Patients' Rights and the Texas Mental Health Law.

A series of court cases between the 1960s and the 1980s focusing on patient autonomy changed the approach to mental health treatment in the United States. The process of involuntary psychiatric treatment can vary greatly between states; thus, all mental health practitioners need to have a strong grasp of their respective state and institutional policies. In this article, we examine the Texas mental health law regarding consent to psychoactive medications and involuntary medications.

True Costs of Medical Clearance: Accuracy and Disagreement between Psychiatry and Emergency Medicine Providers.

Introduction: Medical clearance is required to label patients with mental illness as free of acute medical concerns. However, tests may extend emergency department lengths of stay and increase costs to patients and hospitals. The objective of this study was to determine how knowledgeable emergency and psychiatric providers are about the costs of tests used for medical clearance.

Like the Eye of the Tiger: Inpatient Psychiatric Facility Exclusionary Criteria and Its "Knockout" of the Emergency Psychiatric Patient.

Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer.

Difficult Patients in the Emergency Department: Personality Disorders and Beyond.

Physician-patient encounters in clinical settings, especially in the emergency department, can be of varying degrees of difficulty. Medically complicated, challenging cases can be paradoxically rewarding, whereas psychologically driven difficulty is frustrating and counterproductive for patient care. This article presents 3 different complementary perspectives on difficult patients: clinical presentations, manifestations of personality traits and disorders in clinical settings, and how physician feelings may affect care.

Paradoxical increase in synthetic cannabinoid emergency-related presentations after a citywide ban: Lessons from Houston, Texas.

Synthetic cannabinoids (SCs) have become a major drug of abuse associated with severe hospital presentations. There have been a variety of legislative efforts to regulate these drugs: The authors focus on trends in SC-related hospitalizations at Ben Taub General Hospital before and after a ban enacted by the city of Houston. Data from all consults seen by Ben Taub's Licensed Chemical Dependency Counselor were examined for changes in SC-related presentations before and after the ban.

Stabilization and Management of the Acutely Agitated or Psychotic Patient.

Acutely agitated or psychotic patients are particularly challenging to manage in the emergency department. Often these patients present with little or no history, and an adequate assessment may initially be difficult because of the condition of the patient. This article discusses basic concepts regarding agitation, and the related management goals and strategies.

Down the Rabbit Hole: Emergency Department Medical Clearance of Patients with Psychiatric or Behavioral Emergencies.

Patients presenting with behavior or psychiatric complaints may have an underlying medical disorder causing or worsening their symptoms. Misdiagnosing a medical illness as psychiatric can lead to increased morbidity and mortality. A thorough history and physical examination, including mental status, are important to identify these causes and guide further testing.

Clinical and ethical dilemmas in the psychiatric care of patients who border on the edge of being able to live safely and independently.

In the current economic environment and era of health care finance reform, mental health budgets have faced cutbacks across the nation, and they may face even deeper reductions in the future. Diminished funding for care of patients with severe psychiatric illness creates significant ethical and clinical dilemmas. Throughout medicine, physicians' professional virtues and obligations of beneficence may conflict with the need to balance respect for patient autonomy and deliver clinically appropriate, humane, and ethical care within a limited budget.

Integration of international medical graduates in u.s. Psychiatry: the role of acculturation and social support.

Objective: the authors investigated whether social support and acculturation could predict the mental health of international medical graduates pursuing psychiatric residencies in the United States.

Methods: a 55-item online survey was assembled by combining three validated instruments for mental health, social support, and acculturation. A link to the survey was e-mailed to training directors of all psychiatric residency and fellowship programs.

Nicotine reduces antisaccade errors in task impaired schizophrenic subjects.

Nicotine and/or smoking have been shown to reduce various cognitive deficits associated with schizophrenia. Here, we examine the effects of nicotine gum on repeated performance on a simple eye movement task. Eight schizophrenic subjects and eight controls participated in three days of testing on saccade (S) and antisaccade (AS) tasks.