Desde el 6 de febrero la American Psychiatric Association, en Arlington, Virginia tendra una nueva pagina de la internet. Llena de informacion para el publico y los psiquiatras que la componen.
http://www.psych.org
Wednesday, January 30, 2008
Monday, January 21, 2008
Los medios de comunicacion pueden aportar al crecimiento emocional y la paz de los ciudadanos
Estos son algunos de los criterios de una buena comunicacion en los medios de difusion publica. Sabe usted de algunos otros?
Hace enfasis sostenido en lo positivo de las relaciones humanas
Fomenta la esperanza aun cuando informa algun evento tragico
Enfatiza la colaboración harmoniosa entre personas, grupos u organizaciones
Da importancia a los valores morales y eticos
Fomenta la esperanza de que los problemas sociales se pueden solucionar
Demuestra responsabilidad en la promocion de las relaciones humanas y la educación de los ciudadanos.
Hace enfasis sostenido en lo positivo de las relaciones humanas
Fomenta la esperanza aun cuando informa algun evento tragico
Enfatiza la colaboración harmoniosa entre personas, grupos u organizaciones
Da importancia a los valores morales y eticos
Fomenta la esperanza de que los problemas sociales se pueden solucionar
Demuestra responsabilidad en la promocion de las relaciones humanas y la educación de los ciudadanos.
Friday, January 18, 2008
Recovery has launched in Puerto Rico
Ten States and Puerto Rico Receive SAMHSA Funding for Pilot Programs to Enhance Transformation of Mental Health Systems
http://www.samhsa.gov/newsroom/advisories/0712110604.aspx
http://www.samhsa.gov/newsroom/advisories/0712110604.aspx
Tuesday, January 15, 2008
El matrimonio y la Constitucion de Puerto Rico
El capitulo en Puerto Rico de la Asociación Psiquiatrica Americana, fundada en el 1844, no tiene una posición oficial sobre si el matrimonio en Puerto Rico debe subir a rango constitucional. Tenemos posición oficial en contra de la pena de muerte y hemos recomendado enmiendas a la Ley de Salud Mental para apoyar a los pacientes. Tambien apoyamos el proyecto de negociacion colectiva de los medicos.
Las causas sociales del estrés que pueden llegar a crear trastornos mentales son múltiples. Para unos ciudadanos lo que puede solidificar sus derechos civiles puede ser un factor estresante para otros ciudadanos que no comparten sus creencias y valores.
Por años se ha debatido como el deterioro de la familia tradicional es una de las causas de los problemas sociales. Eso esta ya establecido como una realidad.
Este no es un asunto simple sino muy complejo.
Hay varias organizaciones de psiquiatras en Puerto Rico. La ultima que se fundo en el 2006 se pronuncio a traves de su presidente, en contra de elevar el matrimonio tradicional a rango constitucional anticipando dano a la salud si eso se llevara a cabo.
Lea sobre la Sociedad Puertorriquena de Psiquiatras. http://prpsnewsletter.blogspot.com/2006_10_31_archive.html
y su relacion con la Asociacion de Psiquiatria Latinoamericana.
El segundo de doce elementos de La Vision del sistema de salud mental de la Asociacion Psiquiatrica Americana reza:
"Mental health care should be patient and family centered, community based, culturally sensitive, and easily accessible without discriminatory administrative or financial barriers or obstacles".
En cuanto a la salud mental de las personas, un documento extenso de la APA en el 2003, La guia para el manejo de pacientes con potencial suicida dice en la pagina 55 que,
"Gay, lesbian, and bisexual youths may be at particular risk for suicidal behaviors. Paul et al. (53), in a study of a large urban population–based telephone probability sample of gay men, found that 21% had made a suicide plan and 12% had attempted suicide. Of the latter, almost onehalf had made multiple attempts, and most had made
their first attempt before age 25. The importance of sexual orientation to suicidal behaviors in youths is also highlighted by the findings of a statewide population-based study of public high school students by Remafedi et al. 48).
In this study, suicide attempts were reported by 28.1% of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but not for females, a bisexual/ homosexual orientation was associated with suicidal intent (odds ratio=3.61) and with suicide attempts (odds ratio=7.10).
Thus, although evidence is limited, there is clearly an elevated risk for suicide attempts among cohorts of gay, lesbian, and bisexual individuals that is particularly striking among youths. In addition to addressing risk factors such as psychiatric and substance use disorders in the assessment and treatment planning processes, it is also important for the clinician to address stresses that are unique to being gay, lesbian, or bisexual (e.g., disclosure of sexual orientation to friends and family, homophobia, harassment, and gender nonconformity). Since suicide attempts themselves increase the risk for later suicide, it is presumed that suicide rates may also be increased in gay, lesbian, and bisexual individuals. However, this hypothesis remains to be tested empirically."
Y muy importante que se lea la Posicion de la Asociacion Psiquiatrica Americana en 1973 sobre los derechos civiles de los homosexuales http://www.psych.org/edu/other_res/lib_archives/archives/197310.pdf
Otras referencias relevantes estan aqui:
keywords en Google:
"Deterioro familia"
http://www.google.com.pr/search?q=deterioro+familia&hl=es&client=firefox-a&rls=org.mozilla:en-US:official&hs=dOo&start=10&sa=N
"ley espana homosexual"
http://www.google.com.pr/search?hl=es&client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&q=ley+espana+homosexual&btnG=Buscar&lr=
Nestor J Galarza, MD, DFAPA
Presidente, http://www.puertoricopsychiatricsociety.org
el Capitulo en Puerto Rico de la Asociacion Psiquiatrica Americana
Las causas sociales del estrés que pueden llegar a crear trastornos mentales son múltiples. Para unos ciudadanos lo que puede solidificar sus derechos civiles puede ser un factor estresante para otros ciudadanos que no comparten sus creencias y valores.
Por años se ha debatido como el deterioro de la familia tradicional es una de las causas de los problemas sociales. Eso esta ya establecido como una realidad.
Este no es un asunto simple sino muy complejo.
Hay varias organizaciones de psiquiatras en Puerto Rico. La ultima que se fundo en el 2006 se pronuncio a traves de su presidente, en contra de elevar el matrimonio tradicional a rango constitucional anticipando dano a la salud si eso se llevara a cabo.
Lea sobre la Sociedad Puertorriquena de Psiquiatras. http://prpsnewsletter.blogspot.com/2006_10_31_archive.html
y su relacion con la Asociacion de Psiquiatria Latinoamericana.
El segundo de doce elementos de La Vision del sistema de salud mental de la Asociacion Psiquiatrica Americana reza:
"Mental health care should be patient and family centered, community based, culturally sensitive, and easily accessible without discriminatory administrative or financial barriers or obstacles".
En cuanto a la salud mental de las personas, un documento extenso de la APA en el 2003, La guia para el manejo de pacientes con potencial suicida dice en la pagina 55 que,
"Gay, lesbian, and bisexual youths may be at particular risk for suicidal behaviors. Paul et al. (53), in a study of a large urban population–based telephone probability sample of gay men, found that 21% had made a suicide plan and 12% had attempted suicide. Of the latter, almost onehalf had made multiple attempts, and most had made
their first attempt before age 25. The importance of sexual orientation to suicidal behaviors in youths is also highlighted by the findings of a statewide population-based study of public high school students by Remafedi et al. 48).
In this study, suicide attempts were reported by 28.1% of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but not for females, a bisexual/ homosexual orientation was associated with suicidal intent (odds ratio=3.61) and with suicide attempts (odds ratio=7.10).
Thus, although evidence is limited, there is clearly an elevated risk for suicide attempts among cohorts of gay, lesbian, and bisexual individuals that is particularly striking among youths. In addition to addressing risk factors such as psychiatric and substance use disorders in the assessment and treatment planning processes, it is also important for the clinician to address stresses that are unique to being gay, lesbian, or bisexual (e.g., disclosure of sexual orientation to friends and family, homophobia, harassment, and gender nonconformity). Since suicide attempts themselves increase the risk for later suicide, it is presumed that suicide rates may also be increased in gay, lesbian, and bisexual individuals. However, this hypothesis remains to be tested empirically."
Y muy importante que se lea la Posicion de la Asociacion Psiquiatrica Americana en 1973 sobre los derechos civiles de los homosexuales http://www.psych.org/edu/other_res/lib_archives/archives/197310.pdf
Otras referencias relevantes estan aqui:
keywords en Google:
"Deterioro familia"
http://www.google.com.pr/search?q=deterioro+familia&hl=es&client=firefox-a&rls=org.mozilla:en-US:official&hs=dOo&start=10&sa=N
"ley espana homosexual"
http://www.google.com.pr/search?hl=es&client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&q=ley+espana+homosexual&btnG=Buscar&lr=
Nestor J Galarza, MD, DFAPA
Presidente, http://www.puertoricopsychiatricsociety.org
el Capitulo en Puerto Rico de la Asociacion Psiquiatrica Americana
Saturday, January 12, 2008
Informe parcial a miembros
Apreciados miembros del capitulo de la APA de Puerto Rico
Hay reunion en la Camara de Representantes el 17 de enero, dos dias despues de nuestra reunion oficial.
(Vean la agenda de nuestra reunion abajo)
El reglamento enmendado del 2006 provee para el nombramiento de un Director o Directora Ejecutiva de la APA en Puerto Rico.
Creo que ya debemos preparar una lista creciente de candidatos a Director ejecutivo de la APA de Puerto Rico. Ya hay una posible candidata recomendada por otra organizacion. La persona tiene una maestria en organizaciones sin fines de lucro del Colegio Universitario del Sagrado Corazón. No la hemos conocido todavia.
Por favor recomienden candidatos y candidatas.
Agenda para la reunion de enero 15
Asuntos e Informes:
Comite de legislacion Ramon Parrilla
Proyecto enmiendas a la Ley 408 en la Camara de Representantes
Comite de planes medicos - Ingrid Alicea
Proyecto 2190 de Negociacion colectiva con planes medicos
Comite de desastres - Carlos G Diaz para concertar reunion preparatoria con psicologos
Comite de Geropsiquiatria- Maria Sanchez para Organizar el Simposio de Geropsiquiatria
Informe de NAMI sobre los servicios de ASSMCA, acceso, calidad, satisfaccion
Roundtable en febrero sobre deterioro de la salud mental en Puerto Rico.
Hay reunion en la Camara de Representantes el 17 de enero, dos dias despues de nuestra reunion oficial.
(Vean la agenda de nuestra reunion abajo)
El reglamento enmendado del 2006 provee para el nombramiento de un Director o Directora Ejecutiva de la APA en Puerto Rico.
Creo que ya debemos preparar una lista creciente de candidatos a Director ejecutivo de la APA de Puerto Rico. Ya hay una posible candidata recomendada por otra organizacion. La persona tiene una maestria en organizaciones sin fines de lucro del Colegio Universitario del Sagrado Corazón. No la hemos conocido todavia.
Por favor recomienden candidatos y candidatas.
Agenda para la reunion de enero 15
Asuntos e Informes:
Comite de legislacion Ramon Parrilla
Proyecto enmiendas a la Ley 408 en la Camara de Representantes
Comite de planes medicos - Ingrid Alicea
Proyecto 2190 de Negociacion colectiva con planes medicos
Comite de desastres - Carlos G Diaz para concertar reunion preparatoria con psicologos
Comite de Geropsiquiatria- Maria Sanchez para Organizar el Simposio de Geropsiquiatria
Informe de NAMI sobre los servicios de ASSMCA, acceso, calidad, satisfaccion
Roundtable en febrero sobre deterioro de la salud mental en Puerto Rico.
Monday, January 07, 2008
Aida Collazo de Sabate, MD in memoriam
Dra. Aida E. Collazo Almodóvar
Vda. de Sabaté
Falleció el 1 de enero de 2008
La Puerto Rico Psychiatric Society, el capitulo de la Asociación Psiquiatrica Americana lamenta la perdida de Aida Collazo, MD.
Su sabiduría, su dedicación, su excelencia académica, profesional y personal, y sobre todo su devoción y compasión hacia las personas con condiciones mentales, la distinguieron.
A la Dra. Nuria Sabate nuestra compañera y profesora de psiquiatría de la Escuela de Medicina de la Universidad de Puerto Rico y a los demás familiares, nuestro apoyo ante esta pérdida. Dona Aida cumplió su misión y queda de nosotros imitar su vida.
Monday, December 31, 2007
Salud y alegria de vivir en el 2008
Les desea la Junta directiva de la Puerto Rico Psychiatric Society, Inc.
y su presidente
Sunday, December 30, 2007
Nota historica del 1998: Cumbre sobre la calidad de los servicios de salud mental en Puerto Rico
There is renewed interest to assay access to care, quality of care and patient satisfaction within the mental health community composed of many stakeholders: patients, care providers, third parties, the mental health agency, etc.
This is a historical note on the Puerto Rico Psychiatric Society -Quality Summit of 1998. This coming year marks the 10th anniversary of such first Quality Summit sponsored by this organization of over 150 psychiatrists.
SEE REFERENCE TO THE ENTIRE QUALITY SUMMIT AT THE WEBSITE
http://www.puertoricopsychiatricsociety.org
under Calidad y Cuidado Dirigido
CONCLUSIONS AND RECOMMENDATIONS
This report has attempted to summarize the Quality Summit. The following indicators were recommended to measure access and quality of care:
1) the number of people receiving care
2) frequency of visits
3) time intervals between visits
4) types of treatments provided
5) evidence that patients are provided information regarding diagnosis and treatment 6) evidence that the diagnosis rendered was appropriate to history and examination
7) evidence that treatment was appropriate to the diagnosis
8) evidence that care was provided in a cost effective manner
The conference participants also recommended that future managed care contractual arrangements be written to require systematic and externally conducted evaluations of the quality of care rendered. In addition, parity and confidentiality legislation must be enacted if there is to be any assurance that mental health services will be adequate to the needs of the citizens of Puerto Rico. In order to assure that access is uniform throughout the island, information on indicators of acces must be provided in an open and timely way from ASSMCA and MCO's.
The following indicators were recommended to measure appropriateness of care:
1) effective credentialling, based on licensure and training, of all professionals providing patient care
2) monitoring of hospital readmission rates 30 days post-discharge
3) a treatment standard of 50% of patients returning to a primary social role
4) peer review of 50% of active cases
5) prescribing privileges for medications is restricted to those with proper licensure and training
6) a standard of 0% be set for requiring the submission of a complete medical record for purposes of utilization review by insurance or managed care organizations
7) surveys of psychiatrists indicate that at least 80% believe they are able to offer the an optimal standard of care for their patients.
The conference participants urged the maintenance of a continuous dialogue between clinical groups and managed care organizations which prior to this conference had not occurred on Puerto Rico. Furthermore, the Puerto Rican District Branch of the APA should be actively engaged in reviewing government service delivery plans for patient with mental disorders and in providing peer review for care offered through managed care contracts.
In order to protect the doctor-patient confidentiality, legislation should be enacted that protects the privacy of this relationship. All care for major mental disorders should require that a psychiatrist oversees, supervises or actually provides the direct care to the patient. Finally, an adequate budget should be set and funded that will assure a universal and thorough education of citizens regarding the Health Reform and how to successfully obtain entitlement services. The participants also recommended the further development of consumer-advocacy groups.
Enactment of the new Mental Health Law was strongly supported as was increased activity by the State Planning Council within ASSMCA. Regarding special populations, the conference participants urged the creation, by law, of an agency that would be charged with oversight of the managed care companies and government contracts with the MCOs. There is a particular need for reimbursement of patient care services beyond acute care, such as rehabilitation and services provided in schools. We need also need to measure and monitor longer term social outcomes for the functioning of children and the elderly who are served by the mental health sector.
In order to assure that the voice of the mentally ill and disadvantaged is heard, there must be an agency that will provide oversight for the functioning of the system. This agency should report directly to the legislature or to the Insurance Commissioner to guarantee proper and consistent input in policy and budgetary matters.P> Today's discussion on quality should become a continuous dialogue on quality. Moreover, every effort should be made to improve relations among the professional organizations representing psychiatrists as well as between psychiatrists and other mental health associations. We are recommending an interdisciplinary dialogue through the creation of a new committee on interdisciplinary collaboration. Because so little has been done in the form of collaboration between psychiatrists and primary care practitioners, the latter group should be invited to the Psychiatric Convention in September 1998.
We also need to improve upon and solidify relations between professional organizations and government agencies. The APA Puerto Rico President-elect should be assigned to lead the proposed inter-organizational collaboration committee. The Puerto Rico chapter of the APA would benefit from an executive director with government a public relations skills. The district branch must reach out to nurses, psychologists, pharmacists, social workers, occupational therapists and other mental health disciplines. The work of the organizations, collectively, would be greatly enhance by the creation of a committee that represented a coalition of interdisciplinary organizations.
_ Group I. Glorisa Canino, Erick Santos, Rosso, Margarita Alegria, Jorge Torres, Pilar Christian
Group II: Llado, Polo, Carlos Perez Cortes, Roberto J. Fumero, Rita Rodriguez , Myrna Segarra, Harold Figueroa, Enrique Vazquez Quintana, Marina Diaz, Irma Moreira, Felicita Cintron, Sr. Rebollo, Luz Medina.
Group III: Ramon Parrilla, Luis Canepa, Ileana Vazquez, Angela Diaz, Jose Luis Lopez, Ramon Ortiz
Group IV: Nuria Sabate, Varela, Olmo, Caro, Caban, Fransceschini, Lima, Huertas.
Group V: Galarza, Costas, Silvia Arias, Rosita Esteras, Jose Nunez Lopez, Luz Minerva Guevara, Maria Sanchez Bonilla.
CONSENSUS DEVELOPMENT PANEL
Glorisa Canino
Director, Research Institute
Medical Sciences Campus
University of Puerto Rico
Erick Santos, M.D.
Chief Drug Dependence Treatment Program
VA Medical Center,
San Juan, Puerto Rico
Jorge Rosso
Consultant on Health to the Governor
Fortaleza
Government of Puerto Rico
Margarita Alegria, PhD.
Researcher,
Medical Sciences Campus
University of Puerto Rico
Jorge Torres Administrator,
First Hospital Panamericano
Cidra, Puerto Rico,
Pilar Christian
President,
Mental Health Planning Board
Mental Health and Anti Addiction Services Administration
Goverment of Puerto Rico
San Juan, Puerto Rico
Victor Llado, M.D.
Private Practice of Psychiatry
Past President PR Psychiatric Society
San Juan, Puerto Rico
Dr. Polo, M. D.
Consultant to the Administrator
Mental Health and Anti Addiction Services Organization
Government of Puerto Rico
Roberto J. Fumero, M.D.
Caribbean Behavioral HealthCare
Trujillo Alto, Puerto Rico
Rita Rodriguez-Falciani ,Esq.
Consultant to ASSMCA
San Juan, Puerto Rico
Myrna Segarra, M.D.
Training Director
Puerto Rico Institute of Psychiatry
Harold Figueroa,
Private Practice
Former Consultant to ASSMCA Administrator
Guaynabo, Puerto Rico
Enrique Vazquez Quintana,
President, Puerto Rico College of Physicians and Surgeons
Hato Rey, Puerto Rico
Marina Diaz,
Consultant Options Inc.
San Juan, Puerto Rico
Irma Moreira,
Director
Caribbean Behavioral Healthcare
San Juan, Puerto Rico
Felicita Cintron,
Consultant
ASSMCA
San Juan, Puerto Rico
Sr. Rebollo
Luz Medina
Ramon Parrilla, M.D.
President, Puerto Rico Psychiatric Society
San Juan, Puerto Rico
Luis Canepa, M.D.
Medical Director
Options Inc.
San Juan, Puerto Rico
Ileana Vazquez, M.D.
Private Practice
Treasurer, Puerto Rico Psychiatric Society
San Juan, Puerto Rico
Angela Diaz, M.D.
Liaison Psychiatrist
VA Medical Center
San Juan, Puerto Rico
Jose Luis Lopez, M.D.
Psychiatric Resident
Puerto Rico Institute of Psychiatry
San Juan, Puerto Rico
Carlos Perez Cortes, M.D.
Private Practice
Humacao, Puerto Rico
Ramon Ortiz
Patient Representative
Alianza Puertorriquena de Salud Mental
Ponce, Puerto Rico
Nuria Sabate, M..D.
Child and Adolescent Psychiatrist
Private Practice
San Juan, Puerto Rico
Alberto Varela, M.D.
Private Practice
Inspira
Hato Rey, Puerto Rico
Neftali Olmo, M.D.
Medical Director, CompCare
Hato Rey, Puerto Rico
Osvaldo Caro, M.D.
Private Practice
Caguas, Puerto Rico
Carlos Caban, M.D.
Past President PRPS
Private Practice
Condado, Puerto Rico
Jose Fransceschini
Private Practice
Bayamon, Puerto Rico
Jose Lima
Private Practice
San Juan, Puerto Rico
Sarah Huertas, M.D.
Private Practice of Child Psychiatry
President Elect
Puerto Rico Psychiatric Society
Haydee Costa, M.D.
Private Practice of Forensic Psychiatry
Former President, PRPS
San Juan, Puerto Rico
Silvia Arias, PhD
President, NAMI Puerto Rico
NAMI Board Member
San Juan, Puerto Rico
Rosita Esteras,
Executive Director
MEPSI Center
Bayamon, Puerto Rico
Jose Nunez Lopez,
Former Commissioner for Mental Health
Caguas, Puerto Rico
Luz Minerva Guevara, MD
Chief, Department of Psychiatry
University of Puerto Rico
Medical Sciences Campus
Maria Sanchez Bonilla
Private Practice of Geriatric Psychiatry
Hato Rey, Puerto Rico
_ PLANNING COMMITTEE
Ramon Parrilla, M.D.
President, Puerto Rico Institute of Psychiatry
Medical Director
First Hospital Panamericano
Cidra, Puerto Rico
Carlos Caban, M.D.
Past President, Puerto Rico Psychiatric Association
Private Practice
Condado, Puerto Rico
CONFERENCE SPONSORS
American Psychiatric Association
This is a historical note on the Puerto Rico Psychiatric Society -Quality Summit of 1998. This coming year marks the 10th anniversary of such first Quality Summit sponsored by this organization of over 150 psychiatrists.
SEE REFERENCE TO THE ENTIRE QUALITY SUMMIT AT THE WEBSITE
http://www.puertoricopsychiatricsociety.org
under Calidad y Cuidado Dirigido
CONCLUSIONS AND RECOMMENDATIONS
This report has attempted to summarize the Quality Summit. The following indicators were recommended to measure access and quality of care:
1) the number of people receiving care
2) frequency of visits
3) time intervals between visits
4) types of treatments provided
5) evidence that patients are provided information regarding diagnosis and treatment 6) evidence that the diagnosis rendered was appropriate to history and examination
7) evidence that treatment was appropriate to the diagnosis
8) evidence that care was provided in a cost effective manner
The conference participants also recommended that future managed care contractual arrangements be written to require systematic and externally conducted evaluations of the quality of care rendered. In addition, parity and confidentiality legislation must be enacted if there is to be any assurance that mental health services will be adequate to the needs of the citizens of Puerto Rico. In order to assure that access is uniform throughout the island, information on indicators of acces must be provided in an open and timely way from ASSMCA and MCO's.
The following indicators were recommended to measure appropriateness of care:
1) effective credentialling, based on licensure and training, of all professionals providing patient care
2) monitoring of hospital readmission rates 30 days post-discharge
3) a treatment standard of 50% of patients returning to a primary social role
4) peer review of 50% of active cases
5) prescribing privileges for medications is restricted to those with proper licensure and training
6) a standard of 0% be set for requiring the submission of a complete medical record for purposes of utilization review by insurance or managed care organizations
7) surveys of psychiatrists indicate that at least 80% believe they are able to offer the an optimal standard of care for their patients.
The conference participants urged the maintenance of a continuous dialogue between clinical groups and managed care organizations which prior to this conference had not occurred on Puerto Rico. Furthermore, the Puerto Rican District Branch of the APA should be actively engaged in reviewing government service delivery plans for patient with mental disorders and in providing peer review for care offered through managed care contracts.
In order to protect the doctor-patient confidentiality, legislation should be enacted that protects the privacy of this relationship. All care for major mental disorders should require that a psychiatrist oversees, supervises or actually provides the direct care to the patient. Finally, an adequate budget should be set and funded that will assure a universal and thorough education of citizens regarding the Health Reform and how to successfully obtain entitlement services. The participants also recommended the further development of consumer-advocacy groups.
Enactment of the new Mental Health Law was strongly supported as was increased activity by the State Planning Council within ASSMCA. Regarding special populations, the conference participants urged the creation, by law, of an agency that would be charged with oversight of the managed care companies and government contracts with the MCOs. There is a particular need for reimbursement of patient care services beyond acute care, such as rehabilitation and services provided in schools. We need also need to measure and monitor longer term social outcomes for the functioning of children and the elderly who are served by the mental health sector.
In order to assure that the voice of the mentally ill and disadvantaged is heard, there must be an agency that will provide oversight for the functioning of the system. This agency should report directly to the legislature or to the Insurance Commissioner to guarantee proper and consistent input in policy and budgetary matters.P> Today's discussion on quality should become a continuous dialogue on quality. Moreover, every effort should be made to improve relations among the professional organizations representing psychiatrists as well as between psychiatrists and other mental health associations. We are recommending an interdisciplinary dialogue through the creation of a new committee on interdisciplinary collaboration. Because so little has been done in the form of collaboration between psychiatrists and primary care practitioners, the latter group should be invited to the Psychiatric Convention in September 1998.
We also need to improve upon and solidify relations between professional organizations and government agencies. The APA Puerto Rico President-elect should be assigned to lead the proposed inter-organizational collaboration committee. The Puerto Rico chapter of the APA would benefit from an executive director with government a public relations skills. The district branch must reach out to nurses, psychologists, pharmacists, social workers, occupational therapists and other mental health disciplines. The work of the organizations, collectively, would be greatly enhance by the creation of a committee that represented a coalition of interdisciplinary organizations.
_ Group I. Glorisa Canino, Erick Santos, Rosso, Margarita Alegria, Jorge Torres, Pilar Christian
Group II: Llado, Polo, Carlos Perez Cortes, Roberto J. Fumero, Rita Rodriguez , Myrna Segarra, Harold Figueroa, Enrique Vazquez Quintana, Marina Diaz, Irma Moreira, Felicita Cintron, Sr. Rebollo, Luz Medina.
Group III: Ramon Parrilla, Luis Canepa, Ileana Vazquez, Angela Diaz, Jose Luis Lopez, Ramon Ortiz
Group IV: Nuria Sabate, Varela, Olmo, Caro, Caban, Fransceschini, Lima, Huertas.
Group V: Galarza, Costas, Silvia Arias, Rosita Esteras, Jose Nunez Lopez, Luz Minerva Guevara, Maria Sanchez Bonilla.
CONSENSUS DEVELOPMENT PANEL
Glorisa Canino
Director, Research Institute
Medical Sciences Campus
University of Puerto Rico
Erick Santos, M.D.
Chief Drug Dependence Treatment Program
VA Medical Center,
San Juan, Puerto Rico
Jorge Rosso
Consultant on Health to the Governor
Fortaleza
Government of Puerto Rico
Margarita Alegria, PhD.
Researcher,
Medical Sciences Campus
University of Puerto Rico
Jorge Torres Administrator,
First Hospital Panamericano
Cidra, Puerto Rico,
Pilar Christian
President,
Mental Health Planning Board
Mental Health and Anti Addiction Services Administration
Goverment of Puerto Rico
San Juan, Puerto Rico
Victor Llado, M.D.
Private Practice of Psychiatry
Past President PR Psychiatric Society
San Juan, Puerto Rico
Dr. Polo, M. D.
Consultant to the Administrator
Mental Health and Anti Addiction Services Organization
Government of Puerto Rico
Roberto J. Fumero, M.D.
Caribbean Behavioral HealthCare
Trujillo Alto, Puerto Rico
Rita Rodriguez-Falciani ,Esq.
Consultant to ASSMCA
San Juan, Puerto Rico
Myrna Segarra, M.D.
Training Director
Puerto Rico Institute of Psychiatry
Harold Figueroa,
Private Practice
Former Consultant to ASSMCA Administrator
Guaynabo, Puerto Rico
Enrique Vazquez Quintana,
President, Puerto Rico College of Physicians and Surgeons
Hato Rey, Puerto Rico
Marina Diaz,
Consultant Options Inc.
San Juan, Puerto Rico
Irma Moreira,
Director
Caribbean Behavioral Healthcare
San Juan, Puerto Rico
Felicita Cintron,
Consultant
ASSMCA
San Juan, Puerto Rico
Sr. Rebollo
Luz Medina
Ramon Parrilla, M.D.
President, Puerto Rico Psychiatric Society
San Juan, Puerto Rico
Luis Canepa, M.D.
Medical Director
Options Inc.
San Juan, Puerto Rico
Ileana Vazquez, M.D.
Private Practice
Treasurer, Puerto Rico Psychiatric Society
San Juan, Puerto Rico
Angela Diaz, M.D.
Liaison Psychiatrist
VA Medical Center
San Juan, Puerto Rico
Jose Luis Lopez, M.D.
Psychiatric Resident
Puerto Rico Institute of Psychiatry
San Juan, Puerto Rico
Carlos Perez Cortes, M.D.
Private Practice
Humacao, Puerto Rico
Ramon Ortiz
Patient Representative
Alianza Puertorriquena de Salud Mental
Ponce, Puerto Rico
Nuria Sabate, M..D.
Child and Adolescent Psychiatrist
Private Practice
San Juan, Puerto Rico
Alberto Varela, M.D.
Private Practice
Inspira
Hato Rey, Puerto Rico
Neftali Olmo, M.D.
Medical Director, CompCare
Hato Rey, Puerto Rico
Osvaldo Caro, M.D.
Private Practice
Caguas, Puerto Rico
Carlos Caban, M.D.
Past President PRPS
Private Practice
Condado, Puerto Rico
Jose Fransceschini
Private Practice
Bayamon, Puerto Rico
Jose Lima
Private Practice
San Juan, Puerto Rico
Sarah Huertas, M.D.
Private Practice of Child Psychiatry
President Elect
Puerto Rico Psychiatric Society
Haydee Costa, M.D.
Private Practice of Forensic Psychiatry
Former President, PRPS
San Juan, Puerto Rico
Silvia Arias, PhD
President, NAMI Puerto Rico
NAMI Board Member
San Juan, Puerto Rico
Rosita Esteras,
Executive Director
MEPSI Center
Bayamon, Puerto Rico
Jose Nunez Lopez,
Former Commissioner for Mental Health
Caguas, Puerto Rico
Luz Minerva Guevara, MD
Chief, Department of Psychiatry
University of Puerto Rico
Medical Sciences Campus
Maria Sanchez Bonilla
Private Practice of Geriatric Psychiatry
Hato Rey, Puerto Rico
_ PLANNING COMMITTEE
Ramon Parrilla, M.D.
President, Puerto Rico Institute of Psychiatry
Medical Director
First Hospital Panamericano
Cidra, Puerto Rico
Carlos Caban, M.D.
Past President, Puerto Rico Psychiatric Association
Private Practice
Condado, Puerto Rico
CONFERENCE SPONSORS
American Psychiatric Association
Wednesday, December 19, 2007
Una nota histórica
Conmemoración de la vida de Roberto Navarro Ayala
Nos informaron el Dr. Víctor J Llado y el Dr. Cruz Mena que el Sr. Roberto Navarro Ayala, persona muy importante en la historia de la psiquiatría de Puerto Rico, murió hace ya varios días.
El caso Roberto Navarro Ayala vs Gobernador de Puerto Rico tuvo un efecto positivo en lograr el mejoramiento de las condiciones de tratamiento de los pacientes del Hospital Ramón Fernández Marina (antes Hospital Psiquiátrico Estatal de Rio Piedras).
En el 1974 este caso federal de clase estaba en su apogeo. En el 2004 todavía se estaba trabajando en esto. Llegando al 2008 todavía el presupuesto de ASSMCA hace referencia a ese caso.
Creo que el caso legal fue importante también para impulsar la ley 408 del 2000.
Mucho antes el caso de Carmen Santiago, quien estaba hospitalizada en el Estatal, había sido importante para impulsar el proyecto que luego fue la antigua ley 116 del 1980.
El presupuesto de ASSMCA dice:
"Programa: Administración del Hospital de Psiquiatría de Río Piedras
DESCRIPCIÓN DEL PROGRAMA Ofrece servicios a toda la población de Puerto Rico, admitiendo pacientes con problemas de salud mental, mayores de 18 años durante la fase aguda y sub-aguda. El Hospital tiene capacidad para 200 camas de hospitalización y una Unidad de Evaluación y Ceñimiento, debidamente licenciadas. El Hospital cuenta con unidades de Cuidado Agudo, Sala de Enfermería, para la atención de condiciones físicas y mentales, entre otros. Además, ofrece servicios de emergencias psiquiátricas 24 horas al día, para estos servicios tienen 26 camas adicionales disponibles.
OBJETIVOS
· Maximizar los servicios hospitalarios a pacientes manteniendo la certificación de la "Joint Comission". Proveer servicios de salud mental de acuerdo al Plan de Rehabilitación relacionado con "el Caso Navarro Ayala vs. Estado Libre Asociado de Puerto Rico".
Pueden leer sobre el Caso Roberto Navarro Ayala en http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=91-1600.01A
Sunday, December 02, 2007
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