Risa Cromer is an Assistant Professor in the Department of Anthropology at Purdue University and affiliated faculty in the Women’s, Gender, and Sexuality Studies and Critical Disability Studies programs. Her scholarship investigates the reproductive politics animating the intersections of medicine, science, and technology. Her most recent book is Conceiving Christian America: Embryo Adoption and Reproductive Politics (2023, NYU Press), which examines how the U.S. Christian Right advances nationalist ambitions by strategically interfacing with assisted reproduction through the practice of embryo adoption. She co-leads “The Reproductive Righteousness Project,” an interdisciplinary feminist collaboration on right-wing extremism, and is developing a feminist data studies ethnographic project about abortion-related knowledge in the post-Roe context.
Radical right-wing movements are resurging around the globe and thriving during global pandemic c... more Radical right-wing movements are resurging around the globe and thriving during global pandemic crises. Far-right leaders in India, Hungary, Philippines, Israel, Brazil, United States, United Kingdom and elsewhere have gained and retained power in recent years, despite involvement in massive corruption scandals and failing to deliver on campaign promises. From Trump's "America first" to Kaczyński's "there is only one Poland," expressions of ethnonationalism, right-wing populism, and authoritarianism are taking nightmarish form-especially during the COVID-19 pandemic (Edelman 2020). Strongmen regimes (Ben-Ghiat 2020) are building power through angry politics (Maskovsky and Bjork-James 2020) that polarize populaces, capitalize on catastrophe, and undermine democratic institutions. While not new, right-wing parties worldwide are advancing similar agendas in diverse historical, economic, cultural, and religious contexts that promote nationalist, xenophobic, demagogic, antifeminist, and majoritarian issues-and are doing so more successfully than any other political group in decades (Spierings et al. 2015). The global ascension of illiberal movements is experiencing a distinct "moment" (Mouffe 2018) in the twenty-first century-and reproductive politics are at its center.
iii Acknowledgments v List of Tables and Figures ix Introduction Saving: 1 Freezing Reproductive ... more iii Acknowledgments v List of Tables and Figures ix Introduction Saving: 1 Freezing Reproductive Remainders for the Future Chapter 2 Culturing: 56 Making Potential in an IVF Clinic Chapter 3 Wasting: 94 Making Embryo Trash and Treasure in a Stem Cell Lab Chapter 4 Rescuing: 149 Making Embryo Orphans in a Christian Adoption Program Chapter 5 Sorting: 208 Archiving Embryos for Viable Futures Chapter 6 Redeeming: 251 Claiming Potential Makes Moral Cents Conclusion What Remains 276
Background Studies have proven that lack of access to menstruation products negatively affects sc... more Background Studies have proven that lack of access to menstruation products negatively affects school attendance, academic performance, and individual health. Implementation of “period policies,” or programs offering free menstruation products, are becoming popular in schools, businesses, and communities in high income countries. U.S. based [Blinded University] announced in February 2020 that free pads and tampons would be stocked in all women’s and gender-neutral restrooms in campus buildings. The purpose of this study was to capture the experiences of menstruators about free menstrual products and the impact of a university-wide free menstruation management product policy and program. A second purpose was to understand how access to menstrual management products is intertwined with broader socio-cultural experiences of a menstruator. Methods As part of a larger study, virtual focus group discussions (n = 32 across 5 focus groups) were conducted in February 2021. Eligible participa...
Conform traditiei legilor nescrise, exista un principiu ce interzice proprietatea asupra corpului... more Conform traditiei legilor nescrise, exista un principiu ce interzice proprietatea asupra corpului uman. Luând in considerare proprietatea ca fiind un concept proteic, lucrarea de fata examineaza modul in care proprietatea este definita si aplicata in dispute legislative recente, purtate in S.U.A, privind entitatiile „cu o viata potentiala", precum sunt embrionii si fetusii. O scurta trecere in revista a abordarilor teoretice si a legilor nescrise, toate privind proprietatea asupra trupului, este urmata de o analiza a sase cazuri legale din S.U.A, in cadrul carora sperma, zigotii, embrionii si fetusii au devenit noi subiecte legale, pe fundalul tenologiilor reproductive asistate. Studiul de fata conchide ca proprietatea este functionala nu numai in scopul de a privatiza, a comodifica si a face sa circule, ci in scopul de a aduce entitatiile „cu viata potentiala" mai aproape de oameni si de a le implica mai adanc in retelele relationale.
The journal of pain : official journal of the American Pain Society, 2018
The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain ... more The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain by encouraging routine pain assessment and management. In the Veterans Health Administration, routine pain screening has been practiced in primary care for more than a decade, but has not improved the quality of pain management measured using several process indicators, and some have expressed concerns of potentially fostering undesirable use of prescription opioids. We sought to evaluate the consequences of routine pain screening on clinical practice. We conducted 9 interdisciplinary focus groups with 60 primary care providers and staff from 5 outpatient Veterans Health Administration clinics. We identified 5 themes reflecting 1 intended and 4 unintended consequences of routine pain screening: it 1) facilitates identification of patients with pain who might otherwise be overlooked, 2) may need to be targeted toward specific patients and contexts rather than universally applied, 3) often...
Journal of medical Internet research, Jan 14, 2017
As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides v... more As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings. The aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care. We conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses. Transcripts were analyzed using a thematic analysis approach, which allows for both inductive and deductive themes to be explored using an iterative, constant comparative coding process. OpenNotes is changing VHA mental health care in ways that mental health clinicians perceive as both challenging and beneficial. At the heart of these changes is a shifting power distribution within the patient-clinician relationship. Some clinicians view OpenNotes as an opportunity to better partner with patients, whereas other...
Radical right-wing movements are resurging around the globe and thriving during global pandemic c... more Radical right-wing movements are resurging around the globe and thriving during global pandemic crises. Far-right leaders in India, Hungary, Philippines, Israel, Brazil, United States, United Kingdom and elsewhere have gained and retained power in recent years, despite involvement in massive corruption scandals and failing to deliver on campaign promises. From Trump's "America first" to Kaczyński's "there is only one Poland," expressions of ethnonationalism, right-wing populism, and authoritarianism are taking nightmarish form-especially during the COVID-19 pandemic (Edelman 2020). Strongmen regimes (Ben-Ghiat 2020) are building power through angry politics (Maskovsky and Bjork-James 2020) that polarize populaces, capitalize on catastrophe, and undermine democratic institutions. While not new, right-wing parties worldwide are advancing similar agendas in diverse historical, economic, cultural, and religious contexts that promote nationalist, xenophobic, demagogic, antifeminist, and majoritarian issues-and are doing so more successfully than any other political group in decades (Spierings et al. 2015). The global ascension of illiberal movements is experiencing a distinct "moment" (Mouffe 2018) in the twenty-first century-and reproductive politics are at its center.
iii Acknowledgments v List of Tables and Figures ix Introduction Saving: 1 Freezing Reproductive ... more iii Acknowledgments v List of Tables and Figures ix Introduction Saving: 1 Freezing Reproductive Remainders for the Future Chapter 2 Culturing: 56 Making Potential in an IVF Clinic Chapter 3 Wasting: 94 Making Embryo Trash and Treasure in a Stem Cell Lab Chapter 4 Rescuing: 149 Making Embryo Orphans in a Christian Adoption Program Chapter 5 Sorting: 208 Archiving Embryos for Viable Futures Chapter 6 Redeeming: 251 Claiming Potential Makes Moral Cents Conclusion What Remains 276
Background Studies have proven that lack of access to menstruation products negatively affects sc... more Background Studies have proven that lack of access to menstruation products negatively affects school attendance, academic performance, and individual health. Implementation of “period policies,” or programs offering free menstruation products, are becoming popular in schools, businesses, and communities in high income countries. U.S. based [Blinded University] announced in February 2020 that free pads and tampons would be stocked in all women’s and gender-neutral restrooms in campus buildings. The purpose of this study was to capture the experiences of menstruators about free menstrual products and the impact of a university-wide free menstruation management product policy and program. A second purpose was to understand how access to menstrual management products is intertwined with broader socio-cultural experiences of a menstruator. Methods As part of a larger study, virtual focus group discussions (n = 32 across 5 focus groups) were conducted in February 2021. Eligible participa...
Conform traditiei legilor nescrise, exista un principiu ce interzice proprietatea asupra corpului... more Conform traditiei legilor nescrise, exista un principiu ce interzice proprietatea asupra corpului uman. Luând in considerare proprietatea ca fiind un concept proteic, lucrarea de fata examineaza modul in care proprietatea este definita si aplicata in dispute legislative recente, purtate in S.U.A, privind entitatiile „cu o viata potentiala", precum sunt embrionii si fetusii. O scurta trecere in revista a abordarilor teoretice si a legilor nescrise, toate privind proprietatea asupra trupului, este urmata de o analiza a sase cazuri legale din S.U.A, in cadrul carora sperma, zigotii, embrionii si fetusii au devenit noi subiecte legale, pe fundalul tenologiilor reproductive asistate. Studiul de fata conchide ca proprietatea este functionala nu numai in scopul de a privatiza, a comodifica si a face sa circule, ci in scopul de a aduce entitatiile „cu viata potentiala" mai aproape de oameni si de a le implica mai adanc in retelele relationale.
The journal of pain : official journal of the American Pain Society, 2018
The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain ... more The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain by encouraging routine pain assessment and management. In the Veterans Health Administration, routine pain screening has been practiced in primary care for more than a decade, but has not improved the quality of pain management measured using several process indicators, and some have expressed concerns of potentially fostering undesirable use of prescription opioids. We sought to evaluate the consequences of routine pain screening on clinical practice. We conducted 9 interdisciplinary focus groups with 60 primary care providers and staff from 5 outpatient Veterans Health Administration clinics. We identified 5 themes reflecting 1 intended and 4 unintended consequences of routine pain screening: it 1) facilitates identification of patients with pain who might otherwise be overlooked, 2) may need to be targeted toward specific patients and contexts rather than universally applied, 3) often...
Journal of medical Internet research, Jan 14, 2017
As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides v... more As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings. The aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care. We conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses. Transcripts were analyzed using a thematic analysis approach, which allows for both inductive and deductive themes to be explored using an iterative, constant comparative coding process. OpenNotes is changing VHA mental health care in ways that mental health clinicians perceive as both challenging and beneficial. At the heart of these changes is a shifting power distribution within the patient-clinician relationship. Some clinicians view OpenNotes as an opportunity to better partner with patients, whereas other...
The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain by encoura... more The "Pain as the 5th Vital Sign" initiative intended to address undertreatment of pain by encouraging routine pain assessment and management. In the Veterans Health Administration, routine pain screening has been practiced in primary care for more than a decade, but has not improved the quality of pain management measured using several process indicators, and some have expressed concerns of potentially fostering undesirable use of prescription opioids. We sought to evaluate the consequences of routine pain screening on clinical practice. We conducted 9 interdisciplinary focus groups with 60 primary care providers and staff from 5 outpatient Veterans Health Administration clinics. We identified 5 themes reflecting 1 intended and 4 unintended consequences of routine pain screening: it 1) facilitates identification of patients with pain who might otherwise be overlooked, 2) may need to be targeted toward specific patients and contexts rather than universally applied, 3) often shifts visit focus away from more emergent concerns, 4) may encourage "false positives" and prompt providers to intervene when treatment is not a priority, and 5) engenders a "pain problem" and hinders patients from considering alternative strategies. These findings suggest changes to support patient-centered pain assessment and improve targeted screening and interventions for population pain management. Perspective: This article describes some of the potential unintended consequences of implementing routine pain screening in primary care. This information may help clinicians be more strategic in their consideration and use of pain screening among their patients.
BACKGROUND:
As part of the national OpenNotes initiative, the Veterans Health Administration (VHA... more BACKGROUND: As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings.
OBJECTIVE: The aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care.
METHODS: We conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses. Transcripts were analyzed using a thematic analysis approach, which allows for both inductive and deductive themes to be explored using an iterative, constant comparative coding process.
RESULTS: OpenNotes is changing VHA mental health care in ways that mental health clinicians perceive as both challenging and beneficial. At the heart of these changes is a shifting power distribution within the patient-clinician relationship. Some clinicians view OpenNotes as an opportunity to better partner with patients, whereas others feel that it has the potential to undo the therapeutic relationship. Many clinicians are uncomfortable with OpenNotes, but acknowledge that this discomfort could both improve and diminish care and documentation practices. Specifically, we found that (1) OpenNotes is empowering patients, (2) OpenNotes is affecting how clinicians build and maintain the therapeutic relationship, and (3) mental health clinicians are adjusting their practices to protect patients and themselves from adverse consequences of OpenNotes.
CONCLUSIONS: Our findings suggest that future research should monitor whether OpenNotes notes facilitates stronger patient-clinician relationships, enhancing patient-centered mental health care, or diminishes the quality of mental health care through disruptions in the therapeutic relationship and reduced documentation.
Objective:
This study explored patient perspectives of how online access to clinical notes (OpenN... more Objective: This study explored patient perspectives of how online access to clinical notes (OpenNotes) within the Veterans Affairs (VA) health care system may affect patients’ relationships with their mental health clinicians.
Methods: Semistructured qualitative interviews were conducted with 28 patients receiving VA mental health care who had accessed OpenNotes. Transcripts were coded and analyzed with a constant comparative approach.
Results: Respondents consistently reported that patient-clinician relationships—feelings of trust in particular—are critical to the therapeutic process and that reading clinical notes strengthens or strains patients’ trust in mental health clinicians. Perceptions of transparency and respect as conveyed in notes were central to maintaining trust.
Conclusions: Findings suggest that ensuring consistency between what occurs during appointments and what appears in clinical notes, as well as highlighting patient individuality and strengths in notes, may help engender patient trust and avoid negative consequences of OpenNotes in mental health care.
International Journal of Quality in Health Care, 2016
Objective
Enhanced patient involvement in care has the potential to improve patient experiences a... more Objective Enhanced patient involvement in care has the potential to improve patient experiences and health outcomes. As such, large national and global healthcare systems and organizations, including the US Department of Veterans Affairs (VA), have made patient-centered care a primary goal. Little is known about mental health clinician perspectives on, and experiences with, providing patient-centered care. Our main objective was to better understand VA mental health clinicians' perceptions of patient-centered care, and ascertain possible facilitators and barriers to patient-centered practices in mental health settings.
Design Qualitative study of six focus groups conducted in late 2013.
Setting and participants Thirty-five mental health clinicians and staff from a large VA Medical Center.
Outcomes Transcripts were analyzed using an inductive and deductive thematic analysis approach.
Results Participants described patient-centered care ideally as a process of shared discovery, and expressed general enthusiasm for patient-centered care. Participants described several ongoing patient-centered care practices but conveyed concerns about the practicalities of its full implementation. Participants expressed a strong desire to change the current biomedical culture and policies of the institution that may hinder clinicians' flexibility and clinician–clinician collaboration when serving patients. In particular, clinicians worried about being held responsible for addressing all of the needs or goals that a patient may identify.
Conclusions If patient-centered care is to be practiced fully in mental health settings, healthcare institutions need to develop multimodal strategies to enhance clinician–clinician and clinician–patient collaborations to promote and support a focus on discovery and shared accountability for outcomes.
Denneson, L., Cromer, R., Jacobson, L., Teo, A., Dobscha, S.
Military Behavioral Health.
The su... more Denneson, L., Cromer, R., Jacobson, L., Teo, A., Dobscha, S. Military Behavioral Health.
The suicide rate among female veterans increased 40% between 2000 and 2010, yet very little research has examined the unique psychosocial and health needs of veteran women at high risk for suicide. We describe female veterans’ psychosocial experiences, primary health concerns, and health care received prior to suicide to identify areas for future efforts to improve care and reduce suicide in this population. We conducted a qualitative analysis of the Veterans Affairs (VA) health care records of 27 female veterans, drawn from 11 states, during the six months prior to suicide. The women were mostly White, non-Hispanic, and not married, with an average age of 44 (range 26 to 67). We identified several common experiences: non-military-related trauma, lack of supportive relationships, substance use disorders, and prescription of multiple sedatives. We also observed that communication between patients and clinicians may have been insufficient, resulting in undetected or unmet needs. The findings call for additional research to better understand the frequency and impact of these experiences for women veterans and suggest that enhancing patient-centered and trauma-sensitive care, as well as improving outreach and continuity in care, may reduce instances of unmet needs.
OBJECTIVE:
To describe Department of Veterans Affairs (VA) mental health clinician attitudes towa... more OBJECTIVE: To describe Department of Veterans Affairs (VA) mental health clinician attitudes toward and experiences with OpenNotes (also known as Blue Button), which provides patients direct access to clinical notes online.
METHOD: A 35-item online survey was administered to 263 mental health clinicians and nurses from one VA Medical Center.
RESULTS: Seventy-nine percent of eligible subjects participated. Most respondents agreed or somewhat agreed that OpenNotes is a good idea in general, but only half agreed that making mental health notes available online is a good idea. Most believed that patients will better remember plans of care and be better prepared for visits. Most also felt that patients will worry more and request changes in notes. Many clinicians reported being less detailed and changing the tone of their notes.
CONCLUSION: As a group, mental health clinicians are positive about OpenNotes in general but ambivalent about the use of OpenNotes in mental health care. The results call for research on outcomes of OpenNotes use in mental health and to develop education and support to help clinicians adapt to OpenNotes.
A “Hope Box” is a therapeutic tool employed by clinicians with patients who are having difficulty... more A “Hope Box” is a therapeutic tool employed by clinicians with patients who are having difficulty coping with negative thoughts and stress, including patients who may be at risk of suicide or nonsuicidal self-harm. We conducted a proof-of-concept test of a “Virtual” Hope Box (VHB)—a smartphone app that delivers patient-tailored coping tools. Compared with a conventional hope box integrated into VA behavioral health treatment, high-risk patients and their clinicians used the VHB more regularly and found the VHB beneficial, useful, easy to set up, and said they were likely to use the VHB in the future and recommend the VHB to peers.
The Reproductive Righteousness Project is a new initiative launched to explore the ways in which ... more The Reproductive Righteousness Project is a new initiative launched to explore the ways in which families, fertility and reproduction have become increasingly important discursive moral devices through which right wing populist leaders invoke the threat of national, social and cultural decline. From Trump's "America first" to Kaczyński's "there is only one Poland," expressions of ethno-nationalism, right-wing populism, and authoritarianism are increasingly central to rightwing authoritarian regimes. This project brings together feminist scholars with wide-ranging expertise to collaboratively theorize expressions of what we call "reproductive righteousness." The project is interdisciplinary, comparative, and global in scope. We take a critical approach that incorporates intersectional feminist, queer, and reproductive justice perspectives, and questions normative assumptions about reproduction, gender, religion, race and the state.
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Papers by Risa Cromer
As part of the national OpenNotes initiative, the Veterans Health Administration (VHA) provides veterans online access to their clinical progress notes, raising concern in mental health settings.
OBJECTIVE:
The aim of this study was to examine the perspectives and experiences of mental health clinicians with OpenNotes to better understand how OpenNotes may be affecting mental health care.
METHODS:
We conducted individual semi-structured interviews with 28 VHA mental health clinicians and nurses. Transcripts were analyzed using a thematic analysis approach, which allows for both inductive and deductive themes to be explored using an iterative, constant comparative coding process.
RESULTS:
OpenNotes is changing VHA mental health care in ways that mental health clinicians perceive as both challenging and beneficial. At the heart of these changes is a shifting power distribution within the patient-clinician relationship. Some clinicians view OpenNotes as an opportunity to better partner with patients, whereas others feel that it has the potential to undo the therapeutic relationship. Many clinicians are uncomfortable with OpenNotes, but acknowledge that this discomfort could both improve and diminish care and documentation practices. Specifically, we found that (1) OpenNotes is empowering patients, (2) OpenNotes is affecting how clinicians build and maintain the therapeutic relationship, and (3) mental health clinicians are adjusting their practices to protect patients and themselves from adverse consequences of OpenNotes.
CONCLUSIONS:
Our findings suggest that future research should monitor whether OpenNotes notes facilitates stronger patient-clinician relationships, enhancing patient-centered mental health care, or diminishes the quality of mental health care through disruptions in the therapeutic relationship and reduced documentation.
This study explored patient perspectives of how online access to clinical notes (OpenNotes) within the Veterans Affairs (VA) health care system may affect patients’ relationships with their mental health clinicians.
Methods:
Semistructured qualitative interviews were conducted with 28 patients receiving VA mental health care who had accessed OpenNotes. Transcripts were coded and analyzed with a constant comparative approach.
Results:
Respondents consistently reported that patient-clinician relationships—feelings of trust in particular—are critical to the therapeutic process and that reading clinical notes strengthens or strains patients’ trust in mental health clinicians. Perceptions of transparency and respect as conveyed in notes were central to maintaining trust.
Conclusions:
Findings suggest that ensuring consistency between what occurs during appointments and what appears in clinical notes, as well as highlighting patient individuality and strengths in notes, may help engender patient trust and avoid negative consequences of OpenNotes in mental health care.
Enhanced patient involvement in care has the potential to improve patient experiences and health outcomes. As such, large national and global healthcare systems and organizations, including the US Department of Veterans Affairs (VA), have made patient-centered care a primary goal. Little is known about mental health clinician perspectives on, and experiences with, providing patient-centered care. Our main objective was to better understand VA mental health clinicians' perceptions of patient-centered care, and ascertain possible facilitators and barriers to patient-centered practices in mental health settings.
Design
Qualitative study of six focus groups conducted in late 2013.
Setting and participants
Thirty-five mental health clinicians and staff from a large VA Medical Center.
Outcomes
Transcripts were analyzed using an inductive and deductive thematic analysis approach.
Results
Participants described patient-centered care ideally as a process of shared discovery, and expressed general enthusiasm for patient-centered care. Participants described several ongoing patient-centered care practices but conveyed concerns about the practicalities of its full implementation. Participants expressed a strong desire to change the current biomedical culture and policies of the institution that may hinder clinicians' flexibility and clinician–clinician collaboration when serving patients. In particular, clinicians worried about being held responsible for addressing all of the needs or goals that a patient may identify.
Conclusions
If patient-centered care is to be practiced fully in mental health settings, healthcare institutions need to develop multimodal strategies to enhance clinician–clinician and clinician–patient collaborations to promote and support a focus on discovery and shared accountability for outcomes.
Military Behavioral Health.
The suicide rate among female veterans increased 40% between 2000 and 2010, yet very little research has examined the unique psychosocial and health needs of veteran women at high risk for suicide. We describe female veterans’ psychosocial experiences, primary health concerns, and health care received prior to suicide to identify areas for future efforts to improve care and reduce suicide in this population. We conducted a qualitative analysis of the Veterans Affairs (VA) health care records of 27 female veterans, drawn from 11 states, during the six months prior to suicide. The women were mostly White, non-Hispanic, and not married, with an average age of 44 (range 26 to 67). We identified several common experiences: non-military-related trauma, lack of supportive relationships, substance use disorders, and prescription of multiple sedatives. We also observed that communication between patients and clinicians may have been insufficient, resulting in undetected or unmet needs. The findings call for additional research to better understand the frequency and impact of these experiences for women veterans and suggest that enhancing patient-centered and trauma-sensitive care, as well as improving outreach and continuity in care, may reduce instances of unmet needs.
To describe Department of Veterans Affairs (VA) mental health clinician attitudes toward and experiences with OpenNotes (also known as Blue Button), which provides patients direct access to clinical notes online.
METHOD:
A 35-item online survey was administered to 263 mental health clinicians and nurses from one VA Medical Center.
RESULTS:
Seventy-nine percent of eligible subjects participated. Most respondents agreed or somewhat agreed that OpenNotes is a good idea in general, but only half agreed that making mental health notes available online is a good idea. Most believed that patients will better remember plans of care and be better prepared for visits. Most also felt that patients will worry more and request changes in notes. Many clinicians reported being less detailed and changing the tone of their notes.
CONCLUSION:
As a group, mental health clinicians are positive about OpenNotes in general but ambivalent about the use of OpenNotes in mental health care. The results call for research on outcomes of OpenNotes use in mental health and to develop education and support to help clinicians adapt to OpenNotes.