Psychiatry / Alcohol and Drug

1
Psychiatry / Alcohol and Drug

• FELLOWSHIP SAQ PRINCIPLES

2
Suicide risk assessment

• SAD PERSONS
• Sex male 1
• Age - gt55yr or youth 1
• Depression (PMH) 2
• Previous attempt 1
• Ethanol / drugs 1
• Rational thought loss 2
• Separated / divorced / widowed 1
• Organised plan / serious attempt 2
• No supports 1
• Sickness (organic) 2
• lt6 low, 7-8 moderate, gt8 high risk

3
Risk stratification of suicideattempt

• IPMO
• Intent
• Plan
• Motivation
• Opportunity
• RiskResue ratio
• Lethality vs publicity

4
Depressive Illness

• IN SAD CAGES
• Interest
• Sleep
• Appetite
• Depressed mood
• Concentration
• Activity
• Guilt
• Energy
• Suicidal ideation
• Major depression gt5/9 for gt2 weeks

5
Violent Patient

• Safety
• Self, staff, other patients, violent patient
• Strategies approach
• Recognition - PHx, current Hx, drugs and EtOH
• prevent escalation see early, show force, set
  limits, up triage, area
• Restraint
• Verbal, show of force, physical 6 pt arrow,
  chemical PO IM IV
• Safe disposition
• Inpatient, outpatient
• Continued quality improvement
• CISD
• Future prevention violence ED design, control
  access, education, undress all patients
• EXCLUDE ORGANIC CAUSE!!