scholarly journals Physical examination in psychiatric practice

2005 ◽  
Vol 11 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Gill Garden
Keyword(s):  
Mental Health ◽  
General Population ◽  
Physical Examination ◽  
Mental Disorder ◽  
Physical Illness ◽  
Psychiatric Practice ◽  
Medical Illness ◽  
Physical Disease

Physical disease is more prevalent in people with mental disorder than in the general population. It is important for psychiatrists to maintain skills in physical examination to ensure that physical illness is diagnosed and treated appropriately. A sound knowledge of medical illness ensures that examination is targeted at the relevant diseases. Mental health units should provide adequate facilities and equipment. All detailed examinations should be undertaken in the presence of a chaperone. Opportunities for psychiatrists to refresh their knowledge and skill are suggested.

scholarly journals Involuntary Detention and Treatment: Are We Edging Toward a “Paradigm Shift”?

2020 ◽  
Vol 46 (2) ◽  
pp. 231-235 ◽  
Author(s):  
George Szmukler
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Disorder ◽  
Paradigm Shift ◽  
Treatment Decision ◽  
Physical Illness ◽  
Persons With Disabilities ◽  
Health Laws

Abstract Recent challenges to conventional mental health laws concerning involuntary detention and treatment of persons with a mental disorder have led to proposals, or indeed an insistence, that fundamental reform is necessary. A key theme has been the need to eliminate unfair discrimination against people with a mental disorder because their human rights are not respected on an equal basis with other people. Some proposals depart radically from conventional assumptions concerning the justification of involuntary detention and treatment. One is a “fusion law,” a generic law applying to all persons lacking the ability to make a treatment decision, whether resulting from a “mental” or “physical” illness. An authoritative interpretation of the UN Convention on the Rights of Persons with Disabilities (2006) goes so far as to maintain that involuntary interventions are a violation of the Convention.

Combined effect of mental disorder and low social support on care service use for mental health problems in the Dutch general population

2002 ◽  
Vol 32 (2) ◽  
pp. 311-323 ◽  
Author(s):  
M. TEN HAVE ◽  
W. VOLLEBERGH ◽  
R. BIJL ◽  
J. ORMEL
Keyword(s):  
Mental Health ◽  
Social Support ◽  
General Population ◽  
Mental Disorder ◽  
Service Utilization ◽  
Service Use ◽  
Mediating Effect ◽  
Mental Health Service Use ◽  
Functional Impairments ◽  
General Population Study

Background. People with a mental disorder have high rates of service utilization for emotional or addiction problems. Little is known about the role of functional impairments and low social support in such service use. This article investigates: (1) whether the presence of multiple functional impairments mediates the link between mental disorder and service use; and (2) whether social support modifies that association.Methods. Data were derived from the Netherlands Mental Health Survey and Incidence Study, NEMESIS, a prospective general population study. Predictors of service use (mental disorder; functional impairments; social support) were recorded in the second wave of the study, and service use in the third wave.Results. Persons with a DSM-III-R disorder and persons with multiple functional impairments were three to seven times as likely to use primary or mental health care. People with low perceived social support were two to three times as likely to use them, and living alone increased the likelihood by 30% to 80%. The effect of mental disorder on service use was mediated by multiple functional impairments. In people with a mental disorder, low levels of social support intensified mental health service use.Conclusion. Service utilization by people with mental problems can be better understood through a model incorporating: (1) independent effects of mental disorder, functional impairments and social support on service use; (2) a mediating effect of multiple functional impairments on the link between mental disorder and service use; and (3) interaction effects of mental disorder and low social support on service use.

scholarly journals Mental Health Guardianship—a Change for the Better?

1982 ◽  
Vol 6 (10) ◽  
pp. 176-177
Author(s):  
Gareth W. Hughes
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Legal Framework ◽  
Psychiatric Practice ◽  
Mentally Disordered ◽  
The Past ◽  
Mental Health Act ◽  
Compulsory Care ◽  
The Uk ◽  
As If

The 1959 Mental Health Act has provided the legal framework for psychiatric practice in the UK for the past two decades. The Mental Health (Amendment) Bill (DHSS, 1981) currently before Parliament proposes to update the Act by improving the safeguards for detained patients, clarifying the position of staff looking after them, and by the removal of uncertainties in the law. The Bill incorporates changes relating to the compulsory care of Mentally Disordered patients in the community whereby a person may be accepted into Guardianship on the grounds that he or she is suffering from a Mental Disorder. Once accepted into Guardianship, the person or body named as Guardian has the power to exercise control over the person as if he or they were the father of the patient, and the patient was under 14 years of age.

scholarly journals Meta-analytical evidence on mental disorder symptoms during the COVID-19 pandemic in Latin America

2021 ◽  
Author(s):  
Stephen X. Zhang ◽  
Kavita Batra ◽  
Tao Liu ◽  
Rebecca Kechen Dong ◽  
Wen Xu ◽  
...  
Keyword(s):  
Mental Health ◽  
Latin America ◽  
General Population ◽  
Mental Disorder ◽  
Healthcare Workers ◽  
Mental Health Symptoms ◽  
Eligibility Criteria ◽  
Health Symptoms ◽  
Pooled Prevalence ◽  
Frontline Healthcare Workers

Objective. There is a lack of evidence related to the prevalence of mental disorder symptoms as well as their heterogeneities during the COVID-19 pandemic in Latin America, a continent across the equators. The current study aims to provide meta-analytical evidence on mental disorder symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population, and university students in Latin America. Methods. Bibliographical databases, such as PubMed, Embase, Web of Sciences, PsycINFO, and medRxiv, were systematically searched to identify pertinent studies up to Februry 6, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimize data entry errors. Results. A total of 33 studies with 101,772 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress, and insomnia was 32%, 27%, 32%, and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (33% vs. 27%, p <0.001). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers, and students in Latin America was 33%, 31%, 37%, and 36%, respectively. Conclusion. The high yet heterogenous level of prevalence of mental disorder symptoms emphasizes the need for appropriate identification of psychological interventions in Latin America.

Inequalities in mental health

1998 ◽  
Vol 173 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Claire Henderson ◽  
Graham Thornicroft ◽  
Gyles Glover
Keyword(s):  
Mental Health ◽  
High Risk ◽  
General Population ◽  
Mental Disorder ◽  
Health Inequalities ◽  
Psychiatric Morbidity ◽  
Policy Recommendations ◽  
Relevant Research ◽  
The Government

The Government emphasis on tackling health inequalities and the availability of recent data on mental health inequalities from the Office of Population Censuses and Survey's (OPCS) National Psychiatric Morbidity Survey (NPMS) (Meitzer et al, 1995) suggest that it is time to review the evidence on inequalities in mental health. We aim to summarise the relevant research on rates of psychiatric morbidity within the general population, and define specific populations at high risk of mental disorder. The theories put forward to account for these inequalities are considered, noting the limitations of the data they are based on and highlighting their implications for the data required to facilitate further research. Inequalities in access, provision and appropriateness of services are also discussed. We make policy recommendations for reducing these inequalities at national, regional and district levels.

scholarly journals The Management of Psychiatric Emergencies in Situations of Public Calamity

2021 ◽  
Vol 12 ◽  
Author(s):  
Leonardo Baldaçara ◽  
Antônio Geraldo da Silva ◽  
Lucas Alves Pereira ◽  
Leandro Malloy-Diniz ◽  
Teng Chei Tung
Keyword(s):  
Mental Health ◽  
General Population ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Support Systems ◽  
Health Problems ◽  
Psychiatric Emergencies ◽  
Number Of Patients ◽  
General Rules

The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.

Compulsory treatment of physical illness under MHA 1983

2021 ◽  
pp. medethics-2021-107438
Author(s):  
Robert Wheeler ◽  
Alexander Ruck Keene
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Daily Basis ◽  
Physical Illness ◽  
Compulsory Treatment ◽  
Clinical Question ◽  
Mental Health Act ◽  
Self Harm ◽  
The Law ◽  
Symptom Manifestation

Taken together, Sections 145 and 63 of the Mental Health Act 1983 (MHA) provide for treatment without consent of physical illness ancillary to the mental disorder with which a patient presents. On a daily basis, clinicians make both the decision that the Act’s authority can be applied to their patient’s case, and that it should be applied. But in the unusual circumstances where there is uncertainty as to the applicability of the MHA to the ancillary treatment of physical illness, the assistance of a court may be sought. In so doing, the law (and thence the courts) may justify compulsion but never prescribes it; the clinician is presented with authority that he or she could use but is left to decide whether it should be employed. This paper explores how the clinical question is set before the court, and whether the distinction between symptom, manifestation and consequence is sufficiently understood. This has important consequences in the context of self-neglect and its close cousin self-harm: the question whether the relevant ailment was attributable to or exacerbated by neglect or self- inflicted harm will determine whether compulsion under the MHA is applicable; and furthermore, whether or not compulsion is clinically acceptable.

Persuasion, Coercion, Medical Paternalism or the Mental Health Act: The Dilemma of Detention in the General Hospital

1992 ◽  
Vol 37 (5) ◽  
pp. 146-148 ◽  
Author(s):  
M S Humphreys
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
General Hospital ◽  
Physical Illness ◽  
Mental Health Act ◽  
Medical Paternalism

This paper describes the cases of three patients where the question of the need for formal detention arose due to mental disorder, apparently primarily due to physical illness, which in each case required further investigation and treatment in a general hospital. It states some of the issues facing those caring for patients under these circumstances and offers advice on overcoming some of the problems.

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