Cultural issues in psychiatry/Ethics/Public Health

Question 1

What is the cultural presentation of the following:
-Amok (Malaysian)
-Koro (Asian males)
-Piblokto (female eskimos in Northern greenland)
-Wihtigo (Native Americans)
-Mal de ojo (mediterranean descent)
-Khyal cap or khyal attack (Cambodian population)

Answer 1

-Amok: sudden rampage (homicide or suicide) and ends in exhaustion and amnesia

-Koro: believe penis will disappear into abdomen and cause death

-Piblokto: anxiety, depression, confusion, depersonalization and derealization and ends in stuporous sleep and amnesia

-Wihtigo: delusional fear of being turned into a cannibal through posession by a supernatural monster, the Wihtigo

-Mal de ojo: vomiting, fever and restless sleep (thought to be caused by evil eye)

-Khyal cap or khyal attack: individuals perceive wind like substance causes distress, anxiety, palpitations, and other autonomic symptoms.

Question 2

Name the associated term for these ethical practices:
1) Obligation to work in the patients best interests
2) Obligation to help patients and relieve suffering (goal=healing)
3) Duty to do no harm
4) Patient’s right to self-govern
5) The right to fair allocation of resources (ie transplant organs)
6) Physician’s duty to place patient’s welfare above all else
7) the physician is a trustee of the patient’s health

Answer 2

1) Fiduciary duty
2) Beneficence
3) Non-maleficence
4) Autonomy
5) Justice
6) Fidelity
7) Fiduciary relationship

Question 3

In absence of an advanced directive, which is the best option for making decisions: substituted judgement analysis OR best interest of the patient analysis

Answer 3

Substituted judgement analysis as it considers patients values and attitudes towards sickness, etc

Question 4

What are the 4 elements needed to prove and sustain a claim of malpractice?

Answer 4

Duty, Negligence, Harm, Causation

Question 5

The Kansas vs. Hendricks law regarding sexually violent predators allow for what?

Answer 5

After defendants serves there time, they can be assessed and if still deemed at risk for sexual predation they can be held . It’s a civil commitment rathe than a criminal commitment once their sentence is completed.

Question 6

SAMSHA collects data on several aspects of substance use. Match the data collection set with the purpose.

A. The Drug Abuse Warning Network (DAWN)
B. The Treatment Episode Data Set (TEDS)
C. National Survey on Drug Use and Health (NSDUH)
D. National Mental Health Service Survey (NMHSS)
E. National Survey of Substance and Alcohol Treatment Services (N-SSATS)

1. Collects demographic characteristics and substance abuse problems of admissions and discharges of treatment facilities
2. prevalence, patterns, and impact of substance use and abuse
3. monitors drug related ED visits
4. annual census of all treatment facilities in the United States, both public and private
5. annual survey of all known mental health treatment facilities

Answer 6

A – 3
B – 1
C – 2
D – 5
E – 4

Question 7

What type of managed care is set up so a provider receives a fixed monthly fee per insured person (enrollee), irrespective of how
many enrollees receive treatment and how much it costs.

Answer 7

Capitation

Question 8

What services are covered by Medicare Parts A-D?

Answer 8

Medicare Part A: hospital inpatient mental health care

Medicare Part B: medical insurance, covers outpatient services and lab tests

Medicare Part C: medicare advantage plans, run by private insurers

Medicare Part D: covers prescription drugs

Question 9

Medicaid is a joint federal and state program that pays medical costs for persons with limited income. What 2 service do they cover that Medicare does not?

Answer 9

1) nursing homes
2) home health care

Question 10

SAMHSA collects info about substance use. Match the following sets with their target population.

A) National Mental Health Services Survey
B) National Survey on Substance Abuse Treatment Services
C) Drug Abuse Warning Network
E) National Survey on Drug Use and Health
F) Treatment Episode Data Set

1.SAMHSA’s data collection which contains mental health facilities data.

2. Collects emergency department data
3. Substance abuse facilities data
4. Primary source of information on the population data
5. Collects client level data

Answer 10

A) 1
National Mental Health Services Survey: contains mental health facilities data

B) 3
National Survey on Substance Abuse Treatment Services contains substance abuse facilities data

C) 2
Drug Abuse Warning Network collects emergency department data

D) 5
Treatment Episode Data Set collects client level data

E) 4
National Survey on Drug Use and Health is the primary source of information on the population data