Thank you for Ken Stanton's Treating Mental Illness in the ED (Viewpoint, December 2005). As many mental health care providers can attest, the substandard care and intolerance psychiatric patients receive are not confined to EDs. Caregivers should remember that even patients who are homeless, drug addicted, personality disordered, malingering, or schizophrenic can tell their own stories. Their behavioral problems, irrespective of diagnosis, are often driven by fear, powerlessness, and low self-esteem-exacerbated by intolerance and indifference when they most need compassion. A little understanding in an initial interaction can mitigate behavioral problems, save time, and ensure the good nursing care that all patients deserve. [continues 5 words]
If They're Effective, What's The Controversy? Abstract Overview: Injection drug users and their sexual partners and children represent an increasing proportion of Americans living with HIV or AIDS. Syringe-exchange programs (SEPs), which are based on the theory of harm reduction, are effective in preventing the transmission of HIV and other pathogens through injection drug use. Most programs also serve as gateways to other vital medical services. Yet SEPs remain controversial. This article describes the controversy, considers the evidence, and discusses the nursing implications. [continues 4142 words]
