Physical Examination on Admission

The Royal College of Psychiatrists recommends that every psychiatric inpatient should have a thorough physical examination within 24 hours of admission (Vanezis and Manns, 2010).

 

Patients on psychiatric units have an increased mortality from both unnatural and natural causes when compared to the general public and there is a clear asscociation between mental illness and physicall ill health.

 

Increased cardiovascular morbidity in particular has been associated with schizophrenia, bi-polar illness and major depression.

 

Physical disease can present with psychiatric manaifestations and misdiagnosis can have serious consequences. Therefore a thorough physical examinition must be part of the assessment that takes place at the John Munroe Hospital Group which is facilitated partly by our qualified staff but also by the nurse practitioner and/or General Practitioner.

 

Co- Morbidity is....

 

'The simultaneous presence of 2+ morbid conditions or diseases in the same patient, which may complicate a patient's hospital stay'

 

Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

  

We do this by training all our staff to manager all mental health conditions and by having some basic knowledge of physical conditions, but also by having a enhanced General Practioners Service (GMS) for all of our patients. This allows us to focus on the management and treatment of the primary condition therefore ensuring that the secondary conditions such as the physical conditions have a minimal impact and potentially reducing down the length of stay in hospital.

 

Please view GMS contract below with details of service provided.

 

 

Dual Diagnosis/ Co-existing Mental Health and Drug and Alcohol Problems.

 

The combination of mental illness and use of substances is known as dual diagnosis (Hamilton, 2010). Rassool (2006) highlighted the closure of large psychiatric institutions and the emergence of community psychiatric care as factors that led to increased exposure to substance use among people with mental health problems.

 

Although the term "dual diagnosis" is recognised in contemporary practice to mean mental illness and substance use, it can be viewed as unhelpful. Velleman and Baker (2008) suggested that adopting the term "co-existing mental health and drug and alcohol problems" would be helpful for practitioners, as it states more clearly what the problems are. Other terms used to describe this client group's problems are co-morbid and co-occurring, adding to the potential for confusion.

 

Here at the John Munroe Hospital Group our expertise lies in the management of individuals with severe and enduring mental health problems who may have a history of substance misuse. We therefore manage the primary mental health problems and the secondary associated substance misuse.

 

We work towards the standards as set out by the Dual Diagnosis Good Practice Handbook (2007) as published by Turning Point (see attached for further information). Within the handbook it discuss good practice standards when treating individuals with a dual diagnosis it makes particular reference towards:

 

• Engagement.

• Enhancing motivation for change.

• Active treatment.

• Relapse prevention.

• Access to a full range of substance use services and mental health services as appropriate

• Availability of a range of pharmacological, psychological and social interventions

 

For more information on our services either click here or call 0844 504 5700

 

 

I would like to thank Ian Hamilton, PGDip, PGCAP, RMN, for his article 'Ensuring integrated treatment for people with mental health and substance use problems' 2010.

 

And: Andrew Peter Vanezis, BSc, MBCbB and Duduley Manns, MRCPsych, DipClinPsych for their article 'Physical examinations of mental health service users' 2010.