Psychiatric treatment of the VIP: some paradoxical risks.
One might expect that VIPs-individuals with wealth, fame, or power-would typically receive excellent care when treated for psychiatric disorders. Often, this is the case, but paradoxically, VIP status may compromise the quality of psychiatric treatment. In this article, we present four case examples, representing disguised amalgamations of actual cases from our experience, demonstrating how VIP patients may sometimes receive suboptimal psychiatric care. These cases show certain similarities; typically, there was no serious doubt about the general nature of the treatment that should be undertaken, but the treatment team was unable to deliver that treatment in the usual manner because of various outside pressures created by the VIP status of the patient and by the patient's entourage. One possible solution to this problem, when feasible, is to assign treatment to a team specifically experienced with VIP patients. A strong and united treatment team, accustomed to the unusual difficulties and pressures often encountered with VIP patients, can be prepared to act promptly, firmly, and unanimously to devise an appropriate treatment plan and then maintain this plan true to its course despite these pressures.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Benjamin C
BC
Silverman
Alice
A
Asby
David H
DH
Brendel
Peter
P
Choras
James A
JA
Chu
Julieta
J
Holman
Harrison G
HG
Pope
Jennifer
J
Radden
Jacqueline A
JA
Samson
George W
GW
Smith
Gail
G
Tsimprea
J Alexander
JA
Bodkin
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000523:psychology / Q000534:rehabilitation; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000534:rehabilitation; D034462:Dissent and Disputes; D005197:Famous Persons; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D010347:Patient Care Planning; D010348:Patient Care Team; D010349:Patient Compliance; D010352:Patient Dropouts / Q000523:psychology; D011209:Power, Psychological; D011785:Quality Assurance, Health Care; D012559:Schizophrenia / Q000534:rehabilitation; D012923:Social Class; D013315:Stress, Psychological / Q000150:complications; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D017211:Treatment Failure; D016896:Treatment Outcome