SLA 15 - Mental Health (B) Flashcards
What is the mini mental state examination (MMSE)?
A commonly used set of questions for screening cognitive function. It is not suitable for making a diagnosis, but can be used to indicate the presence of cognitive impairment.
Interpret the following scores for MMSE:
a) 25-30
b) 21-24
c) 10-20
d) 0-9
a) normal cognitive function
b) mild cognitive impairment
c) moderate cognitive impairment
d) severe cognitive impairment
What is the general practitioner assessment of cognition (GPCOG)
A screening tool to test for dementia, by assessing the following components:
- time orientation
- visuospatial functioning
- information
- recall
What is the purpose of a suicide risk assessment?
- establish patient’s intent
- assess the seriousness and perceived seriousness of their attempt
- assess how they feel about the attempt at the time of assessment
What are some risk factors for suicide?
- previous suicide attempt / self harm
- male gender
- unemployment
- physical health problems (e.g. chronic pain)
- living alone
- unmarried
- alcohol dependence
- active mental illness
Note risk factors for suicide are more common in the prison population, therefore this group of people are at higher risk.
List some protective factors for suicide.
- strong religious faith
- family support
- children at home
- sense of responsibility (e.g. work, caring)
- problem-solving skills
Suggest three mental health disorders where suicide risk is heightened.
- depression
- schizophrenia
- personality disorder
What are the ‘red flag’ symptoms of suicidal intent?
- sense of hopelessness
- feeling of entrapment
- well formed plans
- perception of no social support
- significant pain / physical chronic illness
What are the aims of a care plan in reference to suicide risk?
- prevent self-harm or suicide attempts
- reduce level or injury
- improve quality of life
- improve social / occupational functioning
- improve mental health conditions
- improve physical symptoms
Why is the use of SSRIs controversial in the treatment of suicidal ideation?
Some SSRIs and anti-depressant medication can increase suicidal ideation, especially when first introduced.
What is the definitive management of a patient at high-risk of suicide?
Ensure safety with 24-hour support through the crisis team
Consider grounds for psychiatric evaluation and detention under the Mental Health Act (1983) if the patient refuses.
What telephone helplines are available to patients displaying suicidal ideation?
- Shout
- Samaritans
- CALM helpline (prevents male suicides specifically)
Suggest some ways in which self-harm can be inflicted.
- self-cutting
- ingesting a substance in excess of the prescribed or generally recognised therapeutic dose
- ingesting a recreational or illicit drug with the intent to cause harm
- ingesting a non-ingestible substance or object
Give the prevalence of self-harm within the UK.
At least 5% lifetime prevalence.
Note self-harm is often performed privately and discretely, so true number may be much greater.
How should self-poisoning be managed in primary care?
In most circumstances, patients who have self-poisoned should be referred urgently to the nearest emergency apartment.
