60 Seconds with ... Richard Juman

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Richard Juman, PsyD, National Director of Psychological Services, TeamHealth
Richard Juman, PsyD, National Director of Psychological Services, TeamHealth

Q: For providers that still have high rates of antipsychotics, there's a goal to decrease the rate by 15% by the end of 2019. Is this feasible? 

Absolutely. Use of antipsychotics has been the default for so long. It takes time. As providers continue to adopt best practices, it's very feasible that the rates can continue to go down. 

A possible caveat is for facilities that have unusually high percentages of the significantly and persistently mentally ill in their census. These residents need to be treated differently and to receive the psychotropics that are an aspect of an evidence-based treatment plan.

Q: What are strategies providers should use to reduce their rate? 

Environmental changes, resident-centered care, training and non-pharmacologic interventions are more effective [than antipsychotics] in the long run. 

Q: How should caregivers talk to family members?

When the family understands there are alternative approaches, they are generally going to be strongly in favor.

Q: What have providers been doing right with antipsychotic reduction?

I've seen a true sea change, of being critical of previous prescribing practices. Seeking alternatives and performing ongoing gradual dosage reductions.