Alan D. Schmetzer

Overcoming Stigma: Involving Families in Medical Student and Psychiatric Residency Education

ObjectiveThe primary purpose of this article is to present a possible mechanism for increasing communication about psychiatric matters such as diagnoses, treatment, and stigma between the physicians, including psychiatrists, and the families of persons with mental illness through a NAMI presentation.MethodsIncluded are a description of a stigma-reduction presentation to junior medical students; information about an instrument to evaluate pre- and postclerkship student attitudes; and a discussion of consumer and family participation in the education of first-year psychiatric residents.ResultsMoving the NAMI presentation from the freshman year to the junior year rotation and first year resident experience has been more efficacious, possibly because clinically oriented students and medical and psychiatric residents seem more receptive to communication about stigma and the family situation.ConclusionThe educational collaborations between advocacy groups and academia show promise for increasing communication about psychiatric disorders, treatment, and stigma issues between families and psychiatric patients.

CMHC emergency services in the 1980's: Effects of funding changes

Community mental health centers have been faced with the challenge of survival in the wake of funding changes. The authors investigated the impact of these changes on the delivery of emergency services. The results indicated some notable trends including abolishing catchment areas and centralizing emergency services. Additionally, changes in staffing patterns were found, including both an overall decrease in staff providing crisis services and an increase in staff from disciplines eligible for third party reimbursement. Factors that may have influenced these trends are discussed.

A hospital-based mental health court.

Deinstitutionalized chronically mentally ill patients face the prospect of homelessness, insufficient community services, and the possibility of criminalization. Further, many communities do not have a mechanism for recognizing the special problems many of the chronically mentally ill have when they enter the legal system. The following is a description of a hospital-based mental health court, a nontraditional, highly effective program intended to identify chronically mentally ill persons in the community, as well as recognize and correct inadequacy in services available to the deinstitutionalized.

Point–Counterpoint: The Importance of “Open Access” to Psychotropics for our Patients

The opposing arguments regarding so-called “open access” to psychotropic medicines for all physicians are outlined, with references. The reader is left to draw conclusions from the discussion or to utilize the points in presentations to politicians, the media, pharmacy and therapeutics committees, state Medicaid agencies, etc.