RevisePsych

Management

Risk Management:

 

Always consider immediate safety plan first 

• Safety planning- place of care- e.g. to admit or not, under mental health act or not? 

• Supervision- constant or are visits once a day enough? Or once a week/month etc- this will depend on the level of care they need and which team to refer to

• Therapeutic relationship

• Involvement of family & others

• Reduced access to means

• Clear and well communicated plans

 

In terms of longer-term risk management plan, this might be a little different. One thing psychiatrists do need to consider might be ‘therapeutic risk taking’. Admitting someone to hospital for a long period not actually be therapeutic in the long run or helpful for the patient. The decision would need to be made carefully and on an individual basis, considering the case holistically (biopsychosocial). Click here to read more about this: https://www.cambridge.org/core/journals/bjpsych-advances/article/therapeutic-risktaking-a-justifiable-choice/134DFBB0FD51DBB504C5AD81981358B0

 

 

General Management

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In terms of other management strategies- you should structure your plan using the BIO PSYCHO SOCIAL model. See table below to help you do this.

 

Example:

• BIOLOGICAL: exclude underlying physical cause by undertaking blood tests, urine dip, drugs screen, CT head etc. Manage any physical health cause accordingly. Start psychotropic medication (SEE TREATMENT PAGE for more details)

• PSYCHOLOGICAL: psychoeducation to explore underlying condition, aim to work collaboratively with patient (SEE TREATMENT PAGE for more details)

• SOCIAL: look into housing issues, other forms of social support etc

 

Always remember to involve family/friend supports if patient consents- for collateral history and support with management

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Downloadable PDF Version Here