A PUBLICATION OF THE AMERICAN ASSOCIATION OF COMMUNITY PSYCHIATRISTS www.communitypsychiatry.org Community Psychiatrist
behavioral healthcare must be closely coordinated and that preventive care is important, even as far back as early childhood. These elements could improve the efficiency with which providers use their time. Access would
improve, permitting phased-in Medicaid eligibility for people whose income is
A Holiday Wish: Real November 2009 Volume 23, Number 2 Change in Behavioral Health
increase Medicaid enrollment by up to 50%, presenting formally improved
Inside this Issue
reform that really affects the lives of the
people I serve and –as a result –gives
1 President’s Column
me greater satisfaction in the work that I
do. It’s not-self serving but it’s a plea
2 Editor’s Brief 3 Health Care Debate
bill calls for the creation of a “Patient
4 Off-Label Prescribing
recovery goals. It makes it possible for
us to listen more effectively, permits us
6 About AACP / Join
that we are together assisting people we
efficiency and utilization of time. In the
the Senate floor on October 13th there is
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Continued from Page 1 WWW.COMMUNITYPSYCHIATRY.ORG AACP Board of Directors President Vice President Secretary
methodologies like these, and to do so
Treasurer
have occurred in psychiatry over the last
Immediate Past President
bring opportunity – the opportunity to
Founding President Emeritus
administered outside of health insurance
Area Representatives
within “behavioral health”? Finally, we
Stephanie LeMell, MD Area III
charitable non-profit, the possibilities
yet to be interpreted into administrative
Area V Richard Christensen, MD
orphanages for special needs children in
the intent of this law as its details are
two regions of Russia. Children’s Hope
federalism, one possibility is that many
Representatives at Large
details could have state-by-state texture,
Cheryl Bowers-Stephens, MD Michelle Clark, MD
requiring us to focus on our localities.
rational system of financing that permits
recovery-orientation –including the time
we need to assist people in their goals.
found I could be helpful by volunteering
APA Assembly Liaison
Let’s hope that the Federal phase of this
Early Career Psychiatrist Rep.
Over those four trips, I saw the range of
Community Psychiatrist Editor Associate Editor
practice, all these conditions are lumped
Community Mental Health Journal Webmaster
I saw the “baby homes” for pre-school
APA Community Psychiatry Fellows Administrative Director COMMUNITY PSYCHIATRIST
of living. A psychologist’s salary may
a more specific diagnosis for chart than
often learn skills of marginal value and
director is responsible for maintaining a
on her “wish list” a nebulizer for her
If the furnace breaks, there is no money
provided to fix it; there is no budget for
cleaning supplies or toilet paper. Funds
congregation, a change in the trip times
year of Saint Paul, the emissary to other
lands. The priest in my parish felt this
toilet piece breaks off, the rules dictate
whole toilet – not just the broken part.
Improved Medicare
special needs orphanage in the northeast
States is a problem. We spend thirty-one
of special needs orphans will die within
service mission that needs your help. It
Prostitution or drug-related life styles
In 1948 the UN said, "Healthcare is a
right". Improved Medicare for All can
that is a greater gift to offer than giving
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WWW.COMMUNITYPSYCHIATRY.ORG
other resources but lots of unnecessary
This case highlights the extent to which
off-label prescribing. In the settlement,
year and was not "disruptive". Our
treatment of bipolar disorder despite the
reform. "Reform" which leaves the
private, for-profit insurance "system" in
The facts of the settlement raise obvious
Insurers have demonstrated their ability
private for-profit "system" breeds fraud
let me know what you think. how the company was able to
as high as $1.7 billion. The "public
A Cautionary Tale for Off-Label Prescribing Authors:
of depression in primary care has gotten
Inc., serves as a cautionary tale to all
off-label uses. All patients have unique
marketing tactics, it is a lot harder for
professionals to determine what the best
treatment is for any individual patient.
COMMUNITY PSYCHIATRIST Continued from Page 4
trials that demonstrated little, if any,
efficacy. Further still, a majority of the
United States Department of Justice. Press
million to resolve criminal & civil health
care liability relating to off-label promotion.
May 13, 2004. Retrieved from the World Wide Web:
letters to the editor also reflected this
civ_322.htm. Last accessed March 21, 2009.
this collection of mainly case-series and
Chen H, Reeves JH, Fincham JE, et al. Off
label use of anti-depressant, anticonvulsant, and antipsychotic medications among
Georgia Medicaid enrollees in 2001. J Clin
such as the treatment of bipolar disorder
The supplement article in the Journal of Psychiatric Practice provides more
al. Gabapentin in the treatment of mental
these 29 articles had on the greater body
illness: the echo chamber of the case series.
of research literature (ultimately being
J Psychiatr Pract. 2008 Mar;14 Suppl 1:15-
professionals is that the data presented
in this collection of mainly case-series
Label Uses: Shady Practices Within a Gray
warrant a systematic change in practice,
1 Science Panel University of North Carolina at Chapel
health care providers to alert them to the
literature that supports off-label uses for
disorder. This questionable “research”
Pharmacy Benefits Management Services
2 Dissemination Panel
published as part of a supplement to the
Journal of Psychiatric Practice, showed
Leah M. Ranney, PhD Thomas R. Linden, MD
University of North Carolina at Chapel
articles, the authors wrote optimistically
about the drug's effectiveness in helping
This article was funded by a grant administered by a consortium of state
evidence base, like the drug's off-label
attorneys general, independent of any
efficacy for bipolar disorder, warranted
industry funding, which placed no restrictions on the content of these publications.
series. More than a fifth (6) were reports
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WWW.COMMUNITYPSYCHIATRY.ORG AACP MEMBERSHIP YES! I want to join in the AACP’s advocacy efforts to improve
The American Association of Community Psychiatrists (AACP) was
quality care for patients in community settings.
formed in October 1984. The impetus came from a group of community
psychiatrists who began sharing interests and concerns at the May 1984
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American Psychiatric Association Meeting and at many local psychiatric
meetings. We found that community psychiatrists are a concerned,
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COMMUNITY PSYCHIATRIST
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WWW.COMMUNITYPSYCHIATRY.ORG
American Association of Community Psychiatrists
CURRICULUM VITAE - LAURO BUORO Lauro Buoro è il fondatore e il Presidente di Nice S.p.A. ed è altresì il Presidente di tutte le filiali commerciali di Nice S.p.A. ed è stato anche Amministratore Delegato di Nice S.p.A fino al 9 marzo 2009. A partire dal 23 giugno 2008 Buoro è membro del Consiglio di Amministrazione di Banca Antonveneta. 46 anni, è nato a Winterthur (Svizzera) e vive
Treating Your MG Know the Choices You Have Can you think of a time in life when you didn’t Myasthenia gravis (my-as- thee -nee-uh grah -vis) : have a choice about something? How did that make you feel? Did you feel out of control, angry, system (im- mewn sis -tem). Can you think of a time when you felt this way and learned that you did have a choice? How did you How do you