced-based practices (EBPs) to facilitate treatment strategies for this population. Method: The following electronic databases were used to search multiple keywords and keyword combinations: MEDLINE/PubMed, SpringerLink, and Education Resources Information Center (ERIC). The initial search resulted in a total of 911 articles. Next, 906 articles from the initial search were excluded because they did not meet inclusion criteria for the following reasons: duplicates (n = 50), not relating to PsyR outcomes (n = 718) or to co-occurring SMI and SUD (n = 53), and not including Hispanics (n = 85). Five articles were retained for this study. Results: The included studies were classified by intervention into three categories: Integrated Mental Health and Substance Abuse Treatments (3), Motivational Interviewing (1), and Psychosocial Resources (1). Outcomes included reduction in mental health and PTSD symptoms, increased abstinence, decrease in substance use and psychiatric hospitalizations, improved self-efficacy for recovery, and better quality of life (QOL). Conclusion: This review identified several successful PsyR outcomes for Hispanics with co-occurring SMI and SUD; however, it also highlighted the limited availability of extant literature focused on EBPs for Hispanics with co-occurring SMI and SUD. As the Hispanic population increases, their specific needs should be addressed.

Is there a Power Elite in Canadian Psychiatry?

1969 ◽  
Vol 14 (2) ◽  
pp. 199-207
Author(s):  
D. B. Coates
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Private Practice ◽  
Critical Role ◽  
Psychiatric Services ◽  
Professional Organizations ◽  
Power Elite ◽  
Apparent Lack ◽  
Considerable Evidence ◽  
History Of

This paper poses a number of questions regarding the recent history of psychiatric organization in Canada. Using public documents regarding organizational structure, it was suggested that during the decade 1956–1966, there was considerable evidence of a national shaping of policy regarding psychiatric services by a small but influential group of reformers. For other questions such as the organization and dispensing of research funds, access to more privileged sources would be required. In its organization, Canadian psychiatry is of no greater interest than many other professional organizations. However, because of its critical role at a time when health services generally were in transition, the psychiatric elite played an extremely important part in influencing the restructuring of psychiatric services around private practice, around general hospital and medical integration and the ideology that mental illness is identical with physical illness. The blurring of differences between psychiatry and mental health were discussed briefly and the apparent lack of conflict between bureaucratic and professional roles.

scholarly journals Letter from Australia: mental healthcare in Victoria

2011 ◽  
Vol 17 (1) ◽  
pp. 2-4 ◽  
Author(s):  
David J. Castle
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Intellectual Disability ◽  
Mentally Ill ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Mental Illnesses ◽  
Government Agencies ◽  
The Past

SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.

scholarly journals Depictions of psychopathology and mental health issues in music: themes and musical genres

2021 ◽  
Author(s):  
Fabián Pavez ◽  
Erika Saura ◽  
Gemma Pérez ◽  
Pedro Marset
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Mental Disorders ◽  
Social Representations ◽  
Health Issues ◽  
Health Concerns ◽  
Mental Health Issues ◽  
Mental Health Concerns ◽  
Musical Genres

Introduction. In previous communications we have proposed that the analysis of cultural products related to art, and music in particular, can inform us about the social representations of psychiatry and mental illness. This topic is not irrelevant to our clinical practice, since it favors a better understanding about what are the meanings of our profession and its scope of practice for our patients and general population. In this work, we focused on portrayals of psychopathology in music and the musical genres associated. Objectives. By exploring studies addressing depictions of mental disorders or mental health concerns in music, we intend: - to assess the distribution of psychopathological themes alluded; and - to characterize the most studied musical genres that are associated to portrayals of mental disorders or mental health concerns. Methods. Starting from a previous systematic review of studies addressing depictions of mental disorders or mental health issues in music, thirty-seven articles are examined. Frequency of portrayed themes and musical genres associated are presented. Results/Conclusion. As we can expect, references to substance use in music are the most frequently studied. Studies addressing references to 'madness' in music are frequent too, but in a lesser extent. Other mental health issues depicted are: affective disorders; suicide; sexuality and gender; personality disorders; self-destructive behavior; resilience; as well as general links between music and mental illness/psychiatry. Studies addressing substance use are mostly focused on multiple genres (based in popularity rankings). With regards substance use, Rap and Rock are two genres specifically studied. Links between country music, alcohol use and suicide have been described in literature. Rock and Opera are the genres more frequently associated with references to 'madness'.

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