Miscellaneous Psychiatry Stuff Flashcards
- Where are the majority of mental health disorders managed?
- What is the first tier of referral for mental health disorders?
- Primary care
2. community mental health team (or crisis resolution team if emergency/at night)
Define a mental health crisis
an acute disturbance of behaviour/mood/thought which if untreated may lead to harm, either to the individual or others. Needs addressing within a 24 hour period
What are the roles of the crisis team?
- see patients who need to be seen within 24 hours
- gatekeeper to secondary psychiatric services
- prompt assessment
- continued involvement until crisis has resolved
- action to prevent similar crises occuring again
What is the assertive outreach team?
specialist MDT dedicated to engaging with patients with severe mental disorder who are reluctant to seek help and treatment (who consequently only tend to present in crisis)
What is the early intervention team?
A team whose role is to improve the short and long term outcomes of schizophrenia and psychosis
- see patients who are experiencing their first episode of psychosis
- preventative measures
- early detection of untreated cases
- intensive support and treatment in the early stages of illness
Name 3 indications for inpatient psychiatric care
- patient is danger to themselves and/or others
- patient requires specialist care/supervised treatment
- carers are in need of respite
describe the roles of the following psychiatric teams:
- old age psychiatry
- forensic psychiatry
- liason psychiatry
- rehabilitation psychiatry
- LD psychiatry
- Addictions and Substance abuse teams
- psychiatric care for those >60
- assessment and management of mentally disordered offenders and other patients with mental disorders who are, or have been potentially or actually, violent.
- concerned with the assessment and management of psychiatric and psychological illnesses in general medical populations
- Support for patients, especially those suffering from prominent negative symptoms of schizophrenia, who may need a period of long-term rehabilitation either in inpatient units or in the community.
Areas that need to be considered during rehabilitation are accommodation, activities of daily living, occupational activities, leisure activities, and social skills - psychiatric assessment and treatment for persons with intellectual/learning disabilities
- assessment and treatment of patients with problems arising from the misuse of harmful or addictive substances. These include: (1) alcohol; (2) illegal or ‘street’ drugs; (3) prescription and over-the-counter medicines; and (4) volatile chemicals
Which teams should manage the following patients?
1. A patient with schizophrenia has been admitted to the ward under the Mental Health Act on 3 occasions in the last 2 years. He has little insight into his illness or the need for antipsychotic medications.
- A patient has spent 7 months on an acute mental health ward. He had a psychotic illness and is slowly recovering. He has had a history of substance misuse, and has smoked cannabis frequently during his leave from the ward, often leading to relapse. There is some concern about his ability to care for himself after discharge.
- A patient has had severe depression and tried to end his life. He is recovering on the ward but will require frequent contact in the community after discharge to ensure that he will stay well.
- A 26 year old has been referred into service. He has had no history of mental health problems but is now hearing derogatory voices and believes that he is being monitored via his computer.
- A 50 year old has seen his GP with a relapse in depression. He has bipolar disorder and is already taking lithium.
- general adult psychiatry in an inpatient setting
- rehabilitation psychiatry team
- crisis team
- early intervention team
- community mental health team
Describe the roles of the following mental health professionals:
- psychiatrist
- community psychiatric nurse (CPN)
- social worker
- clinical psychologist
- diagnosis and treatment of mental disorders
- facilitation of treatment plan and monitoring of progress
- assist in arranging housing and benefits, and to ensure that the patient makes the most of any services and facilities that are available
- has expertise of human experience and behaviour. May deliver talking treatments such as CBT or family therapy. Spend a lot of time listening to and trying to understand a patient and his or her relatives and carers
- name the 3 criteria for informed, valid consent
2. name 4 things that are required for a patient to be deemed to have capacity
- informed, freely given; patient has capacity
- take on board information
retain given information
weigh up information
communicate their decision
Name the 4 broad areas in which treatment can take place without capacity
- treatment undertaken under common law (e.g. the use of sedation in those with acute behavioural disturbance)
- treatment under the provisions of the mental capacity act (patient lacks capacity)
- treatment under the mental health act (patient is under section)
- treatment authorised by a court
What is section 2 of the MHA?
admission for assessment; detention up to 28 days
What is section 3 of the MHA?
admission for treatment; detention up to 6 months; can be renewed for a further 6 months and then 12 monthly thereafter
What is section 4 of the MHA?
emergency admission for up to 72 hours for those who have not yet been admitted to hospital. Used when waiting for a second doctor to confirm that you need to be admitted to hospital on a section 2 would cause “undesirable delay”.
What is section 5(2) of the MHA?
emergency admission of a voluntary patient/inpatient in a physical hospital. Up to 72 hours
