Mental Health Act, ECT

Question 1

Presumption of capacity?

Answer 1

Unless otherwise, ppl are assumed to have capacity and choose treatment

Question 2

4 key reform objectives in metal health act?

Answer 2

1. Recovery
2. Compulsory treatment
3. Safeguards
4. Oversight and service improvement

Question 3

When to use compulsory treatment.

Answer 3

Appears to be mental illness
Needs Rx
Immediate harm to self or others

Question 4

Purpose of mental health act?

Answer 4

Allow ppl with severe mental illness to have compulsory treatment to prevent serious harm to themselves or another.

Question 5

Evaluation of suicidal patient?

Answer 5

CPR

Current/intent/plan
Past history
Resource

Question 6

Who are most violent ppl in community?

Answer 6

Young men with substance abuse

Question 7

Approach to violent patient

Answer 7

1. No weapons nearby
2. Not cramped room
3. Not in isolated place
4. accessEd to door
5. Not to feel cornered.

Question 8

Describe neuroleptic malignant syndrome

Answer 8

1. Muscular rigidity
2. Autonomic symptoms (temp, sweating, BP, tachy), akinesia, mutism, change consciousness
3. elevated CK, leucocytosis

Question 9

How to treat neuroleptic malignant syndrome?

Answer 9

Supportive
Cease antipsychotic
Dantrolene
bromocryptine (dopamine agonist)
ICU

Question 10

Serotonin syndrome is?

Answer 10

Lifetreatening

Myoclonus, nystagmus
Irritability, confusion
Febrile, arrythmia

Question 11

How do you get serotonin syndrome?

Answer 11

Combining SSRIs

Question 12

How to treat serotonin syndrome?

Answer 12

Supportive

• stop meds
• use 5HT receptor antagonist (cyproheptadine)
• propranolol

Question 13

Indications for ECT?

Answer 13

Major depressive disorder
Mania
Rx resistant Schizophrenia

Question 14

Contraindications for ECT?

Answer 14

Raise ICP
Tumours
Hyperthyroidism (Thyroid storm)

Question 15

ECT Rx protocol

Answer 15

2-3x a week

12 good Rx, 4-6weeks