CME: Emergency Psychiatry

Emergency Psychiatry from SCGH ED CME

Here is Anne’s fantastic talk on “Tricky concepts in ED Psychiatry”.

Other Resources:

• Potentially incapable patients objecting to treatment: doctors’ powers and duties. Kerri Eagle and Christopher J Ryan. Med J Aust 2014; 200 (6): 352-354.
• Capacity and Competence from LITFL
• Medical Clearance of the Psychiatric Patient CME talk 12/2013 by Gareth
• “Emergency Psychiatry and the Law” CME talk 10/2015 by Salam (Psychiatry)

General Psychiatry Resources:

• Office of the Chief Psychiatrist WA:
  • New Mental Health Act Forms (MHA 2014)
    • password protected (password available from the OCPWA – see link above) 
  • WA Mental Health Act 2014 (PDF)
    • not password protected!! so you can read this one as much as you want?!

Assessment of Capacity:

• Capacity Definition:
  • Mental capacity can be defined as having ‘sufficient understanding and memory to comprehend in a general way the situation in which one finds oneself and the nature, purpose, and consequence of any act or transaction into which one proposes to enter’ (www.dictionary.com) – in other words, as the ability to make a decision.
• Capacity assessment principles:
  • A person has decision making capacity to make a specific decision if (at the relevant time) they have the capacity to do ALL :
    • Understand any information about the decision
    • Understand the matters involved in the decision
    • Understand the effect of the decision
    • Weigh up the above factors for the purpose of making the decision
    • Communicate the decision in some way.
    • No Coercion
  • Assess the person’s decision-making ability – not the decision they make

Referral for Psychiatric Examination:

• Form 1A (MHA 2014)
• A practitioner can only refer a person for examination by a psychiatrist where they reasonably suspect that:
  • the person is in need of an involuntary treatment order (see below), or
  • if the person is currently on a community treatment order, the person is in need of an inpatient treatment order.
  • The assessing practitioner must have regard to the criteria for an involuntary treatment order