Psychosis and risk

Question 1

What are the key ideas in risk assessment?

Answer 1

= The assessment and management of risks that are necessary aspects of our work, their to protect the welfare of consumers of mental health services and the community

• Identify particular attributes, characteristics or behaviours are regarded as signs of potential risks
• This is structured into categories of risk in order to communicate the observation and its significance to others
• Which then influences the level of care, surveillance and response deliveres

Question 2

Challenges for nurses in risk assessment?

Answer 2

• There is constant risk within a mental hospital as the patients are unstable
• There are constant challenges which come with this
• Suicide  cannot control or predict people choices
• Iatrogenic risk are rarely considered
  o Mental health care can cause stigma, discrimination, trauma and loss of agency
  o Mental treatments have significant side effects
• Focus on risk can lead to increase coercive care
  o Lead to culture of blame and defensive or overly coercive practice

Question 3

What is psychosis?

Answer 3

= Describes conditions that affect the mind, where there has been some loss of contact with reality
- During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficult understanding what is real and what is not

Question 4

Signs and symptoms of psychosis?

Answer 4

o	Delusions 
o	Hallucinations 
o	Disorganised thinking (speech)
o	Grossly disorganised or anormal motor behaviour 
o	Negative symptoms

Question 5

What is Schizophrenia?

Answer 5

Schizophrenia = split mind  A disorder that affects a person’s ability to think, feel and behave clearly.

Question 6

Signs and symptoms of schizophrenia?

Answer 6

Positive symptoms = experiences that seem to be excesses or distortions: added to persons experience

• Hallucinations
• Delusions

Disorganised symptoms = Unnecessary, detailed and length responses  stray from topic

• Disorganised speech
• Grossly disorganised or catatonic behaviour

Negative symptoms = the loss or withdrawal of qualities that make us emotionally connected and motivated human beings
- Inability to initiate and persist in goal-directed activities or diminished emotional expressiveness

Question 7

Treatment approaches for psychosis?

Answer 7

Psychopharmacology (medication)
• Antipsychotic medications - first line treatment for schizophrenia and schizophreniform disorders
• Dopamine antagonists - block dopamine receptors in the brain
• Significant variation in the efficacy and effectiveness of these medications
• Significant side effects
• Can be useful as part of a comprehensive treatment approach

Question 8

Recovery orientated practice

Answer 8

• Collaborative, partnership based relationship
o Therapeutic engagement based on respect, dignity and non-judgement
o Promote self determination and autonomy
• Strengths based approach
o Focus on identifying and building on existing strengths
o Positive hopeful attitude- change is inevitable
• Psychoeducation and self management strategies
o Build knowledge and skills
o Recognise the reciprocal nature of leaning and development
o Peer support
• Increase access and connection to natural supportive community resources

Question 9

What is public stigma vs self stigma?

Answer 9

Public stigma = negative attitudes held by members of the public about people with devalued characteristics

Self-stigma = occurs when people internalize these public attitudes and suffer numerous negative consequences as a result