Mental Health - Assessment and Mental Health Act Flashcards
What are the 9 components of a mental status exam?
1) general observations (appearance, psychomotor behaviour, attitude towards interviewer)
2) mood
3) affect
4) speech charicteristics
5) perception (hallucinations or illusions?)
6) thought (content, process)
7) sensorium (LOC, orientation, memory, attention and concentration)
8) insight
9) judgement
What are elements of a full mental health assessment?
- health history
- physical exam (includes the mental status exam)
- diagnostics
What are the four criteria for involuntary admission under the mental health act? Does the patient need to meet all four elements?
the patient must meet all four of the following criteria:
1) suffering a mental health disorder that is impairing function (ex. ability to react appropriately to environment or associate with others)
2) requires psychiatric treatment
3) requires care, supervision to prevent deterioration (mental and physical) or to prevent harm to self or others
4) not suitable as a voluntary patient
Who can arrange an involuntary admission?
- a doctor
- the police
- a judge
Can an individual with a mental handicap be admitted as an involuntary patient?
no
An involuntary patient requires non-psychiatric treatment (ex. an antibiotic for an open cut they came in with). The patient can’t give consent. Can you give the antibiotic?
need to seek a substitute decision maker unless it is an emergency
What is the process for admitting an involuntary patient?
- patient can be kept for 48 hours with the certificate of one doctor
- the patient must be kept at a designated facility, or transferred to one
- a second doctor must examine the patient and if they agree the patient meets the criteria for involuntary admission, they can be kept for up to one month before further evaluation is needed
What are some of the rights of involuntary patients?
- right to a second opinion
- right to information about their rights
- right to a review panel
- right to apply to the courts
What is mood? What are three terms used to describe mood?
self reported by the patient - sustained emotion that colours perception
euthymic - normal
euphoric - elated
dysphoric - depressed, disquieted
What is affect? How might it be described?
assessed by interviewer - emotional responsiveness
can describe:
- range (full or constricted)
- appropriateness
- stability
- intensity (heightened, blunted, flat)
What are hallucinations?
false sensory perceptions, not associated with external stimuli (auditory, visual, tactile)
What are illusions?
misperceptions or misrepresentations of real sensory stimuli (ex. thinking the wind is a voice calling your name)
What are delusions?
false, ffxed belief, based on incorrect inference about reality, not shared by others
What are two different categories of delusions?
1) delusions of control - belief that one’s thoughts, feelings or will are being controlled by outside forces
- Thought insertion - belief that someone inserting thoughts into mind
- Thought broadcasting - belief that thoughts are obvious to others
- Ideas of reference - belief that other people, objects, events have special significance to self (ex. Person on tv is speaking directly to them)
2) paranoid delusions - irrational distrust of others, belief that others harassing, cheating, threatening
- Bizarre delusion - absurd or totally implausible belief
- Somatic delusion - false belief about body or body functions
- Delusion of grandeur - exaggerated belief about one’s own power/importance
- Religious delusion - belief one is favoured by greater being
- Depersonalization - belief that one’s self or body is strange or unreal
- Magical thinking - belief that own thoughts, words or actions have power to cause or prevent things from happening
- Erotomania - belief someone unknown to person is in love with them or in a relationship with them
