NSW mental health ACT

Question 1

What is the mental health act?

Answer 1

The main purpose of the legislation is to ensure that people with serious mental disorders which threaten their health or safety or the safety of the public can be treated irrespective of their consent where it is necessary to prevent them from harming themselves or others.

• Treatment can be voluntary or involuntary  the provisions for involuntary treatment are described in the NSW mental health act

Question 2

What is the process?

Answer 2

• Involuntary detention and treatment in a declared mental health facility (DMHF)
  o Multi-step process for involuntary admission, including multiple reviews of involuntary status within the 1st several days
  o Involuntary treatment in the community via a Community Treatment Order (CTO)

Question 3

Types of people who can be detained under the act?

Answer 3

1. Mentally Ill “A person is a mentally ill person if the person is suffering from mental illness and, owing to that illness, there are reasonable grounds for believing that care, treatment or control of the person is necessary..
   a. for the person’s own protection from serious harm, or
   b. for the protection of others from serious harm “ -NSW Mental Health Act (2007)
2. Mentally Disordered – “A person (whether or not the person is suffering from mental illness) is a mentally disordered person if the person’s behaviour for the time being is so irrational as to justify a conclusion on reasonable grounds that temporary care, treatment or control of the person is necessary..
   a. for the person’s own protection from serious harm, or
   b. for the protection of others from serious harm

Question 4

4 categories of psychiatric medication?

Answer 4

Antipsychotics
e.g. Chlorpromazine

Antidepressants
e.g. Citalopram (SSRI) –
inhibits uptake of serotonin

Mood stabilisers
e.g. Lithium

Anxiolytics
e.g diazepam

Question 5

What are antipsychotics?

Answer 5

o Primarily used in the treatment of psychosis and psychotic disorders
 Also bipolar affective disorder, major depression, acute agitation

Mode of action  dopamine antagonists – non-specific blockade of all dopamine receptors

Side effects  Akinesia, Dystonia, Dyskinesia

E.g Chlorpomazine

Question 6

What is antidepressants?

Answer 6

o Primary used in the treatment of depression
 Also anxiety disorders, psychotic, eating disorders
 5 types

Mode of action  reduced the breakdown and reabsorption of the neurotransmitters serotonin and or noradrenaline

e.g.Citalopram (SSRI) – inhibits uptake of serotonin `

Question 7

What are mood stablisers?

Answer 7

o Primary used in the treatment of bipolar affective disorder
 Also psychotic disorders, major depression

• Narrow therapeutic range - regular blood test, risk of high toxicity
• Side effects - dizziness, headache, dry mouth, gastrointestinal disturbance, tremor, hypotension, arrythmias, dehydration
• Long term - irreversible damage to kidney function

e.g. lithium

Question 8

What are anxiolytics?

Answer 8

o Primarily used in treatment of anxiety
 Also insomnia, acute agitation, substance withdrawal

• Mechanism of action – GABA agonist (an inhibitory neurotransmitter) associated with sedation, muscle relaxation and anxiety reduction
• Side effects – sedation, amnesia, dissociation, rebound anxiety

e.g diazepam