Saturday, February 02, 2013

Put All Those Mentally Ill People Into An FBI Database, Stop Reimbursing Psychiatrists, Increase Access to Care, and Hey, Let's Decrease Stigma While We're At It!


Has anyone else noticed that there's a lot about psychiatry in the news, and all the messages are mutually exclusive?  In New York they've decided that a "SAFE Act" includes requiring shrinks to report anyone they believe is likely to be dangerous.  In Maryland, the proposed 2013 Firearms Act includes a provision to report all inpatients who are hospitalized for 30 consecutive days (voluntarily or involuntarily, dangerous or not) to an FBI database, and those who are found to be dangerous by a court are to be reported sooner.  And if the Firearms Act, as written now, passes and they take your gun, you can't get it back until a psychiatrist signs off by saying you are safe to own a gun -- a liability consideration few shrinks will be willing to accept.  And the Washington Post reported that another delegate plans to propose legislation that will require mental health professionals to report dangerous patients.  Funny, but only mental health professionals are required to report.  If you tell your urologist you're so pissed off you might harm someone, you still get doctor-patient confidentiality (and perhaps a specimen jar) with no obligation to report.  I'll limit my CPT code changes to a single sentence, but suffice it to say that many folks are having trouble getting reimbursed and are spending much more time on paperwork.  And yet as the media talks about rounding up all the dangerous mentally ill people, reporting them to...an unknown community service director or to legal authorities or to an FBI database, all with the hopes that this will decrease their access to firearms so we don't have any more mass shootings, and in the same sentences we hear about the importance of increasing access to care and decreasing stigma so that people will want to go for help.  Does anyone else think this is all kind of weird?  It's like the left side of the mouth is saying "run" while the right side of the mouth is yelling "stop."