II
Duke University
Medical Center
Intercom
VOL. 25, NO. 10
MARCH 10, 1978
DURHAM, N.C.
Better care for college students
topic of health officials^ meeting
Better health care for college students
away from home is the main topic under
discussion as the Southern College
Health Association holds its annual
meeting here through tomorrow.
More than 100 physicians, nurses and
administrators representing some 30
college and university student health
services throughout the southeastern
United States were expected to attend the
three-day event which began Thursday.
Dr. Dorothy Naumann, director of the
Duke Student Health Clinic is president
elect of the organization. She said the
meeting offers an opportunity for the
people who take care of students to
exchange information, methods and ideas
for improving the services they provide.
Yesterday participants toured the
Duke campus, the university infirmary
and Burroughs Wellcome Co. and also
heard a talk, "A Look at the Past: The
Dukes of Durham," by Dr. Robert
Durden, chairman of the History
Department at Duke.
This morning's topics
This morning undergraduates Cindy
Hart and Requa Tolbert will describe
student-run sexuality and interpersonal
relationship counseling and the Rape
Crisis Center.
Other talks this morning include:
—"A Study of Divergent Academic
Performance Among Seniors Who Enter
College With Presumed Equal Academic
Potential" by Dr. Kenneth Rockwell,
assistant professor of psychiatry.
—"Sexually Transmitted Virus
Infections" by Dr. David J. Lang,
(Continued on page 2)
[
Prison elective looks at overlooked factors
By John Becton
Given a choice, some psychiatric
residents opt for six months in prison.
They are participants in an elective
offered to third-year residents by the
Division of Community Social
Psychiatry, under the direction of Dr.
James H. Carter, associate professor of
psychiatry.
This past fall, three residents spent one
day a week at Central Prison in Raleigh
and other corrections units, participating
in postrsentence evaluations and treating
some patients on a regular basis.
This semester they are working with
pre-sentence evaluations in Dorothea
Dix Hospital in Raleigh.
Carter said the rotation experience was
established to prepare residents to work
with disadvantaged patients.
"There are fac
tors related to
poverty which
are often over
looked in treat
ment," he ex
plained. "The
prison presents
an opportunity to
look at these.
"State prisoa-
ers are not so- DR. CARTER
phisticated like many in federal prisons.
There are no John Deans, or John
Mitchells. The majority can't read or
write," Carter said.
"So you can't use traditional
psychoanalysis. Instead, you work on
simple living skills — how to get a job,
using appropriate language. It's a reahty-
oriented therapy."
Limited opportunities
One of the residents currently
participating in the elective. Dr. Sally C.
Johnson, added, "It's not as much a matter
of limited intelligence as limited
education. Being from lower socio
economic backgrounds, they don't have
much to look forward to when they get
out. They have no skills, no place to stay.
So, many return."
Consequently, psychiatrists working in
the prisons often treat anger and
depression, as well as some more severe
problems.
Carter said some people have ended up
in prison because they "are so retarded,
that they don't even know their own
names. They have to be led, and often are
led by criminals."
Includes legal training
In coming up with treatment plans
within the limitations of the corrections
institution, the residents get a rather
thorough law course.
They not only need to be knowledgable
of current psychotherapeutic techniques,
but also must be just as knowledgable of
laws governing treatment in this setting.
"Behavior modification is no longer
allowed in corrections," Carter said. "And
they are extremely sensitive to patients'
rights and to the use of medications."
Patients can be instructors
Some of the patients themselves may
also contribute to the legal training.
"Some sit and contrive ways to sue
their doctors," Carter said. "They key to
avoiding such a problem is good record
keeping."
The residents also learn to give credible
testimony in court. To be effective, the
psychiatrist must translate the technical
jargon without losing the significance of
the diagnosis. Carter explained.
Exposure to different facilities
The prison experience features
exposure to different kinds of facilities
within the system.
Central Prison, a maximum security
facility, has a complete mental health
unit, which minimum security units, such
as McCain Prison Unit, lack.
"If someone at McCain is seriously ill,
he has to be shifted to Central Prison for
care," Johnson said.
"Women's Prison has no inpatient
facility," she added. "So psychiatric
services are performed on a more loosely
structured outpatient basis, which limits
what you can do."
But perhaps the most unusual
educational aspect of this fall's experience
was the opjjortunity the group had to
interview the only inmate on death row.
(Continued on p(ige 4)
CAN SPRING BE FAR AYlAY^—ThXt youngster was among those who grasped at last week's
glimpse of spring. Many must have been reminded of how pleasant it is that the Sara P. [>uke
Gardens are next to the medical center. And it's esoecially nice during the spring and on spring
like days. (Photo by Parker Herring)