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She's been a healthcare attorney. A psychotherapist. A clinical nurse. A psychiatric administrator in a maximum security prison.

Jacqueline Melonas, RN, MS, JD has a remarkable background in the fields of law and behavioral healthcare. It is this dynamic experience that she brings to her current role as vice president of risk management at PRMS. To the healthcare professionals seeking her advice, Ms. Melonas not only provides the expertise of an attorney, but also the knowledge and compassion of a healthcare professional who has been in their shoes.

We spoke with Ms. Melonas about why she came to the field of risk management and her outlook for the new liability risks that mental health practitioners need to learn (and the ones they should already know).

Story Archive: 

Limiting Your Risks When Prescribing SSRIs
- Psychiatric News, October 2004
Psychiatrists Advised on Ways To Avoid Legal Quicksand
-
Psychiatric News, June 2004

Making Risk Management Manageable: PRMS Seminar Keeps Psychiatrists on Top of Trends
- PRMS, May 2004

Courts Interpret Boundaries Of HIPAA Privacy Rule
Donna Vanderpool, J.D., M.B.A.
- Psychiatric News, May 2004

Patient-Safety Strategies Can Reduce Suicide Risk
Jacqueline M. Melonas, J.D., R.N., M.S.
- Psychiatric News, April 2004
Use of S&R: Patient Safety, Risk Management Considerations
Donna Vanderpool, J.D., M.B.A.
- Psychiatric News, March 2004
PRMS Assistant Vice President Simplifies HIPAA at AOOP Conference
- PRMS, January 2004

1. What do you find compelling about working in behavioral healthcare risk management?

I believe that the work of psychiatrists and all mental health professionals is so important. Mental health patients are sometimes still not given the support they should receive due to unequal access to health benefits for mental health treatment. Also, our society still attaches some degree of stigma to mental illness. I know that these professionals advocate for their patients and work hard to provide quality care to them. I want to support their efforts by relieving healthcare professionals from the worry and heartache of a malpractice lawsuit. I also believe that good risk management strategies focus on quality patient care, so it is a good feeling to participate in some small way to helping patients as well as clinicians.

2. In your role with PRMS, how often do you present seminars to healthcare professionals?

The PRMS Risk Management department presents three large national seminars each year, as well as at least four seminars in New York (typically in Manhattan, Upstate locations, and White Plains). This year, we will hold our national seminars in Orlando, Fl., Columbus, Oh., and Arlington, Va. Over the past few years, we've presented in such cities as Philadelphia, Hartford, Chicago, Seattle, Denver and more. In addition to the national seminars, PRMS speaks at American Psychiatric Association District Branch programs throughout the country, as well as professional conferences.

3. What is an emerging issue in mental health risk management?

It remains to be seen how big the impact will be but the controversies surrounding prescribing psychotropic medications (especially the recent FDA warnings and the related controversy about antidepressants and suicidality in children & adolescents) is of concern because prescribing decisions may be scrutinized more than ever.

4. What is one liability issue that has remained a constant threat to mental health professionals throughout the years?

A suicide (or attempted suicide) by a patient is the most frequent basis for lawsuits against mental health professionals/psychiatrists.

5. If you had to sum up advice in one sentence to mental health practitioners in minimizing liability risk, how would you do it?

Communication! Good communication between the clinician and patient can, among other things, increase adherence to the treatment plan, manage the patient’s expectations about treatment and treatment outcomes, and reduce the potential for a malpractice lawsuit. Numerous studies have examined the relationship between a strong clinician-patient relationship and the likelihood of a malpractice action being taken against the clinician. Effective communication is the basis for a good relationship and has been shown to improve quality of care and, even in instances in which the treatment outcome is poor, a good clinician-patient relationship acts as an inhibition to lawsuits.

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