5 Special Populations in Psychiatry

July 8, 2016

The need for more mental health providers has galvanized our interest in special populations, each of which requires a vision and framework for establishing assessment and treatment as a standard of care.

Introduction: Unique Needs and Innovative Opportunities
Children in foster care; combat vets; physicians with mental health needs: Dr Steve Koh introduces a series of articles on these and other special patient populations,each of which requires a vision and framework for establishing assessment and treatment as a standard of care for patients.

1. FOSTER CARE

Children in Foster Care: Issues and Concerns
Here's how the general psychiatrist can play a greater role in better outcomes for children in foster care. The author gives us an overview of and current data on child maltreatment and presents guidelines from the American Academy of Child and Adolescent Psychiatry to give recommendations on how to care for foster and/or welfare children.

2. MILITARY MENTAL HEALTH

Combat Veterans: Adaptation to Transition
Thoughts become a heavy blanket of security and comfort from the exposure a veteran feels after leaving the military. It is not an easy or simple process. Like any major transition, it brings the stress of adjustment to new roles, relationships, routines, and assumptions. Here is one psychiatrist's personal story.

Significance for the practicing psychiatrist: The adjustment from military to civilian life is great, especially when we consider the increased risk of suicide during the first 3 years after separation from active duties. For a mobile-friendly view of the Monarch notes, click here.

3. TECHNOLOGY:

Wearable Devices for Mental Health: Knowns and Unknowns
Can a wearable device improve mental health outcomes? As health care providers, we need to look at wearable devices as a new tool that offers both promise and pitfalls. We need to apply the same scientific and clinical mindset to wearable devices.

Significance for the practicing psychiatrist:There is still much we do not know about how fitness trackers can advance care and the data from these devices may not be covered by HIPAA. The plus side is they do have the potential to help make patients with psychiatric disorders more active. For a mobile-friendly view of the Monarch notes, click here.

4. HEALING THE HEALERS:

What You Need to Know When Treating Physicians: Issues, Sensitivities, and Considerations
The very traits that define a good physician make it difficult for most doctors to prioritize basic self-care. Many fail to notice early signs of dysfunction. Notably, physician-patients present to a health care provider’s office with what may seem like a simple problem, illness, or symptom complex. But s/he is also dragging a heavy load of unresolved emotional distress

Significance for the practicing psychiatrist:Clinicians who work with a physician should be alert to several areas of concern, including possible burnout; minimizing of symptom severity; guilt that may masquerade as anger; tendency to self-treat; or lack of insight into professional boundaries.For a mobile-friendly view of the Monarch notes, click here.

5. THE UNDERSERVED:

Collaborative Opportunities: Working With Nurse Practitioners to Meet the Needs of Underserved Populations
The demand for more clinicians to treat psychiatric disorders creates a unique opportunity to integrate nurse practitioners and other multidisciplinary providers into psychiatric training and clinical practice. Psychiatric nurse practitioners are well positioned to extend the psychiatric workforce given their nursing/medical background and the specialized psychiatric training.

Significance for the practicing psychiatrist:Collaboration with psychiatric nurse practitioners is a growing role of the psychiatrist as part of the multidisciplinary team. Understanding the strengths and limitations of each health care provider can lead to effective delivery of care and optimum outcomes. For a mobile-friendly view of the Monarch notes, click here.