Sunday, August 05, 2007

Court psychiatrists found dysfunctional, and plagued by their own disorders

It looks like the dysfunctional nature of psychiatrists as seen on TV is closer to the truth than many people would care to admit. Somehow this supposedly did not affect the quality of their work. Seen in this report

Name-calling, factions and conspiracies are common in the "dysfunctional" office of more than a dozen psychiatrists who analyze criminals for the courts, an Edmonton judge has found.

In a 55-page decision released Friday, Court of Queen's Bench Justice Erik Lefsrud ruled that allegations of defamation in the department were unfounded, but the department was plagued by infighting and lack of leadership.

"What emerged is a picture of a very dysfunctional working environment in which name-calling, finger-pointing, intransigence and conspiratorial workings have thwarted the best intentions of all the psychiatrists involved," he wrote.

How such a group of obviously intelligent professionals could work themselves into such a state is beyond comprehension.

"This litigation served largely as a forum for a litany of complaints ... including complaints of discrimination, intimidation, harassment, mismanagement and lack of effective leadership." The psychiatrists, who work at the Forensic Assessment and Community Services (FACS) outpatient clinic at Alberta Hospital, are highly trained medical doctors who have spent years studying psychiatry.

They regularly write psychological assessments of criminals that are instrumental to the justice system. Lawyers often rely on them in making their arguments before judges, and judges cite their reports in sentencing decisions.

Lefsrud said the "saga" at the department began in February 2003, when respected forensic psychologist Dr. Inderjit Singh Chohan learned that Dr. Otakar Cadsky had called him a "paranoid Sikh" behind his back.

Chohan launched a defamation lawsuit against Cadsky and the Capital Health Authority, as well as several other doctors involved in later events.

Cadsky, also a veteran forensic psychiatrist, was then the clinical co-ordinator of the department and Chohan's boss. He had previously been the subject of disciplinary action for calling a colleague a "greedy money-grubbing Jew." He admitted in court that he had called Chohan a "paranoid Sikh" but said he also referred to other physicians by various epithets during the conversation, including "narcissistic Spaniard" and "disorganized Mexican." Cadsky said he meant no harm, and his lawyer told the court that "many of the medical staff revelled in devising abusive epithets and bandying them about," Lefsrud wrote in his decision.

In the time following the comment, Lefsrud found, factions developed among the staff and meetings disintegrated into shouting matches.

In testimony and letters, doctors in the department told of "politics of intimidation," "gossip and innuendo," as well as "personal attacks" and power struggles.

In a letter of resignation on April 1, 2004, one doctor wrote that "there is an ambience of stealth, guile, subterfuge which has actually destroyed the organization ... the place is totally factionalized and I am perfectly sure that there is harassment and intimidation.

"There is a general distrust, apprehensiveness and uncertainty and no one on medical staff knows exactly what is going on, they are totally demoralized, the place is rudderless." Capital Health authorities intervened and investigated, and ultimately made a series of recommendations to rectify the problems. The court judgment does not indicate the current state of affairs in the department. Capital Health spokesman Steve Buick declined comment Friday.

Lefsrud ruled that while the legal test for defamation had not been met, Chohan "was justified in feeling insulted and humiliated" and that his frustration was understandable.

Alberta Justice spokesman David Dear said his department was reviewing the judgment.

"Our first and only concern in dealing with the psychiatrists who perform psychiatric assessments for the justice system is their professional competence," Dear said.

He said Lefsrud's judgment did not indicate that the dysfunctional environment had affected the psychiatrists' work.

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