Author Archives: Dr. Raymond B. Flannery Jr.

SUDEP: Sudden Unexpected Death in a Person with Epilepsy

This essay has been prepared in consultation with Evander Lomke, president and executive director of The American Mental Health Foundation. It is posted in memory of Elizabeth Leah Lomke, September 19, 1986 – June 4, 2018 The medical community and the general public are fully cognizant of the unexpected death of otherwise apparently healthy infants, […]

Posttraumatic Stress Disorder in Coroner First Responders

Dateline: Miami, Florida, March 15, 2018 The day dawned bright and sunny with typical early spring Florida warmth. People began to wake up, and each person began to plan the day. Everyone left home for work, for school, for local errands. Some did not realize that they would never be returning home. Ever. Each sat […]

Precipitants to Patient Assaults: A Worldwide View, 2013-17

He was quiet but definitely paranoid. The staff could agree on this. He refused to eat any of the hospital meals to avoid being poisoned. He was quite clear about this and would only eat commercially sealed prepackaged foodstuffs, such as corn chips. Nonetheless, he was quiet and usually cooperative. Still, the staff noticed that […]

Staff Victims of Psychiatric Patient Assaults: A Worldwide Perspective, 2013-17

(Please also see Assaultive Psychiatric Patients: A Worldwide Perspective, 2013-17.) Patient assaults on health-care staff are a serious and worldwide occupational hazard for caregivers, all disciplines. These assaults may result in death, permanent or temporary disability, medical and legal expense, lost productivity, and severe psychological distress. They impair overall personal and institutional morale. Assaults may […]

Assaultive Psychiatric Patients: A Worldwide Perspective, 2013-17

There are many types of human-perpetrated violence. However, there is one form of this violence that occurs on a daily basis worldwide and that receives limited media attention. That act of violence is an assault on a healthcare provider in a healthcare setting. Not all psychiatric patients are assaultive but some are, and these assaults […]

Terrorism: An Overview

Where was God? Dateline: Boston, Massachusetts, April 15, 2013 The day was perfect. Bright sunshine, a pleasant warmth. College student, Victoria McGrath, was excited. The Boston Marathon was a premier sports event. The crowd was excited as well. The enthusiasm was electric and Victoria positioned herself near the finish line, so as to have the […]

Psychological Trauma and First Responders

It had been a bad week. Fighting fires is a war that never ends but this had been a bad week. Ladder 6 had been called to a motor-vehicle accident on Monday afternoon. In the passenger’s seat had been a young mother. On impact she was thrown through the windshield and was now impaled on […]

Staff Victims of Psychiatric Patient Assaults: A Worldwide Perspective

(This is the second of two companion essays on assaultive psychiatric patients. The first focused on the characteristics of patient assailants. This second essay focuses on staff victims. The interested reader will want to read both essays to have a comprehensive understanding of this worldwide problem.) Psychiatric patient assaults on healthcare staff are a worldwide […]

Psychiatric Patient Assaults on Healthcare Staff: A Worldwide Perspective

Dateline: Anywhere, Any Time The voice in Daniel’s head kept saying “The nurse is trying to kill you. The nurse is trying to kill you. The nurse is trying to kill you.” Daniel, a twenty-two-year-old patient with schizophrenic illness, became very frightened, then terrified, then explosively angry. “Time for medicines. Patients please come to the […]

Caring Attachments: Their Role in Good Physical and Mental Health

All of the great religious and ethical codes in the history of civilization have had one common denominator: Love one another. This dictum of caring for others has been explained in extensive writings in the fields of theology, philosophy, and literature that cite the resultant benefits to the recipients, the sense of altruism in those […]

Managing Stress in a Global World

Traffic jams, delayed flights, long lines at checkout, college tuitions, no work/mandatory overtime, credit-card debt, family responsibilities, few cost of living increases. The list goes on. Ours is an age of global markets, intense competition, and time scarcity. As a result many of us feel overwhelmed, irritable, and worn-out. It need not be this way. […]

Psychological Trauma and Posttraumatic Stress Disorder: Part 2, Treatment and Interventions

In part 1 of this essay we examined the nature of psychological trauma, an individual’s physical and psychological response to sudden, usually unexpected, potentially life-threatening events, and the emergence of posttraumatic stress disorder (PTSD) thirty-one days later. We reviewed the disruptions that may occur in the domains of good physical and mental health (reasonable mastery, […]

Psychological Trauma and Posttraumatic Stress Disorder: Part 1, Its General Nature

It was seven o’clock in the morning when she awoke, after yet another terrible night’s sleep with her recurring nightmares. As usual, fifteen-year-old Maureen was paralyzed from the waist down. This paralysis had terrified her at first but now she was used to it. It would go away when he left for work. The “he” […]

Preventing Violence in the Workplace: Part 2, Risk Management Strategies

Part 1 of this essay examined the general nature of violence in the workplace. It noted the major types of crimes in the workplace, the various types of patient assailants, the theories that seek to explain such violent behavior, and the various physical and psychological impacts such violence has on staff victims. Part 2 examines […]

Preventing Violence in the Workplace: Part 1, Its General Nature

The alarm clock goes off. You are up and about and, in time, you make your way to work. As you enter your worksite, you think: another routine day at work. But what if it were not a routine day? What if today you became a victim of violence in the workplace? It could happen […]

The Assaulted Staff Action Program (ASAP): Psychological Counseling for Victims of Violence

“Are you sure?” He hadn’t slept well last night. “Of course, I’m sure. You know the secret and they want you dead. Don’t you see? It’s a plot to kill you. You must get them first.” “My knowing the hidden secret of Peterbus has been such a burden. No one believes me.” “Wrong. They all […]

The Violent Person: Guidelines for Service Providers

Your hospital beeper summons you to the emergency room to assess the condition of an assaultive patient. Are you safe as you enter the room? In your private practice office, you are assessing a patient with a known history of organic impairment and impulsiveness. Have you thought to ensure your own safety? You are about […]

Preventing Youth Violence, Part 2

PREVENTING YOUTH VIOLENCE PART 2: INDIVIDUAL AND GROUP APPROACHES Raymond B. Flannery Jr., Ph.D., FAPM, Harvard Medical School, The University of Massachusetts Medical School Part 1 of these two essays on youth violence examined the basic cultural, biological, sociological, and psychological theories of youth violence and the continuum of early (disrupted mastery, attachment, meaning), serious […]

Preventing Youth Violence, Part 1

PREVENTING YOUTH VIOLENCE PART 1: ITS GENERAL NATURE AND WARNING SIGNS Raymond B. Flannery Jr., Ph.D., FAPM, Harvard Medical School, The University of Massachusetts Medical School Recent months have seen outbreaks of mindless violence by youth in Canada, Europe, and the United States. These acts have included homicide rape, robbery, assault, arson, and rioting among […]