xxAACP Newsletter, Volume 11,
Number 1, Winter 1997
Brief Notes
A NEW APPROACH
Dear Editor:
Three cheers for the EXCELLENT article by Linda Morrison, MSW, "Relating to Consumer Activists - A New Approach" in the Autumn '96 issue of Community Psychiatrist!
Psychiatrists take heed ... the hegemonic gig is over. A good way to begin this paradigm shift tomorrow is by going to a first name basis with the people who seek help.
Psychiatrists can and should be agents of social change ... developing power with rather than power over others.
Hunter Yost, MD
New AACP Web Site Under Construction
Despite some recent glitches in getting the membership connected
to the home page, plans are proceeding to develop the site over
the next several months. A consultant has been engaged to help us
realize the full potential of this site and to make it user friendly
to both users and non users. There has been so much confusion over
the old address that it will be changed. The new site will be
more interactive than the previous edition. Bulletin boards,
conversation and consultation rooms, committee meetings and
interorganizationsl e-mail will all be possible once the system
is in place. It is hoped that this will lead to greater member
participation and benefit than has been possible in the past.
LOCUS Version 1.1 Approved
Since its release in May of 1996, LOCUS has been widely distributed and has generated much interest. It is currently being piloted in several locations around the country. (See Community Psychiatrist Volume Ten, Number 3, page 6.) Based on early experiences with the document, several minor changes were suggested before the document was more widely distributed, tested, and copyrighted. This resulted in a LOCUS Adult Version 1.1 which was approved at the October Board of Directors meeting. This will be the official version and no further changes are planned in the immediate future and until broader experience is obtained in its use. In the meantime, a child and adolescent version is being prepared by the AACP's Committee for Child and Adolescent Psychiatry. The research committee has been charged with developing protocols for testing reliability and validity more formally. Several persons have expressed interest in developing computer versions of the instrument to aid implementation and data collection. The Board is currently considering licensing arrangements that may be posible to allow wider distribution and utilization of this instrument and to possiblly generate some income for the organization. Members who have had an opportunity to review LOCUS or have some experience in using it are entreated to register their comments or suggestions with Dr. Sowers. Persons who would like to review the document may contact Wesley Sowers, MD, at St. Francis Medical Center, Center for Addiction Services - 2 East, 400 45th Street, Pittsburgh, PA 15201-1198. Telephone 412-622-6717 or FAX 412-622-6756. E-mail sowers@connecttime.net.
Editor's Note - May 1, 2002 - The current version of LOCUS
is available
here.
Lab Standards
It seems that many of us have been trying to figure out what lab tests are really required for new patients seen in community settings, and what is required for ongoing monitoring in the community when various medications are used. What is required as a minimal work-up for a twenty-five year old man who presents with an initial episode of psychosis, or a forty year old woman with a long history of never treated depressions? What labs are really necessary for a patient on valproate or haloperidol or fluoxetine? The guidelines that are available in textbooks seen to have little data behind them demonstrating what is really required and what just seems like a good idea. More importantly, most seem written by experts working in inpatient settings with unlimited resources. Guidelines are often developed for what would be ideal rather than what is necessary. For many of us working in the community, the costs for lab tests comes out of our budget for staff salaries. In the community, too many requests for lab tests leads to patients stopping medications entirely or refusing all trips to the lab.
A small group has formed to try and develop a set of minimally necessary lab monitoring guidelines for community based services. As a beginning, we are requesting that anyone who has written guidelines that they have developed, or that they know of, or that are in place in their local organizations, please send them to us. Down the road we expect to develop a questionnaire that well help us develop a consensus of what those of us working in the community feel is necessary. Please send your guidelines on medical work-up and laboratory monitoring to:
Ron Diamond, MD
Dept of Psychiatry
University of Wisconsin
6001 Research Park Boulevard
Madison, WI 53719FAX: 608-263-0265
E-mail: diamond@facstaff.wisc.edu
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