MonthJune 2019

Reading of the Week: Can British Reforms Prevent Mental Illness? What Should Every Physician Know About Burnout? Also, Cardiac Surgery (and Us)

From the Editor

Governments in Canada and across the west have committed themselves to spending more on mental health care. But how should we spend this new money? Should we focus on people earlier in the illness experience? Should we fund evidence-based treatments like CBT? Should education campaigns aimed at reducing stigma be the priority?

UK Prime Minister Theresa May recently announced new mental health reforms. She explained: “It’s time to rethink how we tackle this issue, which is why I believe the next great revolution in mental health should be in prevention.” In this week’s first selection, we look at Prime Minister May’s announcement, and we ask: should Canadian policymakers look to 10 Downing Street for mental health ideas?

larry-cat-10-downing-street10 Downing Street

Also, this week, we consider an interview with Dr. Treena Wilkie, CAMH’s Deputy Physician-in-Chief for Medical Affairs and Practice, who talks about physician burnout. Dr. Wilkie closes with a few words of advice for our colleagues: “There’s help available.”

And, in our third selection, The New York Times investigates deaths in an American hospital. The article isn’t about psychiatry (it’s about health care). But could it be about the problems in your hospital?

This will be the last Reading of the academic year. To my young colleagues who have just graduated: I hope you enjoy your careers in psychiatry as much as I have.

There will be no Reading next week. Should you fall off the distribution list of these Readings, please don’t hesitate to pop me an email.

DG

 

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Reading of the Week: Your Patient’s Suicide – the New BJP Bulletin Paper; Also, Langford on Suicide and His Journey

From the Editor

It’s the phone call that we all dread – the call from the family or the coroner, explaining that your patient has died, likely by suicide.

At some point, we all receive that call.

Obviously, we think about the impact of suicide on families. But what impact does suicide have on us clinicians? In this week’s Reading, we consider the new BJP Bulletin paper on suicide and psychiatrists. Dr. Rachel Gibbons, an English psychiatrist, and her co-authors try to answer this question with a survey. Among their findings: a quarter of psychiatrist has considered a career change after a patient’s suicide.

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In this week’s other selection, in a Lancet Psychiatry paper, Dr. Alex Langford, also an English psychiatrist, talks about the impact that suicide has had on his life.

DG

 

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Reading of the Week: Who is at Risk for Daily Cannabis Use? What Should Every Physician Know About Global Psychiatry? And Hussein on Her Psychotic Break

From the Editor

It’s legal. It’s also addictive.

As clinician, we worry about who may be at risk of heavier use of cannabis. In a new paper published in The Canadian Journal of Psychiatry, the University of Montreal’s Erika Nicole Dugas and her co-authors draw on data to try to identify early risk factors for daily use, drawing on 23 potential risk factors. Their findings are plausible – could the list be used for early interventions?

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At risk?

Also, this week, we consider my podcast interview with Harvard University’s Vikram Patel, who talks about mental health services in low-income nations. Dr. Patel is fresh off his win of the John Dirks Canada Gairdner Global Health Award, called the Canadian Nobel by some. (I do ask him what he plans to do with the prize money.)

And, in our third selection, singer Ladan Hussein discusses her psychosis – “I returned home to Toronto in January 2018, broken, dishevelled and deranged” – and her recovery.

DG

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Reading of the Week: On D-Day, Three Papers on Shell Shock, One by Dr. Charles Myers

From the Editor

Today is the 75th anniversary of D-Day.

Ceremonies are planned across the country, and across Europe; Prime Minister Justin Trudeau is in France. During these anniversaries, people comment on the importance of the moment. US President Barack Obama noted: “much of the progress that would define the 20th century, on both sides of the Atlantic, came down to the battle for a slice of beach only six miles long and two miles wide.” And people speak of the loss of life. US President Ronald Reagan, on a past anniversary, talked about “the boys of Pointe du Hoc” who had tried to take “these cliffs” off the beaches, noting that the majority were killed.

But the damage of war is not only in the loss of life.

In this week’s Reading, we consider shell shock and PTSD starting with the first paper on the topic, written by Dr. Charles S. Myers for The Lancet, published just over a century ago. Dr. Myers writes about three cases of shell shock, noting the similarities in their presentations.

La pointe du Hoc en Normandie (Calvados, Basse-Normandie, France)

We also consider a recent paper, published in JAMA Internal Medicine, discussing a more modern presentation – but perhaps not a profoundly different presentation. Finally, we consider a summary of recent published guidelines.

DG

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