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October 18, 2016

The Ethics of Behavioral Health Information TechnologyFrequent Flyer Icons and Implicit Bias

Author Affiliations
  • 1Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 2Thomas Scattergood Behavioral Health Foundation, Philadelphia, Pennsylvania
  • 3Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA. 2016;316(15):1539-1540. doi:10.1001/jama.2016.12534

A subpopulation of individuals with serious mental health conditions makes repeated and frequent visits to emergency departments and psychiatric crisis centers. These so-called super utilizers often have financial problems and present with chronic or untreated comorbid psychiatric and substance use disorders.1 These patients are often well known to clinical staff and are sometimes colloquially labeled “frequent flyers.” A pejorative branding, “frequent flyers” are often assumed to be problem patients. In psychiatric settings, these patients are sometimes said to be “borderlines,” “drug seekers,” “malingerers,” or “treatment resistant.”

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