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Health and Society Year 3 > Psychiatry > Flashcards

Psychiatry Flashcards

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1
Q

4 members of the mental health team in primary care

A

GP: 1st point of contact, refer
Health visitor: child development and postnatal depression
Practise counsellor: mild/moderate health problems
Primary care mental health worker: Assesses and signposts

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2
Q

6 members of the mental health team in the community

A

Psychiatrist: Assess, diagnose, prescribe, manage and section
Clinical psychologist: psychological assessment and therapies
Community psychiatry nurse: Visits patients at home, support with injections
Registered mental health nurse: hospital based
OT: Assess ADL
Social worker: money and housing problems

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3
Q

Who is the key worker

A

Usually a nurse or social worker

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4
Q

Waiting time for consultant led mental health services on the NHS

A

18 weeks

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5
Q

Risk factors for depression (9)

A 
Female
FHx
Bereavement
Physical illness
Dementia
Asian/Afro-Caribbean
Social isolation
Unemployment
Unmarried
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6
Q

Lifetime risk of depression and bipolar disorder

A

Male depression: 10%
Female depression: 20%
Male and Female Bipolar: 1%

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7
Q

Management of depression

A

Often GP

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8
Q

Cultural differences to depression

A 
Higher disengagement
Language differences
Physical Sx (nerves, headaches)
Stigmatised
Relgision
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9
Q

Largest single cause of disability in the UK

A

Depression

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10
Q

3 key facts about depression in primary care

A

1/3 GP appointments contain mental health
2/3 suicide victims see a GP before they die
50% GPs at risk of burnout

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11
Q

When can you treat without consent

A

When patient lacks capacity to consent
Relative or approved social worker must apply for individual to be forcibly kept in hospital and 2 doctors must assess their condition

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12
Q

4 reasons why you can be sectioned

A

urgently treated for mental health
health would be at serious risk of worsening if no treatment
your safety or others would be at serious risk
doctor believes you need treating in hospital

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13
Q

Human rights and detaining

A

Cannot detain without reason or against will unless sectioned
Person must be given a reason why they are detained and given the opportunity to challenge it

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14
Q

What is the mental health act?

A

A law that allows people with a mental disorder who do not give their consent to be admitted to hospital, investigated and treated for their own safety and that of others

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15
Q

Section 2

A

28
Admission, assessment and treatment of a person with a mental health disorder
AMP and 2 approved clinicians (one section 12 approved)

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16
Q

Section 3

A

6 months
Treatment of a mental disorder

Can be renewed
Patients can appeal
AMP and 2 approved clinicians (one section 12 approved)

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17
Q

Section 5(2)

A

A holding order completed by any doctor used for the emergency detention of inpatients on any ward for assessment of a suspected mental health problem

72 hours
Can be made by one doctor with the approval of a mental health professional
Not renewable so patient needs to be assessed quickly

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18
Q

Section 5(4)

A

Urgent detention of inpatients recieving treatment for a mental disorder for 6 hours
Registered mental health nurse

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19
Q

Section 135

A

Allows a police officer to enter someones house and take them to a place of safety if they are thought to be suffering from a mental health disorder

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20
Q

Section 136

A

Allows a police officer to reovoe someone who seems to be suffering from a mental disorder from a pubic place and take them to a place of safety for assessment

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21
Q

Community treatment orders

A

When discharged from section 3
Supervised treatment when you leave the hospital

If you break it, you must return to the hospital for 72 hours

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22
Q

Everyone detained under the mental health act is entitled to an independent mental health advocate who can help and support the patient
What is their role (5)

A

Listen to views and concerns
Explore options and rights (without advising)
Help them contact people
Accompany them to meetings/appointments
Ensure patients opinions and ideas are articulated and taken seriously

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23
Q

What questionnaire can assess cognitive representations of illness.

A

illness perception questionnaire from Leventhal’s self-regulatory models of illness behaviour

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24
Q

Anxiety and depression in people with other medical problems

A

Twice as common

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25
Q

2 good coping strategies for physical illness

A

Problem focussed: seeing information and practical support, participate in treatment and develop new interests
Emotion focused: sharing feelings and concerns, emotional support, give up unrealistic thoughts

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26
Q

Poor strategies for physical illness

A

Denial
Preoccupation with health
Seeking blame
Hoping the condition will go away

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27
Q

Personal factors which impact how an individual responds to illness

A

Stress response

Family

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28
Q

Primary care approach to mental health and wellbeing

A

Exercise, healthy diet and sleep patterns
Mindfulness/relaxation techniques
Self-help and education
Psychological/psychotherapeutic interventions

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29
Q

NHS 5 year forward plan for mental health

A

7 day 24hr NHS service
Integrate physical and mental health
Creating a culture (end the stigma)

30
Q

Elderly and depression

A

More likely to be depressed

31
Q

For consent to be valid (3)

A

Voluntary, informed and the patient must have capacity

32
Q

4 ways consent can be given

A

Verbally, non-verbally, written, implied

33
Q

How can you make consent informed

A

Give basic overview of condition, outcome of decision and treatment options (including a second option)

34
Q

When is consent not required

A

Emergency treatment
Mental health
Risk to public health (e.g. rabies)
Severely ill and living in unhygienic conditions

35
Q

To have capacity

A

Understand the information
Retain the information
Weigh up the information
Communicate the decision

36
Q

If someone lacks capacity

A

Someone else can make the decision for them

Whether this be a lasting power of attorney or advance decision

37
Q

If someone lacks capacity

A

Someone else can make the decision for them

Whether this be a lasting power of attorney or advance decision

38
Q

5 key principles of Mental Capacity Act

A

Presumption of capacity
Being supported to make their own decisions
People have the right to make unwise decisions
Anyone who lacks mental capacity must be acted on in their best interest
Decisions should be made in the least restrictive option

39
Q

Assessment of capacity

A
  1. is there an impairment of or disturbance in the functioning of a persons mind or brain?
  2. is the impairment or disturbance sufficient that the person lacks the capacity to make a particular decision
40
Q

When is an advanced decision not legally binding

A

If the person is held under the mental health act

41
Q

Is consent always needed for sharing information

A

No, it can be breached if demanded by court, patient lacks capacity and disclosure is in their best interest or it is necessary to prevent harm

42
Q

Effect of dementia on carers

A 
Worry about patient discomfort
Overwhelmed 
Frustration over no treatment
Hurt by personality change
Angry with their behaviour
Guilt at resenting care
Sadness over the loss of the person 
Fatigued, poor sleep
Financial, emotional and health burdens
Less time looking after themselves
Lack of practical support e.g. lifting
43
Q

4 tests for dementia

A

MMSE (lengthy but good for monitoring)
6-CIT (short and easy)
AMTS (short and simple)
Addenbrooks (very long)

44
Q

How can social services help carers

A

Physical help e.g. gardening or laundry
Breaks
Direct payments
Assess to determine care

45
Q

What does the care act 2014 state

A

Carers have a right to an assessment of their own needs and the same rights as those they care for

46
Q

4 methods of financial support for carers

A

Carers allowance
Disability living allowance
Attendance allowance
Carers special grant: funding for respite

Dementia nursing care is free but the care home might not be

47
Q

Role of admiral nurses

A

Support emotionally and practical guidance for dementia

48
Q

Community residential and respite services for dementia

A

Community: Primary care, support with daily living
Residential/nursing care: Housing with intensive support, sheltered accommodation
Respite: day centres to allow carers rest, care at home

49
Q

Focuses that CAMHS can provide

A

Art therapy
Psychotherapy
CBT
Family therapy

50
Q

Medications in CAMHS

A 
Clozapine
Fluoxetine!
Lithium
Lorazepam 
Propanolol
51
Q

Common conditions in childhood

A 
Anxiety
ADHD
Mania
self-harm
depression
personality disorder
52
Q

Prevention of child mental health problems

A 
Parenting programmes
Home visiting programmes
Anxiety and depression programmes
Youth offending programmes
School based programmes
53
Q 
Role of the:
School
Health visitor
Social services
Educational psychologists
A

School: ensure equal access to learning, contact parents, manage behaviour and support
Health visitor: offer advice and refer parents
Social services: assess and report to mental health services, ensure child is not disadvantaged
Educational psychologists: support schools and families, tackle learning difficulties, work with individual children

54
Q

3 methods to treat ‘not wanting to go to school’

A

CBT
Systemic desensitisation
Exposure therapy

55
Q

If a child disclosed information to you

A

Stay calm
Do not promise confidentiality
Say it was not their fault
Involve them in a plan

Contact child protection lead, social services or police within 48 hours and document everything!

56
Q

Role of the family in emotional, social and cognitive development

A

Values: right and wrong
Skills: motor, language, emotional
Socialisation: trust and friendships
Security: emotion and physical

57
Q

Which act assesses whether a child is at need

A

The children and family act 2014 and Children act 1989

58
Q

Difficulty accessing support for individuals with sensory impairments

A

Deaf/visually impaired excluded from outreach and mass media –> reduced understanding
Communication barriers - don’t go to the GP
Risk of social eclusion
Access to counselling reduced

59
Q

Impact of addiction on the family

A

Family ashamed and stigmatised causing arguments
Child neglect and poor safety
Children placed in care
Higher chance children will go onto become addicts

60
Q

Impact of addiction on the individual

A

Affect them financially and socially
Withdrawal
Health problems and death

61
Q

Impact of addiction on society

A 
Loss of productivity at work
Resources of child in care
Domestic violence
Cost of rehab
Higher rates of crime
62
Q

Individual and societal factors that maintain drug taking

A

Individual: genetic, influence of family and friends, socioeconomic status, occupation, personality type, physiology of addiction
Society: availability, economics, lawa

63
Q

Mechanism of addiction

A 
Salience
Compulsion
Tolerance
Withdrawal upon abstinence
Narrowing of repertoire
Reinstatement upon abstinence
64
Q

Health promotion strategies to prevent harm from alcohol

A

Primary: educate, increase alcohol tax, advertise, reduce availability, drink free areas, fines
Secondary: Screen for problem drinkers (CAGE, AUDIT), target high risk groups
Tertiary: Treat alcohol related problems, fortify food with vitamins, support groups and counselling

65
Q

Health promotion strategies and prevention of harm from drugs

A

Primary: education, identify at risk groups (including children)
Secondary: immunise Hep B, condoms, needle exchange
Tertiary: Better access to treatment centres, self-help groups, relapse prevention schemes

66
Q

Problems caused by excessive alcohol drinkers

A

Acute: accidents, poisoning, violence, suicide
Chronic: organ damage, dependence/addiction, resource consumption

67
Q

3 types of drinkers

A

Hazardous: drink above limit but not harmed
Harmful: drink above limit and experiencing harm
Dependent: drink above limit and experience harm and sx of dependence (cage)

68
Q

Alcohol harm reduction strategy for england

A

Better communication with public
Prevent and tackle alcohols harms to health
Reduce alcohol related crime and disorder
Work with the alcohol industry

69
Q

Long term effects of drugs

A

Amphetamine: paranoia, hallucinations, aggression, convulsions, resp problems, obsession, loss of coordination
Cocaine: nasal damage
Cannabis: psychosis

General: organ dysfunction, depression/anxiety, paranoia, withdrawal from society

70
Q

Explain the cycle of change

A

Pre-contemplation: Not currently considering change (validate)
Contemplation: Sitting on fence, no plan in the next month (encouragement)
Preparation: Experience with change, trying to change, planning in next month (identify problems, support)
Action: Practise new behaviour for 3-6 months (reiterate benefits)
Maintenance: Continued commitment to new behaviour (6m-5 years) (plan follow-up, discuss relapse)
Relapse: Resumption of old behaviours (evaluate trigger, plan for coping strategies)

Health and Society Year 3 (5 decks)

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