Block 33 H&S Flashcards

Question 1

Q

How many elements are there to negligence?

Answer

A

3
individual to be successfully sued, each must be proved.

Question 2

Q

Negligence: duty of?

Answer

A

A duty of care must be proven between the health authority, individual professional and the patient.

Question 3

Q

Negligence: breach?

Answer

A

A breach in the duty of care must be proven

Question 4

Q

Negligence: damage?

Answer

A

There must be evidence of damage caused by the breach

Question 5

Q

When should confidentiality be broken?

Answer

A

Protect children
Protect public – e.g. from acts of terrorism
Required by courts
Prevent or detect a crime
Provide care in life-threatening circumstances
Protect the service provider in life-threatening circumstances

Question 6

Q

Right to life?

Answer

A

The European court has held that the article requires hospitals to take measures to ensure steps are in place to secure an individual’s right to life = mostly relevant with
regards to suicide

Question 7

Q

Prohibition of torture (human rights act)

Answer

A

Have to justify medical treatment (as side effects / process e.g. ECT) could be classified as torture
Relevant to MHA as could give patient cheaper drug with worse side effects (can’t do this), or give drug instead of psychological thera

Question 8

Q

right to liberty and security?

Answer

A

cannot take away right to freedom without good reason

Question 9

Q

right to a fair trial?

Answer

A

:
* Everyone sectioned has the right to a mental health review tribunal hear

Question 10

Q

independent MH advocate =

Answer

A

Allocated worker to support pt, allow them to express their views and concerns and to defend their rights

Question 11

Q

independent mental capacity advocate =

Answer

A

Support people who lack capacity to make certain decisions are provided under the MCA 2005

Question 12

Q

discrediting stigma =

Answer

A

keeping stigmatising conditions hidden except from close family and friends

Question 13

Q

Discreditin stigma =

Answer

A

keeping stigmatising conditions hidden except from close family and
friends

Question 14

Q

felt stigma =

Answer

A

sense of fear due to ones conditions

Question 15

Q

enacted stigma =

Answer

A

physical act of displaying stigma

Question 16

Q

Courtesy stigma =

Answer

A

Stigma felt by someone who is with a person open to stigma e.g. parent
of a child w/ autism

Question 17

Q

Equality act 2010?

Answer

A

makes it illegal to discriminate directly or indirectly against people with
mental health problems in public services and functions, access to premises, work,
education and transport`

Question 18

Q

Crisis team?

Answer

A

Support mental health crises in the community e.g. suicidal thoughts, self-harm, experiencing psychosis, severe panic attacks, putting others at risk
Offer short term support to prevent hospital admission or can arrange for pt to go to hospital if pt is very unwell
May offer medication, arrange regular visits, make sure pt is in touch with other services to get long term support

Question 19

Q

Early intervention in psychosis team?

Answer

A

Can support a pt 14-35 years old if they experience psychosis for the first time or are at risk of experiencing psychosis (primary or from drug use)
- Pts can be supported by the team for up to 3 years

Question 20

Q

what can the early intervention in psychosis teams do?

Answer

A

Provide self-management skills, housing and debt management, employment support, relapse prevention work, psychological and pharmacological
interventions, carer’s assessments, crisis plan, regular checks and monitoring

Question 21

Q

OAT?

Answer

A

Give intensive support because of complex mental health needs who aren’t engaging effectively with mental health services
Aim to reduce hospital admission
Help with daily living, taking medication, psychological therapy, social support, physical health, finding suitable accommodation, access crisis support
quickly, care plan for family and carers

Question 22

Q

peak onset of depression?

Answer

A

50% of cases occur under 40
peak onset 25-40

Question 23

Q

peak onset for depresion w psychotic features?

Question 24

Q

which ethnic gr has a 4x higher rate of psychosis?

Answer

A

afro-carribean

Question 25

Q

Carers act?

Answer

A

carers act 1995
carers have right to assessment of own needs even if the person they care for refuses

Question 26

Q

help for carers - carers assessment?

Answer

A

Carers assessment - receive a community care assessment to establish how much support from social services they are entitled to
Could mean carer is entitled to personal care assistance - e.g. having someone help pt to wash, adaptations being made to home, respite care

Question 27

Q

Carers UK?

Answer

A

Provide support for carers especially those having difficulty adjusting/ coping with changes in their life

Question 28

Q

carers online support?

Answer

A

online forums
carers support groups
carer’s direct helpline

Question 29

Q

Bed wetting?

Answer

A

Normal for children <6 even if “toilet-trained”
Exclude a physical problem
Educate parent about appropriate toilet training methods

Question 30

Q

Temper tantrums?

Answer

A

normal as a toddler
school refusal could be due to anxiety

Question 31

Q

origins of addiction - predisposing and precipitating factors?

Answer

A

genetics
learned acceptable behaviours
occupation - high in unskilled labourers
stressful life events
males > females

Question 32

Q

maintenance - perpetuating factors in mental illness?

Answer

A

negative reinforcement - taking drug removes negative side effects of withdrawal
psychological - tolerance develops

Question 33

Q

Addiction =

Answer

A

continued repitition of a behaviour, despite adverse consequences

Question 34

Q

What is dependence?

Answer

A

take a substance, and your body becomes dependent

Question 35

Q

what are the symptoms of dependence syndrome?

Answer

A

salience
compulsion
tolerance
withdrawal upon absitnence
resinstatement upon abstinence

Question 36

Q

Salience =

Answer

A

substance takes priority over other behaviours

Question 37

Q

MI 4 principles?

Answer

A

express empathy by using reflective listening
develop discepancy between pt’s values and current behaiours
sidestep resistance with empathy and understanding
support self effiacy by building pt’s confidence

Question 38

Q

Non NHS agencies in MH?

Answer

A

MIND
samaritans
childline

Question 39

Q

reasons why people self harm?

Answer

A

Cry for help
Escape from intolerable situation
Relief from state of mind
Attempt to influence others
Testing the benevolence of fate

Question 40

Q

higher suicide rates?

Answer

A

unemployed
uni students
doctors
lawyers
farmers
politicians

Question 41

Q

List the members of the community MH team?

Answer

A

Psychiatrists
Psychologists
Social workers
Occupation therapists
Community psychiatric nurses
Peer support workers

Question 42

Q

Roles of the community MH team?

Answer

A

Psychiatrists
Assessment and diagnosis of mental health conditions
Prescribing meds
Treatment planning

Question 43

Q

Psychologists?

Answer

A

CBT and other psychological interventions
Psychological assessments and evaluations

Question 44

Q

role of community psychiatric nurses?

Answer

A

Ongoing support and care to indiv in the community
Monitor symptoms and medication adherence
Education and guidance

Question 45

Q

role of social workers?

Answer

A

Assessing social and envir factors impacting MH
Providing support with housing, finances and benefits
Facilitate access to community resources and services

Question 46

Q

role of occupational therapists?

Answer

A

Assess indiv functional ability and daily living skills
Provide interventions to improve independence

Question 47

Q

what does the mental health act allow for?

Answer

A

The mental health act (2007) allows for the compulsory detention of those who are mentally ill

Question 48

Q

section 2 of the mental health act lasts for…

Answer

A

Lasts 28 days max, not renewable

Question 49

Q

section 2 allows for?

Answer

A

Admission for assessment
Treatment can be given against patient’s wishes

Question 50

Q

who applies for a section 2?

Answer

A

AMHP makes the application based on the recommendations of 2 doctors
One of the doctors should be approved under section 12(2) – usually consultant psychiatrist

Question 51

Q

what is a section 3?

Answer

A

Admission for treatment
Up to 6 months but can be renewed
Tx can be given against ppt’s wishes

Question 52

Q

who applies for a section 3?

Answer

A

AMHP along with 2 doctors

Question 53

Q

section 4 is a ?

Answer

A

72 hour assessment order
Used as an emergency when a section 2 would involve an unacceptable delayw

Question 54

Q

who applies for a section 4?

Answer

A

GP and an AHMP

Question 55

Q

what is section 4 often changed to?

Answer

A

Often changed to a section 2 on arrival at hosp

Question 56

Q

section 5(2)?

Answer

A

a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours

Question 57

Q

section 5(4)?

Answer

A

similar to section 5(2), allows a nurse to detain a patient who is voluntarily in hospital for 6 hours
Sec

Question 58

Q

section 17a?

Answer

A

Supervised Community Treatment (Community Treatment Order)
can be used to recall a patient to hospital for treatment if they do not comply with conditions of the order in the community, such as complying with medication
Sec

Question 59

Q

section 135?

Answer

A

a court order can be obtained to allow the police to break into a property to remove a person to a Place of Safety
Sec

Question 60

Q

section 136?

Answer

A

someone found in a public place who appears to have a mental disorder can be taken by the police to a Place of Safety
can only be used for up to 24 hours, whilst a Mental Health Act assessment is arranged

Question 61

Q

under which sections can people not be treated?

Answer

A

section 135
section 136

Question 62

Q

common law?

Answer

A

used to treat patients in emergency scenarios

Question 63

Q

MCA?

Answer

A

used in patients who require treatment for physical disorders that affect brain function.
Remember this may be delirium secondary to sepsis or a primary brain disorder such as dementia

Question 64

Q

MHA?

Answer

A

used in patients who require treatment for mental disorders.
For patients already admitted to hospital, a section 5(2) is used if there is not the time for a more formal section 2 or 3.

Answer 64

A

usually social workers
can also be nurses, OTs, psychologists, doctors, psychiatrists

Answer 65

A

Key symptoms:
* persistent sadness or low mood; and/or
* loss of interests or pleasure
* fatigue or low energy
* at least one of these, most days, most of the time for at least 2 weeks
* if any of above present, ask about associated symptoms:
o disturbed sleep
o poor concentration or indecisiveness
o low self-confidence
o poor or increased appetite
o suicidal thoughts or acts
o agitation or slowing of movements
o guilt or self-blame

Answer 66

A

<4 symptoms

Answer 67

A

4 symptoms

Answer 68

A

5 -6 symptoms

Answer 69

A

seven+ symptoms
with ot without psychotic symptoms

Answer 70

A

symptoms should be present for a month or more and every symptom should be present for most of every day

Answer 71

A

Excessive anxiety and worry, occurring more days than not for at least six months, about a number of events or activities.
The individual finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past six months):
* Restlessness or feeling keyed up or on edge.
* Being easily fatigued.
* Difficulty concentrating or mind going blank.
* Irritability.
* Muscle tension.
* Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not exclusively due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a mood disorder, psychotic disorder, or pervasive developmental disorder.

Answer 72

A

Recurrent panic attacks which are characterised by a discrete period of intense fear or discomfort, typically reaching a peak within minutes and during which time 4+ of the following symptoms occur:
Palpitations, pounding heart, or accelerated heart rate.
Sweating.
Trembling or shaking.
Sensations of shortness of breath or smothering.
Feelings of choking.
Chest pain or discomfort.
Nausea or abdominal distress.
Feeling dizzy, unsteady, lightheaded, or faint.
Chills or heat sensations.
Paresthesias (numbness or tingling sensations).
Derealization (feelings of unreality) or depersonalization (being detached from oneself).
Fear of losing control or going crazy.
Fear of dying.

Answer 73

A

Persistent concern or worry about individual panic attacks or their consequences
Significant maladaptive change in behaviour related to the attacks e.g. avoidance of situations

Answer 74

A

At least one of the following
Must be present for at least a month:
Delusions
Hallucinations
Disorganised speech
Grossly disorganised or catatonic behaviour
Negative symptoms such as avolition – lack of motivation

Answer 75

A

Schizoaffective disorder and mood disorder with psychotic features have been ruled out
Exclusion of organic causes
One of more major areas of functioning such as work, interpersonal realtions or self care are markedly reduced

Answer 76

A

Ensure safety of patient and staff
removal of weapons

Answer 77

A

conduct thorough mental state assessment
assess risk level
create risk management plan tailored to the patient’s indivdual needs

Answer 78

A

verbal techniques to reduce agitation
Calm and non confrontational demeanour

Answer 79

A

IM lorazapam
Haloperidol and other Aps

Answer 80

A

Conselling and other therapy aimed at improving social skills and anger management

Answer 81

A

Prevalence: Adult Psychiatric Morbidity survey – 19% of adults
Gender differences: women > men
Worlwide: 4%

Answer 82

A

Prev: 19%
Gender: women> men
Worldwide: 5%
280 million people worldwide

Answer 83

A

Proportion of people in a population who have a disease at a specific time period or over a specified period
Measure of the total burden of disease in the population

Answer 84

A

Includes new and existing cases

Answer 85

A

Influenced by duration of disease, incidence, rate of recovery or mortality

Answer 86

A

Rate at which new cases occur in the population
Measures risk of developing the disease within a certain time frame

Answer 87

A

New cases per unit of population at risk

Answer 88

A

Used to study risk factors of a disease

Answer 89

A

Assessment and diagnosis: psychiatrists, psychologists, nurses
Treatment planning: development of treatment plans tailored to needs and preferences
Medication management: psychiatrists monitor medications and adjust treatment regiments
Psychotherapy – psychologists - CBT

Answer 90

A

Cultural norms and values – in some cultures mental health problems may be stigmatized or misunderstood -> symptom concealment or symptom delay
rCultural attititudes e.g. towards emotional expression can influence how depression is experienced

Answer 91

A

SES – income, education, housing
Can influence prevalence, severity, and course of depression
Lower SES -> inc stress, financial strain

Answer 92

A

Discrimination and marginalisation based on race, gender, sexual orientation or immigration status -> stress, psychological distress and increasing risk of depression
Discrimination can impact access to healthcare and treatment -> making mental health disparities worse

Answer 93

A

-Cultural beliefs – influence an individual’s understanding of depression and their help seeking behaviours

Answer 94

A

Cultural beliefs can lead to stigma which can deter a person from seeking support due to fear of social rejection or discrimination
Cultural acceptance and understanding can facilitate help seeking and treatment adherence

Answer 95

A

Social support networks – family networks and cultural norms influence availability and effectiveness of social support networks for ppl w depression
Strong support systems -> coping w symptoms and accessing treatment

Answer 96

A

Accessing help – SES, cultural beliefs, and systemic barriers can affect access to HC and treatment services for depression
Limits ability to seek and receive mental health care

Answer 97

A

1 in 3 patients presenting to PC have a MHC
Increased demand – patients with mental health problems often have physical symptoms -> freq consultations -> inc demand
Complexity of care – due to multifaceted nature of mental health conditions and co-morbities

Answer 98

A

Diagnostic challenges due to overlap of physical and psychological symptoms

Answer 99

A

90% of people with mental health problems are cared for entirely within primary care
PC uses less than 10% of the total expenditure on MH

Answer 100

A

13%
Higher rates in females

Answer 101

A

Women: 15-24
Men: 25-34

Answer 102

A

Higher rates in men
Highest amongst middle aged adults, paticularly males
Females are more likely to attempt suicide but men are more likely to die by suicide

Answer 103

A

-45-49 age gr is the peak

Answer 104

A

Assessment of self harm behaviour – including frequency, methods, triggers
Develop a safety plan with the individual – e.g. identifying warnings signs, coping strategies, emergency contacts
Psycho

Answer 105

A

Provide info and psychoeducation about self harm including common triggers, and potential consequences
Alternate coping strategies such as relaxation techniques, mindfulness and problem solving skills

Answer 106

A

CBT or DBT for self harm
CBT focuses on identifying and challenging negative thought patterns, learning adaptive coping skills, and developing alternative ways of responding to emotional distress.

Answer 107

A

Includes PC, CMHTs, specialist services for self harm and suicide prevention
Collaborate with MHPs to develop comprehensive care plans

Answer 108

A

That offer specialized support and interventions for self harm such as counselling, peer support grs, crisis helplines
Discus

Answer 109

A

Diagnostic bias – ppl from ethnic minorities such as Black and Hispanic populations are more likely to be diagnosed with psychosis comp to white people
This may be influenced by diagnostic bias, where cultural differences in expression of distress and symptoms are misinterpreted as signs of psychosis.

Answer 110

A

Access to care – racial and ethnic disparities in access to MH services may result in delayed or inadequate Tx for psychosis

Answer 111

A

-Language barriers contribute to disparities in diagnosis and Tx

Answer 112

A

Cultural interpretation of symptoms – differences in interpretation of psychotic symptoms can influence how families and indiv perceive and attribute distressing experiences
Cultural expression of distress – cultural norms and values influence how psychotic symptoms are expressed within different cultures

Answer 113

A

Childhood onset psychosis may present with atypical symptoms and developmental delays
Age related RF - such as cognitive decline, medical comorbidities, and substance use, can complicate the diagnosis and management of psychosis in older adults
Co-morbidities can mask psychotic symptoms

Answer 114

A

Emotional strain – feelings of stress, anxiety, sadness, frustration
Witnessing struggle of loved ine

Answer 115

A

demands of caregiving as they may neglect their own health

Answer 116

A

Social isolation – many carers find it difficult to maintain social activities and connections outside of caring. Can worsen feelings of loneliness
Financial strain – reducing hours/ leaving job to care

Answer 117

A

Psychological impact – psych distress, depression, burnout – unpredictability and severity of loved one’s mental health symptoms

Answer 118

A

Communication barriers – struggling with telephone systems, GP touchscreens, lack of sign language
Lack of accessibility – digital resources and informational materials may not be accessible
Stigma and discrimination – deter them from accessing help
Transportation challenges

Answer 119

A

Economic burden – healthcare costs, lost productivity, social welfare costs
Crime and violence – ASB, drug related offenses, domestic violence
Public health crisis – HIV. AIDs, Hepatitis

Answer 120

A

Strains relationships
Emotion distress of family members – shame, guilt, depression, low self eseteem
Financial instability – debt, economic hardship for families

Answer 121

A

Physical health consquences – infectious, resp, cardiovascular problems
MH – addiction often co-occurs with MH disorders
Social isolation – due to strained relationships and alientation

Answer 122

A

early aggressive factors
lack of parental supervision
academic problem
peer substance use
drug availability
child abuse/ neglect
poverty

Answer 123

A

genetic disposition
prenatal alcohol exposure
difficult temperament
poor impulse control
low harm avoidance
lack of self regulation
ADHD/ anxiety/ depression/ antisocial behaviour
rebelliousness

Answer 124

A

Personality traits: including disinhibition, poor impulse control, novelty or sensation seeking may increase the risk of substance misuse.

Answer 125

A

Psychiatric co-morbidities (depression, anxiety, PTSD, psychosis): illicit drugs may be used in an attempt to self-medicate.

Answer 126

A

peer pressure
lack of family involvement
attitudes towards drugs/ alcohol
Social and environmental factors:
poor school achievement, unemployment, social deprivation, history of criminal activity, peer influence, and normalisation of substance misuse in the individual’s culture or peer group.

Answer 127

A

Increasing public awareness
By providing accurate information abt health consequences. Social impacts and legal ramifications of substance use ppl can make informed decisions abt drug and alcohol use

Answer 128

A

Promotion of harm reduction strategies to minimise negative consequences
E.g. resp drinking behaviours such as moderate alcohol consumption, avoiding binge drinking

Answer 129

A

Harm reduction strategies – needle exchange programmes, overdose prevention training, access to naloxone

Answer 130

A

EB policies and regulations to reduce misuse and harm at the population level
E.g. restrictions on alcohol advertising and marketing, increasing taxes on alcohol and tobacco products, enforcing age restrictions for alcohol and tobacco sales

Answer 131

A

precontemplation
contemplation
prep
action
maintenance
termination

Answer 132

A

not yet considering changing their behaviour

Answer 133

A

aware of the need to change and are considering taking action

Answer 134

A

person has made a commitment to change and is preparing to take action

Answer 135

A

ppl modify their behaviour to achieve theit goals

Answer 136

A

ppl work to sustain the changes they have made over the long term.
May develop strategies for managing cravings, coping and triggers and preventing relapse

Answer 137

A

In this stage, individuals have successfully integrated the new behavior into their lifestyle, and the risk of relapse is minimal

Answer 138

A

Goal oriented approach to facilitating behaviour change by helping individuals explore and resolve ambivalence

Answer 139

A

Empathetic approach – active listening
Develop discrepancy - Practitioners help clients explore the discrepancy between their current behavior and their goals, values, or aspiration
Avoid argumentation – practioners take a non-confrontational stance
Support self-efficacy – improve confidence of the ppt in making positive changes

Answer 140

A

Co-working allows development of holistic treatment plans
Collaborating with specialists allows HC teams to draw on diverse perspectives and knowledge
Continuity of care – as ppts move between different HC settings and services
Shared care planning and monitorig between different agencies

Answer 141

A

Attachment – e.g. with primary caregivers
Secure attachment: responsive and nurturing caregiving, fosters trust and good emotional regulation
Insecure attachment: inconsistent or neglectful parenting -> insecurity and difficulties in forming close relationships

Answer 142

A

warmth and support -> positive outcomes such as self confidence

Answer 143

A

high control and low warmth -> anxiety, low self esteem and rebellious behaviour

Answer 144

A

Cultural and environmental factors, such as cultural norms, values, and societal expectations, shape personality development by influencing the socialization process and providing context for individuals’ experience

Answer 145

A

Personality disorders are characterized by enduring patterns of thoughts, feelings, and behaviors that deviate from cultural expectations and cause significant impairment in social, occupational, or other areas of functionin

Answer 146

A

Clinical utility – provides a framework for understanding and diagnosing indiv with persistent maladaptive heaviours
Helps to identify people who may benefit from interventions
Treatment planning – allows us to addess the underlying patterns of dysfunction
Research benefits – allows study of etiology, course and treatment outcomes of different PDs

Answer 147

A

Stigmatisation and labelling
Diagnostic overshadowing
Dimensional nature of personality – oversimplification of the complexity of personality functioning
Limited treatment efficacy

Answer 148

A

HCPs have a duty to assess and manage the risk of violence to others

Answer 149

A

Informed consent required before using interventions aimed at managing the risk of violence
May be lack of insight

Answer 150

A

Legal exception where there is a serious risk of harm to others
Balance of duty to maintain confidentiality with the duty to warn others
Least r

Answer 151

A

Least restrictive measures should be used to the level of risk – not restrict their right to liberty unnecessarily

Answer 152

A

Cognitive changes – concerns over memory loss -> anx and stress
Emotional regulation – more susceptibility to depression, anx, loneliness
Physical health conditions such as chronic pain and arthritis -> distress, functional impairment, reduced QoL

Answer 153

A

Diagnosis of a physical illness, particularly chronic or life-threatening conditions, can lead to psychological distress, including anxiety, depression, and adjustment disorders

Answer 154

A

Uncertainty about prognosis, treatment options, and future health outcomes can contribute to emotional distress and existential concerns.

Answer 155

A

Pain and insomnia -> distress, disruption of daily activities
Medication side effects e.g. sexual dysfunction, CI, mood changes
Social

Answer 156

A

Caregiver stress
Financial strain
Changes in family dynamic

Answer 157

A

Emotional strain – witnessing cognitive decline
Caregiver burden – exhaustion, burnout
Social isolation
Financial
Role strain – balancing multiple roles and resp such as caregiver, spouse etc
Loss of personal identity

Answer 158

A

Dementia advisors and support workers – personalised support, info and guidance to carers and families
Practical support with navigating the care system and accessing local support

Answer 159

A

bring together individuals who are caring for someone with dementia to share experiences, advice, and practical tips for coping with caregiving challenges.

Answer 160

A

temp relief for carers by providing short term care and support for the person w dementia
allowing carers to take a break

Answer 161

A

Respite care services may be provided in various settings, including day centers, residential respite care facilities, or through home-based respite care services.

Answer 162

A

CMHTs
day centers
home care centers

Answer 163

A

CHMTs provide MDT support and treatment for older adults w psychiatric disorders in the community
Includes assessment, psych therapies, social support

Answer 164

A

provide structured daytime programs
provide social activities. cognitive stimulation, practical support

Answer 165

A

for people living in their own homes
includes personal care, medication Mx, meal prepping, transportation and companionship

Answer 166

A

Assisted living facilities offer residential accommodation and support services for older adults with psychiatric disorders who require assistance with activities of daily living but do not require 24-hour nursing care.

Answer 167

A

residential care homes
gr homes

Answer 168

A

Residential care homes provide 24-hour supervised care and support for older adults with psychiatric disorders who require more intensive assistance with personal care, mobility, and supervision

Answer 169

A

a.k.a as residential homes and supported housing
offer shared accom for older ppl w psych disorders
Residents live together in a supportive community setting and receive assistance with daily living activities, medication management, and social support.
Nursin

Answer 170

A

provide 24-hour nursing care and support for older adults with psychiatric disorders who have complex medical needs, functional impairments, or behavioral challenges that require skilled nursing care
some have specialised dementia care units

Answer 171

A

active coping
engaging in problem solving strategies
seeking social support
using coping strategies

Answer 172

A

avoiding or denying physical symptoms
minimising significance
refusing to acknowledge need for medical care
delay seeking treatment, ignore warning signs
maladaptive coping – substance abuse, self medication to provide temp relief but can exacerbate health problems

Answer 173

A

Individual differences in personality, coping styles, resilience, and psychological resources can influence adjustment to physical symptoms.
Factors such as self-efficacy, optimism, and perceived control over health outcomes can promote healthy adjustment,
while factors such as low self-esteem, learned helplessness, and negative beliefs about illness may contribute to maladaptive adjustment.
Family

Answer 174

A

Positive family support, open communication, and shared coping strategies can facilitate healthy adjustment,
while family conflict, dysfunction, or lack of support may hinder adaptation and exacerbate distress

Answer 175

A

Cultural factors shape individuals’ attitudes toward seeking medical care, expressing emotions, and relying on social support.
Cultural stigma, discrimination, and beliefs about fate, destiny, or spiritual explanations for illness may impact adjustment and help-seeking behaviors

Answer 176

A

Public awareness campaigns - Public awareness campaigns aim to raise awareness about mental health issues, reduce stigma, and promote positive attitudes toward mental well-being
Education and training programs - Education and training programs provide individuals with knowledge, skills, and resources to promote mental well-being and resilience.
Promotion of healthy lifestyle behaviours – such as regular physical activity, balanced nutrition and adequate sleep

Answer 177

A

Early intervention and risk reduction - Prevention efforts aim to identify and address risk factors for mental health problems in children before they escalate into more severe issues.
By intervening early, prevention programs can reduce the likelihood of children developing chronic mental health conditions and experiencing long-term negative outcomes.

Answer 178

A

Normalizing mental health concerns, such as anxiety, bedwetting, school refusal, or tantrums, helps reduce stigma and increase awareness of common childhood challenges.

Answer 179

A

long term impact of mental health problems on a child’s overall QoL and school functioning

Answer 180

A

Identification of early signs of MH concerns – teachers and staff
Preventative interventions - may include social-emotional learning (SEL) programs, bullying prevention initiatives, stress reduction activities,
Supportive environment for students by providing access to school counselors, school psychologists

Answer 181

A

Identification of RF and screening for parental MH problems
provide information, guidance, and referrals to appropriate services.
Offer home visits, developmental assessments and parenting support
Health visitors promote positive parent-child bonding and attachment by providing guidance on responsive caregiving, communication strategies, and stress management techniques

Answer 182

A

develop support plans and interventions to address concerns such as parental mental illness, substance abuse
child protection and safeguarding - identifying and responding to concerns of abuse, neglect, or exploitation.

Answer 183

A

assessment and intervention - assess children’s cognitive, emotional, and behavioral functioning to identify factors that may impact their learning and well-being.
Support for special education needs

Answer 184

A

higher concordance rate for eating disorders among identical twins compared to fraternal twins

Answer 185

A

dysregulation of neurotransmitters such as serotonin, dopamine, and norepinephrine, may contribute to the development of eating disorders

Answer 186

A

hormonal imbalances such as disruptions in HPA axis and abn in secretion of hormones like cortisol, insulin and leptin

Answer 187

A

Social pressures – medial portrayals of thinness and pressure to attain ideal body images
Exposure to media images, peer pressure and societal emphasis on appearance
Family – parental modelling of dieting behaviours, perfectionism

Answer 188

A

Cultural – societies that prioritise thinness may stigmatise certain body types and may contribute to internalisation of thin-ideal standards

Answer 189

A

Developmental transitions, such as puberty, adolescence, and young adulthood, are critical periods for the onset of eating disorders
Life events such as trauma or absuse

Answer 190

A

Insecure attachment styles, characterized by ambivalence, avoidance, or disorganization, may predispose individuals to develop maladaptive coping mechanisms, including disordered eating behaviors, as a way to regulate emotions and seek validation.

Answer 191

A

Individuals with perfectionistic tendencies, low self-esteem, identity confusion, or difficulties in emotion regulation may be more vulnerable to developing eating disorders

Answer 192

A

If a person with an eating disorder is deemed to be at risk of serious harm to themselves or others due to their condition, they may be detained under the MHA for assessment and treatment.
Compulsory treatment – sectioning or use of CTOs

Answer 193

A

assessed for their capacity to make decisions about their treatment. If a person lacks the capacity to make informed decisions due to the severity of their eating disorder or associated mental health issues, their treatment decisions may be made by healthcare professionals

Answer 194

A

Effectiveness study. Experimental

Answer 195

A

risk or prognosis. Can be retro or prospective

Answer 196

A

risk or prognosis. Always retrospective.

Answer 197

A

Blinding, allocation concealment?
Administering the intervention
Differences in population
Biases introduced
How was the data measured and analysed?

Answer 198

A

Long enough follow up?
Biases
Recruitment
Measurement and analysis?
Differences in population

Answer 199

A

set of laws aimed at safeguarding children from harm and ensuring their welfare

Answer 200

A

mandatory reporting of abuse
child welfare assessments
provisions of children in need of protection or care

Answer 201

A

all cases of FGM under 18s
child sexual abuse

Answer 202

A

Allow children to be healthy
Help children to be happy and enjoy life
Allowing children to remain safe in their environments
Help children to succeed
Help achieve economic stability for the future - of children
Help make a positive contribution to children’s lives

Answer 203

A

children’s comissioner for england
safeguarding boards - co-ordinate efforts between organisations like social, healthcare and the police
imp of info sharing

Answer 204

A

The act introduced the Common Assessment Framework to provide a standardized approach for assessing the needs of children and identifying appropriate services to support them.

Answer 205

A

chronic substance misuse -> cognitive impairment and memory problems
withdrawal symptoms -> emotional instability, agitation and cravings

Answer 206

A

strain on relationships w family or friends -> social isolation
impair functioning in their job or in education
stigma and discrimination -> alientation

Answer 207

A

economic burdens on HCS due to increased healthcare utilisation and productivity losses
financial costs of substance related costs
decreased productivity

Answer 208

A

Substance misuse is often associated with criminal behavior, including drug trafficking, theft, burglary, and violent crime.
may be to finance the addiction
could be due to the increased impulsive and risky behaviour

Answer 209

A

section 135 - at home
section 136 - in a public place

Answer 210

A

GAD-2
anxiety disorder is likely if a person answers 2 or 3 to one or both Qs (ie anxiety present > 50% time)

Answer 211

A

The trigger can be external (eg crowds) or internal (eg heartbeat) – ‘selective attention’/ ‘hypervigilence’
The person misinterprets normal body sensations as meaning that a physical or mental disaster is imminent – ‘catastrophic misinterpretation’
The ‘fight or flight’ survival response produces more symptoms - which fuel the ‘vicious cycle’ of panic
attempts by the person to manage panic bring short term relief but make it worse in the long term (avoidance + safety behaviours)

Answer 212

A

Stressful life events eg relationship problems, physical illness, threatened loss of employment (contrast losses - which tend to provoke depression)

Answer 213

A

CBT theory states that in GAD worrying abour worry maintains anxiety and leads to unsuccessful attempts to control it

Answer 214

A

Female sex
Family history
Childhood abuse and neglect
Environmental stress(e.g. redundancy, divorce)
Emotional trauma
Substance abuse

Answer 215

A

Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health.

Answer 216

A

the ways in which individuals view and engage with the world
the availability and quality of social resources
specific coping strategies

Answer 217

A

anxiety (especially chronic) can hinder our ability to filter things that we think of as a threat in order for our brains to accurately concentrate on the retrieval of info necessary for problem solving

Answer 218

A

nurses
occupational therapists
psychologists
MH support workers
consultant psychiatrists

Answer 219

A

provide medical support
putting patients in touch with other agencies
short term work for a specific mental health diagnosis which requires short term support
physical health monitoring

Answer 220

A

support w employment support
psychological approaches
support with day to day activities and functioning

Answer 221

A

Primary care - GP
community - MH teams
hospitals and in specialist services
this is primary, secondary and tertiary care

Answer 222

A

is going to create intergrated community mental health servcies

Answer 223

A

GP - refer to secondary services but these can also be accessed through the single point of access

Answer 224

A

specialised, include teams like community MH teams, crisis resolution and home treatment teams and hospital care

Answer 225

A

Running alongside primary and secondary services are voluntary services: support provided in the community, usually by charities and other non-profits.
You can often access these services without a referral

Answer 226

A

highly specialised treatment like forensic MH services or specialist psychotherapy services

Answer 227

A

removing traditional divisions between different tiers of care
so that people get less disjointed care

Answer 228

A

aims to remove divisions such as those between hospials and GPs, physical and mental health and the NHS & local authority

Answer 229

A

between the NHS and other health and care organisations. Such as the local authority, voluntary sector and social enterprise sector

Answer 230

A

4th leading casue of disability worldwide
point prevalence 2-5%

Answer 231

A

genetics
Gender – twice as common in women
Childhood experience – e.g. loss of parent, lack of parental care, abuse
Personality – especially neuroticism
Social environment – life stresses, lack of social network etc
Physical illness

Answer 232

A

Self-help materials – This is not a form of psychotherapy and no CBT skills or training are required by the individual reading the self-help material (e.g. books/ websites).

Answer 233

A

Assisted self-help - computerized CBT, self-help material presented to a support group or individuals by a health worker, such as a graduate mental health worker or assistant psychologist

Answer 234

A

CBT approaches - Specific CBT interventions for specific problem areas, e.g. anxiety management, coping with voices etc.

Answer 235

A

Formulation driven CBT– This is a form of psychotherapy, the patients are not fully able to help themselves and have sought help from a trained professional.

Answer 236

A

1) Self help materials
2) assisted self help
3) CBT approaches
4) formulation driven CBT

Answer 237

A

Patient and therapist agree problem list and goals. Treatment is a collaborative partnership
Focuses on ‘here and now’

Answer 238

A

socratic questioning used by the therapist
open therapeutic process
homework used

Answer 239

A

Underlying beliefs centre around being helpless or unloveable
Trigger events typically involve loss or ‘failure’
This produces negative cognitions about self/ future/ world which reinforce underlying beliefs, and affect mood and behaviour

Answer 240

A

These negative thoughts are maintained by distorted information processing (e.g. overgeneralization, personalization, selective abstraction)

Answer 241

A

Risk of suicide
Feeling of hopelessness
Chronic pain
Disabling symptoms
Severe and prolonged symptoms

Answer 242

A

Young adults tend to sleep a lot, overeat, withdraw and show self-neglect.

Answer 243

A

Older adults often present with insomnia, anxiety, anorexia, poor self-care and exacerbation of pre-existing physical conditions like painful arthritis, constipation, head and neck and back pain

Answer 244

A

shock, denial, numbness, guilt, sadness, weeping, resolutuon
Emotional and practical support is normally sufficient.

Answer 245

A

if symptoms are more intense e.g. clinical depression or if they’re prolonged (beyond 6 months) or if they’re delayed in onset
Counselling, “guided mourning” and occasionally medication may be needed.

Answer 246

A

Black and Asian races present less often to their GP with “depression”
Some groups are more likely to complain of physical symptoms eg Mediterranean (“nerves, headache”), China & Asia (“weak, tired”),

Answer 247

A

migration and not speaking the local language are risk factors for suicide
refer to specific services e.g. Refugee council and use a professional translator

Answer 248

A

4+ symptoms for at least 2 weeks include at least 2 of the first 3 core symptoms

Answer 249

A

addenbrooke’s cognitive assessment mainly used - measures new learning, retrograde amnesia and subjective memory impairment

Answer 250

A

Effective when other treatments don’t work
Most effective with most severe illness

Answer 251

A

Multiple brief anaesthetics
Acute confusional states
Memory impairment: anterograde and retrograde

Answer 252

A

· increased cerebral serotonin concentration

Answer 253

A

· increase in post-synaptic 5-HT2 receptors

Answer 254

A

risks including transient increase in anxiety at the start of treatment)
and of the risk of discontinuation/withdrawal symptoms if the treatment is stopped abruptly or in some instances if a dose is missed or, occasionally, on reducing the dose of the drug.

Answer 255

A

treatment resistant depression
severe major depression
bipolar depressive and mania
schizophrenia

Answer 256

A

nausea
headache
fatigue
confusion
slight memory loss

Answer 257

A

royal college of psychiatrists which provides patient information
MIND
Depression UK
mental health foundation

Answer 258

A

provide advice on activities to imptove wellbeing such as
physical activity: walking, jogging, swimming, dance
Maintaining a healthy lifestyle through diet, alcohol intake, and sleep.

Answer 259

A

social support for family/ carers supporting the person

Answer 260

A

patients are then allocated a key worker who co-ordinates their treatments

Answer 261

A

psychiatrists
MH nurses
social workers
support workers

Answer 262

A

can visit the patient’s home or them in hospital if they’re being discharged
assist with self help strategies
administer medications
provide practical help e.g. with money or housing

Answer 263

A

support you if you experience psychosis for the first time

Answer 264

A

they are MDTs set up to identify and reduce treatment delays at the onset of psychosis and promote recovery by reducing the probability of relapse following a first episode of psychosis

Answer 265

A

for those with complex mental health needs e.g. for those with severe long term mental illnesses and those who have been in hospital many times
complex needs such as violent behaviour, drug or alcohol use and mental illness, those detained under the mental health act or serious self harming

Answer 266

A

also known as the complex care team or programme of assertive community treatment
AOTs review the care plan every 6 months

Answer 267

A

poverty and violence

Answer 268

A

cultures vary in their conceptualisation of mental health
symptoms they recognize as signs of depression, and their openness towards discussing feelings of depression.

Answer 269

A

For instance, some cultures might interpret symptoms of depression in a more somatic or physical way, focusing on complaints like fatigue orpain, while others may focus more on the emotional or cognitive symptoms.

Answer 270

A

treatment sought by the patient, wirh some cultures relying more on traditional/ alternative medicines

Answer 271

A

cultural identity influences the degree to which a person shows physical symptoms of depression
in other words, some cultures are more comfortable reporting depressive symptoms that are physical in nature rather than mental.
For example, research shows that many depressed Chinese people complain of bodily discomfort, feelings of inner pressure, and symptoms of pain, dizziness, and fatigue

Answer 272

A

depressed individuals might not readily seek out psychiatric or mental health care for depressive symptoms.
Because the public discourse regarding depression is more prevalent in Western societies, it is more socially acceptable to have depression, and more people are willing to seek help.

Answer 273

A

mental illnesses may be denied out of shame of being identified as craxy
Others may find the label “depression” morally unacceptable, shameful, and experientially meaningless

Answer 274

A

40%, has risen since the pandemic started

Answer 275

A

psychosocial needs - social needs like home environment, recent life events, history leading to the thoughts of self harm
psychological and physical needs - MH disorders, miuse of recreational drugs and/or alcohol

Answer 276

A

hopelessness
features of depression
features suggestive of suicidal intent - evidence of planninf, changes to will, precautions taken to prevent rescue

Answer 277

A

features associated with risk - male sex, physical health problems, low SES, high-risk employment (such as farmers or healthcare professionals)

Answer 278

A

prevent access to means of self harm
written and verbal info for the person and their family
ensure all members of MDT are kept informed

Answer 279

A

involves the patient talking about their feelings and emotions with a trained therapist
the therapist can help the patient gain a abetter understanding of their feelings and thought processes

Answer 280

A

coping with a current crisis such as anger, bereavement, interftility etc

Answer 281

A

talking therapy that aims to help people with depression take simple, practical steps towards enjoying life again.
The aim is to give you the motivation to make small, positive changes in your life.

Answer 282

A

problem-solving skills to help them tackle problems that are affecting their mood

Answer 283

A

improving an individual’s ability to cope with stresful life experiences

Answer 284

A

The underlying assumption of this approach is that symptoms of psychopathology can often be understood as the negative consequences of ineffective or maladaptive coping.

Answer 285

A

realistically optimistic view of coping, understand the role of emotions more effectively, and creatively develop an action plan geared to reduce psychological distress

Answer 286

A

psychoeducation, interactive problem solving exercises and motivational homework assigments

Answer 287

A

there is comorbid physical or mental illness

Answer 288

A

last resort
should only be done in the context of the Mental Health Act 1983 or Children Act 1989.

Answer 289

A

socioeconomic groups

Answer 290

A

female:male 10:1 although incidence in men is increasing
common in adolescent and young adulthood

Answer 291

A

regular binge eating, loss of control eating during binges
attempts to counteract the binges
BMI > 17.5kg/m2
Preoccupation with weight, body shape and body image
Preoccupation with food & diet.

Answer 292

A

bloating & fullness
lethargy
heartburn & reflux
abdominal pain
sore throat & dental problems

Answer 293

A

mood disturbances, anxiety, low self esteem and self harm are common with bulimia
depressive symptoms are more common than anorexia nervosa

Answer 294

A

80% make full recovery without Tx

Answer 295

A

suicide - always screen for mood disturbances and also suicide risk
medical complications - heart failure, fatal arrhythmias, severe dehydration/ malnourishment, multi-organ failure

Answer 296

A

SCOFF questionnaire

Answer 297

A

do you make yourself Sick because you feel uncomfortably full?
do you worry that you have lost Control over how much you eat?
have you lost more than One stone in a 3-month period?
Do you believe yourself to be Fat when others say you’re too thin?
Would you say Food dominates your life? (2+ indicate likely case of anorexia or bulimia)

Answer 298

A

understand information relevant to the specific decision;
be able to understand the nature of their illness and understand the implicationsof non-treatment
be able to rationally weigh up the pros and cons of treatment;
thus make an informed decision regarding their management and communicate their
decision.

Answer 299

A

under the new MCA (2005) people lacking capacity may be treated if it’s in their best interest

Answer 300

A

needs to be the least restrictive option
is not depriving them of their liberty
there is no advanced refusal or objection by a done or court of protection.

Answer 301

A

Treatment of people with severe anorexia nervosa who are not consenting to treatment for their mental disorder will in most cases require use of the MHA as it involves deprivation of liberty and compulsory refeeding.

Answer 302

A

For people lacking capacity, emergency medical treatment can be performed under Common Law.
Non-emergency treatment for a physical condition not related to the eatingdisorder may be performed under the MCA 2005.

Answer 303

A

treatment for 16-18 year olds who are refusing treatment - parental conset cannot be used as authority to treat

Answer 304

A

later age of onset
typically higher rates of obesity pre-onset
Often a fixation on body shape or type rather thanweight. e.g. ‘to be muscular’
More likely to see excessive exercise

Answer 305

A

Alliance and mutual understanding of AN
Enhancing independence from parents
Develop strategies to deal with the tasks of adolescence
AFT less effective and takes longer than FBT

Answer 306

A

1 - Acknowledging state of starvation, focus on refeeding, emphasis on parental control
2 – Continued focus on weight gain, starting to shift responsibility
3 – Weight maintenance, focus on family relationships, develop family strengths
4 – Relapse prevention, endings

Answer 307

A

views the problems as relational not individual
externalisation of the ED
non-blaming, unifies the family and shares responsibility
family is best positioned to find their own solutions

Answer 308

A

features preceding the onset of EDs which are present in childhood
childhood perfectionism
individuals with both constrained (anorexia) and disinhibited (bulimia) eating share the personality trait of high harm avoidance.
impulsivity & binge eating
compulsivity and anorexia

Answer 309

A

genetic predisposition - relatives of those diagnosed with an eating disorder are up to 6x more likely to develop an ED

Answer 310

A

Eating disorders are overwhelmingly found in Western countries where there is a heavy emphasis on thinness- a core feature of eating disorders.
It is also found in countries where food is in abundance as in places of deprivation, round figures are more desirable

Answer 311

A

During childhood, children encode the behaviour of their role models (e.g., celebrities or parents),imitatingit.
They do not imitate all behaviour, but if it isreinforcedor is the generally accepted opinion of society, they are likely to replicate it.
Society and the media perceive ‘skinnier’women and ‘muscular’ men as more attractive.

Answer 312

A

one of the strongest external contributors to maintaning EDs
often family members are praised for their thiness
maintains maladaptive eating behaviours
Families that emphasize thinness or place a large emphasis on physical appearance are more likely to have a child diagnosed with an eating disordeR

Answer 313

A

Perfectionism - especially for anorexia
perfectionism magnifies normal body imperfections, leading an individual to go to excessive (i.e. restrictive) behaviors to remedy the imperfection

Answer 314

A

Self esteem - Low self-esteem not only contributes to the development of an eating disorder, but is also likely involved in the maintenance of the disorde

Answer 315

A

suggests that overall low self-esteem increases the risk for over-evaluation of body, which in turn, leads to negative eating behaviors that could lead to an eating disorder

Answer 316

A

If a person’s physical health is at serious risk due to their eating disorder, they do not consent to treatment, and they can only be treated safely in an inpatient setting
*

Answer 317

A

if physical health is at serious risk and they do not consent to treatment, ask their parents or carers to consent on their behalf and if necessary, use an appropriate legal framework for compulsory treatment (such as the Mental Health Act1983/2007 or the Children Act1989).

Answer 318

A

early dementia
physical health problems like COPD
medication side effects e.g. anti cholinergics or meds that cause drowsiness
MH problems

Answer 319

A

between 5% and 25%

Answer 320

A

65+
prev history of cognitive impairment/ suspected cognitive impairment
current hip fracture
severe illness

Answer 321

A

STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) aims to reduce the incidence of medicines-related adverse events from potentially inappropriate prescribing and polypharmacy.

Answer 322

A

START (Screening Tool to Alert to Right Treatment) can be used to prevent omissions of indicated, appropriate medicines in older patients with specific conditions.

Answer 323

A

MHA states that a person must be assumed to have capacity unless it’s established that they lack capacity
However, if a person is at imminent risk of suicide there may well be sufficient doubts about their mental capacity at that time.
practitioners need to act in the patients best interests - this may involve sharing critical information

Answer 324

A

a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.

Answer 325

A

(a)to understand the information relevant to the decision,
(b)to retain that information,
(c)to use or weigh that information as part of the process of making the decision, or
(d)to communicate his decision (whether by talking, using sign language or any other means).

Answer 326

A

guilt - losing temper, not wanting the responsibility, feelimg embarassed about the person’s off behaviour
grief and loss - loss of the future they planned together
anger - at the person, having to be a carer, angry at lack of support
exhaustion

Answer 327

A

needs assessment used by the LA to decide which support their eligible to receive
works out your abilities and how they affect your caring role
and your needs and which level of support is needed

Answer 328

A

GP, social services, occupational therapists to support and advise on medical issues

Answer 329

A

local support groups - local Alzheimer’s Society office, Age UK and Carers UK.

Answer 330

A

online discussion forums - practical suggestions and letting of steam - e.g. Talking Point

Answer 331

A

talking therapies such as CBT

Answer 332

A

booklets such as Caring for a person with dementia from alzheimer’s.org.uk for practical support

Answer 333

A

homecare visits
adaptations to the home
respite care
support from professionals, such as a dementia specialist nurse
support groups

Answer 334

A

washing
dressing
taking medicines
going to the toilet

Answer 335

A

These also provide personal care but there will always be 1 or more qualified nurses on duty to provide nursing care.
Some nursing homes offer services for people that may need more care and support.

Answer 336

A

severelearning disabilities, severe physical disabilities or both
a complex medical condition that needs help from a qualified nurse

Answer 337

A

the NHS long term plan will ensure consistent access to mental health care for older adults with functional needs (i.e. depression, anxiety and severe mental illnesses).
NHS talking therapies for anxiety and depression which need to meet the needs of older patients

Answer 338

A

Community-based mental health crisis response teams will work closely with ‘physical health’/Ageing Well Urgent Community Response services to provide coordinated rapid response, assessment, admission avoidance, and discharge support functions for older people

Answer 339

A

support people w mental health problems but also their carers

Answer 340

A

a community psychiatric nurse (CPN), a psychologist, an occupational therapist, a counsellor and a community support worker, as well as a social worker.
one member is appointed as a care coordinator and keeps in contact to help plan care

Answer 341

A

social care is support to carry out day to day tasks
e.g. managing money or improving relationships
can be referred or contacted directly

Answer 342

A

if the person is finding it difficult to manage in their own home and needs more support
can be:
support in their own home
supported housing and group homes
short stay supported housing

Answer 343

A

benefits
budgeting
accessing care, local activities, education, training or advocacy.
often run by charities

Answer 344

A

social services offer them a home
care workers might help with things like household tasks, preparing meals and taking medication.
social services do an assessment on how much help you need

Answer 345

A

They offer short-term housing and are an alternative to going into hospital

Answer 346

A

one in 100
ages 15-45, but may develop at any age

Answer 347

A

males and females equally affected but men tend to develop it earlier at around 20 but women 30

Answer 348

A

Genetics- high genetic linkage to schizophrenia.
One parent with Schizophrenia 10% lifetime(10% increased chance if you have member of family with the condition.

Answer 349

A

winter or spring births and infections, obstetric complications

Answer 350

A

Personality – person with underlying Schizotypalpersonality disorder.

Answer 351

A

upbringing and stressful life events - increased risk of relapse rates
social stresses - social drift hypothesis

Answer 352

A

substance miuse - heavy cannabis intake at 18 associated w inc risk of psyhcosis

Answer 353

A

Decreased cortical volume,enlarged ventricles, hypo frontality (associated with negative symptoms and autism.

Answer 354

A

1/3 make complete recovery
1/3 experience recurrent episodes of psychosis with some degree of social disability
1/3 may remain chronically disabled.

Answer 355

A

abrupt onset,
an absence of prodromal disturbances,
onset in midlife,
presence of identifiable life stresses,
absence of blunting/flat affect
and/or early treatment

Answer 356

A

mesolimbic pathway
mesocortical pathway
nigrostriatal pathway
tuberoinfundibular pathway

Answer 357

A

psycho-education
family therapy

Answer 358

A

accepting the illness, addressing routine/activity scheduling, sleep hygiene, breathing techniques, mindfulness

Answer 359

A

awareness of relapse symptoms, supporting structure, looking after the patient

Answer 360

A

rehabiliation
social support

Answer 361

A

Return to education/work, re-establishing family functioning, management of substance-misuse etc.

Answer 362

A

Housing & Accommodation Issues, Access to benefits etc.

Answer 363

A

CPA - Care Programme Approach

Answer 364

A

auditory hallucinations:
hearing thoughts spoken aloud
hearing voices referring to himself / herself, made in the third person
auditory hallucinations in the form of a commentary
thought withdrawal, insertion and interruption
thought broadcasting
somatic hallucinations
delusional perception
feelings or actions experienced as made or influenced by external agents

Answer 365

A

1% lifetime prevalence of schizophrenia
incidence: around 15 new cases per 100000 per annum

Answer 366

A

begins in young adulthood
Children who go on to develop schizophrenia often have subtle premorbid motor, linguistic and social dysfunction
Gradual functional decline: fall off in school/college, loss of friends, odd behaviours, ideas, beliefs etc
May go on for months or years

Answer 367

A

refers to a cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses.

Answer 368

A

the development of legal standards that have been tested in a court of law over time.

Answer 369

A

law passed by Acts of Parliament.

Answer 370

A

*A person with a mental illness is an autonomous individual, ie is presumed to have capacity to consent to or refuse treatment, unless it is shown to be otherwise.

Answer 371

A

–Understand the information given
–Retain that information long enough to make a decision
–Weigh it in the balance free from either internal or external pressures
–Communicate the decision

Answer 372

A

enshires principals of common law as regards to the treatment of persons who lack capacity into statute law

Answer 373

A

The MHA allows for assessment, treatment and in-patient care for persons with a mental disorder and governs the procedure by which that care is given.
The use of the Mental Health Act is not determined by an assessment of capacity, but rather by the presence or absence of a mental disorder.

Answer 374

A

to oneself - about 10-15% suicide risk in schizophrenia
particularly high in young, educated people early in the course of their illness.

Answer 375

A

to others - risk of violence, minor aggression

Answer 376

A

self neglect - due to postive and negatve symptoms
vulnerability of patients to stigma

Answer 377

A

Family history
Social isolation
Migrants
Family problems
Heavy cannabis use in adolescence
Intrauterine and perinatal complications
Intrauterine infection, particularly viral
Abnormal early cognitive/neuromuscular development

Answer 378

A

Severe social problems
Self-neglect
Hallucinations, especially command in nature
Passivity phenomena

Answer 379

A

(a) to understand the information relevant to the decision,
(b) to retain that information,
(c) to use or weigh that information as part of the process of making the decision, or
(d) to communicate his decision (whether by talking, using sign language or any other means).

Answer 380

A

for those w complex psychosis
treatment resistant psychosis
recurrent admissions or extended stays

Answer 381

A

recovery-orientated approach - shared ethos and agreed goals, sense of optimism and aims to reduce stihma
deliver individualised, person-centred care through collaboration and shared decision making

Answer 382

A

be offered in the least restrictive environment and aim to help people progress from more intensive support to greater independence
recognise need for supported accomodation

Answer 383

A

rehabilitation psychiatrists
practitioner psychologists
nurses
occupational therapists
social workers
support workers (including peer support workers)
specialist mental health pharmacists.

Answer 384

A

services should develop a culture that promotes improving daily living skills
offer structured group activities (social, leisure or occupational) aimed at improving interpersonal skills.

Answer 385

A

educational opportunities such as recovery colleges
substance misuse interventions

Answer 386

A

Risk of harm to the person - self harm, suicide, accidental injury, command hallucinations
level of family/ social support
Timing — be aware that the highest risk of suicidetends to be around the time of a psychotic episode and shortly after hospital discharge.

Answer 387

A

Previous violence, whether investigated, convicted or unknown to the criminal justice system
Relationship of violence to mental state
Lack of supportive relationships
Poor concordance with treatment, discontinuation or disengagement
Impulsivity
Alcohol or substance use, and the effects of these
Early exposure to violence or being part of a violent subculture
stable RF or a change in them?
evidence of recent stressors, losses or threat of loss
Are the family/carers at risk? History of domestic violence
Lack of empathy

Answer 388

A

risk on release from restricted settings
Access to potential victims, particularly individuals identified in mental state abnormalities
Access to weapons, violent means or opportunities
Involvement in radicalisation.

Answer 389

A

Evidence of symptoms related to threat or control, delusions of persecution by others, or of mind or body being controlled or interfered with by external forces, or passivity experiences
Voicing emotions related to violence or exhibiting emotional arousal (e.g. irritability, anger, hostility, suspiciousness, excitement
Specific threats or ideas of retaliation
Grievance thinking
Thoughts linking violence and suicide (homicide–suicide)
Thoughts of sexual violence
Evolving symptoms and unpredictability
Signs of psychopathy
restricted insight

Answer 390

A

rates of psychotic disorders like schizophrenia can be as much as 5x higher in some ethnic minority groups such as people of black Caribbean or African heritage in the UK.
Ethnic minority status was associated with more than double the odds of psychotic disorders.

Answer 391

A

Linguistic distance from the majority group, and social disadvantage, were both associated with nearly double the odds of psychosis, which appeared to mostly explain the increased risk faced by ethnic minority groups

Answer 392

A

variation between countries when it comes to diagnosing schizophrenia - overdiagnosis due to ethnic background

Answer 393

A

One issue is that positive symptoms such as the hallucination or hearing voices may be more acceptable in African cultures because of cultural beliefs in communication with ancestors, and therefore people are more ready to acknowledge such experiences - when reported to psychiatrists this is seen as abnormal, ethnocentric approach

Answer 394

A

over-intrepretation of the symptoms of black people during diagnosis - cultural differences in language and mannerisms, difficulties in relating between black patients and white therapists,

Answer 395

A

most commonly diagnosed between the ages 15-35
women tend to present when older (peak in the late twenties, compared to a peak in the early twenties in men).

Answer 396

A

Transient or attenuated psychotic symptomsor
Other experiences or behaviour suggestive of possible psychosisor
A first-degree relative with psychosis or schizophrenia

Answer 397

A

EIP teams are often the first group to review patients with a new episode of psychosis or schizophrenia.
The teams consist of psychiatrists, psychologists, community psychiatric nurses, social workers and support workers.

Answer 398

A

high risk of harm: same-day mental health assessment by the early intervention in psychosis
not at high risk of harm: EIP team

Answer 399

A

necessity
duty of care

Answer 400

A

allows anyone to take reasonable and proportionate action to prevent immediate significant harm to others
applies whether or not he has capacity

Answer 401

A

in an emergency, when it’s not possible to find out a patient’s wishes, you can treat them without their consent
provided the treatment is necessary to save their life or prevent a serious deterioration of their condition
must be the least restrictive of the patient’s future choices

Answer 402

A

the care and treatment is urgent and there is not time to consider the use of alternative legislation (e.g. the patient is unconsious and requires immediate treatment)
care and treatment is necessary to save their life or prevent serious deterioration

Answer 403

A

Admission for assessment
2 doctors need to make the recommendation
lasts for a maximum of 28 days

Answer 404

A

a section 3

Answer 405

A

Admission for treatment
long term civil section
An AMHP makes an application for admission, based on the recommendations of two medical practitioners.

Answer 406

A

The initial period for which detention is authorised is six months, but it can be renewed by the RC for a further six months, then for further periods of 12 months.

Answer 407

A

used when it is of urgent necessity for the patient to be admitted and detained under section 2
It is similar to s2, but differences include that only one medical recommendation is required, and it lasts up to 72 hours

Answer 408

A

holding powers
A nurse of the specified class may detain certain inpatients for up to 6 hours, and a doctor may detain inpatients for up to 72 hours.

Answer 409

A

police
allows them to take and keep a patient at a place of safety
can do this without a warrant if:
you appear to have amental disorder, AND
you are in any place other than a house, flat or room where a person is living, or garden or garage that only one household has access to, AND
you are “in need ofimmediate care or control” (meaning the police think it is necessary to keep you or others safe).

Answer 410

A

police can keep the patient in a place of safety for up to 24 hrs which can be extended for another 12 hours if it was not possible to assess you in that time.

Answer 411

A

CTO is an order made by yourresponsible clinicianto give you supervised treatment in the community.
This means you can be treated in the community for your mental health problem, instead of staying in hospital.
But your responsible clinician canreturn you to hospitaland give you immediate treatment if necessary
comes with certain conditions like living in a certain place or going to appointments

Answer 412

A

last 6 months from date of order
You can only be put on a CTO if you are in hospitalunder certain sections,and ifcertain criteria are met.

Answer 413

A

section 3
section 37 hospital order
Unrestricted transfer direction under section 47 (Notional section 37)

Answer 414

A

You are under sections 2, 4 or 5
You have already been discharged from your section.

Answer 415

A

You are suffering from amental disorderfor which you need to receive medical treatment.
You need to receive this medical treatment for your health or safety, or for the protection of others.
You can receive this treatment without needing to be detained in hospital.
Your responsible clinician needs to be able to recall you to hospital if necessary.
Appropriate medical treatmentis available for you in the community

Answer 416

A

right to life
right not to be tortured or treated in a inhuman or degrading way
right to liberty
right to respect for private and family life. home and correspondence
right not to be discriminated against
Right to freedom of thought, conscience and religion
Right to peaceful enjoyment of possessions

Answer 417

A

If people with mental health/capacity issues have their physical health needs ignored which could risk their life

Answer 418

A

neglect or lack of care leading to serious harm or suffering
a person presenting a risk of serious self-harm or harming others including staff and others using the service
failing to provide treatment to reduce serious harm experienced by the person

Answer 419

A

decisions preventing a person from leaving a place (such as a care home or hospital) and ensuring the correct processes are followed
when a person requires constant supervision or monitoring and ensuring they have access to the relevant safeguards

Answer 420

A

this right can be restricted but only in specific circumstances e.g.
detaining a person under the MA
depriving a person of their liberty under theMental Capacity Act either where

Answer 421

A

not to be treated in a way that causes intense physical or mental suffering
This could include police violence, poor prison conditions, or neglect or abuse in a care home

Answer 422

A

Olanzapine and Clozapine

Answer 423

A

commonly occurs due to initiation of anti-dopaminergic medication or withdrawal of dopamine agonists. S

Answer 424

A

Support mental processes that enable the child to regulate emotions, reduce fear, attune to others, have self-understanding and insight, empathy for others and appropriate moral reasoning

Answer 425

A

If a child cannot rely on an adult to respond to their needs in times of stress, they are unable to learn how to soothe themselves, manage their emotions and engage in reciprocal relationships.

Answer 426

A

6 and 36 months

Answer 427

A

maternal sensitiity
warmth
emotional responsiveness
involvement
reciptocity

Answer 428

A

◦Secure base effect, distressed on separation, greets positively on return

Answer 429

A

◦ Difficult to settle/angry/ ignores on reunion
◦ Explores with no anxiety,
◦ Little distress on separation, ignore on reunion
◦ Fear of or for the care giver

Answer 430

A

poor parenting/ abuse

Answer 431

A

Behaviours on separation and reunion
Patterns of comfort seeking when hurt/ upset
Reliance on caregivers when help needed
Affection shown to caregivers
Exploratory behaviour in different settings
Co-operativeness
Controlling behaviour (seeking to control caregiver)

Answer 432

A

Poverty
Parental mental health difficulties
Exposure to neglect, domestic violence or other forms of abuse
Alcohol/drug taking during pregnancy
Multiple home and school placements
Premature birth
Abandonment
Family bereavement

Answer 433

A

explores room
actively distressed if mother leabes
positive reunion and accepts comfort eaily
more confident and with positive self esteem

Answer 434

A

seen as available
dependable and warm
responsive to child’s cues, quick

Answer 435

A

not distressed by mother leaving
avoids mother on return, focusing on environment
has learnt to suppress behaviours normally used to alert mothers

Answer 436

A

rejecting angry hostile if child makes demands in stresful situation

Answer 437

A

very distressed when mother leaves
ambivalence on return both seeking comfort and then rejecting/ resisting on reunion

Answer 438

A

inconsistent care giving
unresp and insentive to childs needs and demands

Answer 439

A

contradictory behaviours strong proximity seeking and strong avoidance
distress, anger, freezing and stereotypes

Answer 440

A

frightened or frightening
abusive

Answer 441

A

psychoeducation
formulation of difficulties
liason w other agencies
systemic work w whole family

Answer 442

A

> 6m duration
Umbrella term, range of behavioural difficulties inc. CD and ODD
At the most severe end will involve antisocial and criminal acts

Answer 443

A

adhd and autism

Answer 444

A

younger children; defiant, disobedient, disruptive but not aggressive or antisocial behaviour

Answer 445

A

prevention
psychoeducation
family therapy
parenting support via social care
Parenting interventions have evidence for 11 and under; child-focused groups recommended for older children but often not available

Answer 446

A

includes anxiety disorders
depressive disorders
mania
bipolar

Answer 447

A

bullying
school transitions
exams
house moves
physical illness
parental separation
frienship problems
new step parents
domestic discord
bereavement

Answer 448

A

prev of 5-15%
peaks in adolescent years and early 20s
higher rates in females

Answer 449

A

disputes - parents, peers, siblings
difficulties w relationships
school problems
physical ill health
prev history of abuse
intercultural stresses
depression
bullying
sexual problems
alc and drug use
awareness of self harm by friends/ family

Answer 450

A

Conducted in isolation
Timed so that intervention was unlikely
Precautions to avoid discovery
Preparation in anticipation of death e.g. giving things away
Act considered for hours/days beforehand
Suicide note
Adolescent told others beforehand about thoughts of suicide
Or, they did not alert others

Answer 451

A

Strategies that help when upset/distressed.
Talking with an understanding adult.
Ringing a helpline.
Going to see a GP/ CAMHS professional.
Speak to parents or guardians about how they can help to keep that young person safe.

Answer 452

A

Broken home (separation/ divorce/ death).
Family psychiatric disorder or suicidal behaviour.
Psychiatric disorder or behavioural disturbance.
Substance misuse.
Previous self-harm (~¼ to ½ of suicides have previously self-harmed)..
Older male teenagers.
Violent methods of self-harm.

Answer 453

A

Current suicidal thoughts
Previous suicide attempts
Detailed plans of how to carry out self harm
Suicide note
Depression, anxiety, psychosis and other mental illness
Feeling of hopelessness
Poor social support
Family history of self-harm or suicide
Child in care

Answer 454

A

service for young people up to 18yrs
works w families and young people

Answer 455

A

social services, education, voluntary sector, health

Answer 456

A

SPA - single point of access - call from GP or self referral
triage system
then referred to main CAHMS

Answer 457

A

primary care, early intervention: GP, HV

Answer 458

A

individual CAMHS therapists at LTs

Answer 459

A

specialist teams, community teams

Answer 460

A

tertiary services, inpatient service, dead service

Answer 461

A

eating disorder teams
family therapy
ASD and ADHD
CAHMS crisis team
psychosis pathway w the EIT

Answer 462

A

works at hospital 24/7
assesses young people who self harm who are admitted to hospital
complete risk assessment and follow up intevention
team meet to discuss cases, interventions but also offers home based treatment

Answer 463

A

MDT assessment, diagnpsis, risk assessment, formulatiom, treatment planning

Answer 464

A

skill mix - EBD treatment
shared responsibility and knowledge
sharing of skills
range of interpersonal approaches
supervision and support

Answer 465

A

good head control - raises head when on tummy
stabilises head when raised to sitting position

Answer 466

A

tracks objects/ face

Answer 467

A

stills, startles at loud noise

Answer 468

A

social smile

Answer 469

A

sit without support, rounded back
rolls tummy (prone) to back (surprise)

Answer 470

A

palmar grasp
transfer hand to hand

Answer 471

A

turns head to loud sounds
understands bye
babbles (monosyllabic)

Answer 472

A

puts objects to mouth (stops at 1 yr)
reaches for bottle/ breast

Answer 473

A

head control

Answer 474

A

reaches for objects, fixes and follows

Answer 475

A

cries, laughs, vocalises (4 months)

Answer 476

A

sits alone
crawls

Answer 477

A

pincer grip - 9 to 12 months

Answer 478

A

inappropriate sounds

Answer 479

A

stranger anxiety

Answer 480

A

stands alone

Answer 481

A

pincer grip

Answer 482

A

babbles, understands simple commands
says Mamma/ Dadda

Answer 483

A

social: socially responsive
wave bye

Answer 484

A

walks alone

Answer 485

A

uses spoon

Answer 486

A

uses words

Answer 487

A

stranger shyness, tantrums

Answer 488

A

runs
stairs (2 feet per step)

Answer 489

A

circ scribbles and lines

Answer 490

A

knows identity, parallel play

Answer 491

A

stand on one foot
stairs (1 foot per step at 3)

Answer 492

A

builds bridge w bricks

Answer 493

A

short sentences, knows colours

Answer 494

A

interactive play

Answer 495

A

skips/ hops

Answer 496

A

full drawings

Answer 497

A

fluent speech

Answer 498

A

dresses self

Answer 499

A

children learn by observing, family members and caregivers are also the main influencers that determine how a child will socialize and learn—contributing to their overall physical, social and intellectual development.

Answer 500

A

Talking therapies - 1 on 1
group therapy
family therapy

Answer 501

A

creative therapy - using arts to explore feelings with a creative therapist
medication - advising on drugs and prescribing them
inpatient hospital care
physical checks and medical reviews
crisis support

Answer 502

A

helps them overcome negative thoughts, unhelpful behaviours, difficult emotions
low self esteem, depression, anxiety, OCD, PTSD

Answer 503

A

helps families work together to improve relationships and support each other in finding solutions to problems resulting from mental health difficulties

Answer 504

A

physical help - such as assistance in the home, help with gardening, help with laundry
other forms of support - such as trips/holidays, travel assistance, training, or short breaks (see below for more information about short breaks).
a direct payment so you can purchase agreed services or items yourself

Answer 505

A

respite
break from caring responsibilities
home-based respite care – eg a sitting service for a few hours a week or a personal assistant to stay overnight

Answer 506

A

this is where a disabled person is linked with a family who they then go to stay with on a regular basis

Answer 507

A

after school clubs
centre-based short term residential care

Answer 508

A

for parents whose child has received a diagnosis of autism and is aged under 5
The programme aims to support parents in the period between diagnosis and school placement, empowering and helping them facilitate their child’s social communication and behaviour in their natural environment.
It also helps parents to establish good practice in supporting their child at an early age.

Answer 509

A

understand autism and develop ways of interaction and communication

Answer 510

A

commitment of a two-and-a-half hour training session or home visit, and to ongoing work with their child at home.

Answer 511

A

4-9
The programme aims to promote a consistent approach across setting e.g. home and school, by encouraging parents/carers to attend the sessions with a professional who is working regularly with their child.
aims to build parents confidence to problem solve

Answer 512

A

6 session programme
aged 10-16

Answer 513

A

The Teen Life programme aims to empower parents and supporting professionals to understand more about how autism is experienced by autistic teenagers.
Topics covered include understanding autism in teenagers, women and girls, self-esteem, spending time with other people, stress and anxiety, behaviour, puberty, independence skills, education strategies and planning for the future.

Answer 514

A

aims to bring parents together to share info, experiences and ideas in a structured way
emphasises importance of autistic perspectives

Answer 515

A

national autistic society
ambitious about autism

Answer 516

A

search using the national autistic society services directory

Answer 517

A

online groups - e.g. national autistic society facebook group
groups ran by autism charities
forums - national autistic society community

Answer 518

A

people under 25 can ask their local council about their local offer - support they provide for young people with special educational needs.
every council has one

Answer 519

A

mental health support teams
teaching about MH in school
identifying mental ill health and providing targeted interventions
prevention - positive school culture
addressing social deprivation will address one of the root causes of mental illness

Answer 520

A

offer preventative health promotion
referral to specialist MH services
trained to support family relationships
recognition of early cues and reduction in post natal depression
specialist health visitors in perinatal and infant mental health

Answer 521

A

many social workers have therapeutic training and offer individuals or group therapy to children, young people and their families.
risk management, community in-reach, safeguarding knowledge
can refer a child to CAHMS

Answer 522

A

concerned w children’s learning and development , support schools and the LA to improve the child’s exp of learning
They use their specialist skills in psychological and educational assessment techniques to help those having difficulties in learning, behaviour or social adjustment

Answer 523

A

they help to understand the child’s strengths and weaknesses and the quality of their learning envir
encouraging equal access and opportunities to the curriculum for all children
offering intervention strategies for individuals and organisational situations, for example in schools, classrooms

Answer 524

A

bruises - particularly indicative of abuse if observed in infants and immobile children
broken/ fractured bones
burns/ scalds
bite marks
The effects of poisoning (e.g. vomiting, drowsiness, seizures)
Breathing problems from drowning, suffocation, or poisoning
head injuries
Seeming frightened of parents, reluctant to return home after school
Displays frozen watchfulness
Constantly asking in words/actions what will happen next
Shrinks away at the approach of adults

Answer 525

A

seem distant, upset or angry after using the internet or texting
spending a lot more/ lot les time online than usual
be secretive over who they’re talking to

Answer 526

A

bruises
bleeding, discharge, pains or soreness in their genital or anal area.
STIs
pain/ sore throat
Pregnancy.
Difficulty in walking/sitting that are not usual for the child.

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Block 33 H&S Flashcards

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