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Psych > risk assessment and management in psychiatry > Flashcards

risk assessment and management in psychiatry Flashcards

1
Q

what kind of risk factors exist? (3)

A
  1. static - historical
  2. stable - long term but not fixed
  3. dynamic - changing over time - more manageable
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2
Q

what is at risk in mental disorder?

A
  1. self
  2. others
  3. to own mental health
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3
Q

why is risk assessment important?

A
  1. identify adverse outcomes
  2. rank outcomes in likelihood
  3. differentiate what we can change and what we can’t
  4. risk management
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4
Q

deaths from suicide annually?

A

1 million

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5
Q

suicide vs homicide in UK?

A

10x

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6
Q

gender ireland suicide?

A

m>f when young

but female rates in young have doubles in last 10yrs

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7
Q

year of suicide decriminalised?

A

1993

1995 - task force, prevention measures

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8
Q

how many people commit suicide in ireland per year

A

600

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9
Q

people who commit suicide - rate of mental prob, previous attempts?

A

60%

36% previous attempt

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10
Q

what is parasuicide?

A

self harming action that is non habitual and has a non fatal outcome

BASICALLY DSH

NB risk factor for completed suicide - risk in year after 30-50x

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11
Q

what’s the national registry of self harm?

A

collects data on people presenting to ED with DSH - covers all general and paeds EDs in ireland

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12
Q

most common methods DSH?

A

drug OD

  1. tranquilisers
  2. paracetamol
  3. antidepressants/mood stabilisers

second most common is cutting - more in younger

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13
Q

alcohol and DSH?

A

in 40% of DSH presentations

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14
Q

repetition of DSH?

A

higher risk with cutting

high risk repetition

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15
Q

what is anomic suicide?

A

happens when attachment between the person and society are strained

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16
Q

media and suicide

A

reporting of suicide - increased rates- there are guidelines for responsible reporting

17
Q

economics and suicide?

A

lower rates in war

higher in economic prosperity and decline

18
Q

occupations with high rates suicide?

A

doctors - poor help-seeking, stigma
vets
armed and police forces

19
Q

risk factors for suicide?

A
  1. male
  2. social class 1 + 4
  3. single
  4. unemployed
  5. elderly
  6. chronic pain/ill
  7. previous attempts
  8. ideation
  9. mental illness
  10. substances
  11. fhx
  12. recent hosp d/c
20
Q

is DSH a risk for suicide?

A

yes

21
Q

rational suicide

A

without a mental illness
still often change mind
still should try to prevent

22
Q

rate of death in 1st attempt of suicide?

A

55%

most who die by suicide never referred to psych

23
Q

if someone says they attempted suicide what do you want to ask about?

A
  1. before: plan/events/final acts/note/knowledge of method used - perceved lethality
  2. during: what, where, how avoided discovery, did they contact anyone
  3. after: how were they discovered, regret, future plans?
24
Q

parasuicide questions?

A
  1. post discharge accommodation
  2. substance abuse
  3. intention to repeat
  4. has it changed anything
  5. will they engage with MHS?
25
Q

what is SADPERSONS?

A

assesses RFs in patients after an episode of self harm

26
Q

outline SADPERSONS

A
  1. sex
  2. age
  3. depression hx
  4. previous attempt
  5. ethanol
  6. reality break - psychosis/delirium
  7. social support
  8. organised plan
  9. no spouse
  10. sickness
27
Q

people with mental health are likely to ________ crime

A

be the victims of

28
Q

mental health problems ______ violence

A

have a small association with

29
Q

homicide by the mentally ill is _______

A

not increasing

30
Q

homicides by the mentally ill are mostly due to _______

A

system failures

31
Q

RFs for violence

A
  1. personal - previous violence
  2. illness related - psychotic, substance abuse
  3. mental state - planning, threats, anger, command hallucinations
  4. situational - access to weapons
32
Q

what is an SPJ?

A

structured professional judgement- combination of clinical and actuarial risk assessment - ex. is the HCR 20

33
Q

purely clinical risk assessment efficacy -

A

not great

34
Q

MHA and risk?

A

can involuntary treatment if risk to self or others or a risk to their mental health

Psych (23 decks)

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