Overview and challenges of clinical decision making in mental health practice.

2016 ◽  
pp. 3-21
Author(s):  
Jeffrey J. Magnavita
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Practice ◽  
Mental Health Practice

Psychiatric ethics

2012 ◽  
pp. 28-32
Author(s):  
Sidney Bloch ◽  
Stephen Green
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Clinical Decision Making ◽  
Ethical Dilemmas ◽  
Theoretical Perspective ◽  
Codes Of Ethics ◽  
Clinical Decision ◽  
Mental Health Practice ◽  
Ethical Problems

A myriad of ethical problems pervade clinical practice and research in psychiatry. Yet with few exceptions, psychiatric ethics has generally been regarded as an addendum to mainstream bioethics. An assumption has been made that ‘tools’ developed to deal with issues like assisted reproduction or transplant surgery can be used essentially unmodified in psychiatry. These tools certainly help the psychiatrist but the hand-me-down approach has meant that salient features of psychiatric ethics have been prone to misunderstanding. Psychiatric ethics is concerned with the application of moral rules to situations and relationships specific to the field of mental health practice. We will focus on ethical aspects of diagnosis and treatment that challenge psychiatrists, and on codes of ethics. Resolution of ethical dilemmas requires deliberation grounded in a moral theoretical framework that serves clinical decision-making, and we conclude with our preferred theoretical perspective.

scholarly journals Spiritual, Religious and Ethical Values in a Suicidal Individual

2020 ◽  
pp. 109-115
Author(s):  
Ana Cristina Lopes ◽  
Diogo Telles Correia
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Cultural Values ◽  
Clinical Decision Making ◽  
Religious Faith ◽  
Clinical Decision ◽  
Spiritual Experiences ◽  
Mental Health Practice ◽  
Spiritual Dimension ◽  
Spiritual Perspectives

AbstractReligious and spiritual experiences can appear in mental health practice as far as they often structure what aspects of psychopathological phenomena are present, sometimes making it difficult to determine whether some experiences should be classified as symptoms of a psychiatric disorder or crises within spiritual life.We present a clinical vignette of a 62-year-old sacristan who was admitted to the Psychiatric Emergency Room for suicidal thoughts in the context of physical sequelae of a cardiac episode. He confessed that, in the process of coping with his illness, he had a distressing experience of guilt and of losing his religious faith and shared the intention to take his own life by hanging himself.Themes that emerge in the discussion include issues related to the boundaries of psychiatric diagnosis, the spiritual dimension of mental health and the values that underlie clinical decision-making regarding a suicidal individual.Incorporating religious and spiritual perspectives in the clinical assessment of patients is essential to understand individual’s framework of cultural values and social attitudes on disease.

scholarly journals Correction to: Using behavioral insights to design implementation strategies in public mental health settings: a qualitative study of clinical decision-making

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Briana S. Last ◽  
Simone H. Schriger ◽  
Carter E. Timon ◽  
Hannah E. Frank ◽  
Alison M. Buttenheim ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Qualitative Study ◽  
Clinical Decision Making ◽  
Public Mental Health ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Mental Health Settings

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

scholarly journals Probability and loss: two sides of the risk assessment coin

2011 ◽  
Vol 35 (11) ◽  
pp. 413-418 ◽  
Author(s):  
Matthew M. Large ◽  
Olav B. Nielssen
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Other ◽  
Current Form ◽  
Mental Health Settings ◽  
Future Harm ◽  
Two Sides

SummaryRisk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk – the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but less serious harms and comparatively rare catastrophic events is a particular limitation of the value of risk categorisations. We should admit that our ability to assess risk is severely limited, and make clinical decisions in a similar way to those in other areas of medicine – by informed consideration of the potential consequences of treatment and non-treatment.

Mental Health Clinical Decision Support Exploiting Big Data

2019 ◽  
pp. 160-184 ◽  
Author(s):  
Jan Kalina
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Big Data ◽  
Decision Support ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Clinical Decision Making ◽  
Support Systems ◽  
Clinical Decision Support Systems ◽  
Clinical Decision

The complexity of clinical decision-making is immensely increasing with the advent of big data with a clinical relevance. Clinical decision systems represent useful e-health tools applicable to various tasks within the clinical decision-making process. This chapter is devoted to basic principles of clinical decision support systems and their benefits for healthcare and patient safety. Big data is crucial input for clinical decision support systems and is helpful in the task to find the diagnosis, prognosis, and therapy. Statistical challenges of analyzing big data in psychiatry are overviewed, with a particular interest for psychiatry. Various barriers preventing telemedicine tools from expanding to the field of mental health are discussed. The development of decision support systems is claimed here to play a key role in the development of information-based medicine, particularly in psychiatry. Information technology will be ultimately able to combine various information sources including big data to present and enforce a holistic information-based approach to psychiatric care.

Clinical outcome assessment in mental health

2018 ◽  
pp. 191-200
Author(s):  
Skye P. Barbic ◽  
Stefan J. Cano
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Outcome ◽  
Outcome Assessment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Evidence Based ◽  
Measurement Issues ◽  
Health Disorders ◽  
Based Medicine

Clinical outcome assessment (COA) in mental health is essential to inform patient-centred care and clinical decision-making. In this chapter, the reader is introduced to COA as it is evolving in the field of mental health. Multiple approaches to COA are presented, but emphasis is placed on approaches that generate clinically meaningful data. Understanding COA can position clinicians and stakeholders to better evaluate their own practice and to contribute to the ongoing evolution of COA research and evidence-based medicine. This chapter begins with the definitions of assessment and measurement. Conceptual frameworks and models of COA development and testing are then presented. These are followed by a discussion of measurement in practice that reviews measurement issues related to clinical decision-making, programme evaluation, and clinical trials. Finally, this chapter highlights the contribution of metrology to improving health outcomes of individuals who experience mental health disorders.

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