Defining the NHPS Mission

Over the last few Executive Council Meetings we have been stepping back and asking essential questions about our identity and purpose. What is our mission? What is our vision? What do we want to accomplish, and how? Who do we represent? The answers to these questions will guide our decisions about whether to take on certain issues, and how to use limited resources.

Jeff Fetter offered to research the Mission Statements of other APA District Branches. His findings are presented below. This information will help us engage in a meaningful and lively discussion of our mission and purpose, which will take place at our Annual Meeting.

Proposed NHPS Mission Statement

The NH Psychiatric Society exists to bring psychiatrists together to work for the benefit of our profession and our patients.

Proposed NHPS Goals
  1. To shape legislation relevant to mental health and the practice of psychiatry
  2. To uphold professional and ethical standards for psychiatric physicians
  3. To give members opportunities for psychiatric education
  4. To foster the cooperation of all concerned with the treatment of mental illness in New Hampshire
  5. To represent the interests of New Hampshire psychiatrists in local and national organizations
  6. To serve the professional needs of New Hampshire psychiatrists
Proposed NHPS Vision
  1. NHPS will engage a firm to represent the views of the NHPS in the State Legislature and appoint a member as Legislative Liaison.
  2. NHPS will maintain an ethics committee and serve as a resource to members for ethics consultations.
  3. NHPS will publish a newsletter and hold a yearly Annual Meeting for CME.
  4. NHPS will meet with representatives of other NH organizations concerned with mental health and medicine, and cooperate where possible. NHPS will send a delegate to the APA general assembly and a representative to each NHMS meeting, both of whom will report to the Board.
  5. NHPS will facilitate collegial support for members in achieving their career goals in psychiatry. The Board will include liaisons representing special areas of interest within the membership.
Definitions

Mission:Why we exist

Goals:What we want to accomplish in the service of our mission

Vision:What the process of accomplishing our goals will look like



Legislative Report (continued)
  1. SB 123: An Act relative to notification if a person found incompetent to stand trial and civilly committed is released into the community. This bill states that in the event that a person who has been charged with murder, manslaughter, or aggravated felonious sexual assault, found incompetent to stand trial and civilly committed is discharged to the community either conditionally or absolutely, the department of health and human services shall immediately notify the attorney general, who shall notify the family of the victim, or the victim of aggravated felonious sexual assault if an adult, and the law enforcement agency in the community to which the person is being discharged. This provision also needs to be followed the first time a person is allowed to go unaccompanied SB 123: An Act relative to notification if a person found incompetent to stand trial and civilly committed is released into the community. This bill states that in the event that a person who has been charged with murder, manslaughter, or aggravated felonious sexual assault, found incompetent to stand trial and civilly committed is discharged to the community either conditionally or absolutely, the department of health and human services shall immediately notify the attorney general, who shall notify the family of the victim, or the victim of aggravated felonious sexual assault if an adult, and the law enforcement agency in the community to which the person is being discharged. This provision also needs to be followed the first time a person is allowed to go unaccompanied by hospital staff off the grounds of the hospital. A hearing was held on 2/24 in front of the Senate Judiciary Committee. This bill will pass the Senate since the majority of Senators have signed on as sponsors.

Inpatient Psychiatry Liaison Report

by Jeff Fetter

New Hampshire Hospital faced a bed capacity crisis for adults in July 2010 and for children frequently throughout the fall, creating significant management problems for the state’s acute care hospitals. As Inpatient Liaison, I had been participating in the regular Behavioral Health Unit meetings led by Dave Cawley at the New Hampshire Hospital Association (NHHA). We reached out to Steve Ahnen, Executive Director of NHHA, to begin a dialogue around advocacy efforts to protect funding of state mental health services.

On December 15, representatives of NHPS, NAMI-NH, the NH Community Behavioral Health Association, and NHHA met with Department of Health and Human Services (DHHS) officials to learn the current state of the DHHS budget and develop a plan to advocate for mental health funding. DHHS stressed their continued commitment to advancing the items on the 10-year plan. The advocacy group’s plan is to develop a consensus statement for circulation among participating parties for comment and approval for public release.

Top 5 Picksby Doug Noordsy

In this new column, NHPS members will suggest their “top 5 picks” of important publications in their field of interest written in the past two years. Contact Jeff Fetter () to submit your own top 5 picks for future NHPS Newsletters.

This month’s picks were submitted by Doug Noordsy, MD. Doug is Associate Professor of Psychiatry at Dartmouth Medical School, an investigator with the Psychopharmacology Research Group, and a nationally recognized expert in first episode schizophrenia.

1. Insel TR. Rethinking Schizophrenia. Nature. 2010;468:187-193
This editorial by the director of NIMH describes the evolution in conceptualization of the disorder of schizophrenia, and explicates the current view of schizophrenia as a neurodevelopmental disorder. It then describes how this leads to change in how we approach assessment and treatment of schizophrenia using a staging paradigm analogous to those used to transform outcomes in oncology, and dares to use the “cure” word.
2. Pajonk FG et al. Hippocampal plasticity in responses to exercise in schizophrenia. Archives of General Psychiatry 2010;67(2):133-143
Details a ground-breaking study that demonstrates that hippocampal brain volume loss in schizophrenia can be reversible in response to physical exercise, similar to the enhancement of hippocampal volume demonstrated in individuals without mental illness in response to exercise. They also demonstrate that improvement in memory correlated with change in hippocampal volume.
3. Melle I, et al. Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. Archives of General Psychiatry 2008 Jun;65(6):634-40
This study firmly established that reducing the duration of untreated psychosis leads to prevention of the development of symptoms of schizophrenia, particularly in the negative symptom cluster which is one of the hardest to treat with medications. This article carries implications for the long-term impact of defunding of mental health services in this country, and sets the bar for what we should be aiming to achieve.
4. Emsley R et al. Remission in patients with first-episode schizophrenia receiving assured antipsychotic medication: a study with risperidone long-acting injection. International Clinical Psychopharmacology 2008, 23:325–331.
This uncontrolled study is of value because it demonstrates for the first time that patients with first episode schizophrenia can sustain remission for up to 2 years following initial response with sustained medication treatment. Sustained remission is the criterion for “cure” in any other disorder, and this article gives us the guts to start to talk about cure as a target outcome of interest in early stages of schizophrenia.
5. Morrison AP, Barrat S. What Are the Components of CBT for Psychosis? A Delphi Study. Schizophr Bull. 2010 Jan;36(1):136-42
A growing literature has demonstrated the efficacy of CBT for psychosis. This article describes the key components of using a CBT approach for treatment of patients with psychotic disorders, from the treater’s perspective.


New Hampshire Psychiatric Society

7 North State St.

Concord, NH 03301

Tel: 603-224-7083

Fax: 603-226-2432

E-Mail:

American Psychiatric Association

1000 Wilson Blvd
Arlington, VA 22209

TEL: 703-907-7300

EMAIL:

The opinions expressed in this Newsletter belong to the authors only and do not necessarily reflect the official opinion of the NHPS.

NHPS Executive Council

Leonard Korn, M.D. - President, Membership Chair Newsletter Editor

Jonathan Schwartz, M.D. - Past President.

Jeff Fetter, M.D. - Inpatient Psychiatry Representative.

Alex de Nesnera, M.D. - Past President, Treasurer, Liaison to NH Legislature.

Bob Feder, M.D. - Area 1 Representative

Wendy Martin, M.D. - Early Career Representative.

Rebecca Neal, M.D. - Ethics.