Sally Satel - Academia.edu (original) (raw)

Papers by Sally Satel

The Routledge Handbook of Neuroethics, 2017

A disturbing new movement in the mental health field called "Culture Competence" or "multicultura... more A disturbing new movement in the mental health field called "Culture Competence" or "multicultural therapy" threatens to discredit traditional therapy and replace it with identity politics. In its most radical form, multicultural therapy holds that human behavior is primarily culture dependent, that doctors and patients will always experience mistrust and miscommunication if they are of different racial or ethnic groups, and that white therapists should be presumed racists. As extreme as these views may sound, their influence has been indirectly felt in the mainstream. Versions of multicultural therapy, some more moderate than others, are promoted by the federal government, various professional groups, and numerous writers and speakers in the mental health field. The most prominent cultural competitive program in the United States is the Cultural Competence and Diversity Program at San Francisco General Hospital. Doctors in the mental health unit specialize in different patient groups-blacks, Asians, Latinos, gays/lesbians/bisexuals, women, and the HIV-positive. The hospital produces a "curriculum" to guide doctors in treating patients of each group. The city of San Francisco has even created a new specialization for non-doctor health professionals: African American Health Services Specialists. No one believes that race and culture are irrelevant to mental health, but multicultural therapy seeks to establish rigid rules of treatment based on stereotypes and "groupthink." This denies the individual dignity of both doctors and patients. Contains 44 endnotes. (MKA)

The New York times on the Web, Jan 15, 2006

SSRN Electronic Journal, 2017

May the probationer permissibly be required to "remain drug free" as a condition of her probation... more May the probationer permissibly be required to "remain drug free" as a condition of her probation, and may she permissibly be punished for violating that condition, where the probationer suffers from substance use disorder [SUD], and where her continued use of substances despite negative consequences is a symptom of that disorder.

American Journal of Transplantation, 2011

Incentives for organ donation, currently prohibited in most countries, may increase donation and ... more Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation. We believe that if systems based on these guidelines were developed, harms would be no greater than those to today's conventional donors. Ultimately, until there are trials of incentives, the question of benefits and harms cannot be satisfactorily answered.

Law and Contemporary Problems, 2014

The views and opinions expressed in this article are solely those of the authors and not of the P... more The views and opinions expressed in this article are solely those of the authors and not of the Pennsylvania Legislative Budget & Finance Committee. The authors extend deep appreciation to Alan Viard for his most insightful comments, Mark Perry for graphics, and to Rita Gilles for her research and editorial assistance. ** Co-Executive Director of WaitList Zero, a nonprofit devoted to increasing living kidney donation.

The virtual mentor : VM, 2008

PSN: Income Tax (Topic), 2017

We discuss how to design a federal tax credit for organ donations that would help ease the pressi... more We discuss how to design a federal tax credit for organ donations that would help ease the pressing shortage of donated kidneys, saving thousands of lives and sparing many from dialysis.

Psychiatric services (Washington, D.C.), 2014

In the wake of the December 2012 mass shooting at an elementary school in Newtown, Connecticut, t... more In the wake of the December 2012 mass shooting at an elementary school in Newtown, Connecticut, the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce of the U.S. House of Representatives held a hearing on the Substance Abuse and Mental Health Services Administration (SAMHSA) and its role in caring for people with severe mental illness. The author was among those who testified at the hearing. In this Open Forum she raises points made in that hearing-for example, that in embracing the recovery model and certain evidence-based practices, SAMHSA has been derelict in its duty to attend to the sickest individuals, those with chronic psychosis. She calls on the agency to embrace and promote a more balanced and pragmatic agenda.

Journal of Traumatic Stress, 1992

Journal of Mental Health, 2008

New England Journal of Medicine - N ENGL J MED, 2000

Journal of Nervous and Mental Disease - J NERV MENT DIS, 1993

The authors selected at random every fourth inpatient chart (N = 79) of patients enrolled in a sc... more The authors selected at random every fourth inpatient chart (N = 79) of patients enrolled in a schizophrenia clinic for analysis of substance use patterns and psychiatric hospitalizations. Patients were divided into three groups based on operationally defined lifetime drug use histories: a) cocaine and other substance use; b) substance use without cocaine; and c) no substance use. All available hospital records were examined for presenting symptoms and psychosocial functioning at admission, neuroleptic dosing, and hospital management. Cocaine-using schizophrenics had significantly higher hospitalization rates than other substance-using or non-using patients. No differences were found in hospital presenting symptoms among any cohort. However, the cocaine-using schizophrenic patients demonstrated significantly higher rates of suicidal ideation after cocaine use compared with their own non-cocaine-associated hospitalizations or the other groups. The cocaine group also received higher neuroleptic doses by the fifth and sixth weeks of hospitalization compared with their own non-cocaine-associated hospitalizations and with the other groups. This suggests that cocaine use in schizophrenia is associated with poorer illness course and increased hospitalization, including higher rates of suicidal ideation and greater neuroleptic dose.

JAMA: The Journal of the American Medical Association, 1989

Migrainelike headache is a sequela of cocaine use. This finding expands the range of neurological... more Migrainelike headache is a sequela of cocaine use. This finding expands the range of neurological complications of cocaine use and is consistent with the potential role of serotonin in the development of migraine. In these subjects, the desire to avoid the cocaine-induced headache eventually became part of the resolve to quit use.

Clinical Pediatrics, 1990

Glucocorticoid preparations are used commonly in the treatment of many diseases in children and a... more Glucocorticoid preparations are used commonly in the treatment of many diseases in children and adolescents. Although their physiologic side of effects have been described well, the psychiatric side effects of these medications have received little attention. Limited data suggest that disturbances of affect and behavior may occur in 25-50% of children receiving glucocorticoid. These steroid-induced mental changes may be underrecognized in children, and yet these changes can have considerable impact on social and psychological functioning and treatment outcome. An enhanced awareness and reporting of this phenomenon by clinicians, parents, and teachers would likely lead to better compliance with treatment, improved outcomes, and greater understanding of emotional concomitants of illness.

The British Journal of Psychiatry, 1993

One of us has hypothesised that the ‘voices' of schizophrenic patients reflect altered precon... more One of us has hypothesised that the ‘voices' of schizophrenic patients reflect altered preconscious planning of discourse that can produce involuntary ‘inner speech’ as well as incoherent overt speech. Some schizophrenic patients reporting voices do not, however, have disorganised speech. We hypothesise that these ‘counterexample’ patients compensate for impairments of discourse planning by reducing language complexity and relying on highly rehearsed topics. A ‘language therapy’ designed to challenge and enhance novel discourse planning was administered to four such patients; three had significant albeit temporary reductions in the severity of their voices. These clinical findings provide further evidence that alterations of discourse planning may underlie hallucinated voices.

American Journal of Transplantation, 2010