Privacy and safety: Issues of dual compliance in high-secure and other forensic psychiatric hospitals.

Health care organizations are obligated to provide safe and effective treatment to their patients and also protect the safety of their workers. This paper analyzes the tensions arising from legislative regimes that, respectively, protect privacy and workplace safety, using a large, tertiary high-secure forensic psychiatric hospital in Ontario, Canada, as an example. In Ontario, the Personal Health Information Protection Act (PHIPA) prohibits personal health information (PHI) from being disclosed to individuals who fall outside the "circle of care," including nonclinical employees who have direct involvement with patients and may be at risk of violence. PHIPA permits the disclosure of information where there is a risk of violence, but the statute's scheme for privacy protection was not designed to address, and may not be compatible with, the operations and requirements of high-secure forensic and other psychiatric hospitals. At the same time, the Occupational Health and Safety Act (OHSA) creates a regulatory framework that sets health and safety standards, including an employer's duty to disclose the risk of violence. OHSA prosecutions and proceedings demonstrate how these duties have been enforced against psychiatric hospitals. We examine this regulatory backdrop, explaining that PHIPA provides little guidance to psychiatric hospitals, where the risk of violence is elevated. We also discuss issues of dual compliance that arise from a hospital's legal obligations under PHIPA and OHSA. Finally, we turn to the ongoing clinical and operational challenges, suggesting strategies for increasing staff safety. These include strengthening the therapeutic alliance and providing patients with the option of consenting to disclosure of PHI to those outside the circle of care.

A Factor Analytic Investigation of the Person-in-Recovery and Provider Versions of the Revised Recovery Self-Assessment (RSA-R).

Recovery is understood as living a life with hope, purpose, autonomy, productivity, and community engagement despite a mental illness. The aim of this study was to provide further information on the psychometric properties of the Person-in-Recovery and Provider versions of the Revised Recovery Self-Assessment (RSA-R), a widely used measure of recovery orientation. Data from 654 individuals were analyzed, 519 of whom were treatment providers (63.6% female), while 135 were inpatients (10.4% female) of a Canadian tertiary-level psychiatric hospital. Confirmatory and exploratory techniques were used to investigate the factor structure of both versions of the instrument. Results of the confirmatory factor analyses showed that none of the four theoretically plausible models fit the data well. Principal component analyses could not replicate the structure obtained by the scale developers either and instead resulted in a five-component solution for the Provider and a four-component solution for the Person-in-Recovery version. When considering the results of a parallel analysis, the number of components to retain dropped to two for the Provider version and one for the Person-in-Recovery version. We can conclude that the RSA-R requires further revision to become a psychometrically sound instrument for assessing recovery-oriented practices in an inpatient mental health-care setting.

Naomi Weisstein (1939-2015).

This article memorializes Naomi Weisstein, who passed away on March 26, 2015 at Mount Sinai Hospital in New York City. In Chicago, Illinois, Weisstein began what would become a defining feature of her career and legacy-combining feminist political activism with both her academic and personal life pursuits. By the time she began her first faculty position at Loyola University in Chicago in 1966, Weisstein was an outspoken feminist. In 1968, she published her now classic article "Kirche, Kuche, Kinder as Scientific Law: Psychology Constructs the Female" (PCF; New England Free Press), wherein she criticized the field of psychology for failing to understand women because of its overreliance on essentialism and biologically based theories, while ignoring the importance of social context. Her critique laid the groundwork for others to explore the social construction of gender, and for second-wave feminism to take hold within the discipline of psychology. Despite all of her varied contributions, it is PCF that helped to define Weisstein's legacy in psychology. The article has been cited as a defining moment in second-wave feminism, and several psychologists have remembered the piece as a catalyst for their feminist awakening.

Genius [corrected] without the "Great Man": new possibilities for the historian of psychology.

The Carlylian style of history, more commonly known as the "Great Man" approach, presented the "genius" as an individual worthy of celebration: history as hero worship. This style, which characterized the first wave of the history of psychology, has gone out of historiographic fashion. In its place is the "new history," which is marked by its external focus and privileging of social factors and cultural context in its explanations. This shift in historiographic sensibilities has also led to a revision in the appropriate subject matter for psychologist-historians. This article argues, in contrast, that it is possible to study eminent individuals without resorting to hagiography, and it presents various methods that could be used for this purpose. The aim of such an endeavor is to create a space for critically and historically informed perspectives on greatness and to suggest a reconsideration of the value of an "historical psychology".

Twin research, revisionism and metahistory.

We understand metahistory as an approach that studies how histories within a particular discipline have been written and focus on insider scientists' reconstructions of twin research. Using the concept of ethical-political affordances we suggest that such histories are based on a management of resources that prove to be beneficial for representing one's own research traditions in a positive light. Instead of discussing information on the context and intellectual life of pioneers of the twin method, which include high-caliber eugenicists and Nazi ideologues, and on how the twin method has been used and abused, insider scientists' accounts present twin research as neutral, objective and void of any kind of political connotations. We show how important leaders of German twin research have been historically managed, and how their contributions have been distorted and omitted. Reasons for historical revisionism by omission and for selectively revised accounts of the past are discussed. Suggestions for writing accounts of the twin method are included and focus on the necessity of self-reflection, considerations regarding one's own ethical-political inclinations, and review of the existing historical literature. In analyzing these connections, we attempt to understand how science, politics and history interact.