History of presenting complaints (mood, psychosis, anxiety)
Mood: Can you tell me how has your mood been? How would you describe your mod?
Rate from 0 as suicidal, 10 as top of the world and 5 as average where would you rate yourself for most of the time over the past 2 weeks (or other time frame)
Psychosis
Hallucinations
Do you hear voices when there is nobody around
Do you hear voices which other people say they can’t hear
Do you see things which other people can’t see
Ask about any delusions
Look at oxford handbook of psychiatry for how to ask these questions
Anxiety
Self harm
What was the intent? Lethality? Emotional Release?
What were they thinking at the time
What are your thoughts now (e.g. they are remorseful)
Past psychiatric history
Do they agree with their psychiatric diagnoses
Past hospitalisations
Longest admission ⇒ gives an indication of complexity of their psychiatric illness
Community treatment
History of compliance
Voluntary or involuntary treatment
Physical health
Psychiatric patients have poor physical health outcomes
Substance use
Specifically ask for marijuanna as the population may not think of them when thinking about illicit drugs
Current medications (compliance, efficacy, tolerability)
Exercise caution with patients who express delusions regarding their partner’s infidelity (significant risk to their partner)
Risks due to driving
Risk to children / spouse
Harm through exploitation
Harm to reputation
Corporate risk
Management Plan
Biological treatments
Antidepressants
Antipsychotics
Mood stabilisers
Electroconvulsive therapy
Transcranial magnetic stimulation
Psychological treatments
Brief cognitive behavioural therapy
Formal cognitive behavioural therapy
Interpersonal therapy
Mindfulness
Acceptance and commitment therapy
Schema therapy
Social treatments
Lifestyle treatments
Mental Health Act
Schedule 1: (12 hours)
Mentally ill:
Delusions
Hallucinations
Serious disorder of thought form
Severe disturbance of mood
Sustained or repeated irrational behaviour indicating the presence of any one or more of the symptoms above
Mentally disordered:
Whose behaviour for the time being is so irrational as to justify a conclusion on reasonable grounds that temporary care, treatment or control of the person is necessary for the person’s own harm from serious physical harm or for the protection of others from serious physical harm