ACT Psych Flashcards
What are the basic conditions for detainment under the mental health act
Must be suffering from a mental disorder
Must be a risk to self/others
Must be unwilling to go to hospital voluntarily
All alternatives have been considered
Cannot be detained willingly if lack capacity
Describe Section 2 of the Mental Health act
ADMISSION FOR ASSESSMENT
Needs an AMHP and 2 Doctors (1 approved)
Up to 28 days, no renewal
Appeal within first 14 days
Describe Section 3 of the Mental Health act
ADMISSION FOR TREATMENT
Needs an AMHP and 2 Doctors (1 approved)
Up to 6 months, renewal available
Can be appealed twice in first 6 months and then yearly
For treatment of mental disorder, cause of disorder or consequence
NO OTHER TREATMENT
Describe Section 4 of the Mental Health act
URGENT ADMISSION For urgent admission and unable to complete Section 2 Needs an AMHP and any registered doctor Up to 72 hours Convert to Section 2 No treating powers
Describe Section 5 (2) of the Mental Health act
DOCTOR’S HOLDING POWER In-patients only - must be admitted to bed Holding power for MHA assessment Lasts up to 72 hours No right to treat Application by consultant or deputy
Describe Section 5 (4) of the Mental Health act
NURSE’S HOLDING POWER
In-patients only - must be admitted to bed
Holding power for MHA assessment
Lasts up to 6 hours
Describe Section 135 of the Mental Health act
SEARCH WARRANT
Warrant to search and remove patient from property
Police only
Describe Section 136 of the Mental Health act
PUBLIC SAFETY
If found in public place - take to a place of safety
Police only
Lasts 72 hours
Structure of a depression history
Low mood – Anhedonia – Low energy Concentration? Sex drive? Sleep? Appetite? Explore Biopsychosocial causes Assess RISK PPHx, PMHx, DHx, FHx, SHx
Structure of suicide risk assessment
Do you ever feel hopeless?
Do you feel like life isn’t worth living?
Have you ever thought about ending your life?
- Have you made plans?
- Protective factors?
Have you thought about harming others?
Structure of Self harm history
Sequence of events: Before – During – After
Previous attempts - Asses RISK
PPHx, PMHx, DHx, FHx, SHx
Management of Suicide or Parasucide
Full history and examination
Medically treat poisoning or injuries - TOXBASE
Discuss confidentiality - ?speak to family/friends
Must have Psychiatric needs and risk assessment
Section 5 (2) can be used to detain if necessary
If discharging:
- Provide crisis team contact details
- Utilise protective factors eg. Family
- Arrange follow up
Describe Dementia, it subtypes and their aetiology
A progressive, degenerative disease of the brain resulting in difficulty with communication, memory and learning
Alzheimers - sporadic, genetic
Vascular - 15% Cardiovascular risk factors
Lewybody - 15% linked to Parkinsonism
5% Rare: HIV, Huntingtons, CJD,
Pick’s disease - atrophy of frontal and temporal lobes
Describe the pathophysiology of Alzheimer disease
Macroscopic: widespread cerebral atrophy
Microscopic: cortical plaques due to deposition of type A-Beta-amyloid protein and intraneuronal neurofibrillary tangles caused by abnormal aggregation of the tau protein
Biochemical: a deficiency of acetylcholine
Describe the pathophysiology of vascular dementia
Reduced blood supply to the brain caused by atherosclerosis and occlusion of blood vessels due to thrombus formation.
Further classified into: Stroke related and Subcortical
Associated with cardiovascular risk factors