Exam 2 Chapter 12 Caring for Patients with Psychiatric Disorders in General Practice Settings

Identify from a scenario the appropriate referral or screening needed

o   Evidence supports that use of screening tools is better than clinical judgement alone in diagnosis of mental illness.

o   Patients in primary care settings with depression, substance abuse issues, and/or chronic pain should be recognized as having identified risk factors for suicide and should be screened carefully.

o   Although screening of mental health issues has been identified as a critical first step in improving care for both mental illness and other medical illness, controversy exists over how much care can be provided in nonpsychiatric settings, and therefore when a referral to see another provider is appropriate.

Nurses should be making referral decisions for patients only when it is clear that the patients do not have the current capacity to make decisions

Prioritize who would need to be seen first from a list of patients

• Trauma

• Suicide Risk

• Substance Use Disorders

What is the SBIRT used to screen for?

Screening, Brief Intervention, and Referral to Treatment

Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment.

Brief intervention focuses on increasing insight and awareness regarding substance use and motivation toward behavioral change.

Referral to treatment provides those identified as needing more extensive treatment with access to specialty care

How to respond to a patient having thoughts of suicide (other questions to ask)?

o   “In the past month, have you had thoughts about suicide?”

o   “Have you ever made a suicide attempt?”

o   If the answers are yes, also ask:

“Are you having thoughts of suicide right now?”