OSCE Critical Mental Health Treatment

E-Portfolio Reflection:

I completed an OSCE today for the module “Critical Healthcare”. The OSCE took place at the clinical simulation suite on 16th April at 9am.

We had 5 minutes to read through the case notes before the patient assessment. We already knew that the condition would be bi-polar but I was surprised at the amount of information that was given to us. J intended to gather most of the information in the notes during the assessment. But realise now that our job was to create a Mental State Examination not so much gather information.

I did not wash my hands. I did not ask if they used drugs or etoh. I sat by the bedside and wish I had asked the person where she would like to sit. Risk assessment complete but not sure risk level identified. Did not sufficiently engage with service unused to produce an ongoing plan. Escalation pathway pharmaceutical poor did not mention guidelines. Strangely mentioned asd autism in childhood. I feel like I did not actually provide as much information as I could on the mental state examination. Talked about back pain using pain scale assessed pqrst 

On handover talked about excersise etc CBT srt

Estimated mark to be around 65-75

Interesting References

The concept that has interested me this year concerns, Moderators, Mediators, Risk Factors and Outcomes for mental ill health and its relevance to Public Health, Epidemiology, Causal Inference, Psychology, Psychiatry and the interconnectedness of mental health causal factors including the stress vulnerability model.

Food for thought..

Whilst diagnostic labels serve some purpose – they take away the need to “formulate a problem”. Side thought being; as mental health practitioners attempt to understand where does this leave the vulnerable who is providing their version of events? Service user once said that they were where they were because they were unable to keep inside what happened to them. (Unable to internally process? don’t know) tbc….

 

Butler, S. (2024). History taking for advanced clinical practitioners: what should you ask? | Nursing Times. [online] Nursing Times. Available at: https://www.nursingtimes.net/assessment-skills/history-taking-for-advanced-clinical-practitioners-what-should-you-ask-04-03-2024/.

Caiels, J., Milne, A. and Beadle-Brown, J. (2021). Strengths-Based approaches in social work and social care: Reviewing the evidence. Journal of Long Term Care, [online] 0(2021), pp.401–422. doi:https://doi.org/10.31389/jltc.102.

Clinicalskills.net. (2025). Clinical Skills. [online] Available at: https://roehampton.app.clinicalskills.net/organisation_user/organisations/139/content_view/sections/13/categories [Accessed 28 Sep. 2024].

Department of Health and Social Care (2022). Health and Care Act 2022 Impact Assessments Summary Document and Analysis of Additional Measures. [online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1115453/health-and-care-act-2022-summary-and-additional-measures-impact-assessment.pdf.

Eisenberg, L. (1988). The social construction of mental illness. Psychological Medicine, 18(1), pp.1–9. doi:https://doi.org/10.1017/s0033291700001823.

Graney, J., Hunt, I.M., Quinlivan, L., Rodway, C., Turnbull, P., Gianatsi, M., Appleby, L. and Kapur, N. (2020). Suicide risk assessment in UK mental health services: a national mixed-methods study. The Lancet Psychiatry, [online] 7(12), pp.1046–1053. doi:https://doi.org/10.1016/S2215-0366(20)30381-3.

Hartley, S. (2021). Using team formulation in mental health practice. Mental Health Practice, [online] 24(2). doi:https://doi.org/10.7748/mhp.2021.e1516.

Ibrahim, N., Michail, M. and Callaghan, P. (2014). The strengths based approach as a service delivery model for severe mental illness: a meta-analysis of clinical trials. BMC Psychiatry, [online] 14(1). doi:https://doi.org/10.1186/s12888-014-0243-6.

ICD-11. (2022). 6A73 Mixed depressive and anxiety disorder – ICD-11 MMS. [online] Available at: https://www.findacode.com/icd-11/code-314468192.html [Accessed 14 Jan. 2025].

Joseph, S. (2021). How Humanistic Is Positive Psychology? Lessons in Positive Psychology From Carl Rogers’ Person-Centered Approach—It’s the Social Environment That Must Change. Frontiers in Psychology, [online] 12(709789), pp.1–10. doi:https://doi.org/10.3389/fpsyg.2021.709789.

Klinger, D., Oehlke, S.-M., Riedl, S., Eschbaum, K., Zesch, H.E., Karwautz, A., Plener, P.L. and Kothgassner, O.D. (2024). Mental health of non-binary youth: a systematic review and meta-analysis. Child and Adolescent Psychiatry and Mental Health, 18(1). doi:https://doi.org/10.1186/s13034-024-00822-z.

 

Ike, K.G.O., de Boer, S.F., Buwalda, B. and Kas, M.J.H. (2020). Social withdrawal: An initially adaptive behavior that becomes maladaptive when expressed excessively. Neuroscience & Biobehavioral Reviews, 116, pp.251–267. doi:https://doi.org/10.1016/j.neubiorev.2020.06.030.

Janssen (2012). Contents. [online] Available at: https://www.drugsandalcohol.ie/17625/1/MentalHealthAssessmentTools.pdf.

Moriarty, A.S., Castleton, J., Gilbody, S., McMillan, D., Ali, S., Riley, R.D. and Chew-Graham, C.A. (2020). Predicting and preventing relapse of depression in primary care. British Journal of General Practice, 70(691), pp.54–55. doi:https://doi.org/10.3399/bjgp20x707753

NHS England (2023). The mental health nurse’s handbook. [online] Available at: https://www.england.nhs.uk/wp-content/uploads/2022/10/B1011_Mental-Health-Nurses-Handbook_August-2023-v1.1-RCN-Endorsement.pdf.

NICE (2021). How do I diagnose depression? [online] NICE. Available at: https://cks.nice.org.uk/topics/depression/diagnosis/diagnosis/.

NICE (2023). Depression: What Are the Risk factors? [online] NICE. Available at: https://cks.nice.org.uk/topics/depression/background-information/risk-factors/.

NICE (2022). Depression in adults: the matched care model. [online] Available at: https://www.nice.org.uk/guidance/ng222/resources/the-matched-care-model-pdf-11131007011.

NHS England (2023). The mental health nurse’s handbook. [online] Available at: https://www.england.nhs.uk/wp-content/uploads/2022/10/B1011_Mental-Health-Nurses-Handbook_August-2023-v1.1-RCN-Endorsement.pdf.

Orenstein, G.A. and Lewis, L. (2022). Erikson’s Stages of Psychosocial Development. [online] National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/books/NBK556096/.

Pompili, M. (2019). Critical appraisal of major depression with suicidal ideation. Annals of General Psychiatry, 18(1). doi:https://doi.org/10.1186/s12991-019-0232-8.

Rcpsych.ac.uk. (2021). Water towers: icons of the asylums and mental hospitals. [online] Available at: https://www.rcpsych.ac.uk/news-and-features/blogs/detail/history-archives-and-library-blog/2021/08/20/asylum-water-towers. (Accessed, Jan 2025)

Read, J. (2018). Making Sense of, and Responding Sensibly to, Psychosis. Journal of Humanistic Psychology, [online] 59(5), pp.672–680. doi:https://doi.org/10.1177/0022167818761918.

Remes, O., Mendes, J.F. and Templeton, P. (2021). Biological, psychological, and social determinants of depression: A review of recent literature. Brain Sciences, [online] 11(12), pp.1–33. doi:https://doi.org/10.3390/brainsci11121633.

Schafer, M. and Schiller, D. (2022). A dominant role for serotonin in the formation of human social hierarchies. Neuropsychopharmacology, 47(13), pp.2177–2178. doi:https://doi.org/10.1038/s41386-022-01433-y.

SCIE (2022). Deprivation of Liberty Safeguards (DoLS) at a glance. [online] SCIE. Available at: https://www.scie.org.uk/mca/dols/at-a-glance/

Trenoweth, S. (2017). Promoting recovery in mental health nursing. London: Sage, Learning Matters. (Matthews,2008 as cited in Trenoweth, 2017)

Mental Health Act (1983). Mental Health Act 1983. [online] Legislation.gov.uk. Available at: https://www.legislation.gov.uk/ukpga/1983/20/contents.

Health and care act 2012

legislation.gov.uk (2005). Mental Capacity Act 2005. [online] Legislation.gov.uk. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents.

Wright, K. and McKeown, M. (2018). Essentials of mental health nursing. Los Angeles: SAGE