<p>Indian ministers are every bit as corrupt as their American counterparts (though not nearly as corrupt as the U.S. military-industrial complex, which is so corrupt, we don’t even think about it as corruption anymore.)</p>
<p>Protests seemed to stop many of the GMO vegetable crops from going forward in India (which partially prompted the Prez’s India visit - but I won’t go there further, as it would be thought of as “political”), but the cotton is there, and really is resulting in deaths.</p>
<p>Back to our regularly scheduled divertisments.</p>
<p>I’ve missed several pages of this thread, but I can’t help wondering what’s more dangerous to the American public in terms of human suffering: guns or uneven healthcare coverage! And as you can see, there is no consensus (and in some cases acknowledgement) on either problem.</p>
<p>I moved here from Canada ten years ago, and love many things about my new home and the people in it. But if there were two things that could and can still make me cry, it’s gun control and healthcare (and the state of k12 education in urban centers.) But people don’t always understand or fully appreciate the distinction between humanity and inhumanity in policy unless the witness it first hand. My family back home cannot understand that my husband and I pay 20,000 a year for health coverage, but they also don’t see that compared to my earnings in Canada, I also pay less tax. In my case, it’s a wash. That’s not really the problem here, because if you make enough money, if there’s pooled care, you can get coverage even with preexisting conditions. The problem is that ALL humans cannot access it, that it’s very much determined by your socioeconomic status, which leaves this whole proportion of low income workers and their innocent children feral in terms of healthcare, particularly preventative care. And the delivery cost is higher due to the multipayer/insurance system and resulting bureaucratic waste. The differential in delivery cost could likely actually finance healthcare for all, but you’ll never see a single-payer system here because it is a “free” market. This “freedom” often costs us, IMHO, more than we could bare to know!</p>
<p>The psychiatrist indicated to the university threat team that Holmes might be a danger to others in June and then he withdrew from the university so the matter was dropped. It appears that she was Holmes psychiatrist or that she was treating him but it may be that she wasn’t after he withdrew from the university.</p>
<p>The wording that I saw in the CNN article is that he was potentially a threat - and apparently their approach is to convene a meeting of their team which would have then decided on any actions to take.</p>
<p>This is somewhat of a discontinuity in care because the student no longer has a relationship with the institution that provides care. In this particular case, was there a responsibility to notify someone? If so, who would they have notified? They wouldn’t necessarily know where he was.</p>
<p>kmcmom13–you said it very well. The Canadian health care system has a long way to go but the one thing that makes me proud of it is that everyone regardless of age, sex, socioeconomic status has access to preventative medical care. I know that our system over the past few years has also changed and will not necessarily pay for all of the services they used to but that I can accept. I do find it hard to understand your paying 20,000 a year for medical insurance, and yes I know that you pay less taxes but I know that whithin my field at least the salary in the States is substantially lower (before somebody jumps on me for that I know it all depends on where you are). At any that is one thing that is really my D’s mind because what she wants to do for a living is most likely to be in the States and the idea of having to get private health care insurance etc is scarring her.</p>
<p>I think so. If not legally, then certainly ethically. I think a therapist is supposed to break confidentiality if the patient is a threat to himself or others.</p>
<p>They should have notified the police and Holmes’ family. Even if they didn’t know where he was, they knew his name and address. Start there.</p>
<p>Regarding a warning, it all depends on what they knew. If they knew of a specific and credible threat, they should have notified the police and the intended victims. But if they had an uneasy feeling, there wasn’t much they could do. A therapist can’t break confidentiality without a specific threat and the police can’t do anything without one. If there is a specific threat, then they have a duty to warn. Confidentiality is the bedrock of psychotherapy and there are rules and you can get in a lot of serious trouble for breaking confidentiality outside the limits of what is allowed by the law. As for a threat to self, that is a right to warn, not a duty. Therapists can notify someone. The duty is when there is a threat to others. As someone posted upthread, this may vary from state to state, but in my state you need a threat in order to notify police or intended victims.</p>
<p>This person was a psychiatrist and I always thought that the model was that you spend time with a psychologist and short periods of time with a psychiatrist so that they could prescribe medications for you. The reason for the model is that the psychiatrists costs a lot more than a psychologist.</p>
<p>Perhaps Holmes had an ongoing prescription for something and went to see her so that she could write prescriptions for him while in CO.</p>
<p>“The involuntary commitment process is initiated when a
mental health professional71 receives information alleging that
a person presents an imminent likelihood of serious danger to
himself or others, or is in imminent danger because of being
gravely disabled.72 The mental health professional must thoroughly
evaluate information received and assess the “reliability
and credibility” of the person providing the information. 3
The initial detention of an individual may not exceed a 72-hour
evaluation period.74”</p>
<p>Thoroughly implies taking some time and I guess that was what the Beta committee was for. One can see the balance between privacy and public. If you involuntarily commit someone, you may be damaging reputation and generate medical costs for someone.</p>
<p>Basically, therapists are in a sticky position. This sort of thing is rare though (mass murder). Suicides are more common.</p>
<p>This sort of thing ended the career of a psychologist that I know of. A patient committed suicide under her care for a week.</p>
<p>I believe it is Tarasoff we are talking about here, and in the first link, the author describes how Washington has extended it from duty to protect specific people from specific threats, to include duty to protect “anyone who might be foreseeably endangered”, including “unidentified or unintended victims”. I don’t believe that is true elsewhere. The conflict of interest is similar though. Imagine going to see a psychiatrist and he shifts the focus from you, to an evaluation of risk to the community or the world at large.</p>
<p>I don’t think there is any psychiatrist claiming he/she could have prevented this. I sure hope the ability to predict and prevent mayhem doesn’t become the expectation.</p>
<p>From a Psychiatric Times blog; Mass Murders, Madness, and Gun Control
By Allen Frances, MD | July 30, 2012"</p>
<p>" There is a presumption that if we can understand the mind of the mass murderer then perhaps we can prevent the mass murders… Psychiatry has no way of predicting or preventing rare and fairly random acts of senseless violence—it is simply impossible to find needles in haystacks. We must accept the fact that a small cohort of deranged and disaffected potential mass murderers will always exist undetected in our midst."</p>
<p>We might have to go with “The Minority Report”</p>
No but we (apparently) know that he saw the psychiatrist so he must have disclosed something about himself although not necessarily what specifically he planned to do and we can’t expect psychiatrists to be mind readers especially with people who don’t even know what’s going on in their minds themselves.</p>
<p>My point was that he at least sought out a psychiatrist for some reason, must have told her some reason of why he was seeing her, had some discussions, all in confidence, yet it obviously wasn’t enough to stop him from committing this mayhem.</p>