Trauma

− Vicarious trauma (also known as secondary trauma) is trauma that you experience because you hear about other peoples traumatic experiences

− A response to witnessing the 1st hand trauma of another person  − Can resemble PTSD

 

Occupational Violence

− Horizontal or lateral violence is a common experience in the workplace  − A form of bullying that occurs in the health workplace

 

Roles

  • Health professional
  • Multi-disciplinary team- responsible for the management of a consumers plan
  • Social worker- assist with housing, finance issues
  • Occupational therapist- ensure ADLs are met, run activity groups (art, fitness etc)
  • Psychiatrist- responsible for decisions and treatments of a consumer, can prescribe medications
  • Psychologist- focus on behavioural and cognitive behaviours
  • Mental Health Nurse/Nurse- provides primary nursing, administer medication, care for the consumers
  • Peer works
  • NGOs- Non Government Organisation, charities that rely on donations and volunteers

 

 

Least Restrictive rnvironment or Alternative

− A least restrictive environment- think if there’s another way of doing this and have you tried other methods that aren’t invasive/intrusive?

− Justify that you have tried other interventions/methods before restraints are enacted

Social and rmotional Wellbeing of Indigenous Peoples

− Indigenous people have substantially higher rates of suicides then non Indigenous

− Its important to interpret behaviours thoughts and feelings

 

Self-awareness and Reflection

− Personal reflection is important to re-evaluate and reassess their work practice − Reflection ensures that best practices are being met

 

Summary

MSE- (PAMS GOT JIMI acronym)

  • Perception (hallucination, illusion)
  • Affect (how their mood is expressed- appropriate, restricted, blunted, flat)
  • Mood (how the consumer describes how they’re feeling)
  • Speech
  • General appearance and behaviour
  • Orientation/Cognition (determining what their form of concept is)
  • Thought content (delusional thinking, suicidal thoughts)
  • Judgement
  • Insight
  • Memory
  • Intelligence/Form of thought (disorders- flight of ideas, tangential thinking, neologisms, echolalia)

 

Risk Assessments 

  • Deliberate Self Harm (DSH)- intent to harm not die
  • Suicide- intent to die
  • Absconding- running away
  • Vulnerability (sexually, financially)
  • Minors
  • Violence
  • Medication non-adherence

Psychosis

  • Psychosis- an acute presentation where a person loses the capacity to tell what’s real and what isn’t
  • Causes of psychosis?
  • Hallucinations:
    • Auditory (hearing voices, sounds) Ø Visual (seeing things)
    • Tactile (touch)
    • Olfactory (smell)
    • Gustatory (taste)

Schizophrenia

  • DSM- 5 criteria for assessment
  • Negative symptoms- (taking away aspects from the person i.e. motivation, affect, joy, insight etc)
  • Positive symptoms- (adding symptoms onto the patient i.e. delusions, depression, disorganised speech etc)
  • Prodrome- what we see prior to the development of schizophrenia i.e. pre hallucinatory symptoms (subtle)
  • Side effects of antipsychotics? (i.e. Olanzapine, Clozapine)
  • Typical antipsychotics are 1st generation (i.e. Haloperidol, Promazine)
  • Atypical antipsychotics are 2nd generation (i.e. Olanzapine, Seroquel, Clozapine, Risperidone, Paliperidone)
  • Significant side effects of antipsychotics?

− Weight gain à metabolic syndrome à abdominal obesity, hypertension, diabetes, cholesterol

  • Clozapine side effects?

− Agranulocytosis- can occur within the 1st 18 weeks of Tx (weekly blood tests required)

− Weight gain

− Constipation

− Sedation

− Headache

Affective (Mood) Disorders 

  • Symptoms of depression?

− Avolition (lack of motivation)

− Persistently low mood

− Insomnia/hypersomnia

− Weight gain/loss of 5%

− Anhedonia (no pleasure)

  • Depression- DSM 5 criteria for assessment
  • Types of depression:

− Major depressive episodes

− Psychotic depression (symptoms of depression but may also feature psychotic symptoms)

− Bipolar disorder I

  • Treatments include: Cognitive Behaviour Therapy (CBT), antidepressants, rCT
  • Treatments- Antidepressants

− SSRI

− SNRI

− MAOI

− TCA

− Tetracyclic

 

  • Side effects of antidepressants? − Anticholinergic

− Sexual dysfunction

− Dry mouth

− Nausea

 

  • Bipolar disorder is associated with mania
  • Mania = persistently elevated, expansive or irritable mood
  • Hypomania = “mini” mania, no psychotic features or delusional thoughts

 

  • Treatments- Mood stabilisers − Lithium

− Sodium valproate

 

Dual Diagnosis

  • Dual diagnosis= the addition of a mental health condition AND a drug/alcohol addiction
  • Delirium tremens (DTs)- is associated with alcohol withdrawal

− Treated with high does of Valium and Thiamine

Personality Disorders 

  • Borderline Personality Disorder (BPD) criteria:

− Aggression

− Intense fear of abandonment

− rxtremes of moods (unstable/stable)

− History of self harm

− Chronic feelings of emptiness

− Increase in risk taking behaviours (i.e. lots of sexual relationships, unprotected sex, drug use) •  No specific treatment for BPD

 

Eating Disorders 

  • Anorexia Nervosa = low BMI, excessive exercise and diet, poor self image
  • Bulimia Nervosa = binging eating or purging behaviours, excessive exercising

 

Older Adults

  • Know the differences b/w: Depression, Delirium and Dementia

− Causes

− Signs and symptoms

− Treatment