Contributors, xi
Foreword, xv
Acknowledgements, xvii
Abbreviations, xix
About the companion website, xxi
Part I: Introduction
1 Welcome, 3
Sarah Stringer
2 Mental health services overview, 5
Christina Barras, Rory Conn, Laurine Hanna, Abigail G Crutchlow, and Juliet Hurn
3 Your team, 9
Christina Barras, Rory Conn, Laurine Hanna, and Abigail G Crutchlow
4 Your role, 13
Christina Barras, Rory Conn, Laurine Hanna, and Abigail G Crutchlow
5 Getting started, 16
Mujtaba Husain, Christina Barras, Rory Conn, and Laurine Hanna
6 Safety and verbal de-escalation, 19
Sarah Stringer
7 Boundaries, time management and burnout, 25
Sarah Stringer, Christina Barras, Rory Conn, and Laurine Hanna
8 Psychiatric assessment, 31
Sarah Stringer, Mujtaba Husain, Penelope Brown, and Sean Cross
9 Management: General principles, 45
Sarah Stringer
10 Physical healthcare, 48
Katherine Beck, Stephanie Young, and Juliet Hurn
11 Medications, 53
Noreen Jakeman and Sarah Stringer
12 Psychological interventions, 65
Jane Bunclark, Natasha Liu-Thwaites, Cheryl Kipping, Juliet Hurn, and Sarah Stringer
13 Social interventions, 83
Christina Barras, Rory Conn, Laurine Hanna, Abigail G Crutchlow, Juliet Hurn, Rachel Thomasson, and Anna M Burnside
14 Handovers, 96
Rachel Thomasson
15 Mental health legislation, 97
Penelope Brown, Peter Hindley, and Anna M Burnside
16 Compliments, complaints and serious incidents, 107
Anna M Burnside and Sarah Stringer
17 Training in psychiatry, 110
Mujtaba Husain, Juliet Hurn, Rachel Thomasson, Christina Barras, Rory Conn, Laurine Hanna, and Sarah Stringer
Part II: Common tasks COMMUNITY MENTAL HEALTH TEAM (CMHT)
18 Outpatient clinics, 123
Christina Barras, Rory Conn, and Laurine Hanna
19 Care programme approach (CPA) meetings, 127
Abigail G Crutchlow, Christina Barras, Rory Conn, and Laurine Hanna
20 Home visits, 130
Laurine Hanna
21 Depression, 133
Rory Conn and Rachel Thomasson
22 Generalised anxiety disorder (GAD), 141
Laurine Hanna
23 First episode psychosis (FEP), 147
Christina Barras and Juliet Hurn
24 Psychosis - longer term, 154
Stephanie Young
25 Bipolar affective disorder (BPAD), 159
Rory Conn and Juliet Hurn
26 Emotionally unstable personality disorder (EUPD), 165
Jane Bunclark and Juliet Hurn
27 Non-engagement or disengagement, 174
Rory Conn
28 Patients with forensic histories, 179
Penelope Brown
29 Pregnancy, 183
Anna M Burnside and Noreen Jakeman
30 Older adults, 189
Vivienne Mak and Sean Lubbe
31 Trauma and asylum, 196
Laurine Hanna and Juliet Hurn
32 Driving, 203
Christina Barras
33 Discharge, 208
Laurine Hanna
WARD
34 From admission to discharge, 212
Katherine Beck and Abigail G Crutchlow
35 Ward rounds, 221
Katherine Beck
36 Common side effect management, 225
Katherine Beck, Noreen Jakeman, and Sarah Stringer
37 Clozapine, 235
Stephanie Young and Noreen Jakeman
38 Self-discharge and section 5(2), 242
Abigail G Crutchlow
39 Seclusion reviews, 246
Katherine Beck
40 Alcohol misuse, 251
Lisa Conlan, Isabel McMullen, and Cheryl Kipping
41 Illicit drugs, 259
Isabel McMullen, Lisa Conlan, and Cheryl Kipping
42 Pregnant patients, 265
Anna M Burnside
43 Inpatients with forensic histories, 269
Penelope Brown
44 People with learning disabilities (LD), 274
Rory Sheehan
45 Emotionally unstable personality disorder (EUPD), 281
Jane Bunclark and Juliet Hurn
46 Older adults, 287
Vivienne Mak and Sean Lubbe
47 Electroconvulsive therapy (ECT), 293
Sean Lubbe and Vivienne Mak
48 Section 136 assessments, 298
Anna M Burnside
49 Tribunals, 303
Sarah Stringer
ON-CALL
50 Your first on-call shift, 307
Rachel Thomasson, Sean Cross, and Anna M Burnside
51 Self-harm, 318
Rachel Thomasson, Jane Bunclark, Sean Cross, Rory Conn, and Christina Barras
52 Self-harm in young people, 330
Peter Hindley and Matthew Fernando
53 First episode psychosis (FEP), 336
Rachel Thomasson
54 Mania, 341
Rachel Thomasson
55 Delirium, 345
Vivienne Mak, Sean Lubbe, and Sean Cross
56 Obsessive compulsive disorder (OCD), 353
Natasha Liu-Thwaites and Rachel Thomasson
57 Panic attacks, 357
Natasha Liu-Thwaites
58 Drug-seeking, 361
Isabel McMullen and Lisa Conlan
59 Learning disability (LD) and behavioural change, 365
Rory Sheehan
60 'Social' presentations, 369
Sean Cross and Rachel Thomasson
61 Medically unexplained symptoms, 374
John Moriarty
Part III: Emergencies
COMMUNITY MENTAL HEALTH TEAM (CMHT)
62 Acute relapse, 383
Laurine Hanna
63 Adult safeguarding, 388
Rory Conn, Vivienne Mak, and Sean Lubbe
WARD
64 Child protection concerns, 394
Peter Hindley, Juliet Hurn, and Sarah Stringer
65 Medical emergencies, 401
Katherine Beck and Abigail Steenstra
66 Opiate overdose, 405
Isabel McMullen and Lisa Conlan
67 Stiff, feverish patients, 408
Anna M Burnside
68 Catatonia, 414
Anna M Burnside
69 Lithium toxicity, 418
Noreen Jakeman and Katherine Beck
70 Alleged sexual assault, 422
Anna M Burnside, Sarah Stringer, and Penelope Brown
71 Self-harm on the ward, 428
Jane Bunclark and Abigail Steenstra
72 Hanging, 433
Anna M Burnside
73 Death, 436
Katherine Beck
ON-CALL
74 Aggression, 440
Abigail G Crutchlow, Christina Barras, Noreen Jakeman, Sean Lubbe, Vivienne Mak, Rachel Thomasson, and Abigail Steenstra
75 Challenging behaviour in children, 451
Peter Hindley and Matthew Fernando
76 Refusal of urgent treatment, 455
Vivienne Mak, Sean Cross, Sean Lubbe, and Rachel Thomasson
77 Delirium tremens, 461
Rachel Thomasson, Isabel McMullen, and Lisa Conlan
78 Puerperal psychosis, 466
Anna M Burnside
79 Eating disorders, 470
Christina Barras and Sean Cross
80 Threats of violence, 477
Penelope Brown and Rachel Thomasson
Appendices
Appendix A Investigations/Monitoring, 485
Juliet Hurn, Noreen Jakeman, Anna M Burnside, and Abigail Steenstra
Table A.1 Overview of physical health monitoring in Severe Mental Illness (SMI), 485
Table A.2 Delirium investigations, 486
Table A.3 First episode psychosis investigations, 487
Table A.4 Baseline checks before starting psychotropics, 488
Table A.5 Ongoing monitoring - antipsychotics, 489
Table A.6 Ongoing monitoring - mood stabilisers, 490
Table A.7 Rapid tranquilisation (RT) cautions and contraindications, 490
Table A.8 Monitoring after RT, 491
Appendix B Medications, 492
Noreen Jakeman and Sarah Stringer
Table B.1.1 Oral antipsychotics-approximate relative side effects, 492
Table B.1.2 Depot antipsychotics-approximate relative side effects, 493
Table B.2 Common oral antipsychotics-key information, 494
Table B.3 Common depot antipsychotics-key information, 496
Table B.4 Selective Serotonin Reuptake Inhibitors (SSRIs)-key information, 498
Table B.5 Non-SSRI antidepressants-key information, 499
Table B.6 Mood Stabilisers-key information, 502
Table B.7 Sedatives-key information, 504
Appendix C Alcohol and drugs, 505
Table C.1 Quick guide to alcohol units (Cheryl Kipping), 505
Table C.2 Alcohol Use Disorders Identification Test (AUDIT) questionnaire, 506
Table C.3 Severity of Alcohol Dependence Questionnaire (SADQ), 508
Table C.4 Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar), 509
Table C.5 Clinical Opiate Withdrawal Scale (COWS), 511
Table C.6 Common illicit drugs summary, 513
Appendix D Cognitive testing, 515
Appendix D.1 The Montreal Cognitive Assessment (MOCA), 515
Appendix D.2 The Addenbrooke's Cognitive Examination-III (ACE-III), 516
Appendix D.3 The Mini-Addenbrooke's Cognitive Examination (M-ACE), 530
Appendix E Mental health legislation, 532
Anna M Burnside & Penelope Brown, with thanks to Daniel M Bennett and Edward Noble
Table E.1 The Mental Health (Care and Treatment) (Scotland) Act 2003: common civil sections, 532
Table E.2 The Mental Health (Northern Ireland) Order 1986: common sections (Part II), 534
Table E.3 The Mental Health Act 1983, amended 2007 (England & Wales): forensic sections, 537
Appendix F Useful contacts, 539
Index, 541
