Psychopharmacotherapeutics review Flashcards
Define mental health according to the World Health Organization
A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community
What is mental health not?
Mental health is more than the absence of a mental illness
Are mental health and mental health problems opposing conditions?
Mental health and mental health problems are not opposing conditions
What is a critical component of mental health to understand?
Someone diagnosed with a mental health condition can experience good mental health, while someone without a diagnosed mental illness can experience difficulties at certain times of stress (job loss, housing changes, grief)
What is a mental health disorder? How is it defined? What are some other names? Examples?
Results in significant changes in a person’s thinking, emotional state and behavior, and ability to function in social and occupational settings.
Meets defined diagnostic criteria.
Psychiatric diagnosis, Mental illness
Examples: Depression, anxiety, insomnia, bipolar, schizophrenia
What is the critical component of mental health disorder?
Meets defined diagnostic criteria
What is a mental health problem? How is it defined? What are some other names? Examples?
Broad term that includes mental health disorders and less severe mental health symptoms that do not meet diagnostic criteria but may disrupt personal, social, and occupational functioning.
Experienced and expressed uniquely by individuals.
Poor mental health, Minimal mental well-being
Examples: Stressed, tired, anxious, worried
What is the purpose of the Mental Health Services Act?
Purpose: assist people suffering from serious mental illness in receiving treatment
Encourages voluntary receipt of services
Describes what is voluntary and involuntary
Define “Voluntary” under the Mental Health Services Act
A person can voluntarily request to be admitted to a mental health centre under the MHSA:
A person may on HIS OR HER OWN REQUEST
a) receive assesment and treatment services
b) With advice and on the on the arrangements of a physician with admitting privileges to a mental health centre, be admitted to a mental health centre
OR
c) Receive other service available pursuant to this ACT
Who can make a voluntary request under the MHSA for children?
The admission may be requested by a parent or guardian of the child, or by a mature minor - someone able to make this healthcare decision
For children up to 18 years of age, a parent or guardian can voluntarily admit the child to a mental health centre in order to receive MHSA services with agreement of a physician with admitting privileges to a mental health centre.
However, if the child is a mature minor, the child may have the same health decision-making rights as an adult.
What is the only criteria for someone to be voluntarily committed? Does someone require a diagnosis of a mental disorder?
- Only criteria is that the person requires care that can be provided in a mental health centre, and the person consents to the admission
- The person does not have to meet the “mental disorder” definition of the MHSA
What are the methods for the initiation of involuntary admission under the MHSA?
Physician or prescribed health professional
–> Examined and Form A completed
Peace officer
–> May apprehend a person without warrant and take a place where he/she may be examined by a physician if the officer has reasonable grounds to believe that the person is: suffering from a mental disorder and likely to cause harm to him/herself or to others or to suffer substantial mental/physical deterioration if he or she is not detained in a mental health centre
Provincial Court Judge
–> May be asked to issue a warrant providing authority to a specified person (usually a peace officer) to apprehend and convey the person to a mental health centre for a psychiatric examination
Under the MHSA, what does involuntary refer to?
Where a person needs hospitalization for a mental disorder but it is not possible for them to be admitted voluntarily
What are the requirements for an individual to be involuntarily admitted under the MHSA?
2 Form Gs are required before a person is fully involuntarily admitted to a mental health centre
- Forms completed by psychiatrist
Who authorizes treatment for involuntary patients under the MHSA? What treatment cannot be authorized?
Mental health treatment for an involuntary patient is authorized by the attending physician under the MHSA
Non-mental health treatment cannot be authorized
S.C. is a 40 year old male involuntarily admitted for schizophrenia after addressing concerns about harming other individuals. S.C. is also diagnosed with type 1 diabetes and has not been adherent to there insulin therapy. S.C. is non-adherent to all their medications and states that “medications are only a way for the government to track me.” Under the MHSA, the attending physician may:
a) Only initiate treatment for the diabetes, as S.C. does not meet the criteria for involuntary admission
b) Initiate mental health treatment and administer insulin against the patients wishes
c) Determine S.C. can legally be involuntarily admitted as they are causing personal harm by not adhering to their insulin
d) Determine S.C. can be involuntarily admitted as they are diagnosed with schizophrenia and indicated they may harm others
e) Inititate treatment for S.C. schizophrenia only as insulin cannot be authorized if S.C. is not willing to take the medication
f) D and E are correct actions under the MHSA
F –> D and E are the correct answers
Peace officer
–> May apprehend a person without warrant and take a place where he/she may be examined by a physician if the officer has reasonable grounds to believe that the person is: suffering from a mental disorder and likely to cause harm to him/herself or to others or to suffer substantial mental/physical deterioration if he or she is not detained in a mental health centre
Mental health treatment for an involuntary patient is authorized by the attending physician under the MHSA
Non-mental health treatment cannot be authorized
For an involuntary admission under the MHSA, what criteria must be met?
All three criteria must be met including:
1) being found to be a person with a mental health disorder who needs inpatient care
2) not being fully capable of making an admission or treatment decision
3) likely to harm self or others or suffer substantial mental or physical detioration
Describe the process for examination, admission and community treatment under the MHSA for voluntary and involuntary admission?
Discharge –> Patients can be made voluntary or form H3 and 4 (put the person under a CTO and defined criteria to meet upon discharge) CTO – need to show once a month with pharmacist to get long acting anti-psychotic (depo)
Describe the difference between physical fields of medicine and psychiatry?
What is involved in the clinical assessment in psychiatry?
Combination of physical exam & clinical interview
Diagnostic Statistical Manual of Mental Disorders
Currently 5th Edition (DSM-5)
Published by the American Psychiatry Association
Establishes consistent diagnoses
List the components of a psychiatric interview?
Patient demographics
–>Name
–>Age
–>Gender
–> Marital status
–> Housing
–> Finance
–> Education
Chief complaint
History of Presenting Illness
Past Psychiatric/Substance Use/Legal History
Medical History
Family Psychiatric history
Social History
Medication History
Risk assessment
Suicide, homicide
Differential Diagnosis
Impression
Treatment Plan
Describe the overall concept of a mental status exam?
Observations of patient
–> Throughout the clinical psychiatric interview
Questions about patient’s thoughts, beliefs, perceptions, and cognitions
Creates a picture of the patient
A mental status is an analogue of….
Analogue to the physical exam in physical medicine
What are the four components of a mental status exam?
