Category Archives: Mental Health

Correctional Medicine is a Great Job! Who Knew?

I have a confession to make.  Before I knew anything about Correctional Medicine, I had a bad opinion about it.  I’m not proud of this.  I even turned down my first opportunity to get into Correctional Medicine because of my preconceived prejudice. Thank goodness I got a second opportunity, because Correctional Medicine changed my life! Who knew that Correctional Medicine was such a great job and a great career?

Certainly not my colleagues.  Back when I made the mid-life career change to jail medicine, my physician friends asked me, bewildered, “Why in the world would you want to work in a jail?”  Without knowing anything about it, they had a preconceived notion of Correctional Medicine as being low skill and basically without redeeming features.

What a difference 15 years makes! careersprisondoctor Continue reading

Essential Pearls from Essentials

Essentials of Correctional Medicine was held last week in Salt Lake City, Utah and included some great talks.  Today’s post is a list of Pearls I gleaned from the conference speakers.

The definition of a “Pearl” is a bit of pithy and insightful information that can be communicated in one or two sentences. Hopefully, it is also something that you have not thought of yet and will change your practice for the better.

I ran into several Pearls at the Essentials conference. Here is a sampling (in no particular order): Continue reading

Review Articles of the Month–Emphasis Psychiatry

Like most physicians, I subscribe to several medical education and CME sites.  One of my favorites is Primary Care Medical Abstracts.  PCMA chooses 30 papers a month of interest to primary care physicians and then these papers are reviewed by two physicians (usually Rick Bukata and Jerry Hoffman).  The reviews are insightful and funny and pretty fun to listen to.  These guys have no problem calling B.S. when they review certain papers.  I like that!  (By the way, I have no affiliation with PCMA). Continue reading

Embracing the Placebo Effect of Antidepressants.

Social Worker Shanna at work in the Ada County Jail Boise, Idaho

I recently ran across this interesting article (found here) which is the latest in a long series over the years comparing antidepressant efficacy to placebos.  I know that this is a controversial subject with some believing that all (or most) of antidepressant effect is placebo effect and others believing that antidepressants do indeed work better than placebos, especially among the most severely depressed patients.  The researchers in this article did a review of several trials and concluded that antidepressants work better than placebo in those with mild and moderate depression.  The most interesting statistic from this paper in my mind is this:  in this, the most positive analysis that I have read  on the effect of antidepressants, the “Number Needed to Treat” (NNT) to have one patient do better than by placebo alone was five (5).  In other words, 4 out of 5 patients in this study got no benefit from the antidepressant over placebo. Continue reading