New York Times letter about Jeff Sessions and Asylum–What Sessions Did 2 Days Ago is Beyond Abhorent

Here it is:

To the Editor:

Re “Sessions Shrinks Paths to Asylum” (front page, June 12):

The ruling that Attorney General Jeff Sessions handed down saying that fleeing domestic or gang violence isn’t reason enough to qualify someone to receive asylum here in the United States is tantamount to holding a gun to someone’s head and pulling the trigger.

I am a psychiatrist who has performed scores of evaluations of asylum seekers over the last decade and can attest to the fact that asylum seekers overwhelmingly face death if they are sent back to their country of origin.

For example, if a Central American gang has recruited an adolescent male and he refuses to join, he will be killed. Or if an adolescent girl refuses a gang’s request that she become a sex slave for the gang (no matter how they phrase the request), she will be killed. I have seen mothers who fled Central America only after not one but two of their children were killed for refusing to comply with gang requests.

Mr. Sessions’s decision will be analogized to the United States’ turning away boats filled with Jews trying to escape Nazi Germany. Those who support the administration that made this happen will find themselves on the wrong side of history.


The writer is an associate professor of psychiatry and on the faculty of the Center for Bioethics at Harvard Medical School.

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This November you must vote–even if or especially if you think it doesn’t matter.  IT MATTERS.  Even a slim majority of Dems in the House will inject SO much accountability into the federal government right now.  Jeff Sessions’ most recent action will literally kill many individuals who are fleeing for their lives and your vote might make a difference.

Sessions was refused a federal judgeship years ago because he was a racist.  His actions on this matter are dramatically more lethally effective than even the most blood-thirsty, racist, fascist could hope for.  We need to do everything we can to stop him–and his boss.

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Single-Payer System Is the Solution for Mental Health Care, Panelists Say

Just back from the national meeting of the APA.  While there I presented in 3 workshops:  the first on immigration and asylum, the second on everyday racism in the workplace, and the third on the ways in which the insurance industry makes it difficult to provide mental health care for those who need it.  This piece appeared today to my surprise, detailing our presentation in the last session.

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Still Worth a Look–Duties of Doctors During Times of War

We need to keep a focus on what the duties are of physicians and other health care personnel are during times of war:

See video here.

The fact that health care personnel actively participated in torture during our war on terror is going to be one of the largest stains on the US for the next century.

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Using marijuana 2 times a month cost this doctor his license

Just posted on KevinMD.  The piece is here.  Some state PHPs are advocating a zero tolerance policy for any positive marijuana test and also often have a de facto zero tolerance policy for any positive test for metabolites of alcohol.  That means that even if physicians have never used marijuana or alcohol before going to work and have never even remotely practiced medicine under the influence, physicians might be accused of having a substance use disorder and forced into expensive evaluations and rehab (which often have financial ties to state PHPs) or else run the risk of losing their ability to practice medicine.

Since the national federation of PHPs has not taken action to sever the financial ties between PHPs and their “vetted eval/treatment centers” and eliminate conflicts of interest, all physicians ought to begin to pressure their state medical boards societies and the AMA to effect change.

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Do state physician health programs encourage referrals that violate the Americans with Disabilities Act?

Hot off the presses with co-author Nick Lawson in the International Journal of Law and Psychiatry is this article entitled “Do state physician health programs encourage referrals that violate the Americans with Disabilities Act?”  A PDF of the paper is  available by clicking this link:  Do PHPs Violate the ADA.  And supplemental material for the paper is available by clicking here:  Supplementary Material for ADA PHP Paper 2018

The abstract states:  The websites of many physician health programs provide lists describing signs of impairment or indications to refer physician-employees for evaluation and possible treatment. This study aimed (1) to determine how many of these descriptions likely provide physicians’ employers with sufficient evidence to legally request mental health examinations under the general regulations of the Americans with Disabilities Act (ADA); and (2) to find out who they described. The authors applied US Equal Employment Opportunity Commission guidance documents and sought expert legal advice to evaluate the descriptions for their consistency with the ADA. They used directed content analysis to review and code these descriptions into categories. Very few, if any, of the 571 descriptions appeared to provide sufficient evidence for employers to request an examination under the ADA. About 14%, however, could refer to physicians attempting to defend themselves, assert their ADA rights, or otherwise complain about the hospital; and 27% either described physicians who complain or else had discriminatory effects in one of several different ways. Leaders within the medical field should ensure that their policies and state laws pertaining to physician impairment comply with and incorporate the language of the ADA. They should also reevaluate the functions of these policies, laws, and physician health programs, and the implications for patient safety, physician wellness, suicide, and other important issues.

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Mass Murder in the US

We are the only country where these mass killings happen regularly. Even though some say “How can we prevent this?” the answer is quite clear and has worked in every other country in the world. No way the men who wrote the Second Amendment would stand for this horror. And why on Earth would anyone sanctify the Constitution (which was meant to be amended!) if anyone thought otherwise?


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How mass incarceration harms U.S. health, in 5 charts

Co-author Emily Nagisa Keehn and I just published this piece about the extensive health toll that incarceration exacts.  The AP just picked it up!

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Mental Health Matters–Thinking about Stigma, Parity, and the Obstacles to Obtaining Needed Mental Health Care

Pat Lawrence interviews J. Wesley Boyd., M.D., Ph.D., a psychiatrist at Harvard Medical School. They discuss the crisis in mental health care, focusing on difficulty in getting insurance coverage, substance abuse issues, and advances in treatment.  The interview can be found here.


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Our Youth Deserve Better: We Fail Our Youth When They are Most at Risk for Drug and Mental Health Problems.

I co-authored this piece with Sarah Samuelson for Psychology Today.  In the piece we write that transition-age youth (age 18-25) are at high risk for mental health, physical health, and substance use problems, yet they are falling through the cracks due to the lack of services aimed directly at this vulnerable population.

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