Treatment of Suicidal Patients in Managed Care [Paperback]

James M., M.D. Ellison (Editor)

Book Description

Publication Date: January 2001

Suicide remains all too common in the United States. As the ninth leading cause of deathAresponsible for 30,000 deaths annuallyAit is also one of the more preventable causes of death Increasingly, mental health clinicians must care for suicidal patients within managed care systems. Managed careAs cost-driven focus on rapid assessment and triage, narrowly restrictive hospital admission criteria, and abbreviated inpatient stays have resulted in poorer clinical care and increased opportunities both for adverse outcomes such as suicide and for clinician liability. Bringing together a unique mix of clinicians, authorities, and administrators from private practice and managed care, Treatment of Suicidal Patients in Managed Care offers practical guidance on how to improve care and reduce risk for suicidal patients. Contributors explore a wide range of topics: -HospitalizationAEmphasizes the increased importance of the initial assessment when managed care systems shorten or deny hospitalization for suicidal patients and of knowing whom to call within the managed care system. Includes alternative programs from acute residential care to cognitive-behavioral strategies and dialectical behavior therapy for the suicidal patient in crisis -Suicide risk among adolescents and the elderlyAFor adolescents, emphasizes the value of multiple levels of care when admissions are too short and too often followed by distressing and costly readmissions. For the elderly, offers preventive interventions for primary care physicians who are uncomfortable discussing depression and suicidal ideation and intention with their elderly patients -Suicide and substance abuseADetails the role of case managers in providing continuity of care in a disorder known to be chronic and relapsing -Pharmacotherapy of depression and suicidalityADiscusses the effects of managed care and raises questions about the expertise of the prescriber, especially relevant now that more primary care physicians are treating patients with uncomplicated unipolar depression -Risk management issuesATo counter the perception that managed care companies profit from withholding care, emphasizes the crucial importance today of documenting the reasons for treatment decisions -Helping those affected by the aftermath of a suicideAA step-by-step process: 1) anticipating a suicide, 2) announcing or sharing the news of a suicide, 3) assessing those affected by a suicide, and 4) seeing what can be learned from reviewing the patientAs treatment This clinical guide will aid understanding of clinical, administrative, and risk management issues relevant to the care of suicidal patients. Psychiatrists, psychologists, nurse clinical specialists, social workers, administrators, and primary care physicians will also rely on it as they cope with the mounting pressures of managed care while maintaining the quality of their care for these vulnerable and patients.

Editorial Reviews

Review

"Any practicing mental health professional will benefit from a careful reading of this well-written book." -- Doody Health Science Book Review, December 2001

About the Author

James M. Ellison, M.D., M.P.H., is Associate Clinical Professor in Psychiatry at Harvard Medical School, a consultant to The Cambridge Hospital Psychiatry Department, and Interim Clinical Director of Geriatric Psychiatry at McLean Hospital in Belmont, Massachusetts. He is also President of the Northeast Affiliate of the American Foundation for Suicide Prevention.

Product Details

• Paperback: 218 pages
• Publisher: Amer Psychiatric Pub; 1st edition (January 2001)
• Language: English
• ISBN-10: 088048828X
• ISBN-13: 978-0880488280
• Product Dimensions: 9.1 x 6.2 x 0.7 inches
• Shipping Weight: 12 ounces (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #3,832,778 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

5.0 out of 5 stars The Problem of Suicide, January 3, 2002

By 

David Milofsky "Jean Milofsky" (Englewood, CO USA) - See all my reviews
(REAL NAME)   

This review is from: Treatment of Suicidal Patients in Managed Care (Paperback)

As chief of a busy psychiatric service in a managed care company, I found a great deal of solace, support and practical information in Dr Ellison's timely and useful collection of essays. Neither Dr Ellison nor any of his contributors take the easy way out of 'bashing' managed care organizations. Rather, they seem to understand the socioeconomic rationale for these organizations, take them as a given and objectively delineate their strengths and weaknesses. They then set about the really important task of showing the way for the practicing clinician to cope with them. The book is empowering on many levels offering strategies for providing the most effective care, warnings about what to anticipate in planning treatment for a patient covered under managed care, and techniques for objecting effectively when real clinical concerns cannot be satisfactorily dealt with in an existing system of care. Never did I detect a victimized stance with regard to clinician or patient.
The book offers legal perspectives, special sections on the care of the elderly and the adolescent suicidal patient, and helpful background about the evolution of managed care systems. One of the best chapters in the book, written by Dr Steve Stelovich, discusses the aftermath of suicide in terms of risk prevention, support of providers, and compassionate treatment of the survivors.
Dr Ellison has done a great service to clinicians in organizing this helpful compendium of expertise about a subject that needs constant revisiting. I am grateful for his doing so and will find many applications for his book in the life of my clinic.