Psych Flashcards
Name the main components that need to be included in a psychiatric history
Introduce
Presenting complaint
History of presenting complaint
Past psychiatric history
Past medical history
Medication history
Personal history - from birth to adulthood eg early life and school
Social history eg current job, relationship etc
Family history - psychiatric and physical illness
Drug and alcohol use
Forensic history
State the components of the mental state examination
Appearance + Behaviour Speech Emotion - Affect and mood Perception Thoughts Insight Cognition
What are the 5 P’s used in formulation?
Presenting problem Predisposing factors Precipitating factor Perpetuation factors Protective factors
How is management of psychiatric illness broken down and give examples of each
Biological eg medications and any other medical illnesses
Psychological eg counselling
Social eg finances, social support and housing
What are risk factors that mean someone could be a harm to others?
Young male Unemployed Unstable accomodation Low educational attainment Mental disorders eg schizophrenia, paranoid psychosis and personality disorder Substance misuse
What are the risk factors that mean someone could be a harm to themself?
Older, male Separated, divorced or widowed Living alone Unemployed, retired Poor physical health Mental disorders eg depression or schizophrenia Substance misuse
What are the 2 main principles of the Mental Health Act?
Minimising restrictions on liberty
Public safety
State some of the principles of the Mental Health Act
Minimising restrictions on liberty Public safety Respect for patients past and present wishes and feelings Respect for diversity Avoidance of unlawful discrimination Involvements of patients in their care Effectiveness of treatment Views of carers and other interested parties Patient well being and safety
Outline section 2 of the Mental Health Act
Duration = 28 days and shouldn’t be renewed
Used for assessment (treatment without consent can also be given)
Needs 2 doctors (one S12 approved) and an AMHP
Evidence = patient has a mental disorder needing hospital treatment and needs to be detained for their safety or the treatment of others
Can’t be treated in the community
Outline section 3 of the Mental Health Act
Duration = 6 months and then can be renewed
Used for treatment
Needs 2 doctors (one S12 approved) and an AMHP
Evidence = patient has a mental disorder meaning that they need treatment in hospital, treatment is in their best interests and appropriate treatment must be available
The patient needs a diagnosis, treatment available for this and an element of risk so can’t have it in the community
Outline section 4 of the Mental Health Act
Duration = 72 hour
Used as am emergency order only in an urgent necessity when waiting for a second doctor would cause an undesirable delay
Need one S12 approved doctor and an AMHP
Outline section 5(4) of the Mental Health Act
For a patient ALREADY admitted to hospital (not A&E but AMU would count) who is wanting to leave
Nurses can hold this until a doctor arrives for up to 6 hours
Outline section 5(2) of the Mental Health Act
For a patient ALREADY in hospital but wanting to leave
Doctors holding power = 72 hours
Allowing time for section 2 or 3 assessment
Can’t give coercive treatment
What are some screening questions for depression?
Over the last 2 weeks have you: Had little interest in doing things? Felt down, depressed or hopeless? Had a change in appetite? Any changes to your sleeping? Felt a reduction in energy? Trouble concentrating? Feel like you've let someone down? Thoughts about self harm or suicide?
What are some questions to ask someone who presents with suicidal thinking?
Have you ever acted on your ideas?
What is stopping you from acting on them? (protective factors)
If acted - when, where, planned or impulsive, want to be found? and are they glad it didn’t work?
Do they have plans to kill or hurt themselves now?
