(Vitacco 2). Patients that are still dependent on any substance whether it be prescription or not are not subject to receiving conditional release and must stay in hospitalization until he or she is independent from the substance. In a study completed by Anthony Jorm and K.M. Griffiths they determined that the biomedical conceptualizations are not the major cause of stigma. The cause of stigma was determined to be defined by the behavior associated with the mental illness and the belief of personal
In doing so, doctors also disregarded the patients’ autonomy in their decision to have themselves committed for their altered mental state. Invalidating the patients claim and affecting their trust, which is the pinnacle of the patient-doctor relationship. With psychiatric patient even more so because there must be a level of trust in the person’s claim and in their determination, that they might be having a breakdown. A beneficial scenario for the parties involves would have been if the doctors’ actions promoted more good, or beneficence, and gave Jessie better tools to cope with his PTSD. Instead, of taking an inactive approach, which allowed the situation to escalate to the point he became a danger to himself and others.
For the last six years, I have been working in the substance abuse industry in both inpatient and outpatient settings. It would be fair to say that most people that are in need of substance abuse treatment have a co-occurring disorder such as depression, bipolar disorder, schizophrenia, and anxiety. These people are diagnosed by a psychiatrist or medical doctor and are typically given medication to help the patient. However, the problem can be that if a person sees a psychiatrist and is not honest about their substance abuse history the mental diagnosis can be deceiving.
Many times symptoms will also be over looked as a part of the dependency. This confusion is a complexity in dual diagnosis in clients like Jerome who have a mental illness that “seem to be extremely heterogenous in terms of the variety of substances that they abuse and that clinical decisions must be based on a careful examination of each client's diagnosis and specific use of substances”(Polcin,1992).The counselor must be certain in what is a substance abuse symptoms and what is a mental illness symptom, but also how each symptom may impact the other. Another complexity of dual diagnosis seen in the case of Jerome and in low income areas is that “some mental health programs deny access to people with active substance abuse problems, while chemical dependency providers may refuse to treat those taking prescribed psychiatric medications”(Mancuso,1991). This leads many places to not treat dual diagnosis and not treating the total problem. Individuals who do not seek treatment will often end up in jail because of their behavior, instead of getting the treatment they need for their dual
It seems that there are many pros and cons to allow Primary Care Prescribing Psychologists (RxP) to prescribe prescription psychotropic medications. There are questions to whether they are knowledgeable enough to do so though. In the next few paragraphs I will discuss these pros and cons. In the end, I will divulge my overall opinion on the matter.
Limitations recognised throughout the SDM process were related to risk of further deterioration in the Consumer’s mental state. As the Consumer was slowly taken off his medications, in a safe clinical manner, his presentation deteriorated. The Consumer’s sleep pattern worsened due to the elevation in his mood, there was a noted increase in impulsivity and poor boundaries with others on the inpatient unit, leading to the Consumer becoming vulnerable. There was a prominent increase in erratic and aggressive towards others, leading to the assault of a staff member on the inpatient unit and subsequently required the use of restrictive interventions. The decline in mental state resulted in the Consumer’s father, case manager and treating team coming together for a family meeting with the Consumer present in which the previous medications the Consumer had been previously prescribed were recommenced in an attempt to re-stabilise his presentation, unfortunately this was a substituted decision made by the consumer’s father and treating tream.
As a disclaimer, it must be stated that it is unethical for a psychiatrist to offer a professional
Ofer Zur, Ph.D., a licensed psychologist, writer, forensic consultant, and lecturer asserts that in today’s culture majority of the American population considers themselves a victim and psychotherapists are financially profiting off the oppressed. Therefore, Zur claims, the industry’s “focus on victimhood” (par.1) is falsely creating new disorders and fueling the fire of America’s sudden sense of vulnerability. Zur explains “Victim means good business for attorneys and psychotherapists. The search for the cause and the person or circumstances to blame helps support hundreds of thousands of therapists” (par. 5) The stakeholders over this psychiatric debate are the psychotherapists and the American people.
In fact, the California Legislature created a specific exception to the psychotherapist-patient privilege where there is reasonable cause to believe that the patient is dangerous to another, and disclosure is necessary to prevent the threatened
1.2 Explain the key strengths and limitations of the psychiatric classification system? The classification of mental disorders is a key aspect of psychiatry and other mental health professions and an important issue for people who may be diagnosed. The key strengths of the psychiatric classification system are the inappropriate behaviours displayed by individuals are dealt with, all disorders are arranged, organised and described in an acceptable manner and order, it is used all over the world so correct diagnoses and treatment are used.
However, it’s not always as simple as doctors being able to get away with it. Depression was the cause of Goodman’s downfall “The primary diagnosis was long-standing depression” (103). People’s view of doctors as machines, perhaps contributes to the transaction of good to bad. Gawande suggests a prevention method which consists of a gentle approach to falling doctors” only as long as the consequences is closer to diagnosis and treatment than to arrest and prosecution. And this requires that people be ready to view such doctors not as sociopaths but merely as struggling human beings”
Another example of clinical practice that raises legal, moral and ethical conflict when a PWD refuse to take prescribed medication is ‘therapeutic lying’. Therapeutic lying is the practice of deliberately deceiving patients by giving false information for intentions considered to be in the best interest of the patient. Considerably, research revealed that in RACF, almost 96% of all staff acknowledges lying to a PWD. Additionally, 66% of psychiatrist evaluated had sanctioned the use of therapeutic lying with a PWD by carers (Culley et al., 2013; Sprinks, 2013). Factors that contribute to the propagation of this deceptive practice include: (1) medication compliance; (2) ease the PWD and family stress; (3) improve compliance; (4) to save time;
Edgar Allan Poe, a man who has changed literature through his numerous pieces of writing, such as The Cask of Amontillado, The Tell-Tale Heart, and The Fall of the House of Usher. In Edgar Allan Poe’s famous work, The Raven, the main character is confronted with a raven. The character speaks to the raven, thinking it couldn’t respond, but the raven did respond, but only speaking one word, “Nevermore” (Poe 331). In some cases of mental illnesses, one can experience hallucinations, hearing voices, paranoia, and even persecutory delusion. Is it possible that the Raven could have symbolized something other than a bird.
Nowadays it seems like legal drugs are more expensive than illegal ones. This dilemma occurs because the pharmaceutical industry affects the economy significantly. Although the United States is a mixed market economy, there are instances where the economy seems like a free market economy. A free market economy allows companies to determine the prices of goods free from government intervention. The pharmaceutical industry, despite several regulations set by the food and drug administration, is a free market economy.
DISCUSSION From the beginning, the therapist had to deal with own doubts and anxiety. The therapist had heard a lot about the psychodynamic psychotherapy but this was the first time he conduct the sessions by himself. Unlike pharmacotherapy, there is no standard clinical practice guideline or recommendation for the therapist to refer to or follow. The therapist was worried that he was unable to conduct the therapy effectively and his patient would not benefit from the therapy.
