Diagnosing Mental Health Patient WhileMaintaining Anonymity

Author(s):  
Shagun Saboo ◽  
Srishti Gupta ◽  
Isha Nailwal ◽  
Rithik Gandhi ◽  
Sameer Rana
Author(s):  
Pawan Gupta

It is estimated that 1 in 4 people in a year will have some kind of mental health problem, and that mixed anxiety and depression is the most common disorder in the UK. There is an increasing number of mental health patients attending the ED, and a new FY doctor in the ED will encounter such patients from their first shift onwards. The approach to a mental health patient is only marginally different from the approach to those presenting under other specialties. The assessment largely depends on careful history taking and attentively listening to the patient’s narrative. There are only a few situations in psychiatry in which a physical examination and investigations are required in the ED to make a diagnosis. As it would not be possible to cover all the areas of psychiatry which come through the doors of the ED in one chapter, only a few questions have been included here to provide a flavour of the common psychiatric situations that FY1/2s may come across in their early training period. The UK has the highest rate of self-harm in Europe and so one of the most important points is to recognize suicidal patients who can harm themselves seriously and manage them appropriately. If such patients are discharged following an inadequate assessment, they may go on to commit suicide and the attending doctors would have missed the opportunity to support and save them. In this category of patients, when they present to the ED, no matter how minimal is the level of their self-mutilation, it is a serious ‘cry’ for help. Our job is to listen to the patient and support them with the maximum help we can provide. As it may be difficult to occasionally get to the bottom of the problem, particularly within the time constraints in the ED, a low level of suspicion should be kept to ask for the assistance of the mental health expert. Self-harm and depression go almost hand in hand. The suicidal rate is higher in depressed patients than in the general population.


2019 ◽  
Vol 25 (05) ◽  
pp. 279-286 ◽  
Author(s):  
Suzy Ker ◽  
Emily Peckham ◽  
Simon Gilbody ◽  
Susan Bonner

SUMMARYMental health clinicians are expected to offer support and advice to patients to promote smoking cessation. Alongside this is the relatively new and increasingly popular phenomenon of electronic cigarette use. The absence of any long-term evidence regarding safety is recognised and clinicians' awareness of e-cigarettes may be limited to personal experience or media publications, leading to uncertainty in their confidence discussing e-cigarettes with patients, both in general and as an aid to quitting smoking. This article provides a historical and contemporary overview of e-cigarettes and vaping. The reader will gain an understanding of e-cigarette usage, risks and benefits, the current position on use of e-cigarettes in mental health settings, and tips on how to take an e-cigarette/vaping history and how to offer advice about use. This is achieved in the context of recent publications and national recommendations. Although the focus is primarily on the mental health patient, the article is of benefit to all health and social care professionals to help them develop an understanding of e-cigarettes as a tobacco-smoking cessation or harm-reduction aid.LEARNING OBJECTIVESAfter reading this article you will be able to: •provide a balanced overview of e-cigarette use•understand the risk reduction approach in the use of e-cigarettes versus tobacco smoking in people with mental illness•demonstrate the principles of taking a vaping history.DECLARATION OF INTERESTS.G. was chief investigator for the Smoking Cessation Intervention for Severe Mental Ill Health Trial (SCIMITAR) (HTA 11/136/52) and is supported by the National Institute for Health Research (NIHR) Yorkshire and Humber Collaboration for Leadership in Applied Health Research and Care (CLAHRC YH). S.K. received an NIHR grant to part fund her research time for SCIMITAR. This article evolved from the SCIMITAR study.


Author(s):  
Matthew McKillop ◽  
John Dawson ◽  
George Szmukler

<p>In England and Wales, there are now two regimes under which an adult can be deprived of liberty when receiving mental health treatment: the regime established by the Mental Health Act 1983 (MHA), and the Deprivation of Liberty Safeguards (DOLS) authorisation regime established by the Mental Capacity Act 2005 (MCA). Where both regimes might apply to a mentally disordered person in hospital for mental health treatment, a major dividing line between them is the ability of the patient to “object” to being a mental health patient or to being given mental health treatment. If such an objection occurs, a hospitalised patient is ineligible for the DOLS regime and only the MHA regime may be used to authorise the deprivation of their liberty.</p>


2021 ◽  
Author(s):  
Jana Strahler ◽  
Konrad Smolinski ◽  
Karsten Krüger ◽  
Britta Krüger

Abstract Background Quarantine and social-distancing measures during the COVID-19 pandemic situation resulted in a radical change in lifestyle behaviors. While the reduction of total physical activity is assumed to negatively impact psychological health (higher stress and anxiety levels), regular sports activity during lockdown conditions has beneficial effects on health. Mechanisms are however unclear. The present analysis therefore examined the associations of sports activity with mental health, and assessed whether this is due to a direct effect on experiencing positive emotions and mental health, due to a stress-buffering mechanism, and/or through protecting/enhancing resilience. Methods An online survey, accessible from April 7th to April 30th 2020, gathered data on sports activity (Physical Activity, Exercise, and Sport Questionnaire, BSA), mental health (Patient Health Questionnaire-4, PHQ-4, WHO Wellbeing Index, WHO-5), momentary stress (single item), and resilience (i.e. feeling determined, cheerful, content, and being interested in the things one is doing). The final data set comprised 742 subjects including 534 (72.0%) women and ranging in age from 16 to 83 years (mean: 28.13 ± 11.46 years). Results Across all participants, sports activity was related to higher wellbeing and resilience but lower affective psychopathology. Importantly, all coefficients were below 0.2 indicating only small-sized associations. Moderation analyses confirmed a direct effect of sports activity on affective symptoms and wellbeing. Stress-buffering effects were not confirmed for either outcome but a resilience-protecting effect was seen for both wellbeing and affective psychopathology. Conclusions During the initial phase of the first COVID-19 lockdown, sports activity was associated with better mental health and wellbeing. Besides this direct effect, there was also evidence for a resilience-protecting effect of sport. The assumed stress-buffering effect could not be confirmed. Present findings indicate resilience-protective mechanisms to be a major contributor to sports beneficial effects on mental health during quarantine. Though, results from this cross-sectional, predominantly female, and convenience sample study must be confirmed in more diverse samples.


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