Power of medications and prescribing scenarios
In this post I will spend some time understanding the power of medications, then extract some fundamental principles from the GMC’s guidance on prescribing (April 2021). I then analyse two real-world scenarios in prescribing that I have experienced and reference each against the GMC’s guidance. The power of medications Medicines are powerful ‘chemicals’. How? A few milligrams – thousandths of a gram – can have powerful effects on the body’s organs. 20 mg of citalopram is 7 ten thousandths ofRead More …
What exactly is support?
Over the years I have come to appreciate that patients in psychiatric services very much value support. I’ve been wondering ‘What does support mean?‘ Hold on – I know that everybody knows support when they feel it. That would not inform me what aspects of support make it real or valid. Mental health workers and services without doubt need to provide support. Support can vary across various types of activities e.g. emotional support, advice, guidance, therapy etc. That does notRead More …
Surgical and psychiatric malpractice compared
As a result of recent media publicity about surgeon’s performance, I began thinking that I rarely if ever see any stories in the media about psychological harm caused by failures in psychiatric treatments. I reflected on this and thought, that with surgery it is easier to spot errors in retrospect because patients can be subject to x-rays, scans and other tests to show physical things that went wrong procedurally. But in psychiatry where we use medications (or occasionally ECT), thereRead More …
The relevance of culture in mental health services
I imagine that most people would begin thinking of the influence of culture on expression of signs and symptoms among mental disorders. However, there are wider areas of importance. What is culture? The concept of ‘culture’ is broad and multifaceted, encompassing a wide range of ideas, practices, and societal norms. The main concepts that comprise culture: Shared beliefs and values: Culture is often defined by a shared set of beliefs and values that guide behaviour within a group. These beliefsRead More …
Fundamentals of psychiatric diagnosis
Back in the 1990s, diagnostic criteria existed for sure. We had ICD-9 as our main diagnostic manual. My recollections from around that time was that the criteria were hardly ever referenced. How it worked was, the consultant psychiatrist would declare diagnosis or differential diagnoses without actually stating which criteria were met from available evidence. As a junior trainee, I had no say in the matter. In one adolescent psychiatry service around 1993, the consultant psychiatrist and a consultant psychologist stated,Read More …