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Post by Admin on Oct 28, 2015 9:30:09 GMT -4
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Post by Steven Choi on Oct 28, 2015 14:25:39 GMT -4
I could pretty confirm this woman's experience to a tee (not that I went to women's prisons or anything). My core psych rotation was done at an acute in-patient facility in Glendale, Arizona. My preceptor was in charge of an adolescent psych unit, and we students did our rounds and all of that on that unit. In my six weeks of experience, I probably saw about four girls for every guy, and over a vast majority of those kids had borderline personality disorder, or was diagnosed with it when they got their psych evals. I've seen a lot of these kids have an initial 'bipolar disorder' diagnosis done by whoever saw them last, when in reality, they met over half of the 9 criteria for BPD.
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Post by afilatov on Oct 28, 2015 14:56:43 GMT -4
Being a fan of the show, Orange is the new black shows great depiction of mental health disorders involving the inmates. As per the article, “crazy eyes” suffers from borderline disorder with unadorned splitting. In the show, “crazy eyes” definitely looks for constant approval and endorsement by her fellow inmates. She turns to women for affection whether romantic or parental. If these emotions are not reciprocated she automatically turns to abhorrence and detestation, the epitome of splitting. Thearticle mentions “feminine manipulation,” which does not necessarily indicate a psychiatric disorder. The dynamic of prison, which makes the show so great, reveals each character and theirstruggles within the jail. In order to survive or make it thruthe system, they must undergo psychological challenges and in some cases deploy their jail mates in order to benefit themselves. To touch on, overmedicating inmates almost to sedation to treat the underlying cause is not new to the show or reality. One of the characters suffered from complete isolation and depression shunted by her peers by her bubble personality was prescribes an anti-depressant which she had easily accessed. Without proper evaluation and diagnosis, inevitably the inmate overdosed, although it did not result in her death, her issues were not addressed properly. It is a misconception that everyone incarcerated has a psychological manifestation that leads them to commit crime. Most of the women on the show, may be emotionally disturbed due to their harsh lives, and ended in prison due to poverty, lack of education and pure bad luck.
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Post by Gily Raz on Oct 28, 2015 15:32:06 GMT -4
There is an undeniable correlation between mental illness and prisoners, but the stigma that mental illness rates are higher in women is somewhat more contestable. In my opinion, men are rather weary of seeking treatment or help, and hence this may account for the discrepancy. As for Borderline Personality Disorder, the resistance which the author of this article refers to seems to be perfectly in line with patients of BPD that I have seen in Psychiatry. Just yesterday, a patient with BPD who was sitting calmly during the office visit, suddenly completely acted out. She began banging her head against the wall, hitting the floor loudly with both of her hands, and crying/screaming. Exactly like the article describes, it was as if silence was deafening for the patient, whereby she found comfort amidst her Chaos. Yet even still, she contended nothing was wrong with her, and resisted any help or counseling.
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Post by kunalgandhi on Oct 28, 2015 15:43:05 GMT -4
After spending three weeks in an inpatient psychiatry setting, the complaint of overlooking Borderline PD seem accurate. In my limited experience, almost every young female with a history of aggression towards others and troubled relationships left the hospital with a diagnosis of Borderline PD. In correlation with this article, very few of them received any real one-on-one therapy prior to admission. And those without private insurance had no real options to pursue such a thing even if they were interested. But I disagree with the anti-psychopharmacology slant of the article because frankly, our healthcare system just does not have the resources nor support of the general public to do anything with these patients besides stabilize their mood to a more acceptable baseline. It seems like we have adopted an “Out of sight, out of mind’ mentality with these difficult to manage patients.
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Post by Tony Johnson on Oct 29, 2015 10:03:09 GMT -4
One of the largest problems that we have in this country is that we have thousands of people with psychiatric disorders who are either not being treated, misdiagnosed, or have never been diagnosed. While doing a 3 week rotation in inpatient psychology I was made more aware that this population contributes heavily to the impoverished, homeless and prison populations. A lot of the time it is due to the fact that they don't receive the adequate treatment to function on a daily basis. I do believe that there is a large population of borderline personality disorder (BPD) in women's prisons. I also agree with the article that inmates are being misdiagnosed and treated for other psychiatric illnesses, such as bipolar disorder. Although I believe this is a huge problem with BPD in women's prisons, I think it's an even larger problem with all psychiatric illness in men and women's prison. One of the issues is that our prison systems do not have the adequate funding or personnel to be able to provide the right treatments for these inmates. Another issue is that once the inmates with psychiatric illness are released from prison, many don't have the means or the family support system to continue with their treatment. This leads toOne of the largest problems that we have in this country is that we have thousands of people with psychiatric disorders who are either not being treated, misdiagnosed, or have never been diagnosed. While doing a 3 week rotation in inpatient psychology I was made more aware that this population contributes heavily to the impoverished, homeless and prison populations. A lot of the time it is due to the fact that they don't receive the adequate treatment to function on a daily basis. I do believe that there is a large population of borderline personality disorder (BPD) in women's prisons. I also agree with the article that inmates are being misdiagnosed and treated for other psychiatric illnesses, such as bipolar disorder. Although I believe this is a huge problem with BPD in women's prisons, I think it's an even larger problem with all psychiatric illness in men and women's prison. One of the issues is that our prison systems do not have the adequate funding or personnel to be able to provide the right treatments for these inmates. Another issue is that once the inmates with psychiatric illness are released from prison, many don't have the means or the family support system to continue with their treatment. By not receiving any treatment, it can lead to recidivation.
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Post by Andrew Resnick on Oct 29, 2015 11:22:25 GMT -4
Misdiagnoses exist in all facets of medicine, from psychiatric illness to more organically identifiable pathology. This is a static problem in our society as it does not allow for the patient to be treated appropriately. Their condition will inevitably continue to worsen, and more resources are then subsequently utilized in an attempt to "correct" the original misdiagnosis. This is not sustainable. It is the taxpayers of the United States, who provide the funding to care for those who are financially unstable or don't have any finances at all. Prisoners residing in U.S. prison systems are a prime example of this. A great deal of the funding allocated to these patients is in the form of medical care...to pay the providers who attend to their care and to pay for the medications in which they will take to improve their state of health. If a patient is misdiagnosed, they are inevitably consuming these limited finances. This is multiplied on a grand scale, which amounts to millions and millions of dollars wasted on caring for patients with inappropriate diagnoses. Should these patients be correctly diagnosed, these millions of dollars can be saved and utilized for other entities that truly need funding to exist, such as education. Additionally, misdiagnoses also devalue other, more appropriate illnesses that become masked behind other, more "mainstream" illnesses.
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Post by Danielle Gordon on Oct 29, 2015 13:21:41 GMT -4
I think this article highlights an aspect of the overall trend that's developed in treating patients with psychiatric illnesses: a pill will fix everything. The realm of psychiatry in the US is currently in shambles. Mental health facilities and it's infrastructure are usually the first parts defunded in budget cuts, leaving community clinics, prisons, and psychiatric hospitals severely underserved. At that point, how is it possible for people to receive appropriate care? It becomes nearly impossible, especially for those who require lifelong therapeutic services like women suffering from borderline personality disorder. Women with BPD cannot be "fixed" with a pill. They have deep rooted mental, emotional, and social issues that need to be discovered to aid in their recovery - a pill cannot provide that. A pill can provide mood and cognition stability but it does not fix the emotional and mental wounds they carry. Medical therapy becomes a band-aid.
Unfortunately, psychiatrists are propelled into a difficult situation. They're overworked like many physicians and their patients usually require more delicate attention, so they resort to the path of least resistance - medical therapy. I believe psychiatrists do the best they can with the resources available. They work to provide their patients with medical stability and direct them to facilities that can, hopefully, aide them. It's the system that's broken and until it's fixed, many patients with psychiatric illnesses will fall through the cracks - like female inmates with BPD.
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Post by Peter Ezika on Oct 29, 2015 14:22:00 GMT -4
Borderline personality disorder is relatively common among female offenders in prison, and is associated with substantial psychologic stress, punitive environment and impaired quality of life. Prison-based mental health care is problematic because of a lack of resources, the complexity of these matters, difficulties in making referrals, the paucity of good mental health care providers, and the inappropriateness of prisons as a setting for such care. For women, who are more likely to suffer from various mental health-related matters, this is an acute assortment of concerns. Borderline personality disorder (BPD) is a condition that affects approximately 20 percent of incarcerated women. Recent research suggests that being in prison makes this matter worse. Hence, I do believe that there is a large population of borderline personality disorder (BPD) in women's prisons
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Post by Tobi Tayo on Oct 29, 2015 15:47:33 GMT -4
Weeks ago we had a paper that focused on a drug that was reexamined after some decades. It noted that less than half of papers in psych held up after reexamination. Nowadays it looks like there are so many niche diagnosis that do not exist yet, and patients have to be pigeonholed into a diagnosis that's simply closest to their symptoms. As we get further in our knowledge base, we are bound to see past mistakes and aim to rectify it. Misdiagnoses for these women are unfortunate, but time might just tell that they are more far reaching than just the prison system. Another factor is the link with low socioeconomic status and increased chances of having a mental health status. A low SES also statistically shows incarceration as another link. This would definitely affect the incidence of the diagnosis amongst other factors as well.
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Post by David Whitfield on Oct 29, 2015 15:57:16 GMT -4
The correlation between incarnation and mental illness is undeniable whether it be in the male or female system. Society as a whole needs needs to be more proactive and less reactive when it comes to fixing our very disfunctional penal system. The misdiganosis or complate non diagnosis of BPD looks like a major cause of women becoming incarcerated. If we want to help these women and lessen the burden or our public services such as the police, legal and penal then society needs to treat this issue from both sides. That is inside the prison system and outside the prison system and this can only be done if we have a better understanding of BPD. Linking a misunderstood issue like BPD with something as popular as Orange is the new Black is brilliant and I hope this helps to bring some much press to the issue of BPD in the women's prison system so can start to help these ladies rather than just locking them up.
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Post by riddhiupadhyay on Oct 29, 2015 17:13:27 GMT -4
Chandra Bozelko writes about how easy it is to misdiagnose any psychiatric disorder thru an experience that she faced herself with when she was diagnosed with BPD. As a third year medical student and currently seeing hands on experience with many psych patients, it is evident that psychiatry is a field where misdiagnosis can be common due to lack to specific tests. For example, to diagnose COPD or restrictive lung disease a spirometer test will be done to get results. For the diagnosis of MI, an EKG, troponin levels and other enzyme levels are detected. For the diagnosis of celiac disease, a blood test will be done to check for specific antibodies. Different screening tests and biopsies and specific diagnostic and confirmatory tests can be done for many acute or chronic illnesses; however in the field of psychiatry, we are faced with the biggest problem which is believing what the "patients tell us". Like we were told, "many patients lie". So, left with a full history that was provided by the patients, and questionnaires filled out by the patient, all that the physicians have for a diagnosis is patient's presenting symptoms. Yes, any disease can be misdiagnosed but in the world of psychiatry where not many confirmation tests are provided other than seeing improvement after psychopharmacology is prescribed, I would say it is easy to misdiagnose psychiatric disorders. This results in a good amount of waste of money on prescribed drugs for the misdiagnosed patients, however more importantly it is effecting the patients and their psychology, their compliance regimen for future treatments and their contribution to their surroundings.
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Post by Andrew Hariraj on Oct 29, 2015 20:06:49 GMT -4
When looking at female prisoners and bipolar personality disorder, the situation can cause stress to make the issues worse. It becomes a major environmental issue as BPD has increased among prisoners. Thus, the scope of prisoner rehabilitation should be expanded to adequately deal with mental health issues of those who are incarcerated. This solution seems pretty simple, however, with funding issues and healthcare within the U.S., healthcare providers are limited to what they can assist prisoners with. This also allows for the increase in mental health issues among those who are incarcerated. For instance, a general treatment regimen a prison offers may only cover a portion of conditions. Thus, others with more severe mental health issues descent into a downward spiral as environmental factors and limited medical management play a greater role into their condition.
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Post by Stephen W Beckett on Oct 29, 2015 22:45:46 GMT -4
It's interesting to note that over half of the female inmate population are sufferers of BPD. Even with the author's claim that it is over-diagnosed, by her own numbers, at it's worst the figure is still around 55%. It sounds like she has an axe to grind, having been on the "inside", but offers no real solutions to effective treatment above what is already offered by the criminal justice system. The author does begrudgingly acknowledge the efficacy of group therapy outside of prison, but criticizes its implementation with prisoners due to one statement in the literature she cites. She missed mentioning the part from the same source, that BPD patients in group therapy mix well with those that have dependent, narcissistic, schizoid and depressive personalities. The cited source also suggests that a mix of group and combined individual dynamic therapy has the best outcome. So, if anti-social types are the real hindrance to successful group therapy, then they can be tested and screened out of the mix.
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Post by evangelinej on Oct 30, 2015 9:19:22 GMT -4
During our inpatient experience we got the chance to witness the scenario described in this article. The patient was a female in her late 40's who had been arrested for aggravated assault. She was brought to the inpatient facility for stabilization before returning to prison to complete her sentence. The admitting physician diagnosed her with Bipolar Disorder based on the assault being a manic episode and started her on lithium. When we followed up with her, the Borderline Personality became apparent, leaving us students to wonder how an experienced psychiatrist could have missed that? Was it a missed diagnosis or was there something else at play? Was it because Bipolar and Borderline are so similar in presentation or Was it because the patient wouldn't get the individual psychotherapy she needed while she was in jail and started her on a pill that would at least stabilize her mood? Was it because patients don't feel like it's treatment unless there is a pill involved? Was he trying to work around a broken system and get her the best care- for right now?
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