Scientific Advances Bring Major Changes to Forensic Psychiatry

As it ends its second decade as an official subspecialty, the field of forensic psychiatry is digesting dramatic changes that are making it more science based and expanding the areas in which it contributes expertise.

“Clinical evaluations have in many settings been supplemented by more systematic data-gathering tools, such as scales for the assessment of symptoms and mental states.” In addition, “forensic psychiatry has become much more important in child custody, disability evaluations, and perhaps more significantly for the public, in sickness-for-duty evaluations,” said Patricia Recupero, M.D., J.D., a professor of psychiatry at Brown University.

–Psychiatric News Alert

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New Study Finds Assisted Outpatient Treatment Saves Money. Why Aren’t More States Using It?

It just got a lot harder for opponents of court-ordered outpatient treatment for mental illness to argue that it costs too much to use.

A study of mandatory outpatient treatment costs published today in the American Journal of Psychiatry found that use of assisted outpatient treatment (AOT) can vastly reduce overall costs of mental health services for persons with serious mental illness.

“Common sense has always argued that treating people with severe mental illness is a lot cheaper than arresting, jailing and/or hospitalizing them – not to mention more humane,” said Doris A. Fuller, executive director. “Now Duke University and its research partners have produced the numbers to validate it.”

“The cost of assisted outpatient treatment: Can it save states money?” by Dr. Jeffrey W. Swanson of Duke and six other researchers reports that service costs for 634 frequently hospitalized patients with severe mental illness declined 50% in New York City – from $104,753 to $52,386 – in the first year they received AOT after psychiatric hospitalization and dropped another 13% the second year.

Even larger cost savings were reported in five suburban New York counties also analyzed in the study.

Swanson and fellow researchers analyzed the costs of providing program, selected legal and court services, mental health and other medical treatment, and criminal justice involvement to people who met the strict criteria for New York’s involuntary outpatient treatment program (“Kendra’s Law”). Dramatic  savings were realized even though the cost of providing outpatient services to people under Kendra’s Law AOT orders was higher.

The researchers said that by saving money with greater use of AOT, mental health agencies could actually find themselves with more resources to meet other mental health needs.

“Unfortunately, compassion for those suffering these consequences as a result of untreated symptoms of severe mental illness has not been enough to motivate most communities to put their AOT laws to work,” Fuller said. “We hope the prospect of saving their taxpayers money will.”

Read the Abstract

Abstract identifies one of SARDAA’s conference speakers, Marvin Swartz, MD

August 13th Webinar: “Ketamine & Next Generation Therapies”


Meet the Scientist logo

Tuesday, August 13, 2:00 p.m.–3:00 p.m. EST

Carlos A. Zarate, M.D., a NARSAD Independent Investigator Grantee (2005), has pioneered revolutionary studies that have led to novel treatments for mood disorders such as depression and bipolar disorder that begin working much faster than previous options. With a strong focus on the pathophysiology of severe mental illnesses, his goal is to develop better treatments particularly for patients living with depression, bipolar disorder and/or other mood disorders. His research into a drug called Ketamine has resulted in rapid-acting depression treatments that work within hours and last 3-5 days or more. Because of the speed at which this drug reacts within the body and the duration of its effects, it is possible that emergency room doctors may have a possible treatment for those suffering from depression and acute suicidality.

Information and Registration

Great News! We Have Added a Second Weekly Schizophrenics Anonymous (SA) Conference Call Group

Due to increased demand and additional leaders, we are pleased to offer a second weekly meeting. Please help us get the word out so that people can get the support and help that they need. For those who do not have an SA group in their area, this may be the only way to connect with others who understand what they are going through.

SA Conference Call Groups
Every Sunday – 7 pm Eastern Time
Every Thursday – 7 pm Eastern Time

Toll-free calls
Call-in information: (888) 617-3400; Pass code: 1086548#
 International Number: (760) 569-4400

Solitary Overused, Harmful in Prison, Advocates Say

Former inmate Jose Bou remembers the anxiety of solitary confinement as being so powerful that when he finally stepped out of his cell, he felt “like a rubber band pulled tight . . . ready to snap.”

A decade ago, the now 37-year-old Bou was serving time in a maximum-security prison after being convicted on drug charges. He remained there for two years, confined to his cell 21 hours a day.

….Massachusetts is one of two states (the other is Arkansas) where an inmate can be sentenced to solitary confinement for up to 10 years.

….Stuart Grassian, a Massachusetts psychiatrist, said confinement exacerbates suffering for the mentally ill and can cause previously healthy inmates to become psychotic.

“Environmental deprivation has a profound, deleterious effect on mental function,” he said.

By Alyssa A. Botelho, Boston Globe

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Brain Imaging May Identify Depression in Very Young Children

Functional magnetic brain imaging (fMRI) of preschool-age children appears to be useful in identifying early childhood depression, according to a study in the July Journal of Child and Adolescent Psychiatry. Researchers…used fMRI to compare blood-flow activity in the amygdalae of 23 nonmedicated preschoolers with depression and 31 nondepressed peers. The children were shown pictures of peoples’ faces with happy, sad, fearful, and neutral expressions. The researchers say the findings could lead to ways to identify and treat depressed children earlier, potentially preventing problems later in life.

–Psychiatric News Alert

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Schizophrenia 24×7 Website Helps Caregivers and Patients

Dear Readers:

I would like to inform you of a new source of information, tools and support for both caregivers and patients. Janssen Canada has launched a website called

We all love to watch videos, and this website allows you to watch a video which takes you through a day in the life of a patient. The website also has many useful tools such as a Digital Diary, which allows patients and caregivers to adhere to medications with reminders, symptom trackers and special tools to help you when you are speaking with your doctor. There is also a short questionnaire to assess how your treatment may be working for you.

If you are into social media, there is also a Facebook page for the caregiver community. Through market research it was determined that there was a lack of support and education for those caring for patients with schizophrenia, so the Facebook page was set up where an all-new schizophrenia caregiver community can share stories, get helpful tips and download tools for patients and caregivers. For example, you can share art through the online patient art gallery, which I think is fantastic.

As publisher of SZ Magazine and someone who lives with schizophrenia, I wholeheartedly support this new website, and I know the Schizophrenia Society of Canada supports it as well. In fact, if you ‘like’ the Facebook page before July 31, Janssen Canada will donate a dollar to the Schizophrenia Society of Canada.

So check out the site. You’ll be glad you did.


Bill MacPhee
CEO, Magpie Media Inc.

Judge Orders Relief for Deaf California Prisoners

California must start providing deaf prisoners in solitary confinement with sign-language interpreters, a federal judge ruled, noting inmates there are 33 percent more likely to kill themselves.

The state’s obligations stem from a series of orders between 1996 and 2002 in which the Northern District of California found that that disabled prisoners were enduring violations of the American with Disabilities Act and section 504 of the Rehabilitation Act.

Sign language interpreters must be present in the solitary unit when technicians evaluate the mental health status of inmates, according to the ruling.

by Philip Janquart, Courthouse News Service

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Lurasidone is Approved for Treatment of Bipolar Depression

The FDA has approved new indications for the atypical antipsychotic drug lurasidone (Latuda; Sunovion) in treatment of patients with depressive episodes associated with bipolar I disorder. The approval covers use alone and as adjunctive therapy with lithium or valproate.

Lurasidone was already approved for use in patients with schizophrenia.

With the new indications, the drug appeared to cause fewer metabolic problems or weight gain than other drugs in its class.

–Psychiatric News Alert

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