General/ Misc

Question 1

Mental State Assessment

Answer 1

ASEPTIC

Appearance
Speech
Emotion (mood/affect)
Perception (hallucinations)
Thoughts (themes, paranoia, homicidality, delusions)
Insight
Consciousness

Question 2

Mental Health Triage Scale:

Answer 2

Question 3

Differentiating organic and psychiatric presentations:

Answer 3

Question 4

What MSE features favour ORGANIC illness?

Answer 4

Fluctuating conscious level
Visual/ tactile/ olfactory hallucination
Disorganised delusions
Movement disorders
Confabulation
Circumstantiality
Concrete thinking (ASD)

Question 5

Differentials for mania:

Answer 5

PSYCHIATRIC
Bipolar
Anxiety
OCD

ORGANIC
Hyperthyroidism/ thyroxine
Stimulants
Steroids
Dopamine agonists

Question 6

What age of first onset psych symptoms is a red flag?

Answer 6

> 40

Question 7

Protective custody:

Answer 7

Invoked by:
1- Police
2- ‘Mental Health Officer’
—> nurse, paramedic etc. specially appointed under Act by chief psychiatrist

When patient suspected to have MENTAL ILLNESS AND they or others are at risk (by own judgement, or others’ report)
AND
Will not come willingly.

May enter without warrant, use ‘reasonable force’, take possession of belongings, search if thought necessary.

In ED, PC ‘handed over’ to another MH officer.

PATIENT RIGHTS
- Statement of Rights
- Examined within 4 hours (from arrival) by doctor

DISCHARGE
- Assessment or Treatment Order commenced
- Patient becomes voluntary (informed consent)
- Released
- 4 hours expires (since arrival at ED)

Question 8

Assessment Order:

Answer 8

Invoked by:
- Doctor
then affirmed by a second doctor (psych)

Thought to have mental illness
AND
likely to require treatment for safety of patient, and/or others.

AND
- Not voluntary
- No capacity
- No less restrictive option

Allows detention, assessment, property to be held etc.

Lasts 24 hours but can be extended up to 96 hours

PATIENT RIGHTS
- Statement of Rights
- Copy of Assessment order
- Can complain to an Official Visitor, or Mental Health Tribunal

DISCHARGE
- Treatment order
- Release

Question 9

Treatment Order:

Answer 9

Invoked by:
- Mental Health Tribunal
—> after receiving an application following Assessment. If not on AO, needs second doctor to apply for TO)

Determines treatment to be given, and location of this.

Lasts up to 6 months. Discharged (doctor or tribunal) or renewed (tribunal).

PATIENT RIGHTS
- Statement of Rights
- Copy of Assessment order
- Can complain to an Official Visitor, or Mental Health Tribunal