Quick Takes | Dr. David Gratzer

Reading of the Week: Innovation & Pandemics (NEJM); Also, Telemental Health & Practice (QuickTakes) and Scott on Isolation (NYT)

From the Editor

After a short break, the Readings are back. And the world has changed over these past weeks.

We are all dealing with the stress of the pandemic, both at home and at work. I spoke recently with a physician who is a young mother, and she talked about balancing her different obligations, and working to keep her patients and family safe.

These are challenging times.

I want to acknowledge the frustration that we all have, particularly the PGY5, who are so close to completing their studies but have had their Royal College examination postponed. It’s a tough moment for our young colleagues. But I have a few grey hairs, and have seen tough moments come and go – and I believe that things will work out just fine.

This week’s Reading includes three selections.

In the first selection, we consider innovation in the age of pandemic, with a new NEJM paper by Drs. Judd E. Hollander (of Thomas Jefferson University) and Brendan G. Carr (of Sinai). They discuss telemedicine and COVID. “Disasters and pandemics pose unique challenges to health care delivery. Though telehealth will not solve them all, it’s well suited for scenarios in which infrastructure remains intact and clinicians are available to see patients.”

mobile_phone_with_stethoscope_showing_technology_and_health_stock_photo_slide01

Then, we take a practical turn. Many of us clinicians use telemental health; with COVID, many more are thinking about taking the virtual care plunge. In the second selection, we consider a new podcast discussing telemental health. I talk with Dr. Allison Crawford of the University of Toronto. And, yes, she has tips on how to up your virtual care game. And to those thinking about using telemental health, she offers simple advice: “Do it. Try it.”

Finally, in the third selection, we look at a NYT essay by an astronaut. Thinking about his time and isolation in space, Scott Kelly provides some clever advice. “I’ve found that most problems aren’t rocket science, but when they are rocket science, you should ask a rocket scientist.”

Reading of the Week: Better PTSD Symptom Control, Less Diabetes (JAMA Psych)? Also, Buckley on Cannabis (Quick Takes), and the Life of Kajander (Globe)

December 5, 2019 / David Gratzer / Comments Off

From the Editor

Better PTSD symptom control, less diabetes? How do we talk to our patients about cannabis (and cannabis use disorder)? Who was Dr. Ruth Kajander?

This week, there are three selections. The first two deal with timely and relevant topics: the intersection of physical and mental health and the use of cannabis post-legalization. The third reminds us of the youth of our field.

In the first selection, Saint Louis University School of Medicine’s Jeffrey F. Scherrer and his co-authors consider PTSD and diabetes, asking if improvement with the mental health disorder results in a lower risk of type 2 diabetes. Drawing on Veterans Health Affairs data involving nearly 1 600 people, they find that “clinically meaningful reductions in PTSD symptoms are associated with a lower risk of type 2 diabetes.”

treating-ptsd-may-help-reduce-risk-of-type-2-diabetes-696x464

In the second selection, we draw on a podcast interview with the University of Toronto’s Dr. Leslie Buckley, the chief of addictions division at CAMH, on cannabis. What advice would she give clinicians about cannabis use? “Try to have that long conversation with [patients] about their use and make sure that they know the harms – because I feel like most people don’t.”

Finally, with an eye on yesterday and not today, we look at the recent Globe obituary for Dr. Ruth Kajander, a psychiatrist who served in many roles, and was a member of the Order of Canada.

Reading of the Week: Postsecondary Students & Mental Illness (CJP), a New Podcast (CAMH), and Bipolar & Social Media (NYT)

October 3, 2019 / David Gratzer / Comments Off

From the Editor

Social media. An uncertain job market. Increasing academic demands.

Is life for our postsecondary students harder than ever? And are we seeing a surge in mental health disorders as a result?

In the first selection, we consider a new Canadian Journal of Psychiatry paper on postsecondary education and mental illness. While many have opinions on this topic, the University of Toronto’s Kathryn Wiens and her co-authors seek to add data to the discussion. Drawing on the Canadian Community Health Survey, they find: “The results do not imply the emergence of a mental health crisis among postsecondary students.”

In the second selection, we look at a new podcast considering technology and education. I interview some accomplished educators, including the University of Toronto’s David Goldbloom. “This is about challenging our own norms, values and expectations as clinicians.”

And in the final selection, we consider a New York Times essay on bipolar and social media. “Facebook snitched our big family secret: Roland, the literary prodigy, the tenderhearted musician, the Ivy League grad, was bipolar.”

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

June 27, 2019 / David Gratzer / Comments Off

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-street 10 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.

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

June 13, 2019 / David Gratzer / 1 Comment

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?

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.

Dr. David Gratzer

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TagQuick Takes

Reading of the Week: Innovation & Pandemics (NEJM); Also, Telemental Health & Practice (QuickTakes) and Scott on Isolation (NYT)

Reading of the Week: Better PTSD Symptom Control, Less Diabetes (JAMA Psych)? Also, Buckley on Cannabis (Quick Takes), and the Life of Kajander (Globe)

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

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