MSE

Question 1

What are the 4 Ps of Formulation?

Answer 1

• Predisposing
• Precipitating
• Perpetuating
• Protective

think of it in terms of biopsychsocial.

Question 2

What is an acronym for the MSE?

Answer 2

ASEPTIC - appearance/behaviour? - Speech - emotion (affect) - Perception - Thought content - insight/judgement - cognition

Question 3

What is the Mental Health Act? How is it applied?

Answer 3

to enforce the MHA you have to have no consent and a criteria of: 1) need immediate treatment or is a serious risk (imminent risk) 2) appears mentally ill (mental illness) 3) able to be assessed (treatment available) 4) no less restrictive assessment available (lacks capacity) An Assessment order lasts for 24 hours (can be extended to 72 hours) - can be community or inpatient A TTO - temporary treatment order can last for 28 days once enacted. Need a compulsory mental health tribunal hearing which can revoke or upgrade to a treatment order.

Five Criteria:

1. need a mental illness
2. pose an imminent risk to themselves or others (imminent deterioration)
3. appropriate treatment facility is available
4. person is incapable of providing informed consent or unwilling
5. involuntary admission is the least restrictive method available (declare cannot treat as outpatient).

3 orders inpatient or community:

AO - assessment order - buy time to diagnose formally with psychiatric condition. Reviewed by psychiatrist.

TTO - temporary treatment order - 28 days

still meets 5 criteria TTO can convert to treatment order (inpatient or outpatient) CTOvsITO

Question 4

Things NTBM in the MSE?

Answer 4

• Psychotic symptoms
• Mania symptoms
• RISK ASSESSMENT (no matter what the presentation is) (A SAD PERSON)
  
  • Self (suicide, DSH, accidental self-harm (mania), vunerable to abuse, self-neglect, risk to reputation/employment)
  • Others (homicide, infanticide, accidental)
  • Property
  • Static (male over 50, comorbid illness, lack of social supports, past attempts of suicide)
  • Dynamic (what happened - context, university studies, relationship breakdown)
• DUP - duration of untreated psychosis
• substance use - substance induced psychosis or precipitant

Question 5

Restrictive Measures, what are they?

Answer 5

1. bodily restraint
2. seclusion

• into a seclusion room

require lots of monitoring

form that goes in the patients file, all less restrictive tried, considered and deemed unusable.