Day Fortythree; Another new case

A day of frustrations overcome. The Guardian cryptic started well, and then I had difficulty. Over lunch, all the unsolved clues became clear, as I stopped complicating them. 

The challenge of managing the call for admissions as the willingness to discharge has all but disappeared, was able to be worked around, and the tensions went.

Zoom kept freezing and I couldn't join meetings; trying persistently eventually worked. The meetings varied from same old (new matters from the pandemic) to discussions about what we can do differently after the pandemic.

The Ministry is encouraging clinicians to propose innovative approaches and has advised that we should work with a private group who use a system called KEN (Knowledge Exchange Networks). The process appears to be sensible, but the idea of our underfunded public system putting money into a private company to do what professionals like psychiatrists and other mental health workers should be doing jars mightily. 

We would be paying young generic "researchers" to read the literature, and interpret it for us. I may be old. I may be post retirement two or even three times now. But I can still read and assess the literature for myself. I can see that a paper I read today which describes the poor functional recovery in the 12 months after a first manic episode, and relates it all to the duration of untreated psychosis at the start of treatment and to having a family history is mightily flawed by not considering the impact of medications, which are not mentioned at all. Antipsychotics in bipolar disorder do foster poor psychosocial functioning. Were these patients on those medications? The reader is not told. One of the authors is a world leading expert in this field. Is he right, or has the team overlooked the ill effects of medications?

I will be very sad if my colleagues and I need to be told what to think of research by someone with no actual training in the field.

I left work early after finishing reading that paper; later I will summarise it and I will discuss it with colleagues and I will try to encourage appropriate scepticism about research with holes in it. I felt better thinking that, and liked this view of the upper Waitemata Harbour as I neared home.