Casebook of a Residential Care Psychiatrist: Psychopharmacosocioeconomics and the Treatment of Schizophrenia in Residential Care Facilities

Overview

The Casebook of a Residential Care Psychiatrist: Psychopharmacosocioeconomics and the Treatment of Schizophrenia in Residential Care Facilities addresses the problems involved in the onsite treatment of mentally ill patients in residential care facilities. This book is the first to identify the need for psychiatrists to be available to individuals in such facilities as adult homes, community care homes, transitional living facilities, and rest homes. This vital resource also contains specific recommendations as ...

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The Casebook of a Residential Care Psychiatrist: Psychopharmacosocioeconomics and the Treatment of Schizophrenia in Residential Care Facilities

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Overview

The Casebook of a Residential Care Psychiatrist: Psychopharmacosocioeconomics and the Treatment of Schizophrenia in Residential Care Facilities addresses the problems involved in the onsite treatment of mentally ill patients in residential care facilities. This book is the first to identify the need for psychiatrists to be available to individuals in such facilities as adult homes, community care homes, transitional living facilities, and rest homes. This vital resource also contains specific recommendations as to how these visits should be conducted with regard to frequency, duration, space, and the types of Medicare procedure codes to utilize. In The Casebook of a Residential Care Psychiatrist, Dr. Fleishman uses his 40 years of experience as a psychiatrist to show you the ins and outs of practicing psychiatry in residential facilities. The book also discusses the profound changes psychiatric drugs have produced in the social, economic, and legal arenas. Using anecdotes, personal stories, and actual documents from Dr. Fleishman's files, this book provides you with a wealth of knowledge not found anywhere else.

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Editorial Reviews

Doody's Review Service
Reviewer: Raj Tummala, MD (Wyeth Pharmaceuticals)
Description: This is a thorough review of patient treatment in residential care facilities with a focus on patients with schizophrenia. This book is an absolute must for any clinician taking care of patients in private residential facilities.
Purpose: TThe purpose is to provide a comprehensive, easy to read, quick reference of the residential care system.
Audience: It is targeted at anyone dealing with patients in residential care settings such as psychiatrists, residents, social workers, case managers, etc.
Features: Psychopharmacological advances and economic legislations have led to the deinstitutionalization of psychiatry. As a result, chronically ill psychiatric patients now reside in residential facilities. Dr. Fleishman details his experiences in this well written review on the residential treatment system. He starts off with the history of residential care systems and outlines the facilities, the team responsible for the care of the patient with various intervention modalities. He uses case vignettes, and spreads his humor throughout. The section on space, time and techniques deserves special mention: in it, Dr. Fleishman outlines "The Ten Commandments of Residential Care Psychiatry." In view of the disparities that arise in the treatment of mentally ill patients, Dr. Fleishman outlines the various legal and economic problems and calls for a new definition of medical necessity. He does a wonderful job of explaining the Medicare audit process and the complexities associated with the Medicare system. The book has a focus on schizophrenic patients, as they comprise the majority of the patients in these settings. Special emphasis is placed on various pharmacoeconomic measures that reduce costs as a result of on-site services and new pharmacological advances. Dr. Fleishman states six goals for writing this book, including new legislation, Medicare reform, and guidelines for residential care. He has done a great job of making a case for all six of his goals.
Assessment: The book is written in a very practical, user-friendly format differentiating itself from other books in this category. It is an absolute must for anyone dealing with patients in residential care settings.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780789023735
  • Publisher: Taylor & Francis
  • Publication date: 2/28/2005
  • Pages: 476
  • Product dimensions: 6.00 (w) x 8.30 (h) x 1.30 (d)

Table of Contents

Foreword
Preface
Acknowledgments
Introduction
The Goals of the Book

PART I: THE PLACES
Chapter 1. What Is a Residential Care Facility?
Infrequently Asked Questions
Chapter 2. The Problem of the Problem
The Problem of Data Collection
Chapter 3. The History
Residential Care Facilities in San Francisco
Personal History
The Pioneers
Chapter 4. The Facility
The Evolution of Residential Care Facilities
Case Histories
Specialized Referral Patterns

PART II: THE PEOPLE
Chapter 5. Who Should Do It?
Psychotherapeutic Considerations
The Advantages of a Sense of Humor
Behavioral Therapy Applications
Group Psychotherapy Considerations
Chapter 6. The Job Description
Chapter 7. The Cast
The Patient
The General Medical Physician
The Social Worker
The Psychologist
The Administrator
The Pharmacist
The Case Manager
Relatives
The Modern Residential Care Psychiatric Team

PART III: THE PROBLEMS
Chapter 8. How It Should Be Done: Space, Time, and Techniques
Space Constraints
Time Constraints
The Techniques
Chapter 9. The Problems of Frequency and Duration
Visitation Frequency in Relation to the Unpredictability of Adverse Events
The Standard of Care in the Community
Duration
The Effects of Offsite Work on Onsite Visits
A Typical Day in the Life of a Residential Care Facility Psychiatrist
Chapter 10. Why Do It?
The Value of Onsite Visits by Psychiatrists and the “Continuity of Care”
Issue
Clinical Examples of the Advantage of Onsite Encounters
The Effect of Onsite Visits on the Administrator
Chapter 11. The Residential Care Facility Paper-Reduction First-Aid Kit
Chapter 12. The Legal Problems
Recent Changes in Residential Care Psychiatry
The Impact of HIPAA
The Problem of Medical Necessity
Redefining Medical Necessity for Psychiatry
Computers and the Medicare Audit
Computers and the Medicaid Audit
Audits and Health Care Fraud
Chapter 13. The Medicare Audit Process
Chapter 14. Progress Note Problems
Examples of Progress Notes
Medicare Policies Regarding Progress Notes
Chapter 15. Special Problems
The Poorly Organized Facility with Substandard Professional Services
The Well-Organized Facility with Regular Visits by the MRCPT
The Well-Organized Facility with No Regular Visits by the MRCPT
The Nonemergency Emergency
The Problems That Occur When MRCPT Members Do Not Visit Regularly
Chapter 16. Suicide
Chapter 17. IM Medications—How to Do It and Why
The Technique of IM Administration
Clinical Examples of the Use of Long-Acting IM Depot Injections

PART IV: REMEMBRANCES OF THINGS PAST
Chapter 18. School Days
Chapter 19. How to Fail in Psychology Without Really Trying
Chapter 20. Life in the Prechlorpromazine Period of Nongeological Time

PART V: ISSUES IN PSYCHOPHARMACOSOCIOECONOMICS
Chapter 21. How Antipsychotic Drugs Have Changed the World
Chapter 22. The Cost of the Treatment of Schizophrenia for Society
Chapter 23. The Cost of the Treatment of Schizophrenia for the Patient
Chapter 24. How Onsite Services Can Reduce the Cost of Treatment
Chapter 25. Residential Care Facilities and the Cost Savings Associated
with Rehospitalization

PART VI: SUMMING UP
Chapter 26. Of Wind and Gravity
Chapter 27. Summary and Recommendations
The Evolution of Psychiatric Treatment in Residential Care Facilities
The Scope of the Problem
Goals and Recommendations

PART VII: APPENDIXES
Appendix A. The Problem of Competing Acronyms
Appendix B. A List of Psychiatric Medications
Appendix C. Metabolic Monitoring Recommendations
Appendix D. The Problem of Rare Side Effects
Appendix E. Qualifications and Duties of the Residential Care Administrator
Appendix F. The Federal Nursing Home Reform Act (OBRA)
Appendix G. A Brief History of Medicare
Appendix H. The Twenty-Five Warning Signs of Poor Documentation
Notes
Index

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