CONSULTATION LIASON Flashcards
(47 cards)
What is Consultation Liaison Psychiatry (CLP)?
The study, practice, and teaching of the relationship between medical and psychiatric disorders.
Who do psychiatrists in CLP serve as consultants to?
- They serve as consultants to:
- Medical colleagues: other psychiatrists, or other non-psychiatric specialists or primary care practitioners
- Other mental health professionals: psychologists, social workers, psychiatric nurses, occupational
therapists, etc - Non-medical professionals: in medico-legal cases
In what settings do psychiatrists in CLP assess and treat patients?
They asses and treat patients in non psychiatric wards (medical, surgical, etc), in collaboration with primary treating physicians
What is the role of Psychiatrists in CLP?
- serve as consultants
- asses and treat patients in non-psychiatric wards (medical, surgical, etc), in collaboration with primary
treating physicians - provide in-patient diagnostic and therapeutic programs for patients with medical and psychiatric co-morbidities
- provide out-patient maintenance and follow up treatment via variety of psychiatric and medical clinics
- conduct intense teaching, training and research in all academic levels and groups
In what kind of cases do CLP psychiatrists serve as consultants to non-medical professionals?
In medico-legal cases.
How do CLP psychiatrists assist in non-psychiatric wards?
They assess and treat patients in collaboration with primary treating physicians.
What type of programs do CLP psychiatrists provide for patients with medical and psychiatric co-morbidities?
In-patient diagnostic and therapeutic programs.
What academic activities do CLP psychiatrists engage in?
They conduct intense teaching, training, and research at all academic levels and groups.
What is involved in a bio-psycho-social-cultural assessment in CLP?
Conducting the assessment, creating a formulation, and implementing appropriate treatment in a general hospital context, including effective communication with the treatment team.
How does CLP address mental health in medical settings?
By assessing reactions to illness and differentiating between presentations of depression and anxiety.
What does CLP consider regarding the trajectories of illness?
They understand the combined trajectories of illness and developmental issues of individuals with mental health problems.
What emphasis is placed on neurocognitive disorders in CLP?
Emphases on assessing and managing delirium .
What disorders should CLP psychiatrists be able to assess and treat?
Somatic Symptom and related disorders.
What special populations have particular needs in CLP?
The young, the old, the indigenous,and those with intellectual disabilities, and others with psychiatric and psychosocial morbidity in medical settings.
What is the role of capacity assessments in CLP?
Conducting Capacity Assessments in clinical settings and assisting patients and clinicians in obtaining Informed Consent for relevant clinical investigations and treatment.
What are the categories of psychiatric differential diagnoses in the general hospital?
- Psychiatric presentations of medical conditions
- Psychiatric complications of medical conditions or treatments
- Psychological reactions to medical conditions or treatments
- Medical presentations of psychiatric conditions
- Medical complications of psychiatric conditions or treatments
- Comorbid medical and psychiatric conditions
What are the steps in the procedural approach to psychiatric consultation?
- Speak directly with the referring clinician.
- Review the current records and pertinent past records.
- Review the patient’s medications.
- Gather collateral data.
- Interview and examine the patient.
- Formulate diagnostic and therapeutic strategies.
- Write a note
- Speak directly with the referring clinician again.
- Provide periodic follow-up.
What are the key legal and ethical issues in Consultation Liaison Psychiatry (CLP)?
- Confidentiality
- Health Insurance Related Matters
- Treatment Consent and Refusal
- Advanced Directives and Substitute Decision Making
- Treatment Refusal and Involuntary Treatment
- Malpractice
- Parental Capacity
List exceptions to confidentiality in CLP?
- Exceptions include public safety
- welfare, duties to third parties
- and duties to protect/inform.
What is the principle of confidentiality in CLP?
Confidentiality is rooted in the Hippocratic oath, emphasizing:
* respect for the individual
* beneficence (doing good), and non-maleficence (avoiding harm).
* It is crucial for building trust but is not absolute; certain situations may require breaching confidentiality.
What are exceptions to confidentiality?
- circumstances involving Public Safety and Welfare, where harm to others may occur
- Duties to Third Parties, which may require disclosure to protect individuals.
- Duties to Protect/Inform, where a clinician must act to prevent imminent harm.
What matters are related to health insurance in CLP?
Health Insurance Related Matters->involve understanding coverage and the implications of insurance on treatment decisions, which can affect patient care and access to necessary services.
What is involved in treatment consent and refusal?
Treatment consent requires Capacity Assessments
Why are Capacity assessments used ?
- to ensure patients understand their treatment options and implications.
- They can then make informed consent and knowledgeable decisions about their care.
