Psiquiatria Comunitaria Flashcards
30.1.
In addition to promotion of health, what is the main mission
of public health programs?
A. Lobbying for government funds
B. Preventing disease
C. Training health care providers to work in the community
D. Increasing opportunities for research
E. Forming partnerships with for-profit health care entities
30.1. B. Preventing disease
Public health consists of organized community efforts with the goals
of prevention of disease and promotion of health. Lobbying for
government funds to support not-for-profit community health care
delivery systems is necessary, but not a main mission of public health
programs themselves. Similarly, training providers to work in the
local area and increasing research are important, but not part of the
main mission
30.2.
The teacher of an 8-year-old girl notices that she is often
disengaged in class and stares absently during lessons. She
often gets only halfway through her classwork, while her
classmates finish the assignments with time to spare. The
teacher is concerned that the child may have an attention
problem and would like her to get evaluated. In an ideal
collaborative care public health model, what would be the next
step in the evaluation of this child?
A. The school will set up an appointment with the child’s
pediatrician
B. The teacher will relay the concern to the school nurse
C. The child will be seen by a psychiatrist at her pediatrician’s
office
D. The child will be seen by a psychiatrist at the school
E. The parents will come to the school to observe the child
30.2. D. The child will be seen by a psychiatrist at the
school
In an ideal collaborative care model, a psychiatrist would be present
at the school to serve as a consultant for the faculty and staff there.
This psychiatrist would likely not work for the school full time, but
may have weekly or monthly hours there. Another example of a
collaborative care model would be to have a psychiatrist working in
the same office as the pediatrician. However, this would add another
step in getting the child evaluated, so it is not as ideal as an in-school
psychiatrist.
30.3.
A pediatrics office begins screening every adolescent for
depression using a nine-item questionnaire. They then offer to
enroll the patients who score above a certain threshold but are
not yet showing depression symptoms into an online therapy
program. The referral to the program is an example of what
level of intervention?
A. Universal
B. Indicated
C. Selective
D. Multimodal
30.3. C. Selective
Screening every patient is an example of universal intervention,
while attempting to prevent depression from occurring in those who
may be at higher risk as indicated by the screening tool is an example
of selective intervention. If some of the patients progress to develop
depression, treatment would be an indicated intervention. A
multimodal intervention would involve the patients, their families,
peers, school, and the larger community in the intervention effort.
30.4.
A 54-year-old man is serving 30 days in prison for public
drunkenness for the third time in nine months. Prior to
incarceration, he stayed at a homeless shelter or slept under
an overpass. While in prison, he participated in an alcoholics
anonymous (AA) group and substance abuse counseling. Once
his sentence has been served and he is released from prison,
what is the most likely outcome regarding further addiction
treatment?
A. He will be court-ordered to receive treatment from the local
mental health center
B. He will be court-ordered into an inpatient rehab facility
C. He will be released to a halfway house
D. He will continue AA groups in the community
E. He will receive no addiction treatment
30.4. E. He will receive no addiction treatment
For many low-income and/or minority individuals, the jail/prison
system provides the most reliable access to mental health and
addiction treatment. An overwhelming majority of individuals with
addiction disorders will not receive steady addiction treatment once
released from incarceration.
30.5.
A 34-year-old man who was diagnosed with schizophrenia
enters outpatient treatment with a community psychiatry
multidisciplinary team. He states that he has been homeless
off and on since getting out of jail 3 weeks ago, where he was
held on a trespassing charge. He has not been on medication
since he was released. He has not been employed in the last 10
years. He previously worked at a warehouse stocking shelves
and was fired because of symptom exacerbations. He says that
his main priority is to be a good father to his 6-year-old son,
who lives in the same city, but who he has not seen in over a
year. What should be the major focus of communication by the
team with the patient regarding the patient’s treatment?
A. Securing stable housing
B. Decreasing the chance of rehospitalization
C. Restarting his medication
D. Reuniting him with his son
E. Helping him get a job
30.5. D. Reuniting him with his son
The success of a public community psychiatry multidisciplinary team
depends on successful, effective communication with the patient,
with a focus on the patient’s stated goals. This ensures that the
treatment is patient centered and is most likely to lead to maximum
engagement and buy-in by the patient to the services provided. As
being a part of his son’s life is his stated priority, that should be the
focus of the team, which can point out that housing, symptom
control, employment, and staying out of the hospital can greatly
enhance the probability of him realizing his goal
30.6.
In the system of care model for children and adolescents with
severe emotional disturbances, what is the unifying factor of
the consortium of community agencies that participate in the
patient’s treatment?
A. All agencies share the same pool of government-provided
resources
B. Team members are employed by the consortium, not the
individual agencies
C. Agencies have a common plan of care for treatment of the
child and their family
D. Representatives from each agency are present at each
encounter with the patient
30.6. C. Agencies have a common plan of care for
treatment of the child and their family
The systems of care model consists of an interagency structure which
can include child welfare, juvenile justice, the school system, and
medical services which form a consortium to respond to the needs of
the child and their family. The consortium agencies agree on a
common plan of care and pool their resources to provide the most
optimal treatment. Team members are employed by their respective
agencies and come together, as needed, during patient and family
encounters to care for the child and family.
30.7.
What is a characteristic of an assertive community treatment
(ACT) team model that differentiates it from standard
outpatient psychiatry multidisciplinary team treatment?
A. 24/7 team member availability to the patient
B. Assistance with job placement
C. A working relationship with other community agencies
D. Individualized treatment plans
E. A psychiatrist conducts evaluations and provides
pharmacotherapy
30.7. A. 24/7 team member availability to the patient
Both standard outpatient multidisciplinary treatment teams and
ACT teams employ psychiatrists to evaluate and pharmacologically
treat the patient. They also both develop individualized treatment
plans based on patient goals, assist with job placement as needed,
and can have a working relationship with other community agencies.
A differentiating feature of an ACT team is the relatively small
caseloads and 24/7 on-call availability of a member of the team to
the patient.
