The Royal Australian & New Zealand College of Psychiatrists, Part I

I just got back from Hobart, Tasmania in Australia for the annual Royal Australian & New Zealand College of Psychiatrist conference. It was a very interesting conference, I learned a lot and met many people who are doing good work.

Hobart, Tasmania, Australia

Hobart, Tasmania, Australia

Here is the abstract for the first presentation I did:

What Does It Man to Be Human?

The Role of Psychiatrists in Philip K. Dick’s Life & Writing

Author: David R. Kopacz, M.D.

Philip K. Dick was a prolific author of over 50 novels. Many films have been based on his work, including Blade Runner, Minority Report, Adjustment Bureau, and the upcoming Radiofree Albemuth. His continued relevance seems due to the timelessness of his two main themes:   “what is human and what is real?” In the course of living these questions he was prescribed most classes of psychiatric medication, took street drugs, routinely consulted psychotherapists and psychiatrists, and was psychiatrically hospitalized several times.

Not surprisingly, psychiatrists often appear in his writing, sometimes as humanizing forces but also as forces for dehumanization. Dick called dehumanization, “androidization,” where a human being becomes a machine:  obedient, predictable, and lacking independent thought. When psychiatric interventions are applied without thought and wat ithout appreciation of the humanity of the recipient, the psychiatrist can be seen as an “android” who is trying to turn the patient into an “android” as well. In Dick’s life and work, psychiatrists also act as human beings, with concern and empathy to empower the humanity of the client.  Although Dick developed extensive, elaborate theories about the question of ultimate reality, his litmus test for humanity is much simpler – is one kind to other beings? Kindness is the hallmark of whether one is acting as a human or a machine. This presentation will examine Dick’s concepts of the android and the human in the context of contemporary debates regarding the recovery movement and the role of the psychiatrist as an evidence-based technician and/or as a humanitarian.

The Royal Australian & New Zealand College of Psychiatrists, part IThe Royal Australian & New Zealand College of Psychiatrists, part I

The presentation went well and I had some interesting discussions after it. One thing I came away thinking about was PKD’s subversive humanism (the little guy trying to stay human in the face of overwhelming technological or political attempts at androidization) and how that is similar, in some ways, to the true work of psychiatrists – fostering human growth and development in the face of mental illness, traumatic past experiences, and restrictive belief systems of family and society.

The Royal Australian & New Zealand College of Psychiatrist, Part II

The Royal Australian & New Zealand College of Psychiatrists, part I

Here is the second presentation:

A Chart Review Comparison of Rates of Abnormal Vitamin D Results in a New Zealand and US Mental Health Population

Author: David R. KOPACZ, M.D., Mary Pat Traxler, Ph.D.

Affiliation

Kopacz: Buchanan Rehabilitation Centre, Auckland District Health Board, New Zealand
Traxler: Private Practice, Auckland

RANZCP guidelines for maintaining certification in Psychiatry recommend yearly clinical practice audits. This is to assure that individual practice is consistent with evidence-based guidelines. A dilemma arises when there are no clear guidelines for specific practices. In these cases, the findings of the audits of individual clinicians can identify areas that require future research. These audit results raise the question of whether there should be routine testing of Vitamin D levels, given that the majority of clients tested had abnormal Vitamin D levels.

The current study compares retrospective clinical audits of two different mental health populations: a community mental health sample in New Zealand and a private practice sample in the United States. In the New Zealand sample of 88 clients, 32 were tested for Vitamin D, with 66% having abnormalities in Vitamin D. In the US sample of 114 clients, 32 were tested for Vitamin D, and 53% of clients had abnormal levels. These high levels of Vitamin D abnormalities could have clinical implications.

The findings of these audits raise a number of questions that require future research: do these findings differ from general population data; should Vitamin D be tested on a routine basis in mental health populations; are there subgroups who are at greater risk of Vitamin D abnormalities; what is the implication of abnormal Vitamin D levels for the physical and mental health in these populations; does correcting Vitamin D abnormalities have a positive effect on the acute and long-term physical and mental health of clients?

This presentation was really challenging to put together. There is a lot of controversy surrounding testing for Vitamin D as well as treating insufficiency/deficiency. There was another presentation in our same section by another American psychiatrist who has been in New Zealand for a number of years and has also been studying Vitamin D!