tag:blogger.com,1999:blog-7594514Sun, 18 Apr 2010 16:25:37 +0000Mental health, mental illness, developmental disabilities...and this & thathttp://www.jamesbakermd.com/mentalnotes@jamesbakermd.com (James Baker MD MBA)Blogger256125tag:blogger.com,1999:blog-7594514.post-8329605501278836646Sun, 18 Apr 2010 16:25:00 +00002010-04-18T11:25:37.891-05:00 This blog is now located at http://jamesbakermd.blogspot.com/. You will be automatically redirected in 30 seconds, or you may click here. For feed subscribers, please update your feed subscriptions to http://jamesbakermd.blogspot.com/feeds/posts/default. http://www.jamesbakermd.com/2010/04/this-blog-has-moved.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-521125841884912670Thu, 15 Apr 2010 11:00:00 +00002010-04-17T19:20:43.711-05:00The major pharmaceutical companies are starting to post the amount of money that they pay to physicians for helping to market their products.Recently, Merck, GSK, Lilly and Pfizer have also posted their relationships from last year.http://www.jamesbakermd.com/2010/04/docs-pharma.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-1854653383337134471Wed, 14 Apr 2010 11:00:00 +00002010-04-17T19:16:45.870-05:00Prader-Willi Syndrome is a genetic disorder that, in addition to causing developmental disabilities, is associated with many other significant challenges, especially a chronic, very powerful feeling of hunger.It turns out that Texas Rangers' hitting coach Clint Hurdle has a daughter named Madison who is challenged by this disorder."You really don't understand what special-needs parents go throughhttp://www.jamesbakermd.com/2010/04/this-little-one-is-my-sign-to-you.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-5463498502138996155Tue, 13 Apr 2010 11:00:00 +00002010-04-17T15:14:56.656-05:00In public mental health care, "local control" is the mantra that describes the desire to assure that mental health policy is dictated by local communities rather than by state or federal government. I hope that folks who insist upon this are mindful that power-hoarding in the form of "local control" is no blessing in itself, except when it is used, in turn, to empower the people we serve. I hope http://www.jamesbakermd.com/2010/04/on-local-control.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-4834277800948049029Mon, 22 Mar 2010 11:00:00 +00002010-04-17T15:19:26.256-05:00What is the new healthcare law's effect upon our patients? Not much on our current patients, best I can tell. About 100,000 more people in Dallas will be eligible for Medicaid in 2014. If they were getting services from us already, then it just means that most of the cost of their services would be paid for by the federal government instead of by the state government.Benefits and payments stay http://www.jamesbakermd.com/2010/03/on-new-healthcare-law.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-7363282132039762405Wed, 10 Mar 2010 12:00:00 +00002010-04-17T15:21:55.020-05:00I am often asked what the future will hold for public mental health in Texas, given the huge deficit looming in the Texas state budget. I do not know the answer. So far, proposed state-level cuts would not effect the services that Metrocare provides, at least not directly. But, there will be much more budget-cutting to come in Austin once the legislature is elected in November and starts to http://www.jamesbakermd.com/2010/03/impact-of-texas-budget-cuts.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-3598833360912425010Tue, 02 Mar 2010 12:00:00 +00002010-04-17T15:27:03.864-05:00The Christian Lenten season reminds me about how hard it is not to cave in to society and effectively sell your soul for “thirty pieces of silver.” I am also reminded about the painful remorse that comes when you do sell out.Now “thirty pieces of silver” is a lot of dough. It symbolizes a lifetime of work. So I, for one, certainly have some understanding of that level of temptation.But I have http://www.jamesbakermd.com/2010/03/contemporary-30-pieces-of-silver.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-3265522184339061568Mon, 15 Feb 2010 12:00:00 +00002010-04-17T15:30:14.204-05:00Throughout the country, the enduring impact of the Great Recession has led to cutbacks in publicly funded healthcare services in virtually every state in the country. Almost every day I receive an email-news-report of another cut elsewhere.The cuts had not come to Texas because our legislature only meets once every two years. And while the legislature was aware of the turbulent waters ahead http://www.jamesbakermd.com/2010/02/great-recession-comes-to-texas.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-1671324284819877654Tue, 09 Feb 2010 12:00:00 +00002010-04-17T15:32:36.724-05:00I tell this story all of the time: the very first time I was ever summoned to Austin to give a report to the Commissioner, the very first thing she said after I finished my report was, "What do the Dallas advocates say about this?" It was a very powerful experience. It reinforced for me that we are here to serve people with mental illness and developmental disabilities and that we need to be http://www.jamesbakermd.com/2010/02/march-for-respect-namiwalks.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-1889551218817324815Mon, 25 Jan 2010 12:00:00 +00002010-04-17T15:37:27.784-05:00On Thursday I received a call from a distraught brother of one our patients concerned about the lack of services available for his younger sister with schizophrenia. He wasn’t complaining about Metrocare. He was complaining about “the system.”On Friday, I was at a NorthSTAR meeting where stories were shared about families served by other NorthSTAR providers who did not understand the service http://www.jamesbakermd.com/2010/01/if-one-is-hurting-we-are-all-hurting.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-6845010797245070123Mon, 18 Jan 2010 12:00:00 +00002010-04-17T15:40:36.132-05:00Dr King taught that we must each decide whether to walk in “the light of creative altruism or the darkness of destructive selfishness.” He cited the teaching of Jesus of Nazareth who told his followers, "If anyone wants to be first, he must be the very last, and the servant of all.” Most in our world define greatness in terms of power, money, athletic ability, or actress good-looks. Dr King http://www.jamesbakermd.com/2010/01/light-of-creative-altruism.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-6884704227005594132Sun, 10 Jan 2010 12:00:00 +00002010-04-17T15:44:56.645-05:00"I am only one, but I am one. I cannot do everything, but I can do something. And I will not let what I cannot do interfere with what I can do." - Edward Everett HaleI believe that our future is shaped by how we care for the least among us.That’s because whether rich or poor, sick or well, the boundaries that separate our neighbors and us are overwhelmed by our connections. The prosperity of http://www.jamesbakermd.com/2010/01/i-cannot-do-everything-but-i-can-do.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-5757695958314276491Tue, 22 Dec 2009 12:00:00 +00002010-04-17T15:48:31.867-05:00Roman-era shepherds were not very romantic figures. Theirs was a rough and dirty profession – and they were dirt-poor, as well. No one even cared that most shepherds stayed out in their fields rather than cleaning up and going into town for the census, because most people didn’t even consider them to be citizens. Indeed, most didn’t even consider them worthy of being counted because http://www.jamesbakermd.com/2009/12/angels.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-2676185804507483765Tue, 01 Dec 2009 12:00:00 +00002010-04-17T15:50:37.521-05:00Many historians attribute the romantic-era revival of the Christmas celebration as we know it to Charles Dickens.Yet Dickens actually wrote A Christmas Carol to bring attention to hunger among the poor and to poverty among the sick of mid-19th-century England, and to ask how the spirit of Christmas could be used to serve the sick (like Tiny Tim) and the poor (like the Cratchit family) throughout http://www.jamesbakermd.com/2009/12/christmas-carol.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-323753542928372424Sun, 31 May 2009 21:53:00 +00002009-05-31T16:59:52.639-05:00If you feel like the medication your doctor prescribes isn't working for your depression, a recent study suggests a couple of possible reasons:First, it might simply be that the dosage is too low.Second, it might be that the diagnosis is wrong, or perhaps incomplete.These two problems seem especially likely to occur when the diagnosis and prescribing are done at an emergency room or crisis http://www.jamesbakermd.com/2009/05/my-anitdepressant-doesnt-work.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-5477460972929934993Sat, 30 May 2009 11:00:00 +00002009-05-30T06:00:01.064-05:00There is a very special group of children who most clinicians are not comfortable treating: children with both a developmental disability and behavior challenges.The families of these patients, referred to as “dual diagnosis” patients, often require specialized support.Metrocare has a special program to meet this need: Behavioral and Psychiatric Services (BPS).The team at BPS includes a child http://www.jamesbakermd.com/2009/05/parenting-and-special-needs-children.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-2772698103306766230Fri, 29 May 2009 11:00:00 +00002009-05-29T08:11:46.526-05:00When Metrocare put together the grant proposal for housing for the homeless who live with mental illness (the proposal funded by the WW Caruth, Jr Foundation Fund of Communities Foundation of Texas and described a bit more in the Feb 15th posting here), we pulled data that showed how much less expensive it is to keep patients in their own homes instead of in shelters or in the jail.It's an http://www.jamesbakermd.com/2009/05/doing-same-thing-and-expecting.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-3735984244462377271Thu, 28 May 2009 11:00:00 +00002009-05-28T06:00:00.705-05:00Wish I had a cookie for every time that I have been asked that question!There is some pretty good new research on that topic, and on the efficacy of short-term and long-term treatment of ADHD in children.The bottom line is that kids dont seem to outgrow ADHD, at least not by age 17.And the research seemed to show that treatment for ADHD is not like treatment for an ear infection. With an ear http://www.jamesbakermd.com/2009/05/will-my-child-outgrow-adhd.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-4122753794573427231Wed, 27 May 2009 13:09:00 +00002009-05-27T11:19:55.233-05:00At Metrocare, we have seen significant growth in the number of new people we are serving. A lot of those folks seem to be people who used to have jobs and health insurance, but now are unemployed and are coming to us for their medications, especially for major depression.But that does not seem to be the whole story on the increased numbers.Here's another part:A Gallup-Healthways poll published inhttp://www.jamesbakermd.com/2009/05/can-economic-recession-cause-major.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-5027207291562514531Tue, 26 May 2009 12:00:00 +00002009-05-26T14:49:06.501-05:00Ideology aside, Jim Landers of the Dallas Morning News makes the counter-intuitive case for insuring all immigrants -- legal or illegal -- from a taxpayer's perspective, that is, as a way of lowering overall healthcare costs.A similar argument can be made for full mental health benefits on all insurance policies, but more on that some other day...http://www.jamesbakermd.com/2009/05/on-controlling-healthcare-costs.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-2886852025592008067Mon, 25 May 2009 16:15:00 +00002009-05-27T08:18:36.348-05:00 Honoring the memory of my father: a career Marine, veteran of WWII, Korea and VietNam, and recipient of the Air Medal. "What transforms this nation’s cemeteries today isn’t merely fresh flowers or small American flags or carefully tended gravestones. It’s the presence of quiet people — gathered in small groups or standing alone — paying homage to a grave that marks a life..."http://www.jamesbakermd.com/2009/05/for-memorial-day.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-3810086247527683140Mon, 25 May 2009 02:25:00 +00002009-05-26T18:47:28.365-05:00I was reminded again today of how honored I am to be a colleague to the docs, clinicians and support staff at Metrocare who share their talents with the poor and the challenged. The reminder came through today's Epistle lesson: "As each has received a gift, use it to serve one another, as good stewards of God's varied grace." - 1 Peter 4:10http://www.jamesbakermd.com/2009/05/on-stewardship.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-6290697839785355016Thu, 21 May 2009 02:03:00 +00002009-05-26T18:51:02.676-05:00During April, 15,800 unique patients were served at Metrocare -- a new record for one month.That's nearly 60% more than during the same month one year ago. Some anecdotal evidence suggests that it is the recession, so that some people who used to have health insurance are now without it, and are depending on us. But I have a hunch that there are two other factors: population growth and the http://www.jamesbakermd.com/2009/05/growth-at-metrocare.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-4952710317437423566Sun, 03 May 2009 17:15:00 +00002009-05-26T18:52:51.601-05:00Kim Horner points out the need for structured living alternatives other than hospitalization and incarceration for people living with mental illness in her Dallas Morning News article.http://www.jamesbakermd.com/2009/05/housing-for-people-with-mental-illness.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)tag:blogger.com,1999:blog-7594514.post-8713870204400888921Mon, 20 Apr 2009 01:33:00 +00002009-05-26T15:42:11.579-05:00There are many elderly parents around the state who have had children who have lived in the the state schools for years and years. They are among the most vocal of advocates for keeping-but-improving the state school system.It makes no sense to me to completely close the schools and displace older clients who have lived in them for years and years. Reports on the schools tend to show that the http://www.jamesbakermd.com/2009/04/like-treating-heart-attack-with-aspirin.htmlmentalnotes@jamesbakermd.com (James Baker MD MBA)