The Psychiatric History and Assessment

As with all patients a good thorough history is key. The psychiatric assessment follows the medical and surgical assessment format. However in the ED an abridged psychiatric assessment will probably be used. The key differences between an abridged and a full psychiatric assessment is that the full assessment:

  1. Is longer, allowing to explore the psychological needs of a patient
  2. The assessment process itself can be therapeutic

Both assessments include:

  1. A mental state examination
  2. Personal history, forensic and pre-morbid personality
  3. An expanded section for social history, drug and alcohol use,

Although these are likely to be longer and more detailed in the full psychiatric assessment. The full assessment should be undertaken by a suitably trained individual.

Hints and Tips

  • Safety is always the first priority, this includes the safety of the patient as well as that of you and other patients and staff members.
  • If at all possible, ensure that you see the patient in a quiet room.
  • Ideally, this room should be laid out with all chairs at equal levels, with furniture fixed to the floor.
  • There should be two exits, with your seat nearest to one.
  • Doors should open outwards and should include a glass panel so you can be seen by colleagues.
  • Tell someone where you are and how long you expect to be
  • Carry a personal alarm.
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