Introduction

Question 1

What are the big 3 mental health disorders in primary care?

Answer 1

Depression, anxiety, and substance abuse

Question 2

What are 3 screening tools to address each of the big 3 in primary care?

Answer 2

Depression = PHQ9
Anxiety = GAD7
Substance abuse = CAGE

Question 3

What is an emergency mental health scenario?

Answer 3

Suicide, homicide, and acute psychosis

Question 4

You must always ask patients about what?

Answer 4

Ask if they have any intention of hurting themselves or others

Question 5

If a patient says that they do want to hurt themselves or others, what must you do?

Answer 5

DON’T let them go home! Needs transportation to the ED for safety & STAT psych consult

Question 6

When do you refer a patient for mental health problems?

Answer 6

Psychosis, bipolar disorder, active suicide/homicide/plan, multiple diagnosis (depression + substance abuse), treatment resistant

Question 7

So when a patient is a harm to self or others and they must be involuntary hospitalized – what is this known as?

Answer 7

Civil commitment

Question 8

If you are trying to explain something important to a patient regarding their care/plan but they are not mentally competent and therefore need guardianship, what does this fall under?

Answer 8

Informed consent

Question 9

What is Tarasoff law? What is the technical name?

Answer 9

It is Duty to Warn – if a patient tells you they intent to do harm to someone you as a healthcare provider have a duty to disclose/warn the unsuspecting victim

Question 10

What legally prohibits professionals from revealing information about a client to anyone?

Answer 10

Confidentiality

Question 11

Confidentiality does not apply to specific types of information and therefore may need to be disclosed in a legal setting – which is known as?

Answer 11

Privilege

Question 12

When are we most likely to see a combative patient?

Answer 12

Drug & alcohol intoxication or withdrawal, schizo (paranoid), mania, and dementia

Question 13

What type of DDx do you need to keep when you suspect delirium & violence?

Answer 13

FIND ME (functional [psychiatric], infectious, neurological, drugs, metabolic, and endocrine)

Question 14

How do we prevent violence?

Answer 14

Ongoing staff education! Adequate personnel, well-designed physical structure (security, alarm buttons, locked unit, metal detectors, and cameras)

Question 15

How do you manage a violent patient?

Answer 15

Verbal – “you look angry”
Chemical – Haloperidol & Lorazepam
Physical Restraint

Question 16

When we have a patient struggling with mental illness, what must we educate them about?

Answer 16

Stress-coping techniques; building healthy relationships; and getting sleep/eating well/and be active