Why people should be concerned with the impending revision of the DSM

An excellent but long post from the fine folks at feministing.com, with only a portion quoted below

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been called the "bible of mental illness" because it lists and defines all of the "official" psychiatric diagnoses according to the American Psychiatric Association. The DSM is in the early stages of undergoing its 5th major revision; each previous revision has seen the total number of mental disorders recognized (some might say invented) by the APA greatly increase. Last year, trans activists were particularly concerned to learn that Ken Zucker and Ray Blanchard had been named to play critical lead roles in determining the language of the DSM sections focusing on gender and sexuality, especially given that these researchers are well known for forwarding theories and therapies that are especially pathologizing and stigmatizing to gender-variant people.

Blanchard has recently presented some of his suggestions to revise the "Paraphilia" section of the DSM. In the past, this section has generally received little attention from feminists, as it has been primarily limited to several sexual crimes (e.g., pedophilia, frotteurism and exhibitionism) and a handful of other generally consensual but unnecessarily stigmatized sexual acts (such as fetishism and BDSM) that are considered "atypical" by sex researchers. However, there are two aspects of the proposed Paraphilia section revision that should be of great concern to feminists, as well as anyone else who is interested in gender and sexual equality.

Expanding "Paraphilia"

First, Blanchard is proposing a significant expansion of the DSM's definition of "paraphilia" to include:

"any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners."

The first concern here is the term "phenotypically normal" (meaning "normal" with regards to observable anatomical or behavioral traits). Thus, according to this definition, attraction to any person deemed by sex researchers to be "abnormal" or "atypical" could conceivably be diagnosed as paraphilic. So, do you happen to be attracted to, or in a relationship with, someone who is differently-abled or differently-sized? Or someone who is gender-variant in some way? Well congratulations, you may now be diagnosed with a paraphilia!

Seriously.

Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions.

This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.

Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia.

In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilias.

So, do you and your partner occasionally role-play or talk dirty to one another over the phone? Or engage in arousing play that is not intended to necessarily lead to "doing the deed"? Do you masturbate? Do you get a sexual charge from wearing a particularly sexy outfit or performing any act that falls outside of "genital stimulation or preparatory fondling"? Well, then congratulations, you can be diagnosed with a paraphilia!

3 Skilled Nursing Facility staff arrested for drugging deaths of patients

Report from thje Kern Valley Sun

Attorney General Jerry Brown today announced the arrests of a nurse, physician, and a pharmacist of the Kern Valley Healthcare District's Skilled Nursing Facility for “forcibly administering psychotropic medications for their own convenience, rather than for their patients’ therapeutic interests.” The Attorney General said these actions are alleged to have resulted in the deaths of three residents.

Taken into custody earlier today, Feb. 18, by California Department of Justice special agents were Gwen Hughes, the former Director of Nursing at the Skilled Nursing Facility of the Kern Valley Healthcare District in Lake Isabella, on charges of elder abuse and assault with a deadly weapon; Debbi Hayes, the former pharmacist at KVHD, on charges of elder abuse and assault with a deadly weapon; and Dr. Hoshang Pormir, a staff physician at Kern Valley Hospital, who was serving as the medical director of the Skilled Nursing Facility, on charges of elder abuse.

“These people maliciously violated the trust of their patients, by holding them down and forcibly administering psychotropic medications if they dared to question their care,” Attorney General Brown said. “This is appalling behavior, which amounts to assault with a deadly weapon.”

According to the statement issued by the Attorney General's office, Hughes, upon taking over as Director of Nursing in September 2006, ordered that Alzheimer’s and other dementia patients be given high doses of psychotropic medications to make them more tranquil and easy to control. It goes on to say, “She ordered the administration of these medications to patients who argued with her, were noisy, or who were otherwise disruptive.” Two patients who resisted were held down and forcibly given injections.

The complaint also alleges that Hughes directed Debbi Hayes, the hospital pharmacist, to fill prescriptions for these psychotropic medications. Hayes wrote and filled these prescriptions without first obtaining a doctor’s approval, the complain said.

According to complaint, Pormir approved these psychotropic medications only some time after they had been administered and without examining the patients first and determining whether these psychotropic medications were medically necessary.

Investigators allege that several of these patients had medical complications as a result of being given these psychotropic medications, including lethargy and the inability to eat or drink properly. It is believed that that three patients died and one patient suffered great bodily injury as a result.

The case came to the attention of authorities in January 2007, when an ombudsman reported to the Bakersfield office of the California Department of Public Health that a patient in the Skilled Nursing Facility had been held down and given an injection of psychotropic medication by force.

The Department of Public Health immediately sent an investigative team with a doctor, a nurse, and a doctor of pharmacology. They determined that 22 patients, including some who were suffering from Alzheimer’s at the Skilled Nursing Facility, were being given high doses of psychotropic medication not for therapeutic reasons, but to simply control and quiet them for the convenience of the staff.

The Department of Public Health issued a Certificate of Immediate Jeopardy which resulted in the immediate dismissal of the Ms. Hughes. The matter was then turned over to the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse.

Special Agents from the Bureau of Medi-Cal Fraud and Elder Abuse began a year-long investigation, with the co-operation and assistance of the Department of Public Health and the administration of the Kern Valley Healthcare District.

Pamela Ott, CEO at the time, left the district in May 2007. Current KVHD Board of Directors Chair Kay Knight said, “A lot of people don't understand that this happened more than two years ago and is not going on now.”

Chet Beedle, Chief Financial Officer, reported that CEO Rick Carter and Board of Directors spokesperson Victoria Alwin were unavailable. He added that he was prohibited from commenting on the arrests and that a formal statement was coming.

A search warrant was served on the facility in August 2008, resulting in the seizure of 36 patients' medical files and records.

Criminal charges were filed in Kern County Superior Court and the defendants are being held in Kern County Jail in Bakersfield. Pormir is charged with one felony count of causing harm/death of an elder of dependent adult. He is being held on $400,000 bail. Hughes and Hayes are each charged with two felony counts, one count of causing harm/death of an elder of dependent adult and another felony count of assault with a deadly weapon other than a firearm of great bodily force. The trio will be arraigned in Superior Court in Bakersfield Friday morning. If convicted, the defendants could face up to 11 years in prison.

The case is being prosecuted by the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse, with the co-operation and assistance of the Kern County District Attorney’s Office.

Fourteen psychiatric patients have been sterilised in the Perm region of Russia against their will and without an appropriate court ruling.

As reported in Russia Today

This was the striking discovery made by the region’s human rights committee over the course of a two-year investigation, revealing numerous grave offences.

After receiving more than 50 complaints from patients of the 15 psychiatric asylums in the Perm region, an investigation was launched to analyse living conditions in these institutions. After two years of detailed study, a series of shocking discoveries was made.

Read more

Fourteen young women, born in the 1970s and 1980s were sterilised against their will, without the signed permission of their families or any appropriate court ruling. As the report states, the most poignant justification of these actions came from an unnamed asylum staff member. They did it so that the women “would not give birth to lunatics”.

In the Russian legislation, sterilisation of legally capable women is only permissible with their accord and when they’re aged over 35, or already have two children. When the woman is not legally capable, the signed permission of two gynaecologists and a court ruling are required.

There exists, however, an appendix to the law, which states that sterilisation can be carried out based purely on medical reasons if there exists “a threat to the woman’s life or health”. Staff have tended to interpret this appendix at will, using it to cover many sterilisations.

According to the human rights commission, the staff at the institutions were not even aware that a court decision was required to conduct the procedure. They based their decision simply on the advice of the institution’s administration.

Other infringements

It was discovered that the shocking cases of unlawful sterilisation were not the only cases of severe breaches of human rights in these psychiatric institutions. The official report drafted by Tatyana Margolina outlined three main areas of severe infringements of human rights in these institutions: medical care, the right to housing and the right to fair employment.

Perhaps the most fundamental malpractice in the institutions is the lack of adequate healthcare provision. According to the report some psychiatric institutions do not even have an appropriate medical licence.

Despite being state organisations, the institutions need to renew their medical licence every few years. Of those whose license had expired, the most recent renewal was in 2001. Since then, no new medical or diagnostic supplies were provided and no new medical personnel had been taken on.

“In several institutions medical attention was not provided and people simply died,” Margolina pointed out in the report. “Their death was a result of appropriate measures not being taken in due course.”

The lack of a medical licence resulted in the absence of basic medicines and diagnostic equipment. This has resulted in several deaths due to negligence in the last two years alone. The report refers to a number of unnamed cases. The causes of death named by coronary analysis include untreated and misdiagnosed pneumonia, a stomach ulcer and meningitis.

The last case is given specific attention. The patient was admitted to an institution and passed away only days later. The orderly simply gave the patient medicines against flu-like symptoms and proceeded to ignore the case for the next two days, during which the patient’s condition steadily worsened. Renewed medical attention was only given when the patient was on his deathbed, but it was too late. Even then, an appropriate diagnosis was not made.

Staff members point out that they don’t even call ambulances for the patients since the medics simply refuse to drive out to the institutions. In most places, no individual rehabilitation programmes were developed for patients. Some do not even have a stock of the required anti-psychotic drugs.

As a result, the patients’ abilities are not developed to their fullest potential. According to the report, some of the patients would have had the chance to do basic manual work and provide for themselves if given the appropriate training. Nevertheless, such fundamentals as sports equipment, professional and educational training and development programmes simply do not exist in Perm region institutions.

The living space provided for the patient is often far less than the basic minimum required by the Russian state. Some patients live in as few as three square metres of individual space with no access to privacy – nurses often break through locked doors and into restrooms as well as shower facilities.

The report points out that the conditions in the institutions breach several clauses of the UN charter and the human rights declaration: the patients do not have access to medical care, individual space, basic dignity, employment and personal development. Nevertheless, the report only goes as far as “advising” the local administration and the relevant institution to take these facts into account.

Regional problem?

Despite the gravity of the problem and its deep-rooted nature, the local administration appears to be inert in dealing with it. RT tried to get information of what the regional government is planning to do in order to resolve this shocking breach of basic human rights.

“Tatiana Margolina is refusing to give any comments on the situation, referring to the fact that it is a regional problem and the report was released regionally,” the human rights commissioner’s press office told RT.

When the local administration’s press office was contacted directly, RT was told that the general office does not have the competence to comment on such issues, and the human rights commission should be contacted.

As a result, no official comment was given on how the living conditions of the psychiatric patients will be ameliorated. So, despite the severe cases of human rights breaches and even abuse from state care providers being brought to public light, it remains unclear what will be done.

Medical board seeks to yank license of former UCSC psychiatrist over sex acts

A Report in the Mercury News

The state medical board is seeking to revoke the license of a former UC Santa Cruz psychotherapist who authorities say admitted to having a brief sexual relationship with a 21-year-old student whom he was treating for relationship issues and an eating disorder.

Milton Peechuan Huang, 45, of Scotts Valley, was a staff psychiatrist at the Student Health Center during the alleged affair that began in November 2007 and ended the next month, according to a complaint filed by the California Attorney General's Office. Huang resigned his half-time post with UCSC in February after the university launched an investigation that resulted in the medical board probe.

The Medical Board of California is expected to hold a hearing to determine if Huang crossed professional boundaries of therapy and committed unprofessional conduct. If found guilty, Huang's license could be revoked or suspended, or he could be placed on probation.

A spokeswoman with the Attorney General's Office said she did could not say how the university came to learn of the alleged impropriety, and a university spokesman could not immediately provide information about the case. Authorities have not identified the patient.

"We obviously take these allegations very seriously, and have cooperated fully with the state Medical Board during its investigation into this accusation," campus spokesman Jim Burns said Monday.

Huang could not be reached Monday, and an attorney who represented Huang
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during the medical board's investigation did not return several messages. Huang, who worked 5 1/2 years for the university, has maintained a private practice in Santa Cruz, but it's unclear if he is still seeing patients.

A recent posting on Jobster.com indicates Huang is "job hunting." Huang's profile on that site, as well as his own Web site, said that he is interested in the connections between technology, science and emotions.

"This includes learning something about sociology, anthropology, religion, mathematics, cognitive science, neurobiology and philosophy," his site says. "It also includes working on being more true to myself and despite failings, striving to live a better life. I practice tai chi and being a father. I continue to look at how I can best pursue creating change in myself and my personal relationships."

According to a Nov. 6 complaint signed by Barbara Johnston, executive director of the medical board, Huang admitted in an July 29 interview with the agency that he had sexual contact on at least two occasions with the patient, who was first referred to him in January or February 2007. On one occasion, he said the patient told him she was sexually attracted to him.

Students being seen by campus psychotherapists have to transfer treatment to the chief psychiatrist or be referred to a private practice over the summer, so the woman asked to be transferred to Huang's private care in July, the complaint says. After several months of weekly appointments, Huang said the two began sharing "each others' thoughts and emotions" during a Nov. 2 session he described as one of "self-revelation."

The complaint said Huang acknowledged that session was "his first boundary crossing," and said the two started talking to each other on the telephone and exchanging text messages, though he resisted physical contact for two more weeks. During a Nov. 16 session at his office, however, Huang said they both disrobed and touched each other.

At the following session, Huang said he handed his patient a booklet titled "Professional Therapy Never Includes Sex," to which he said she replied, "Shouldn't we have sex first?" The doctor described the next two sessions as "emotionally tense" as they discussed possibly ending their relationship.

Still, Huang said he agreed to the patient's request to hold their Dec. 21 therapy session in her Santa Cruz apartment, where he said they exchanged gifts before entering her bedroom. Huang told the medical board the patient performed oral sex on him and snapped a photo of him standing by her car before he left, after which he said the two did not speak again.

Huang said he did not bill the patient for that session or the preceding one because they were "informal," but all others, including the Nov. 16 session when the two disrobed in his office, were billed for 50 minutes of time.

Since July 2007, the medical board has filed 240 cases of alleged physician misconduct, according to the Attorney General's Office. Thirty-two of the licenses were revoked, but 91 doctors were placed on probation and 87 others were subject to various forms of reprimand.

Former psychiatrist guilty of raping patients

From ABC News in Australia

An 80-year-old former Perth psychiatrist has been found guility of molesting and raping two of his patients more than 30 years ago.

Alan John Stubley had been on trial for the past week accused of forcing the two women to have sex with him during psychotherapy sessions between 1975 and 1978.

After six hours of deliberations, a Supreme Court jury found him guility of ten charges, but acquitted him of four others.

Stubley, who has senile dementia, has been remanded in custody and will be sentenced in January.

Woman describes alleged abuse by psychiatrist

From a Report in the West Australian

A 62-year-old woman has described freezing with fear as her psychiatrist sexually abused her during a session for post-natal depression in the 1970s.

Former psychiatrist Alan John Stubley, 80, is on trial in Perth Supreme Court accused of forcing sex offences against two of his female patients in the mid-late 1970s.

One of the alleged victims today told the jury the doctor had abused her on her first face-to-face session after being discharged from a psychiatric hospital where Dr Stubley had treated her for post-natal depression.

She said she had been shocked when the doctor told her to sit on his knee.

“It was just a terrible silence and then he repeated it (in a tone that) was very authoritative, quite demanding,” she said.

“He put his hand on my leg and he rubbed his hand up my leg and between my legs.

“I just froze, I was just so afraid. I was afraid of him and what he might do to me.

“I said I didn’t want to do this.”

Prosecutor Alan Troy said Dr Stubley had abused his position by taking advantage of his patient’s vulnerability in the pursuit of his own sexual gratification.

He said the two women submitted to the sexual contact because they had felt intimidated.

Mr Troy said one of the victims, who continued seeing the doctor for decades, had feared that no-one would believe her if she spoke out at the time about the alleged abuse.

“She had recently been in a psychiatric hospital and she didn’t think anyone would believe her,” Mr Troy said.

Mr Troy said she also feared she would be put in an institution if she did not continue to see him.

Defence lawyer Mark Trowell said the sex between his client and the women was consensual and there had been no intimidation.

“This is not a court of morals…he may well have acted unprofessionally as a doctor but that doesn’t make him guilty of criminal charges,” Mr Trowell said.

Boston Legal: TV Drama Or Reality Show?

The Website PharmaLot has an item noting the intrusion of recent scandals involving Harvard Psychiatrist Joseph Biederman into primetime TV in the form the TV show Boston Legal

There is little time to watch TV on the Pharmalot corporate campus, but we were directed to a recent episode of ‘Boston Legal,’ that compelling drama about - what else? - a bunch of emotionally challenged lawyers, because there was mention of a recent pharma issue being investigated by the US Senate Finance Committee.

To wit, the committee is looking at alleged instances of undisclosed conflicts of interests involving academics who receive National Institutes of Health grants to research certain drugs and payments from drugmakers for consulting, research or speaking (back story). This is prominently noted by actress Candace Bergen, along with other matters such as pharma ties to the FDA, Congress and doctors, in a speech to a jury about a woman who suffered a heart attack after taking a drug…

[...]

(To watch, please go to this link and click on season 5, episode 6, and skip to about 27 minutes into the program, although it can take awhile to load and you may need to install a plug-in).

Psychiatrist in Murder Suicide

A report from Beirut, Lebanon

A psychiatrist committed suicide Wednesday morning after shooting dead a father and his two daughters.

Jack Hreiki, a 42-year-old psychiatrist, shot a 26-year-old lawyer, Chantal Ghanem; her sister Cheryl, a 29-year-old accountant; and their father Ghassan, a 58-year-old engineer; in the town of Batroumin in the northern province of Koura.

The victims were on their way to work in Tripoli when they were shot with a pump-action shotgun.

Hreiki, whose fellow townsmen described as a "psychiatrist in need of a psychological assistance," then went home and committed suicide.

A security source told The Daily Star that Hreiki knew his victims, as he was in love with Chantal, who had rejected him, for three years.

The source said Hreiki waited for the Ghanem family to leave for work, and when he blocked their path carrying a shotgun, the father stepped out from the car in an attempt to dissuade him from shooting. Ghassan was targeted first.

Hreiki then shot and killed the man's two daughters, who had witnessed the first shooting from the car.

Hreiki had repeatedly threatened Chantal, the sources said, and the Ghanem family had alerted the Internal Security Forces.

The homicide is the third this month [...]

Jerusalem man says affair with psychiatrist damaged his mental health

A report out of Jerusalem

A 55-year-old man from Jerusalem intends to tell a Jerusalem court next month that a sexual relationship he had with his female psychiatrist in her private clinic damaged his mental health. The case is expected to set precedents concerning the psychiatrist-patient relationship.

The case, pertaining to 114 therapy sessions between October 2000 and November 2001, had been under a gag order since deliberations began in the Jerusalem District Court in January 2004. The psychiatrist, Tamar Kafri-Deutsch, denies ever sleeping with the man.

In March this year, Judge Zvi Zylbertal granted the complainant's request to make the details of the case public, except for the complainant's identity. "There is a distinct public interest in putting this issue on the agenda, to demonstrate the dangers of what could occur during psychological therapy," Zylbertal wrote in his ruling.

"The special relationship that is formed between patient and psychiatrist and the dependence that could grow from it - which could result in abuse - merit examination."

By making the case public, Zylbertal said he hoped to "increase awareness and prompt victims to come forward and complain to the authorities or seek compensation," as well as to "deter other therapists from crossing lines and boundaries, thereby sparing other patients future transgressions."

Zylbertal also chose to hear the complainant's case after becoming convinced that patient and psychiatrist indeed engaged in a romantic relationship - a fact that Kafri has consistently denied.

Although the court has yet to determine whether a sexual relationship between doctor and patient damaged the complainant's mental health, the court's ruling means that Kafri seriously violated the medical ethics code. The code states that "sexual and erotic contact between a therapist and a patient seeking psychological therapy is strictly forbidden and constitutes a grave ethical transgression and patient abuse, which could irrevocably damage the patient's mental health."

Israeli law had hitherto viewed sexual contact between psychiatrist and patient as a criminal offense carrying a sentence of up to seven years in prison. But the law has been made less stringent because of the case in question.

Kafri, according to the ruling, first met the complainant at a Health Ministry mental-health clinic in Jerusalem's Talpiot neighborhood, where the complainant's family doctor had referred him.

The psychiatrist then suggested that he come to her own clinics, one in Bnei Brak and the other in Jerusalem, for private treatment to prevent him from "falling between the cracks," as she put it. She repeatedly told the complainant not to mention this to other employees at the ministry's clinic, according to the ruling.

Kafri, also 55 years old, graduated in 1984 from Tel Aviv University as a medical doctor. She then specialized in psychiatry, serving at several public mental health facilities including Be'er Yaakov, Talbieh, Kfar Shaul and Hadassah University Hospital, Ein Karem. She also specialized in psychoanalysis. She described herself in court as an "accomplished and renowned psychiatrist privately treating many patients.

She added that she has stopped practicing psychiatry in recent years since she moved to the United States with her husband. Kafri cited this in requesting that the court squelch the story. "Those who were treated by Dr. Kafri in the past are entitled to know about this case," Zylbertal ruled.

Another issue in the indictment is payment that Kafri received from the complainant. He claimed that he paid the psychiatrist not only with money, but with gardening and minor construction work at her Jerusalem home.

Kafri explained that this was in the framework of "rehabilitative work." The Israel Psychiatric Association's ethics code from 1997 states that a psychiatrist can only receive monetary payment, which should be agreed on in advance, and must not receive anything else. The court calls the payment procedures "bizarre," adding that the complainant claims that this arrangement set the scene for a sexual affair.

The central piece of evidence in the case is a 70-minute telephone conversation, which was recorded, transcribed and submitted to the court in a 33-page document. In the document, Kafri replies to the complainant's observations about an "affair that was ignited" between them.

"I shouldn't have let it happen," Kafri said in the conversation. "We managed to viciously hurt one another - we were both very frivolous. We tried to ignore it, and then it hit us when we weren't expecting it. I had to put an end to it at some point because I saw what huge damage it was causing both of us."

Psychiatrist had been previously investigated, and now faces more complaints

Report From the Hartford Courant

On Feb. 14, 2002, Attorney General Richard Blumenthal asked Connecticut health regulators to yank Dr. Peter Benet's license to practice medicine, calling the psychiatrist a "physician who sacrificed his patients for money and power."

But the state didn't take action. Benet continued to see patients. Now he is facing disciplinary action by the Department of Public Health, based on two unrelated complaints.

Those complaints, Blumenthal said, might have been prevented if the health department had listened to him six years ago when he recommended that Benet's medical license be suspended or revoked.

"Tragically and unfortunately, these latest complaints vindicate the serious recommendations we made years ago," Blumenthal said. "We issued a scathing report that left no doubt about this physician arbitrarily denying medically necessary care to patients."

A spokesman for the Department of Public Health refused to explain why nothing was done six years ago, citing department policy. Blumenthal said his office is now looking into possible further legal action against Benet.

At the time that Blumenthal issued his 2002 report, Benet was the founder and medical director of Psych Management Inc., a firm that Anthem Blue Cross-Blue Shield hired to manage mental health care for Anthem's HMO.

Blumenthal found that Anthem's low payments to Psych Management, also known as PMI, combined with financial misdeeds by Benet, resulted in at least one patient, and probably others, being denied necessary mental health care.

"Dr. Benet devised a plan to bilk [PMI] of its assets and profit personally," Blumenthal's report alleges. At the same time that Benet was denying care to patients, Blumenthal contended, Benet was using company funds to support a lavish lifestyle.

"This report presents a picture of a physician driven by the promise of wealth to disregard health needs," Blumenthal said at the time.

Although Blumenthal's investigation was related to the psychiatrist's business practices, and not directly to his own care of patients, the attorney general said he had reason to suspect at that time that Benet could pose a risk to patients. He said his call for revocation or suspension of Benet's license — a move Blumenthal called "highly extraordinary" — was an indication of the seriousness of his concerns.

Earlier this year, Benet agreed to pay a $3,000 fine as part of a consent order he reached with the state in connection with a complaint that Anne Kristine Blake filed. Blake started treatment at Benet's South Windsor office about three months after Blumenthal issued his report in 2002. Although the names of patients who file complaints with the health department are kept confidential, Blake, of Manchester, has come forward and identified herself.

Health department investigators found that during his treatment of Blake, Benet "deviated from the applicable standard of care" by failing to adequately justify his diagnoses of post-traumatic stress disorder and bipolar disorder and by failing to coordinate his prescription for lithium — a drug used to treat bipolar disorder — with the diagnosis that Blake had a thyroid condition, documents show.

In addition to the fine, Benet was ordered to take a class in diagnosing, treating and documenting mood disorders.

The disciplinary action is listed on Benet's physician profile, a public record designed to help would-be patients make more informed decisions when selecting a doctor. It was not, however, reported to the National Practitioner Data Bank, a federal clearinghouse of doctors who have run into disciplinary trouble.

William Gerrish, a spokesman for the Connecticut Department of Public Health, said the federal data bank requires the state to report only reprimands and other more serious disciplinary actions against a doctor's license. He said the state was not required to report the action against Benet because it was only a fine.

Another Case

A second case against Benet is scheduled to be heard by the Connecticut Medical Examining Board at hearings set to begin Sept. 26. The board is a volunteer panel of doctors that works alongside the health department to monitor members of the profession. Cases are usually sent to the examining board when a settlement cannot be worked out between the health department and the doctor.

In that case, a patient identified as P.M. sought care at Benet's South Windsor office in 2004 — two years after the Blumenthal report. In a complaint to the health department, the patient accused Benet of prescribing a dangerous combination of medications.

In a statement of allegations against Benet sent to the medical examining board in May, health department investigators said that Benet prescribed two drugs to treat schizophrenia that could be harmful to people with high blood pressure and Type 2 diabetes, both of which the patient had.

Benet also prescribed five medications for insomnia at once without ordering a sleep study or warning the patient about the possible side effects, which included deterioration of the patient's mental status, the allegations say.

Benet said he would like to respond to the allegations against him, but cannot because he is bound by an obligation to protect his patient's confidentiality. But he maintained that he did not harm either of the patients who made the complaints.

"If you look at the consent decree, it really comes down to technical documentation issues," he said. "In neither case did any harm come to the patient from anything I did or didn't do."

The consent order in the Blake case says that the department reviewed a large sample of Benet's documentation of cases that required coordinating prescriptions for mood disorders and other conditions and found that his "current practice meets the standard of care."

Bad Reaction

Although Blumenthal's allegations against Benet were the subject of press reports, Blake said she found no public records of complaints against Benet when she found his name on the Internet and made an appointment with him in May 2002.

She was recovering from a back injury and had been embroiled in a dispute with the state Department of Mental Retardation, where she had worked with patients in group homes since 1993.

Then on March 14, 2002, she learned that her closest friend, Renea Ervin, then 34, had died. Ervin's husband, Michael Ervin, was eventually convicted of murder and sentenced to life in prison. During the trial, Blake sat in the courtroom, holding her friend's picture.

"It wasn't just little stresses," Blake said. "They were huge."

But she said the medications Benet prescribed made matters worse.

"I couldn't walk, I couldn't talk, I was not a good mother, I couldn't function," Blake said.

After two years of treatment, Blake left Benet's practice.

In July, she sued Benet in small claims court, seeking $5,000 in damages. She wants Benet to cover co-pays on future prescriptions of alprazolam, better known by its brand name, Xanax, and for future psychiatric care.

She said in an interview that she has been dependent on the tranquilizer since Benet prescribed it for her anxiety and panic attacks.

She said she is functioning well now, working as a volunteer on the presidential campaign of Barack Obama and traveling back and forth to Jamaica, where she donates books to poor, rural schoolchildren.

But she says she remains on disability and continues to be unable to work. And she wishes she had been warned before she sought care from Benet.

"I was very vulnerable," Blake said. "I believed he was trying to help me."

Minnesotta Psychiatrist admits having sex with patient and calling it therapy

From a report in the Star Tribune

A New Brighton psychiatrist charged with sexually assaulting one of his patients pleaded guilty to one count of criminal sexual conduct Monday in Hennepin County District Court.

Thomas Folsom, 53, admitted to having sex with the patient and calling it therapy. He had been charged with four counts of criminal sexual conduct in the third degree; three of the charges were dropped.

According to the charges, the patient said Folsom told her that he was doing her a favor by engaging in sex with her and that she gradually became emotionally dependent on him. She also said she was led to believe it would be difficult for her to find someone to marry if she did not engage in sex acts with Folsom.

The patient began seeing Folsom two to three times a week in 1999 for depression and eating disorders. By May 2002, she was seeing him daily. When the patient's father became concerned after she had been charged about $77,000, Folsom said he would continue working with her for free.

Prosecuting attorney Theresa Galatowitsch said she will ask for the maximum sentence of 48 months. Sentencing is scheduled for Sept. 11.

Australian Psychiatrist admits inappropriate sexual relationship with patient

A Report from the Herald Sun in Australia

Dr Jerry Gelb - suspended from treating patients over the gun incident early last year - is facing further sanctions from the Medical Practitioners Board over his relationship with the patient.

The board heard this week that Dr Gelb was a "naive and inexperienced" psychiatrist in his first year of practice when he began a sexual relationship with a woman he was treating for bulimia and emotional problems in the 1980s.

The woman only complained about the relationship in 2005.

Last year the County Court sentenced Dr Gelb to a 12-month intensive corrections order after he walked into the Magistrates' Court with a loaded .22 calibre Ruger pistol and ammunition in his backpack on February 1, 2007.

The Medical Practitioners Board suspended Dr Gelb's medical licence pending its own hearing into the incident later.

This week the board heard Dr Gelb had rejected the initial advances of his patient.

But when she asked the then young doctor to her birthday, Dr Gelb accepted, buying her a drink before they began kissing on the dance floor and later spending the night together.

When the patient's friend died the next day, and she asked Dr Gelb for help, he invited her to his Toorak home and they again ended up kissing and embracing.

At the patient's psychiatric appointment the following day, Dr Gelb instead took her to lunch and insisted the doctor-patient relationship had to end because he had feelings for her.

Counsel assisting the board, Andrew Clements, asked for Dr Gelb's licence to be suspended because he had abused the doctor-patient relationship.

Dr Gelb's lawyer, Bob Galbally, said a reprimand would be an appropriate sanction.

The board has adjourned to make its decision.

Woman files suit against psychiatrist boyfriend after crime spree.

As reported in the Milwaukee Journal Sentinel

A former Cedarburg woman who along with her psychiatrist boyfriend led police on a cross-country chase has filed a lawsuit against him alleging medical malpractice because the two began a sexual relationship while she was his patient.

Darcy J. Bogenrief, 43, alleges in the lawsuit filed in Ozaukee County Circuit Court that she sought treatment in late 2001 or early 2002 from former Thiensville psychiatrist Lyndon K. Steinhaus, 48, the two began a sexual relationship later in 2002 and he continued to be her doctor and prescribe medication for her until at least December 2006.

Steinhaus’ “conduct was negligent and in violation of the standards of care” prescribed in state law, the lawsuit alleges.

According to the lawsuit, Bogenrief “sustained severe physical, mental and emotional injury” and “loss of earning capacity and has incurred medical and related expenses in the past” and will continue to do so.

Steinhaus’ medical insurer and a state risk-sharing fund for health-care providers also are named in the lawsuit.

Bogenrief, a Marquette University Law School graduate who formerly practiced law in Illinois, and Steinhaus are each charged in Ozaukee County with misappropriating Steinhaus’ ex-wife’s identity.

They used it to open bank accounts, apply for credit cards and buy jewelry as revenge for her seeking child support, according to a criminal complaint.

They were arrested in November 2006 in Gillette, Wyo., where Steinhaus was employed as a child psychiatrist after years of practicing in Ozaukee and Washington counties, and charged with one felony count of identity theft. Steinhaus also was charged in Wyoming with 27 misdemeanor counts of illegally prescribing drugs to Bogenrief.

After posting bail in Wyoming, the pair led police on a two-week cross-country spree that included trashing a South Dakota motel room; crossing into Canada, where Bogenrief was arrested on suspicion of drunken driving; posting bond in Montana by leaving behind a BMW car; and finally being arrested in Brownsville, Tenn., when they stopped at a check cashing store to get an advance on a federal income tax refund, according to authorities and court records.

Steinhaus served nine months in jail in Gillette and then was extradited to Ozaukee County. He was freed after posting $10,000 bail and now lives in Kewaskum while awaiting trial, according to online court records. He is next due in court on July 23.

According to Wyoming court records, Bogenrief was found not guilty by reason of mental disease or defect.

She is free on a signature bond. She lives in Gillette and is under treatment there, according to court records. She is due in court Oct. 7.

Psychiatrist reprimanded for misconduct

A report from the North Bay Nugget out of Ontario, Canada

A North Bay doctor has received a public reprimand for professional misconduct and was ordered to be monitored by a fellow physician for 30 months.

Dr. Darren Saunders was accused of grabbing a registered nurse at the North Bay and District Hospital and causing bruises, and making statements about love bites," says a summary by the Ontario College of Physicians and Surgeons.

The college released the results of its most recent disciplinary hearings Tuesday.

A hearing in May found Saunders must continue being treated by his psychiatrist who will provide quarterly reports to the college until treatment is no longer necessary.

Saunders is allowed to see patients on his own, but was to find a physician in the North Bay hospital who would agree to monitor his behaviour and report back to the college every three months.

Physicians and appointed members of the public make up the five-member panel.

A written decision of the panel's findings is not yet available and usually takes months to prepare, said college spokeswoman Kathryn Clarke.

Psychiatrist accused of sexually assaulting patient

As reported by the Post Crescent, out of Appleton, Wisconsin.

An Affinity Behavioral Health psychiatrist has been suspended from his position after he was charged this week with sexual exploitation by a therapist.
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Charles D. Morgan, 62, of Neenah, charged Monday in Winnebago County Circuit Court, faces a maximum penalty of 12½ years in prison and a $25,000 fine if convicted.

Morgan is due back in court July 10 for a preliminary hearing to determine if there is sufficient evidence to send the case to trial.

He sexually assaulted a 27-year-old woman, whom he had been treating for bipolar disorder the past two years, according to a criminal complaint.

The woman told police she was admitted to Mercy Medical Center on June 17 to receive electronic convulsive therapy. Morgan came into her room June 18 and gave her hug.

She said he came into her room again on June 19, kissed her and told her he did it "because I like you." Morgan kissed the woman again on June 20 and told her she needed to keep it confidential, the complaint said.

The woman told Morgan she wanted a different psychiatrist on June 21. Morgan arranged to meet the woman at his Oshkosh office once she was discharged from the hospital.

At the office, the woman and Morgan were sitting on a couch when he began kissing her and having inappropriate sexual contact with her, the complaint said.

Psychiatric Ward video shows no one helped dying woman

A report out of Brooklyn from the NY Daily News, we also have the video in question at the bottom of this report

A shocking video shows a woman dying on the floor in the psych ward at Kings County Hospital, while people around her, including a security guard, did nothing to help.

After an hour, another mental patient finally got the attention of the indifferent hospital workers, according to the tape, obtained by the Daily News.

Worse still, the surveillance tape suggests hospital staff may have falsified medical charts to cover the utter lack of treatment provided Esmin Green before she died.

"Thank God for the videotape because no one would have believed this could have happened," said Donna Lieberman, executive director of the New York Civil Liberties Union.

"There's a clear possibility of criminal wrongdoing with regard to recordkeeping, and that has to be investigated."

The city Department of Investigation is part of a sweeping probe that has brought some changes to the ward known as G Building.

A federal suit filed last year in Brooklyn alleged neglect and abuse of mental patients at the hospital. The suit sparked an investigation by the Brooklyn U.S. attorney's civil rights unit before the June 19 death.

Two different security guards spotted Green, a native of the island of Jamaica, prone on the floor and did nothing, the tape shows. They have been fired, along with four other staffers.

Green, 49, taken to the unit for "agitation," keels over out of her chair at 5:32a.m., according to the time stamp on the video. She had been sitting about 3feet from an observation window. Two other patients were in the room.

Green is lying facedown on the floor, her legs splayed, when a security guard strolls by at 5:53 a.m., looks at her for about 20 seconds and then walks away.

She is writhing on the floor, thrashing her legs, about 6 a.m., when her medical chart contends she was "awake, up and about, went to the bathroom."

Green rolls on her back at 6:04a.m. She stops moving at 6:08 a.m., but two minutes later a security guard pushed his chair into camera view.

He never gets out of the chair, but looks at Green and scoots away. A female patient who was in and out of the room finally brings a clinic staffer to check the woman and a crash cart is summoned.

The medical chart claims she was "sitting quietly in [the] waiting room" at 6:20 a.m., although she was already dead. The cause of death is still under investigation.

"We are shocked and distressed by this situation," the Health and Hospitals Corp. said in a statement.

and of course we have the video:

Another Cartoon on Therapists

As seen at the Perry Bible Fellowship

Unfortunately this one is Not Safe For Work, dealing as it does, with adult topics.

Here is the Link:

Psychoanalyst

Psychiatrists Do Not Know What Normal Sex Is.

Psychiatrists are trying to define what normal sex is for the next edition of the DSM, but will probably wind up making everything a for-profit treatable condition that be be treated with a pill.

As Seen on MSNBC

This month the American Psychiatric Association announced the names of “working group” members who will guide the development of the new Diagnostic and Statistical Manual of Mental Disorders, or DSM, the codex of American psychiatry.

Not surprisingly, given the DSM’s colorful history, particularly when it comes to sex, controversy erupted within days of the announcement, especially over membership of the Sexual and Gender Identity Disorders working group, which will wrestle with questions such as:

• Are sadomasochism or pedophilia mental disorders?
• Are dysfunctions like female hypoactive sexual desire disorder (low sex drive) psychiatric issues, or hormonal issues?

Perhaps the most important question is whether, when it comes to many sexual interests and issues, it’s even possible or desirable to create diagnostic criteria.

At least one petition, spearheaded by transgender activists, is being circulated to oppose the appointment of some members to the Sexual and Gender Identity Disorders work group and its chair, Kenneth Zucker, head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto, Canada. The petition accuses Zucker of having engaged in “junk science” and promoting “hurtful theories” during his career, especially advocating the idea that children who are unambiguously male or female anatomically, but seem confused about their gender identity, can be treated by encouraging gender expression in line with their anatomy.

Zucker rejects the junk-science charge, saying that there “has to be an empirical basis to modify anything” in the DSM. As for hurting people, “in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.”

That sex is controversial comes as no surprise to Dr. Darrel Regier, the vice-chair of the APA’s DSM-V Task Force, based in Arlington, Va.

Sex, he says, in an understatement, “is an area that obviously has lots of emotion attached to it.” But the APA, he says, is doing its best to put science and evidence first, both in who it appoints to working groups and in the process it will use to create the DSM-V (so called because it is the fifth complete version). Each working group will accept input from many experts with varying views, reach a consensus on DSM content, and then put that work group’s product before the board of trustees of the APA and the APA assembly.

All that may be true, but Regier does not expect such reassurances to quell the forces already swirling around the DSM-V as it moves toward a 2012 publication date. Currently, the DSM-IV includes sex-related activities as varied as paraphilias like voyeurism, klismaphilia (erotic use of enemas) and sadism, and functional disorders like dyspareunia (pain with intercourse), erectile disorders and premature ejaculation.

'A set of scientific hypotheses'

The first DSM was issued in 1952. The idea was to create a more standardized way of talking about psychiatric disorders. As psychiatrist Dr. Gail Saltz, a TODAY Show contributor who also practices in New York, explains, the DSM is best viewed as “a language we have chosen to speak, a talking point we mental health professionals have created to communicate as well as we can with each other and with other professions.”

It is not a final arbiter of who’s crazy and who’s not. Saltz, who says she thinks the DSM can be limiting in clinical practice, prefers to take a holistic approach and look at each patient’s collection of symptoms and concerns without being restricted by the DSM’s various criteria.

Regier agrees that’s how doctors should use it, arguing that the DSM “really needs to be seen as a set of scientific hypotheses.” It is, he believes, “a living document” changeable with new research.

But if the DSM is a book of “hypotheses,” why the fuss? Does the DSM matter?

Yes. A lot.

The first reason why is prosaic. If you want your insurance to reimburse your visit to a mental health professional, you are probably going to need a DSM code signifying a diagnosis.

But the more profound reason is that it shapes how doctors, even the rest of rest of society, view sexuality.

“A psychiatric diagnosis is more than shorthand to facilitate communication among professionals or to standardize research parameters,” wrote Dr. Charles Moser and Peggy Kleinplatz in a 2005 paper published in the Journal of Psychology and Human Sexuality.

“Psychiatric diagnoses affect child custody decisions, self-esteem, whether individuals are hired or fired, receive security clearances, or have other rights and privileges curtailed. Criminals may find that their sentences are either mitigated or enhanced as a direct result of their diagnoses.

The equating of unusual sexual interests with psychiatric diagnoses has been used to justify the oppression of sexual minorities and to serve political agendas. A review of this area is not only a scientific issue, but also a human rights issue.”

A problem for whom?

There is no shortage of opinion on what ought to be changed, deleted or included in the new DSM-V. Sandra Leiblum, formerly a professor at New Jersey’s Robert Wood Johnson Medical School and an expert in female sexual health who is now in private practice in Bridgewater, N.J., says she wants to see a revision of diagnoses of female hypoactive sexual desire disorder, other female arousal disorders and sexual pain like dyspareunia. For example, she wants language that would separate arousal disorders into genital (more biological in origin) and subjective subtypes.

Carol Queen, a sexologist, sexual rights activist and co-founder of San Francisco’s Center for Sex and Culture, believes the new DSM should stress that sexual variances are only a problem “if they are problems in the life of the person showing up” in a psychiatrist’s office “so that when somebody is eroticizing something, or doing something in a consensual way, that’s not a problem” even if it may seem odd to most of us.

She also proposes an addition, a diagnosis of “absexual” (“ab” meaning “away from”). This would include those who appear to be “turned on by fulminating against it.” Examples could include state governors who crusade against prostitution even while paying hookers for sex, and religious leaders who wind up trying to explain engaging in the sex acts they preach against.

Moser, who is affiliated with the Institute for Advanced Study of Human Sexuality in San Francisco, and Kleinplatz, from the University of Ottawa, argue that all paraphilias, like sexual sadism, sexual masochism, transvestism, should be removed from the DSM, insisting that “the DSM criteria for diagnosis of unusual sexual interests as pathological rests on a series of unproven and more importantly, untested assumptions.”

This does not mean, as opponents of this idea have suggested, that they somehow approve of sex between adults and children. “We would argue that the removal of pedophilia from the DSM would focus attention on the criminal aspect of these acts, and not allow the perpetrators to claim mental illness as a defense or use it to mitigate responsibility for their crimes," they wrote. "Individuals convicted of these crimes should be punished as provided by the laws in the jurisdiction in which the crime occurred.”

Most of these suggestions are inherently political, as much as the APA and most psychiatrists would wish to avoid politics. Sex exists as part of the culture, and it cannot be separated from it.

The DSM has reflected cultural shifts through its revisions and new editions. The most famous example is homosexuality. When the first DSM was created in 1952, homosexuality was declared a mental illness. By 1973, and after much heated debate and over objections from religious conservatives, the DSM-II excluded homosexuality as a disorder with the exception of one variant, and that was soon dropped in an interim revision.

Once deviant, now desirable

“Definitely a change in culture affects diagnoses,” Leiblum says. “We used to think oral-genital sex was deviant and we have embraced that. Masturbation was evidence of out-of-control behavior, now we see it as not only normative but to be encouraged.”

So if enough people start to do it, or are more public about doing it, does that mean it is no longer a disorder? “I think it probably affects the degree to which people are willing to look at scientific evidence,” Regier says.

This fuzziness is why, starting in the 1980s, the field moved toward adding the notion of “distress” to the DSM.

“We do not consider something a disorder unless there is a clearly defined description of this entity and there is clearly some significant dysfunction and distress associated with it,” explains Regier. “I would say also if there is no victim involved … this behavior is not imposing a person’s will on another person, that is a critical component when one looks at conditions in this area.”

If you aren’t distressed, and everyone is a consenting grown-up, then there probably isn’t a disorder. But things won’t be that simple for the creators of the new DSM.

“How do you make a criteria that does not pathologize low desire?” Leiblum asks rhetorically. You add the need to be distressed about it. “But then whose distress should be looked at?” she asks, referring to a sexual partner. “You can have hypertension and not feel any distress because there is objective criteria for what is high blood pressure. But there is none of that for sexual diagnoses, even premature ejaculation. What constitutes premature?”

(At a press conference Monday, the International Society of Sexual Medicine made a stab at a definition, saying premature ejaculation is "a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.”)

This problematic lack of clarity, Leiblum argues, is especially acute for the paraphilias. Does the criteria amount to “If it’s mine it’s OK, but if it’s yours it’s kinky? These issues need to be grappled with.”

Women in mental wards face grave risk of abuse

From The Age (an Australian Newspaper), as seen on the Psych Observer Website

NEARLY two-thirds of female patients surveyed in psychiatric wards in Victoria have been sexually abused or harassed by male patients, new figures show.

A report by the Victorian Women and Mental Health Network has also revealed that 70% of mental health staff surveyed by the group knew the abuse and harassment was occurring in public hospital wards. A further 30% of the 42 staff surveyed said the abuse, usually perpetrated by sexually disinhibited male patients, happened frequently.

Network convener Heather Clarke said the report, Nowhere to be safe: Women's experiences of mixed-sex psychiatric wards, showed that 61% of the 75 female patients surveyed about their experiences in psychiatric wards had been abused or harassed in some way and did not feel safe.

"These women are being admitted to hospital to get well and then they are being subjected to harassment and abuse that has an adverse effect on their health," she said.

"The situation is most concerning in areas of wards where staff are not always present, or in cases where patients are heavily medicated, making them more vulnerable to abuse."

Ms Clarke said any form of abuse in psychiatric facilities had great potential to retraumatise women. "Evidence suggests that up to 70% of women admitted to psychiatric inpatients units have experienced past sexual abuse," she said. "These women are at risk of having that trauma retriggered in a place where they should be safe."

During inpatient meetings last year, some women said they had been sexually assaulted or had seen women engaging in sexual activity with men when they did not seem well enough to consent. One woman fled from a high-dependency unit after a male patient sexually assaulted her in her bedroom. When she returned to the unit days later, the offender was still there.

Monash University psychiatrist Jayashri Kulkarni said most of Victoria's public inpatient units became mixed wards in the 1960s, creating the potential for men to assault women.

"It's a system that is a recipe for problems," she said. "There are lots of minor incidents occurring all the time that can have quite an impact on vulnerable female inpatients. Unfortunately, there are major incidents occurring as well. The framework of the inpatient settings has allowed this to happen."

Professor Kulkarni said that while some units tried to separate men and women when they could, ward design often hindered their efforts.

"A lot of wards have very rabbit-warren-like structures so there are lots of pockets staff can't see. Some of the designs are better with smaller bedrooms now, but you can often still have common bathrooms, which means both sexes traipsing around from bathroom to bedroom and so on … It's a situation where women can be assaulted too."

She said she knew of two cases now before the courts involving a public and a private hospital.

Ms Clarke and Professor Kulkarni said Australia needed to follow British policy to segregate new wards for patient safety.

"What's happening at the moment is a dereliction of that duty (of care), which could lead to litigation if nothing is done about it," Professor Kulkarni said.

A spokesman for the Department of Human Services said the Government was looking at ways to increase women's safety in new hospitals, which "may involve creating spaces that are for women only".

The department gave some centres a $20,000 grant to promote gender sensitive practices last year, which included the development of separate outdoor garden areas, he said.

But Ms Clarke said it was not enough. "At the end of the day, this is about people's safety. If the UK can introduce segregation, we should at least be able to start talking about it here," she said. "The safety of vulnerable people in hospital should be paramount."

Ex-patient sues psychiatrist over sex abuse

From a report in the Calgary Herald

A city psychiatrist barred from practising medicine is facing a lawsuit from a former patient accusing him of "professional negligence and sexual abuse."

On Monday, the Alberta College of Physicians and Surgeons announced it had revoked Jeremy Roberts' licence to practise. A hearing found he'd had an inappropriate relationship with a patient that included sexual activity. The woman was not identified.

The patient's $250,000 lawsuit was launched independently from the college's investigation into Roberts' conduct.

The statement of claim says the woman went to see Roberts for treatment of anxiety, marital stress and postpartum depression.

The woman had two young children and was still married when she first visited Roberts in January 2003.

Ten months later, the woman alleges in the statement of claim, she and Roberts had sex in his office. They married in July 2005.

It was only when the woman was hospitalized for harming herself, the statement of claim says, that she revealed the secret relationship.

The woman makes allegations of negligence, breach of fiduciary duty and breach of contract against Roberts.

None of the accusations have been proven in court.

The woman accuses Roberts of getting involved in an intimate relationship when he should have known she "was inherently incapable of properly consenting to the sexual involvement."

The woman is claiming a series of injuries, including intense shame and guilt and an eating disorder.

In a statement of defence, Roberts denies he was the cause of his wife's troubles.

In late summer of 2003, the woman disclosed she had feelings for him and alleges he told her the same, according to the statement of claim.

But in the statement of defence, Roberts says he encouraged the patient to stay with her husband.

It also says the psychiatrist was "lonely, isolated, vulnerable and depressed following the breakup of his first marriage in 2001."

Roberts says he no longer considered her a patient in late 2003.

The statement of defence does not address when the two started their sexual relationship.

The statement of defence denies the woman came to any harm -- and says if she did, it was due to her pre-existing condition, and not because of Roberts.

"Dr. Roberts' treatment of the plaintiff was timely, skillful, competent, careful and appropriate," the statement of defence says.

"Dr. Roberts accurately diagnosed the plaintiff's conditions and provided a timely and appropriate treatment plan for them."

The woman, according to her claim for damages, said she had to keep the relationship secret. That meant she could not seek other treatment, the claim says.

Roberts became erratic during their marriage, says the claim, which accuses him of abusing the stimulant Dexidrine.

The woman began suffering "suicidal ideations," and cut herself. She was hospitalized for two months in November 2005.

"Despite the terror, shame and guilt she experienced, and the belief that she may drive (Roberts) to commit suicide, she disclosed her relationship with (Roberts) and sought medical help," the claim says.

The statement of defence, however, says it was Roberts who disclosed the relationship.

Although his licence has been revoked in Alberta, Roberts is still licensed to work in Ontario.

On Monday, a spokeswoman with the College of Physicians and Surgeons of Ontario said it will look at the facts of the case before determining if any action will be taken in its jurisdiction.

But one group wants disciplinary actions to be more swiftly adopted by other colleges.

The president of the Newfoundland and Labrador Provincial Advisory Council on the Status of Women said she doesn't believe medical bodies are doing enough to protect patient safety.

"It's our recommendation that there be mechanisms within each of the jurisdictions which would enable them to accept this kind of disciplinary action on the face of it without having to launch their own investigation," Leslie MacLeod said.

In November 2005, Newfoundland psychiatrist James Hanley was suspended in that province pending an investigation into allegations he'd had sex with a patient.

But despite that suspension, Hanley worked for 15 months in New Brunswick.

A spokeswoman with the College of Physicians and Surgeons of Alberta said every professional body in North America is notified of any disciplinary action against any physician.

Kelly Eby said the Alberta College has the power to suspend a physician who holds a licence in this province but is facing disciplinary action in another jurisdiction.