Tag Archives: Dorothea Dix Hospital

A Compendium of Letters

“Monday Musings”  for Monday July 15, 2013

Volume III, No. 26/129

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(Editor’s Note: Today’s column is a compendium of letters to the editor of various publications)

Profligacy of our Postal Service

By Assad Meymandi, MD, PhD, DLFAPA*

Recent articles in the press re: USPS evoke some thoughts and suggestions. Postal service started by Cyrus the Great, the King of Persia (600- 530 BC), around 570 BC. He needed to have postal couriers to bring him news from the four corners of his vast empire on a regular and daily basis. His first person for the job, his Postmaster General, was a woman, a Postmistress by the name Mithra. She was Vizier of the Postal Services. Benjamin Franklin, a genius, a polymath, a polyglot, and fluent in history of civilization, in his writings made frequent references to Mithra. This little known fact also reflects the human right and equality women enjoyed in pre-Islamic Achaemenid Persia. Cyrus had two other female viziers also.

Thanks to our founding fathers, and especially to Benjamin Franklin, for more than 200 years, Americans have relied on the US Postal Service to deliver the mail through storms of all kind. But changing technology, a global recession, and rising debt now threaten the national mail service. Mail volume is expected to drop by 14% this year, and the USPS estimates that it will lose seven billion dollars. There is no question that by any measure the USPS’s financial condition is dire.

Among solutions contemplated is by USPS officials are closing of up to 700 branches and delivering mail five days a week or at least to stop Saturday mail delivery. USPS has tried to balance the budget by raising rates, trimming its work force through attrition and buyouts, automating mail sorting, realigning routes, and freezing executive salaries. Here are some thoughts about alternative solutions: Like Germany, Britain and Japan USPS ought to open its services to competition from private companies. In a recent report in Financial Time, professors of the London School of Economics suggest “profit motive would bring a drive for efficiency…”

As I travel around the world and observe national habits, I have not seen any country that offers so much in amenities to the postal carriers as we do in America. Our postal carriers seem to all have jeeps to carry them around. I suggest that USPS, like Germany, Britain and Japan mothball the millions of combustion engine jeeps they buy, fuel and maintain, spending billions of dollars on that one item and encourage the delivery to be carried on foot. Another benefit of such change in policy is trimming down the unwanted fat the jeeps carry around. Trimmer, and healthier postal workers save on the health bill. Obesity that causes diabetes, cardiovascular disease, hypertension and musculoskeletal problems, like chronic backache, could be prevented and truly billions and billions dollars in healthcare savings realized through switching from machine delivery to foot delivery. American profligacy is not only driving us to bankruptcy, it is literally killing us.

Assad Meymandi, MD, PhD, DLFAPA


 One Serpent or Two Serpents Caduceus

Letter to the Editor, News and & Observer

The wrong caduceus was used in the op-ed page article “Dying Well, Knowing the Cost”, N&O, June 13, 21013. Caduceus, a staff with two serpents is related to Mercury and all its functions and attributes including commerce. Caduceus with a staff and one serpent is medical symbol that goes to Asclepius. In 1902 through an error made by a culturally illiterate VA doctor in NY, the commercial caduceus was adopted as a medical symbol and never corrected. However in 1952, American Medical Association (AMA) took action to correct the symbol. AMA has taken further initiative of correcting the symbol in all its formal medical printings and communications.

A M

“Iran, 3000 Years of Stoning Women”

Letter to the Editor, The News and Observer, Raleigh, NC

I am writing to strongly object to the content of the political cartoon on the editorial page of N&O, Monday June 10, 2013. Among many evils going on in the world your cartoonist lists “ 3000 years of stoning women in Iran”.  A bit of history might be helpful.

It is the Persian Empire and not Iran that is over 3000 years old.  As a matter of fact, Persia and some of its cities go back 8000 years. Cyrus the Great and other kings of Persia are invoked in the 66 books of the Bible on innumerable occasions. Isaiah 45 is almost singularly devoted to the beneficence of King of Persia where he is named Messiah. Cyrus emancipated the Jews and established equal rights for men and women. In managing his vast empire, to be in touch with his emissaries, rulers in distant parts of the kingdom, Cyrus developed a formal service charged with sending and receiving communiqués to and from his lieutenants, thus the birth of the postal service which he called “Peyk”. The cabinet of Cyrus the Great consisted of twelve viziers (ministers or secretaries), several of whom were women. The first person in charge of the Royal mail service was a woman. Her name was Mithra (which in Zoroastrian parlance means, dignity). The father of the United States Postal Service (USPS), the polymath Benjamin Franklin, being the amorous type and a lady’s man, has referred to Mithra in his writings. In addition, we had Toorandokht and Poorandokht (both women) ruling the Persian Empire during the Sassanian (Sassanid) dynasty, 224-651 AD. Also, we are reminded repeatedly in the Old Testament that wisdom is a woman (Proverb 1-9), and in Greek the word for wisdom is Sophia. May be one of these days we will have a female US President to bring some wisdom and love to our dialectically torn nation. I have a granddaughter who will make a good candidate…

Cyrus Cylinder, the iconic representation of declaration of human rights, is now on tour in US.  Yes, under the Mullahs and the present day regime, the level of human dignity and civility has deteriorated.  But the regime is only 30 years and not 3000 year old.

AM

Letter to the Editor, The News & Observer, Raleigh, NC

 

Dear Sir:

Mental Health

Kudos to John Drescher for his insightful column N&O, June 1, 2013, “On Mental Health, Job isn’t Done”. The only correction I offer is that some studies reveal that over one third of NC inmates have a diagnosable mental illness (brain disease), not 15 to 20 percent as stated in the article.

For over 50 years, I have been involved in various capacities with the North Carolina mental health system. At no time the services to and for our patients have been as chaotic, sparse, and erratic as they are today. Fifty years ago, in North Carolina, we had a system in place that was truly superb. At Dorothea Dix Hospital, where I received my psychiatric training, in the late 50’s and early 60’s, patients had predictable, excellent,

and academically cutting edge treatment available to them with ready access. No patients had to wait for days and in some instances for weeks in emergency departments of general hospital waiting for a bed.  And no patients were put in jail and prisons because of lack of mental health treatment and shortage of psychiatric beds. We have certainly devolved and regressed. Taking care of patients with mental illness–and really it is brain disease—is a moral responsibility about which Thomas Jefferson and our country’s other founding fathers have expounded.

There is a glimmer of hope.  UNC system President Tom Ross, his chief of staff, Kevin Fitzgerald, Dean of UNC School of Medicine at Chapel Hill, Dr. William Roper, and WakeMed administrator William Atkinson have agreed to provide a psychiatric unit of 40+ psychiatric beds for Wake County.  With the projected population growth in our area, to do an adequate job, we need a facility with 500 psychiatric beds.  We can do better, and must do better.

AM

Editor, WSJ: I am submitting the essay below for op-ed page, or the letter in response to Mr. Gary Fields’ excellent article in today’s WSJ. Thank you

AM

Gary Fields’ comprehensive article, WSJ, June 8-9, 2013, on the dilemma of the families where there is severe mental illness is indeed of Pulitzer quality. Mr. Fields took a psychological and historical scalpel and ably dissected the huge problem of mental health care in America. However, here are some reflections:

In the debate of violence, especially gun violence, mental illness has gotten a bad rap. The alleged connection between mental illness and mass violence is not supported by objective data and science:  “substantial research shows that the vast majority of people with serious mental illness never act violently, and the vast majority of violent crimes -96 % by the best available data- is not perpetrated by persons with mental disorder” said Paul Appelbaum, Past President of APA, Professor of Psychiatry, Medicine and Law at Columbia College of Physicians and Surgeons. What we need to do is to face and design program of mental healthcare instead of warehousing the mentally ill in jails and prisons.

The APA position which I am advocating is to appoint a presidential commission to develop a vision for a system of mental health care, creating a mechanism for facilitating responses to key mental health issues such as designating a white house point person, improving early identification of youth with mental health problems and developing sensible, non- discriminatory approaches to ensuring that dangerous individual cannot gain access to guns. In his report and testimony Dr. Appelbaum stated “that people with mental illness who are engaged in regular treatment are considerably less likely to commit violent acts than those who need but do not receive appropriate mental health treatment.”

Another expert testimony at the Vice President Task Force was Dr. Thomas Insel, Director of National Institute of Mental Health stated that “Suicide, not homicide, is the most urgent public health problem associated with gun violence.  About 90% of suicides involved individuals with mental illness. Dr. Insel reported that “the popular association of homicidal violence and mental illness is tenuous at best..”  Despite common public perceptions, there is little connection between gun violence and mental illness.  Only 6 percent of violent crimes are committed by someone with a diagnosed mental illness, as opposed to 96 percent suicides that are associated with mental illness.

What to Do? 

For nearly 50 years, I have been involved in various capacities with the North Carolina mental health system. At no time the services to and for our patients have been as chaotic, sparse, and erratic as they are today. Fifty years ago, in North Carolina, we had a system in place that was truly superb. In the late 50’s and early 60’s, patients had predictable, excellent, and academically cutting edge treatment available to them with ready access. Taking care of patient with mental illness, which is really brain disease, is a moral responsibility about which Thomas Jefferson and our country’s other founding fathers expounded. America has a moral obligation to provide care for the mentally ill.

Assad Meymandi, MD, PhD, DLFAPA

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He serves as a Visiting Scholar and lecturer on Medicine, the Arts and Humanities at his alma mater the George Washington University School of Medicine and Health.

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On Mental Health Care and Gun Violence

Monday Musings for Monday May 27, 2013

Volume III, No. 19/122

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Gun Violence Control, Where is the Wisdom?

By Assad Meymandi, MD PhD, DLFAPA*

(Editor’s note: On Tuesday May 28, at 7:30 PM, Congressman David Price, TV newsman David Crabtree and I will participate in a seminar organized by Quail Ridge Books & Music, 3522 Wade Avenue, Raleigh, NC, on the topic of gun violence. Free admission).  Also, the link below for your viewing: 

http://www.wral.com/news/local/video/12435002/

President Obama called the massacre of 20 innocent children and six adults on Dec 27, 2013, in Sandy Hook Elementary school in Newton, Connecticut, the “worst day of his presidency.” History tells us that every president since George Washington has had a/the ‘worst day. ‘ For George W Bush it was September 11, 2011, for FDR it was Pearl Harbor, December 7, 1941.  All our 44 presidents have had a worst day in their presidencies. It would be a meritorious project for some PhD candidate in history to compile a volume on every US Presidents’ worst day in the office.

The December 27 occurrence could have been a turning point in the debate over guns in America. Knowing the history of gun violence- especially since the 1960s- The University of Texas clock tower in Austin Texas, in the 70’s Kent State University Massacre, the 80’s Cleveland School mass killing and the 90’s several schools, including Columbine High School, mass shooting at Virginia Tech, not counting mass murders in other facilities including Sikh Temple, army bases and others, the numbers are staggering. But none was as gruesome as the Sandy Hook massacre. Every one seem to agree that these tragedies must end. Vice President Joe Biden chaired a task force to examine the issue by holding extensive public hearings in which expert testimony was given by representative of American Psychiatric Association (APA), American Medical Association (AMA), American Bar Association (ABA), and forensic authorities. But the matter became politicized; the National Rifle Association’s (NRA), Democrat’s, and Republican’s different interpretations of Second Amendment to the Constitution all began spinning in the media. Gun control advocates brought in an extensive agenda, namely tougher penalties for illegal gun sales, increased school safety programs, expanded background check for gun buyers and mandates to keep guns out of the hands of criminals and folks with history of mental illness.

Republicans and NRA saw this as unnecessary interference by government. So a compromise was generated by Senators Joe Manchin, a Democrat from West Virginia and Patrick Toomey a Republican from Pennsylvania, focusing attention on background checks. It failed.

Issues like gun violence control, abortion, and cloning carry within their constitutional DNA a huge dose of controversy. My focus in this essay is a dispassionate and analytic examination by separating the hype and hysteria from reality and data. It is hoped that cool heads and wisdom will prevail.

In the debate of gun violence mental illness has gotten a bad rap. The alleged connection between mental illness and mass violence is not supported by objective data and science: “substantial research shows that the vast majority of people with serious mental illness never act violently, and the vast majority of violent crimes- 96 % by the best available data- is not perpetrated by persons with mental disorder”,  said Paul Appelbaum, Past President of APA, Professor of Psychiatry, Medicine and Law at Columbia College of Physicians and Surgeons. What we need to do is to face and design program of mental healthcare instead of warehousing the mentally ill in jails and prisons.

The APA position which I am advocating tonight is to appoint a presidential commission to develop a vision for a system of mental health care, creating a mechanism for facilitating responses to key mental health issues such as designating a White House point person, improving early identification of youth with mental health problems and developing sensible, non- discriminatory approaches to ensuring that dangerous individuals cannot gain access to guns.  In his report and testimony Dr Appelbaum stated that people with mental illness who are engaged in regular treatment are considerably less likely to commit violent acts that those who need but do not receive appropriate mental health treatment.

Another expert testimony at the Vice President Task Force was Dr. Thomas Insel, Director of National Institute of Mental Health stated that “Suicide, not homicide, is the most urgent public health problem associated with gun violence. About 90% of suicides involved individuals with mental illness.”  Dr. Insel reported that “the popular association of homicidal violence and mental illness is tenuous at best.”  Despite common public perceptions, there is little connection between gun violence and mental illness.  Only 6 percent of violent crimes are committed by someone with a diagnosed mental illness, as opposed to 96 percent suicides that are associated with mental illness.

What to Do?

For nearly 50 years, I have been involved in various capacities with the North Carolina mental health system. At no time the services to and for our patients have been as chaotic, sparse, and erratic as they are today. Fifty years ago, in North Carolina, we had a system in place that was truly superb. At Dorothea Dix Hospital, where I received my psychiatric training, in the late 50’s and early 60’s patients had predictable, excellent, and academically cutting edge treatment available to them with ready access. No patients had to wait for days and in some instances for weeks in emergency departments of general hospital waiting for a bed.  And no patients were put in jail and prisons because of lack of mental health treatment and shortage of psychiatric beds.  We have certainly devolved and regressed. Taking care of patient with mental illness–and really it is brain disease—is a moral responsibility about which Thomas Jefferson and our country’s other founding fathers expounded.

There is a glimmer of hope.  UNC system President Tom Ross, his chief of staff, Kevin Fitzgerald, Dean of UNC School of Medicine at Chapel Hill, Dr. William Roper, and WakeMed administrator William Atkinson have agreed to provide a psychiatric unit of 40+ psychiatric beds for Wake County. With the projected population growth in our area, to do an adequate job, we need a facility with 500 psychiatric beds.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He serves as a Visiting Scholar and lecturer on Medicine, the Arts and Humanities at his alma mater the George Washington University School of Medicine and Health.

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