Wildlife biologist end of 6 his own yet means taking parity for a great psychiatric patients is a little closer to being won. The second U.S. Court of Appeals ruled 2016, that third party administrators of health care insurance plans can be sued for allegedly illegally restricting plan members' access to residential and outpatient treatment. The ruling allows such allegations to be pursued as class actions addition to individual lawsuits, the latter being prohibitively expensive for the vast majority of patients and their families. Plan members had sued UnitedHealthcare and United Behavioral under the federal Employee Retirement Income Security Act for creating and promulgating defective and overly restrictive acceptance guidelines for a number of psychiatric services. United Behavioral is the largest mental health care insurer the United States, with plans that cover over 60 million subscribers. There's a complete article about the decision at http: article 20160920 NEWS 160929989 Treatment of Psychopathy and Antisocial Syndromes Some colleagues and I recently completed a book chapter on the treatment of severe antisocial syndromes It's not first rodeo I've written about psychopaths, asocial people, and those whom courts and the press call the criminally insane for decades. I've evaluated a great treated some, and overseen the treatment of scores, maybe hundreds. The treatment field for these people and their disorders has some promising features, even though the general picture is usually considered bleak. The end of our chapter remembers a great and kind whose call should be heard widely and often among mental health professionals, particularly those who work correctional settings and forensic hospitals: years ago, I met with Dr. Georg Stürup his Randers, Denmark, home. Dr. Stürup, now deceased but then the retired superintendent of Herstedvester Institution, author of and a tireless worker to change some of his country's most reviled, severely antisocial people, was still enthusiastic, but bent with age. Knowing that his decades of work treating the untreatable were over and he was his international forum of advocacy, he said to me, Those who labor these fields have our admiration, and our that their work someday bear lasting fruit. Assessing Social Security Payee Competency Dr. Mark Amdur recently published a useful group of pearls for the sometimes-vexing problem of assessing whether or not a person is competent to be the payee for his her own social security disability payments. Dr. Amdur's brief article refers mainly to treating physicians, such as psychiatrists and primary care doctors, who deal with such questions with every Social Security disability evaluation, but the principles often apply to independent medical examinations by psychiatrists and psychologists, and to other kinds and sources of payments. He lists a number of situations under which a separate payee be required They include clinical ones such as dementia, intellectual limitation, other deficits, manic spending, depressive withdrawal, psychosis, and substance abuse, as well as behavioral problems often associated with financial incompetence Patients evaluees whose competency is questioned often become demanding, even belligerent. Confrontations about payeeship and money general can be difficult, even violent. than one family member has been injured by a paranoid or otherwise-incensed patient demanding money. Dr. Amdur notes that when he considers recommending a third-party payee, he often suggests a three-month trial which the patient beneficiary receives his her own payments but is monitored by family or some other caregiver. If all goes well during that time, he is comfortable signing the SSA-787. Today's doctor-patient relationships encourage autonomy, but clinicians and evaluators should not be reluctant to explore and recommend when appropriate alternative payeeship when it is clearly the patient's evaluee's interest. Patients, Email, and Legal Risks clinicians, especially those approaching age, are still concerned about whether and how to use email for various kinds of patient communication. Lots of professional organizations, including the American Psychiatric Association, recognize the utility of email, but specify that it must be used