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	<title>Comments on: What&#8217;s Wrong With Mental Health Care in America?</title>
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		<title>By: Grace</title>
		<link>http://www.blog.drsarahravin.com/psychotherapy/whats-wrong-with-mental-health-care-in-america/comment-page-1/#comment-829</link>
		<dc:creator>Grace</dc:creator>
		<pubDate>Sun, 31 Jan 2010 16:44:38 +0000</pubDate>
		<guid isPermaLink="false">http://www.blog.drsarahravin.com/?p=104#comment-829</guid>
		<description>Dr. Ravin,

I completely agree with your views regarding psychological assessment of potential adoptive parents.  In many (the majority) of instances of adoption (domestic private, domestic public, and some international), this is the policy.  There are adoptive parents with well-managed depression/anxiety and even bipolar disorder in this country.  It is certainly widespread, at least in the two types of domestic adoption, to be in psychotherapy during the process.  It is likely to be beneficial to potential adoptive parents, particularly those who arrived at adoption as a means of parenting via infertility issues, to participate in psychotherapy, and for the vast majority of situations this is completely acceptable.  

And for the BMI requirements...I don&#039;t recall ever hearing of a minimum BMI requirement, although to the best of my knowledge this is a policy of only China at this point.  

Weight has never been, and never will be a prerequisite for good parenting.  There seems to be a schema floating around that this is the case, and that is disturbing.  

It is often said in the adoption research world that adoptive parents are the cream of the crop because of all the scrutiny they must pass through.  Some of these requirements, however, are just discriminatory.</description>
		<content:encoded><![CDATA[<p>Dr. Ravin,</p>
<p>I completely agree with your views regarding psychological assessment of potential adoptive parents.  In many (the majority) of instances of adoption (domestic private, domestic public, and some international), this is the policy.  There are adoptive parents with well-managed depression/anxiety and even bipolar disorder in this country.  It is certainly widespread, at least in the two types of domestic adoption, to be in psychotherapy during the process.  It is likely to be beneficial to potential adoptive parents, particularly those who arrived at adoption as a means of parenting via infertility issues, to participate in psychotherapy, and for the vast majority of situations this is completely acceptable.  </p>
<p>And for the BMI requirements&#8230;I don&#8217;t recall ever hearing of a minimum BMI requirement, although to the best of my knowledge this is a policy of only China at this point.  </p>
<p>Weight has never been, and never will be a prerequisite for good parenting.  There seems to be a schema floating around that this is the case, and that is disturbing.  </p>
<p>It is often said in the adoption research world that adoptive parents are the cream of the crop because of all the scrutiny they must pass through.  Some of these requirements, however, are just discriminatory.</p>
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		<title>By: Dr. Ravin</title>
		<link>http://www.blog.drsarahravin.com/psychotherapy/whats-wrong-with-mental-health-care-in-america/comment-page-1/#comment-813</link>
		<dc:creator>Dr. Ravin</dc:creator>
		<pubDate>Sat, 30 Jan 2010 15:03:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.blog.drsarahravin.com/?p=104#comment-813</guid>
		<description>Grace,

Thank you so much for the clarification.  I apologize for the inaccuracies in my post.  I agree with you that the other qualifications from China are equally discriminatory, and I also agree that it would be unethical for adoption agencies to accept applicants who don&#039;t meet the country&#039;s criteria.  

In my opinion, potential adoptive parents sould be screened for psychological fitness on the basis of a psychological assessment alone, rather than automatically  ruled out because they have received a diagnosis in the past, or are taking psychotropic medication, or are in psychotherapy.  That way, individuals who have been diagnosed and treated and are currently psychologically fit to be parents would be approved, and individuals who have undiagnosed or untreated mental symptoms that render them unable to parent effectively would be ruled out.  This policy, I believe, would protect the best interests of the child while also being fair to potential adoptive parents who may have so much to offer to a child despite (or perhaps because?) of mental health diagnosis and treatment.  

As for the BMI &lt;25?  That is ludicrous and arbitrary. Weight is an imperfect measure of health.  Many people with BMI &gt; 25 are healthy and fit but have higher BMI&#039;s due to having large body frames or being very muscular.  I would at least hope that they have a minimum BMI requirement, since underwieght is more immediately dangerous and potentially life-threatening than being slightly overweight.  And since when was weight a prerequisite for good parenting?</description>
		<content:encoded><![CDATA[<p>Grace,</p>
<p>Thank you so much for the clarification.  I apologize for the inaccuracies in my post.  I agree with you that the other qualifications from China are equally discriminatory, and I also agree that it would be unethical for adoption agencies to accept applicants who don&#8217;t meet the country&#8217;s criteria.  </p>
<p>In my opinion, potential adoptive parents sould be screened for psychological fitness on the basis of a psychological assessment alone, rather than automatically  ruled out because they have received a diagnosis in the past, or are taking psychotropic medication, or are in psychotherapy.  That way, individuals who have been diagnosed and treated and are currently psychologically fit to be parents would be approved, and individuals who have undiagnosed or untreated mental symptoms that render them unable to parent effectively would be ruled out.  This policy, I believe, would protect the best interests of the child while also being fair to potential adoptive parents who may have so much to offer to a child despite (or perhaps because?) of mental health diagnosis and treatment.  </p>
<p>As for the BMI &lt;25?  That is ludicrous and arbitrary. Weight is an imperfect measure of health.  Many people with BMI > 25 are healthy and fit but have higher BMI&#8217;s due to having large body frames or being very muscular.  I would at least hope that they have a minimum BMI requirement, since underwieght is more immediately dangerous and potentially life-threatening than being slightly overweight.  And since when was weight a prerequisite for good parenting?</p>
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		<title>By: Grace</title>
		<link>http://www.blog.drsarahravin.com/psychotherapy/whats-wrong-with-mental-health-care-in-america/comment-page-1/#comment-805</link>
		<dc:creator>Grace</dc:creator>
		<pubDate>Sat, 30 Jan 2010 07:25:00 +0000</pubDate>
		<guid isPermaLink="false">http://www.blog.drsarahravin.com/?p=104#comment-805</guid>
		<description>Yes.  To most of this.  However, I need to correct something about the adoption part: it is not the agencies that put restrictions on who can adopt, it is the sending countries.  For example, to adopt from China, which is the strictest sending country at this particular time, you have to be between of a certain age (under 45, not sure of the lower limit), you cannot have a BMI over 25, you must make a certain amount of money, you may not be on any psychotropic medication, and you must be in a heterosexual marriage.  There has been talk of excluding potential adopters with less than above average IQs.  Saying that it is the adoption agencies is inaccurate, and yes, it does depend on diagnosis/treatment, but the adoption process involves psychological assessment by at least one qualified professional.  There are also other factors that exclude potential adopters that are just as discriminatory, and using this as an example of discrimination against treatment isn&#039;t quite accurate and is also quite out of context.  There&#039;s a lot more going on in China around international adoption than you said.  And yes, adoption agencies may say on websites that they don&#039;t accept applications to China/certain other countries if one has been treated for mental illness, but it would be unethical for them to accept applications and do homestudies and take incredible amounts of money from people who will just be rejected from the country per the country&#039;s policy.</description>
		<content:encoded><![CDATA[<p>Yes.  To most of this.  However, I need to correct something about the adoption part: it is not the agencies that put restrictions on who can adopt, it is the sending countries.  For example, to adopt from China, which is the strictest sending country at this particular time, you have to be between of a certain age (under 45, not sure of the lower limit), you cannot have a BMI over 25, you must make a certain amount of money, you may not be on any psychotropic medication, and you must be in a heterosexual marriage.  There has been talk of excluding potential adopters with less than above average IQs.  Saying that it is the adoption agencies is inaccurate, and yes, it does depend on diagnosis/treatment, but the adoption process involves psychological assessment by at least one qualified professional.  There are also other factors that exclude potential adopters that are just as discriminatory, and using this as an example of discrimination against treatment isn&#8217;t quite accurate and is also quite out of context.  There&#8217;s a lot more going on in China around international adoption than you said.  And yes, adoption agencies may say on websites that they don&#8217;t accept applications to China/certain other countries if one has been treated for mental illness, but it would be unethical for them to accept applications and do homestudies and take incredible amounts of money from people who will just be rejected from the country per the country&#8217;s policy.</p>
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		<title>By: KristineM</title>
		<link>http://www.blog.drsarahravin.com/psychotherapy/whats-wrong-with-mental-health-care-in-america/comment-page-1/#comment-803</link>
		<dc:creator>KristineM</dc:creator>
		<pubDate>Fri, 29 Jan 2010 16:56:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.blog.drsarahravin.com/?p=104#comment-803</guid>
		<description>You tell &#039;em, Dr. Ravin. I am sharing your post on my Facebook account.  The state of mental health care in our country is beyond deplorable.</description>
		<content:encoded><![CDATA[<p>You tell &#8216;em, Dr. Ravin. I am sharing your post on my Facebook account.  The state of mental health care in our country is beyond deplorable.</p>
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