Behavioral Health - Severe Risk Condition

[miketsp]

I have just been re-reading the UHMS guidelines to doctors for diver medical approval and was surprised to see that in the Behavioral Health section, classed as "Severe Risk Condition" is
• Inappropriate motivation to dive – solely to please spouse, partner or family member,

Given that nowadays, many partners participate in their spouses activities and this can be motivating in itself, I found this "Severe Risk" a little exaggerated.

Do you agree that this should be sufficient motive for a doctor to bar someone from diving?

 

[Uncle Pug]

Can doctors in Brazil bar people from diving?

 

[miketsp]

Can doctors in Brazil bar people from diving?

Not in the sense of black-listing, but you need to get a doctor to sign off a medical certificate for you to do your basic training. So you may have to shop around to find one that will sign.
Many schools nowadays require the certificate from a particular doctor as they had problems in the past with false declarations.

I used to have the same problem when renewing my Amateur Masters ticket for my boat. The navy required a medical certificate which simply stated "Apt for Navigation - YES / NO" and there were no published guidelines.

Nowadays I have no problems as the company where I work pays for a complete annual checkup which takes about 6 hours and includes just about everything and then at the final interview I ask the doc to sign off various declarations whether I expect to need them or not in the next 12 months.

 

[Spratman]

I was just reviewing this over on DAN, because of the thread that was running on Depression and Diving. I'm a bipolar 2 and have been on medication for three years, and will continue to do so for the rest of my life.

Having said that, I was in to see my shrink last night, and asked him to comment on the subject. He told me that if he thought that I was a severe risk (suicidal, sociopath, etc), he wouldn't even let me drive a car. So, his opinion is that I would be less of a risk diving, because I would kill a lot more people in a car than in the water. Anyway, if I were going to kill myself, it would be in a much quicker fashion. I sure as hell wouldn't want to drown.

It is something that I have foremost in my mind when diving. And actually, I was more concerned about narcosis, than anything else. I feel confident when I get in the water, that I can keep things under control, and be a safe diver. By nature, I'm a self control freak anyway.

I think that what the papers and articles that I've read, to include your thread title, has more to do with people who are not under a doctor's care and not on medication. I'm sure that my doctor would nix me in a heart beat if he had any inkling of danger to myself or others. It's a stigma that is attached to the person. It's taken me three years to come to grips with the fact that something is wrong with my brain. (chemical imbalance) If you tell people that you have diabetes or cancer, that's okay and they will sympathize. If you tell people that you are suffering from mental disorders, they think of the Bate's Motel...;-)

Anyway, that's my $.02 on the subject. I would hope that I am the kind of diver that anyone wouldn't hestiate to have as a dive buddy.

Jack

 

[scubaPT]

• Inappropriate motivation to dive – solely to please spouse, partner or family member

Do you agree that this should be sufficient motive for a doctor to bar someone from diving?

I do think it should be taken into consideration.
My spouse does not dive and is not very comfortable swimming underwater or snorkeling, but she has stated that she would get certified if I wanted her to. My response was a resounding NO, because I see this as a safety issue. The person seeking the certification should be doing it for themself, the desire to dive should be their focus, not pleasing a spouse or partner.

 

[diverbrian]

I was just reviewing this over on DAN, because of the thread that was running on Depression and Diving. I'm a bipolar 2 and have been on medication for three years, and will continue to do so for the rest of my life.

Having said that, I was in to see my shrink last night, and asked him to comment on the subject. He told me that if he thought that I was a severe risk (suicidal, sociopath, etc), he wouldn't even let me drive a car. So, his opinion is that I would be less of a risk diving, because I would kill a lot more people in a car than in the water. Anyway, if I were going to kill myself, it would be in a much quicker fashion. I sure as hell wouldn't want to drown.

It is something that I have foremost in my mind when diving. And actually, I was more concerned about narcosis, than anything else. I feel confident when I get in the water, that I can keep things under control, and be a safe diver. By nature, I'm a self control freak anyway.

I think that what the papers and articles that I've read, to include your thread title, has more to do with people who are not under a doctor's care and not on medication. I'm sure that my doctor would nix me in a heart beat if he had any inkling of danger to myself or others. It's a stigma that is attached to the person. It's taken me three years to come to grips with the fact that something is wrong with my brain. (chemical imbalance) If you tell people that you have diabetes or cancer, that's okay and they will sympathize. If you tell people that you are suffering from mental disorders, they think of the Bate's Motel...;-)

Anyway, that's my $.02 on the subject. I would hope that I am the kind of diver that anyone wouldn't hestiate to have as a dive buddy.

Jack

I would bet that you are that kind of diver. You are considerate. As another member of the dive community that uses medication (an SSRI antidepressant), I know what you are saying. I also have a friend with bi-polar disorder that dives. There are doctors that have a valid point that we don't know the interaction of these drugs on the high partial pressures of various gases in our breathing mix at depth. These doctors have a point. But, if you were to check my profile, you would see that it doesn't keep me from diving. As a matter of fact, I am taking a normoxic tri-mix course right now and my instructor is an MD.

My theory is that there are many in things in life that we don't know. I take a risk driving to work and running the machinery in the production area. My diving (even to 200 ft.) is more of a calculated risk than many other things that I do in life. My limits should be my decision, as long as I have the information necessary to make that decision. This is the same as dealing with chemicals at work and the other things that I do.

I do believe that it is incumbent on the instructor rather than a doctor to "ground" a new diver for what I consider a bad reason to learn diving. We haven't had a person make it through our OW that took the course ONLY to please their significant other.

 

[Spratman]

thanks for the encouraging words. I agree, that the instructor should bag you if you demostrate some unsafe act, and show some inability to understand the instruction. I would expect that.

I guess I sorta got off point and that wasn't my intention. Sorry, miketsp.

My wife seems to feel that she needs to do this, since I am doing it. Last year, when I decided to get certified, it turned out pretty well. She sat around the pool reading, taking a dip, having the pool guy bring her pina colada's, and then she was doing ceramics! Well, I wasn't arguing. She did willingly go out on the dive boat when I did my second dive. She stated getting motion sickness when the boat was anchored. One of the young divemaster's asked her if she wanted to snorkel. So, she put on a vest, got into the water and was spell bound, by all the fish and seeing me floating along the bottom. Then she really got sick from bobbing in the water....One of the other DM's was watching another snorkeler (not one of our's) barfing her guts out in the water. So, seeing my wife a bit green around the gills, started talking to her. He said that he could make her a very large pan of scrambled eggs if she was hungry, and that nearly made her yak! LOL!! I thought it was really funny! She told the guy to bugger off or something, and he made a flying somersault over the railing laughing the whole time.

Sorry, I digress. If she does get certified it will be of her own volition, not my prompting. I've been eyeing up an Aggressor trip and she wants to go along. I'm afraid that she'll be sick the entire time out there, particularly if we run into some rough whether.

I've thought about a trip to the lakes to try diving. I'd like to see what the water is like up there.

I hope things continue to go well for you.

Jack

 

[miketsp]

I do think it should be taken into consideration.
My spouse does not dive and is not very comfortable swimming underwater or snorkeling, but she has stated that she would get certified if I wanted her to. My response was a resounding NO, because I see this as a safety issue. The person seeking the certification should be doing it for themself, the desire to dive should be their focus, not pleasing a spouse or partner.

I agree that nobody should do it just because they feel an obligation, but I've seen a lot of spouses start off with doubts, because they do feel an obligation, but then get really enthusiastic when they see how enjoyable it can be.

 

[Damselfish]

I think it should be taken into consideration, but I don't think a doctor is the right person to make a call on this. (A suggestion that it's not a good idea, perhaps.)

 

[Spratman]

Hmm, but I would beg to differ. If a dive operator or instructor is going to base their decision because of the list of meds that I take, that is not a judgement that can be made by them. If that were the case, I would never get under the surface. I would think that it's a matter of liability for them, rather than a safety issue.

As stated above, the articles that are posted under Psychiatry on DAN, it alluded specifically to short term problems and non-treatment.

So, are you telling me that you wouldn't want me for a dive buddy?!