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mental health and the government

Mojo Hand

By Mojo Hand
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Anastasis

Anastasis 23394

Posted
Posted (edited)
10 minutes ago, ndawg said:

Anyone else ever try to imagine what kind of worldview @Anastasis actually holds? Or, rather, what kind of worldview he'd actually espouse, if he had the courage to relate one, rather than just cowardly bait people with hypercontextualized drivel?

Who are you?  Why don't you tell us yours, as it relates to the subject of opportunities for meaningful research on the complex dynamics related to mass violence.  Or you just prefer a drive by?

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ndawg

ndawg 1242

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Posted
3 minutes ago, Anastasis said:

Who are you?  Why don't you tell us yours, as it relates to the subject of opportunities for meaningful research on the complex dynamics related to mass violence.  Or you just prefer a drive by?

Wow, you really have this message board posting thing figured out. Glad that's going to help reverse our rapid demise.

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Mojo Hand

Mojo Hand 4580

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3 minutes ago, Anastasis said:

LOL, no.  Not personally involved. Just reading the tea leaves. 

A psychiatrist is a physician. I am willing to wager any amount you wish that a US-based nationalized healthcare system will involve utilization management programs that will require physician notes, lab data, and other supporting documentation be provided to adjudicate coverage appeals.  Just as current Medicare FFS requires clinical justification for treatment coverage in certain situations. "In fact, I would go further in that I would wager that within 5 years the lab companies are feeding their data right into CMS, just like they do today with other payers.

You are very hung up on the Amazon Echo thing in this. Something that is not even a direct quote used in the WaPo article. It would probably be helpful to this discussion as it is hard to discuss beyond concept level without a very fleshed out proposal. As I said, between you and me, I would agree that removing that data source would mitigate potential risks associated with unintended use of the results.  So drop them and move on. You are acting like it is THE pivotal aspect of the overall proposal. From my perspective is a minor data source detail that would be more fully vetted as the study progressed from concept document to protocol development.  There would be a scientific process. Discussion along the lines of that taking place here would be part of that process.     

Psychiatrist notes are usually held to an even higher privacy standard than other medical information.   Many psychiatrists keep them on paper just to prevent them from being hacked.   I'm sure a diagnosis used for insurance purposes will be recorded in some electronic form, but I doubt shrinks will be forced to enter their therapy notes in a government database.  Any such proposal would be DOA the second it becomes part of any rule or law.   And I would post my concerns here, too. 

Yeah, I guess I am hung up on the Echo thing.  Seems kind of important to me.   It's not a direct quote, but the article says those devices are specifically listed in the proposal.  If it's such a minor detail to the overall research, that's great.  All the more reason to raise these concerns publicly so it gets dropped and the research goes on without it. 

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ndawg

ndawg 1242

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2 minutes ago, Anastasis said:

so drive by. 

Why do you characterize the dynamics related to gun violence as complex? If you're speaking relatively, then what other public safety issue are you comparing it to?

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Anastasis

Anastasis 23394

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1 minute ago, BradInATX said:
42 minutes ago, Anastasis said:
You mean the devices that study subjects would be voluntarily consenting for the researchers to gain access to?

You think after the initial study it will remain that way? It's a pilot.

You are just making stuff up now.  Find the word pilot in the article.

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Anastasis

Anastasis 23394

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12 minutes ago, Mojo Hand said:

Psychiatrist notes are usually held to an even higher privacy standard than other medical information.   Many psychiatrists keep them on paper just to prevent them from being hacked.   I'm sure a diagnosis used for insurance purposes will be recorded in some electronic form, but I doubt shrinks will be forced to enter their therapy notes in a government database.  Any such proposal would be DOA the second it becomes part of any rule or law.   And I would post my concerns here, too. 

So I've worked in both inpatient and outpatient MH facilities. In my experience, electronic record documentation was the norm, largely unstructured but in many cases structured. There were some things on paper, but a substantial portion of the information was electronic.  This was over a decade ago. I am not suggesting that shrinks will be forced to enter their therapy notes into a government database, this is a bit of a sidebar to the point that under a nationalized healthcare system, extremely sensitive health related data will be consolidated under government control. If you are worried about the inappropriate use of sensitive health related data by the government because "firewalls" or whatever don't exist between the health and human service and the NSA than you should issue some serious concerns about a nationalized healthcare system. 

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Anastasis

Anastasis 23394

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6 minutes ago, BradInATX said:

Lol. Look at where you've ended up here.

A: Nobody is advocating involuntary data collection, that's not what this is about. 

B: It won't be that way for long. This is a pilot.

A: You are just making stuff up now. Find the word pilot in the article describing what we are talking about.

B: Look at where you have ended up. 

 

OK Brad.

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Mojo Hand

Mojo Hand 4580

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1 minute ago, Anastasis said:

So I've worked in both inpatient and outpatient MH facilities. In my experience, electronic record documentation was the norm, largely unstructured but in many cases structured. There were some things on paper, but a substantial portion of the information was electronic.  This was over a decade ago. I am not suggesting that shrinks will be forced to enter their therapy notes into a government database, this is a bit of a sidebar to the point that under a nationalized healthcare system, extremely sensitive health related data will be consolidated under government control. If you are worried about the inappropriate use of sensitive health related data by the government because "firewalls" or whatever don't exist between the health and human service and the NSA than you should issue some serious concerns about a nationalized healthcare system. 

What do you think are the risks of the NSA knowing what medications I take and my cholesterol levels?   I'm not minimizing the importance of the privacy of medical data, but what should I be imagining as worst case scenario?   Because we can all picture the worst case scenario for pre-crime based on eavesdropping. 

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Anastasis

Anastasis 23394

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18 minutes ago, Mojo Hand said:

 I'm not minimizing the importance of the privacy of medical data, but what should I be imagining as worst case scenario? 

You are the one talking about brown shirts rounding up mental defects for institutionalization.

 

Look, in my mind it should be fairly easy to find some common ground, I think, to close out the night and likely my participation in this thread. 

I think that we should be doing more population research related to important public health priorities. Gun violence should be one of those priorities.

The government can and should play a role in driving important population health initiatives.

We should pursue novel ways of tackling these issues through public-private-academic research relationships.

Such scientific research should be conducted according to the highest biomedical ethics standards.

We should roll around and argue vociferously about the benefits and potential unintended consequences of specific research proposals, and things like privacy and confidentiality and government abuses.

  

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SmokeyTheBear

SmokeyTheBear 5562

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From my perspective: I trust the intent, ethics, and general competence of this administration far more than the previous when handling this type of data. Norms were broken by the previous administration in a way that makes you question the scheme behind their actions.

Is there value to this data? Obviously. Are there concerns that need to be addressed to guard the rights of citizens? Obviously. 

Cool? Cool. 

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Anastasis

Anastasis 23394

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Posted (edited)
On 8/23/2019 at 9:34 AM, Anastasis said:

The HARPA initiative and the concept behind it, a DARPA-like academic-public-private push to advance biomedical research with specific and targeted goals to address healthcare needs in cancer, neurodegenerative disorders, and mental health, is worth a look.

I support the same statement today as made nearly 2 years ago, almost verbatim from Biden's speech. #bothsides

 

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