Wisdom Forum

Psychiatrist Assessment and Malpractice Lawsuits  
  
Psychiatrists assess patients who haven't yet been able to make a decision on their treatment. They also evaluate the mental health of patients who are in acute internal medicine wards. The results of this assessment can be used to help determine the best treatment plan. However psychiatrists are in danger of malpractice lawsuits.  
  
Assessment of behavioral health using ED  
  
A growing number of patients are taken to emergency departments (EDs) for mental health concerns. They could be suffering from acute distress or intoxication. An ED visit is designed to determine if a patient is at risk and if the patient needs urgent psychiatric intervention. During the visit, the patient will be examined for any substance abuse or other disorders of the behavioral health.  
  
The primary challenge of conducting a psychiatric evaluation in an ED is obtaining sufficient information to make an educated decision. There are a variety of instruments have been developed that can assist in this process. They are needing further study to improve their effectiveness.  
  
The AAP encourages the use of special instruments for screening children for mental health issues. These instruments can be utilized by clinicians to identify children who require treatment in the ED. HEADS-ED is an example. It is an research-based tool that can be used to determine the mental health patients. It is simple to use and provides important information quickly.  
  
BHS-ED is one of the most well-known tools used in EDs. It is online-based, utilizes skip logic, and generates real time reports. It also addresses some of the common problems that arise from scoring and administration.  
  
In addition, the BHS-ED accurately reports about one-third of patients who are not in need of admission. It also identifies 18% pediatric mental health patients who need admission.  
  
An ED psychiatrist should be prepared to work with a wide variety of patients. A competent doctor is able to get enough information and establish an immediate rapport. This is especially important in a noisy, crowded environment.  
  
More research is needed to address the issue of setting and methodological obstacles. Clinicians need to be aware of the strengths and weaknesses of the current tools, as well as the evidence basis.  
  
Assessment by a psychiatrist of patients who are unable to give consent to treatment on an acute internal medicine ward  
  
In an acute internal medicine ward there is a tendency to find patients without the capacity to consent to treatment. In the daily practice and administration of medicine, it is vital to consider ethical and legal concerns when assessing the capacity of patients.  
  
The capacity to evaluate is a multidimensional concept. It is essential to be aware that various assessment tools have their limitations. It is crucial to think about the level of information required to make informed choices about treatment.  
  
This study examined the assessment of patients within the first 72 hours following their admission to an acute intern medical ward. Our goal was to find out if the psychiatric examination could identify patients who are unable to give consent to treatment.  
  
A decision support tool was utilized in assessing the ability to comprehend and act upon information about treatment options. The best gauge of an individual's capacity to make informed medical decisions was the one they made with their medical team. Clinicians tend to rely on informal clinical impressions for their assessments. However should the team be not able to come to an agreement regarding the patient's capabilities, a mental health consultation may be necessary.  
  
Utilizing a standard Mini-Mental State Examination (MMSE) we were able determine a score that could predict a person's willingness to consent to a specific procedure. We also studied the most reliable indicator of an individual's capacity to comprehend the process of making decisions.  
  
These findings have led us to believe that the best method to determine a patient's readiness to consent to treatment is to evaluate the patient's ability to comprehend the benefits and consequences of each option. This is especially true when treatment options could be fatal.  
  
Psychiatrists are at risk of malpractice suits  
  
Psychologists face a myriad of legal issues when treating patients. In particular, there is a growing tendency to file malpractice lawsuits against physicians. These cases can cover a variety of different scenarios. The plaintiff's burden of proof is typically very high. Plaintiffs may be subject to suspensions or psychiatrists professional licensure revocations.  
  
The majority of cases involving psychiatrists based on malpractice revolve around a number of various causes. The most common reason behind these lawsuits is a mishap with a medication. There is evidence that suggests that lawsuits involving medication account for a large portion of litigation against psychiatrists.  
  
Another common cause of malpractice lawsuits is the negligent discharge of the patient. However, the risk of liability is greater when psychiatrists treat patients who are violent or have suffered trauma or abuse.  
  
Some states have a variety of statutes that provide the therapist with immunity from lawsuits. These laws are designed to protect patients from harm as well as the therapist from legal consequences.  
  
A variety of ethical standards are also required for psychiatrists. Examples include the law of informed consent, and advance directives.  
  
A lack of informed consent however, isn't always a case of malpractice. The courts are divided between two models: a treatment-driven one and a rights-based model.  
  
A moral issue that the therapist must take into consideration is whether a treatment plan is appropriate for the patient. It will be based on the needs and preferences of the patient.  
  
One of the best practices in psychiatric care is a thorough assessment of the patient. This includes a physical exam if clinically indicated.  
  
Another ethical consideration is the right of the patient to refuse to be a patient of certain treatments. This is especially important for patients suffering from psychiatric illness who suffer from severe depression.  
  
Self-administered computerized adolescent behavior screening  
  
Computerized, self-administered adolescent behavioral health screenings can be integrated into routine clinical practice. It can help to address small but significant rises in unrecognized psychiatric problems. The results are private.  
  
Behaviorally-oriented assessment tools can be readministered periodically to establish a baseline for progress. They can also be used to assess multiple issues at the same time.  
  
A variety of studies have evaluated the effectiveness of electronic screening tools. Studies showed that adolescents were positive for a variety of psychosocial disorders, including suicidal thoughts, depression, and substance abuse. However, the study did not focus on outpatient referrals.  
  
Other research suggests that youth screening rates are higher through the use of web-based screening tools. E-screening has also been proven to be effective in assessing trauma stress. In one study, a computerized, self-managed previsit screening tool was found to increase communication and disclosure among children.  
  
The Columbia Depression Scale, a self-report tool that measures suicide risk, has 22 items. There are also parallel instruments for parents. There are several versions of the PHQ questionnaire, each of which has different amounts of questions. These include longer versions that address anxiety and mood as well as eating disorders.  
  
KSADS-COMP is an extensive assessment tool for youth. This tool can be used in courts for juveniles and can assist in identifying comorbid diagnoses. The tool can be used in the ED to assist the clinicians in identifying adolescents with psychiatric or behavioral disorders.  
  
A review of the data from the BHS ED revealed that more than a third of youth had been tested positive for at least two risk behavior. A third of those screened for depression were diagnosed with moderate or severe symptoms. A third of those who were surveyed were able to identify signs of suicidal thinking. During the implementation phase, ED assessments performed by social workers or psychiatrists increased.  
  
The findings suggest that the youth screening rates are contingent on the skills and resources of health professionals. Clinicians should offer relevant training and resources to patients.  
  
Recognizing the mental illness biases of psychiatrists  
  
In the field of psychiatry implicit bias has been found to influence care for patients. Implicit bias can also lead to tension between providers and patients as well as poor clinical outcomes. Healthcare professionals need to be aware of their implicit biases to be able to act accordingly.  
  
There are many ways to detect implicit bias. One of the most popular is the assumption method. It involves a hypothetical person with certain characteristics that are assumed to be present. Studies using the assumption method have shown that there is a relationship between the characteristics of a "patient and their healthcare provider's implicit attitudes.  
  
Another option is subliminal priming. This technique has proven useful in detecting implicit bias in a variety of studies. The most convincing studies combine the IAT with a measure of quality of treatment.  
  
Numerous other studies have demonstrated that implicit bias could play a role in healthcare professionals the decision-making process. For instance an investigation compared the mental health of welfare recipients to that of mentally ill patients. They discovered that implicit stereotypes have a negative impact on disadvantaged groups.  
  
The American Psychiatric Association (APA) organized an open forum and suggested that medical professionals minimize implicit bias. They also recommended that medical professionals understand the nature of implicit bias in mental health.  
  
A 2015 review of the literature on implicit bias in healthcare examined the consequences of this phenomenon. These findings have been distilled into an article titled PatientEngagementHIT.  
  
There are many methods to identify implicit bias, the assumption method is by far the most widely used. There are however other methods that are as efficient.  
  
Another method that has received much attention is the subliminal priming technique. It is a method which involves the use of actors in a simulation to influence participant behavior. Often, participants are required to behave in a way that reflects their best behavior.