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Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
The aims of the psychiatric assessment are to: Take a detailed history and mental state examinationMake a diagnosisPerform a risk assessmentFormulate a management plan
Specialist ServicesAcute Inpatient
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
When a young person is a risk to themselves, because of strong suicidal urges, or when a young person is a risk to others, because of the effect of severe mental illness on their behaviour, hospital admission can provide safety. Close supervision and modifications of their hospital environment will keep them safe and protect other people. This allows for a thorough psychiatric assessment and for intensive treatments to begin. In hospital the young person may benefit from contact with other young people in similar circumstances. The group process can be used for therapeutic purposes, as is the case of eating disorders, whereby the group effect is helpful in encouraging the individual to eat.
Introduction
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Psychiatric assessment includes a structured clinical conversation, complemented by observation and mental state examination and supplemented by a physical examination and the interview of other informants when appropriate. After the initial interview, the clinician should be able to establish whether the individual has a mental health problem or not, the nature of the problem, and a plan for the most suitable treatment.
Clinical characteristics of medically hospitalized youth with anorexia nervosa/atypical anorexia nervosa and premorbid overweight/obesity
Published in Eating Disorders, 2023
Abigail Matthews, Katelyn Gordon, Rachel Kramer, Jessica Lin, Adi Ziv
Significant differences in mental health characteristics for premorbid weight status were not demonstrated, suggesting comparable psychiatric comorbidities, prior mental health treatment, psychotropic medication use, family history of EDs and psychiatric diagnoses, and hospital discharge disposition, often reflecting severity of mental health problems. This is a novel finding and suggests similar mental health characteristics among medically compromised youth with AN/AAN across the premorbid weight spectrum. Of note, psychiatric assessment is a complex process and relying on chart review of historical mental health problems must be interpreted cautiously. We found significant variability in the level of detail documented about mental health histories and the absence of documented problems cannot be equated with a true absence of problems. As such, standardized assessment could offer a more sensitive comparison of mental health characteristics for premorbid weight, as was illustrated by Matthews et al. (2021), in which patients with AN/AAN and premorbid overweight/obesity endorsed more severe anxiety, depression, and ED symptoms on self-report questionnaires than patients without a history of overweight/obesity (Matthews et al., 2021).
Enhancing staffing methods and improving the admission process of a psychiatric hospital using simulation
Published in International Journal of Healthcare Management, 2023
Pritom Kumar Mondal, Bryan A. Norman
Average length of stay (LOS) in this psychiatric hospital is significantly higher than in a general hospital, as patients often need to stay for several weeks. Because there are many referrals and a long average LOS, there is not enough psychiatric hospital capacity to handle all of the potential patients. Therefore, a thorough, multi-stage admission process is developed, and due to the complex nature of psychiatric assessment it can take several days to properly assess patients which makes the process longer and more complicated than a typical referral decision process for other types of patient care. There is the additional issue of referred patients requiring continuous PM until they are transferred to the psychiatric hospital which is both expensive and consumes healthcare resources. The patient evaluation process can also be disrupted by emergent situations that arise since psychiatric patients may be at risk of injuring themselves or others. All of these combine to make the psychiatric hospital referral context quite different from the general hospital referral context.
Health professionals’ attitudes on integrated care and social work practice
Published in Social Work in Health Care, 2022
Zachary Cooper, Melissa Reitmeier, Samuel R. Bethel
In general, social workers on integrated care teams is an evolving and needed role (Bakos-Block, 2018; Fraser et al., 2018; Rowe et al., 2017; Keefe et al., 2009; Zerden et al., 2017). However, social workers often engage in roles that are limiting. Social workers commonly engage in case management activities, but may be less likely to provide behavioral health services such as assessment, diagnosis, and treatment of mental, emotional, and behavioral disorders (Fraher et al., 2018). Clinical social workers have competencies to conduct psychiatric assessment, psychoeducation, case management, and psychotherapeutic intervention (NASW, 2005). Social workers also possess skills to perform mezzo and macro level roles such as program implementation and population health interventions. However, social workers frequently do not perform all of these tasks within one job (Bakos-Block, 2018; Fraher et al., 2018). It is unclear whether barriers to a more comprehensive social work role is due to a lack of understanding of the social workers, a deficit in individual social work competency, or negative attitudes among health care providers about social workers and the social work role in integrated care settings (Glaser & Suter, 2016; Zerden et al., 2021).