Follow-up Treatment of Mental Patients in Klinik Kesihatan SIMON BLUN PENOLONG  PEGAWAI  PERUBATAN PSYCHIATRIC UNIT HOSPIT...
Introduction <ul><li>Klinik Kesihatan can play important role in providing mental health services. </li></ul><ul><li>Depre...
Introduction <ul><li>Lack of proper follow-up </li></ul><ul><li>Frequent readmissions & relapses </li></ul><ul><li>Do not ...
Why Need For Follow-Up <ul><li>Psychiatric patients tend to default </li></ul><ul><li>Attend clinic when well </li></ul><u...
<ul><li>Feel well </li></ul><ul><li>Don’t think they are sick </li></ul><ul><li>Stigma of mental illness </li></ul><ul><li...
Why Need For Follow-Up Monitoring <ul><li>Prevent relapse by appropriate medication and support - lead to better quality o...
Objective of Proper Follow - up <ul><li>Enable mental patients to receive optimum follow-up care at klinik kesihatan </li>...
<ul><li>Mental health assessment </li></ul><ul><li>Early warning signs: </li></ul><ul><ul><li>Change in behaviour </li></u...
Follow-up Treatment Plan   <ul><li>Individual Treatment Plan  </li></ul><ul><ul><li>Continue medication treatment </li></u...
Monitoring Compliance to Follow-up Attendance   <ul><li>Check Buku Daftar Kedatangan Pesakit PKM3/2001 </li></ul><ul><li>R...
Monitoring Compliance to Follow-up Attendance   <ul><li>Home visit  - 1 week after phone reminder / 2 weeks after defaulti...
WHEN TO REFER  ?
Patient with potential <ul><li>       </li></ul><ul><li>to danger himself / herself. </li></ul><ul><li>to danger others. <...
Changes In <ul><li>Emotion </li></ul><ul><li>Thought </li></ul><ul><li>Behaviuor </li></ul>
Patient whom danger self / others   <ul><li>Poor /refused eating  </li></ul><ul><li>-  Bulimia  </li></ul><ul><li>-  Anore...
Patient whom danger self <ul><li>Severe manic   </li></ul><ul><li>Dementia  - with uncontrollable agitation. </li></ul><ul...
Suicide/homicide/infanticide <ul><li>Acute psychosis  </li></ul><ul><li>Puerperal psychosis </li></ul><ul><li>substance ab...
Severe Drug Side Effect <ul><li>- Acute dystonic reaction </li></ul><ul><li>- Akathisia </li></ul><ul><li>- Neuroleptic ma...
SEKIAN  TERIMA KASIH
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Follow Up Treatment Of Mental Patient s At Klinik Kesihatan In Sarawak

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Transcript of "Follow Up Treatment Of Mental Patient s At Klinik Kesihatan In Sarawak"

  1. 1. Follow-up Treatment of Mental Patients in Klinik Kesihatan SIMON BLUN PENOLONG PEGAWAI PERUBATAN PSYCHIATRIC UNIT HOSPITAL MIRI
  2. 2. Introduction <ul><li>Klinik Kesihatan can play important role in providing mental health services. </li></ul><ul><li>Depression, Schizophrenia and anxiety is commonly found in the community. It can be treated effectively at Klinik Kesihatan thru intervention like monitoring follow-up treatment like continue depo injection and oral medication, giving Psycho-education and Psycho-therapy. </li></ul>
  3. 3. Introduction <ul><li>Lack of proper follow-up </li></ul><ul><li>Frequent readmissions & relapses </li></ul><ul><li>Do not ensure the good work done in hospital is carried on when the patient is at home </li></ul><ul><li>Poorly focused </li></ul>Problems in present system of follow-up
  4. 4. Why Need For Follow-Up <ul><li>Psychiatric patients tend to default </li></ul><ul><li>Attend clinic when well </li></ul><ul><li>Stop attending when unwell </li></ul><ul><li>Relapse occur with default </li></ul><ul><li>Relapse need admission ( length of stay at least 3 week ) </li></ul><ul><li>Cost of patient admission is expensive </li></ul>
  5. 5. <ul><li>Feel well </li></ul><ul><li>Don’t think they are sick </li></ul><ul><li>Stigma of mental illness </li></ul><ul><li>Stigma of psychiatric facility </li></ul><ul><li>Medication side effects </li></ul><ul><li>Fear of dependence </li></ul><ul><li>Lack of efficacy </li></ul><ul><li>‘ I’ have to do it myself </li></ul>Patients Stop Medications for Various Reasons
  6. 6. Why Need For Follow-Up Monitoring <ul><li>Prevent relapse by appropriate medication and support - lead to better quality of life & level of functioning </li></ul><ul><li>Identify emotional distress & provide early intervention (emotional distress can precipitate relapse) </li></ul><ul><li>Provide support and reduce care-giver distress </li></ul><ul><li>To achieve optimal functioning in the community (rehabilitation is a continuous process) </li></ul>
  7. 7. Objective of Proper Follow - up <ul><li>Enable mental patients to receive optimum follow-up care at klinik kesihatan </li></ul><ul><li>Prevention of relapse </li></ul><ul><li>Promote rehabilitation </li></ul><ul><li>Encourage integration back into the community </li></ul>
  8. 8. <ul><li>Mental health assessment </li></ul><ul><li>Early warning signs: </li></ul><ul><ul><li>Change in behaviour </li></ul></ul><ul><ul><li>Mood and emotional disturbances </li></ul></ul><ul><ul><li>Early signs and symptoms of psychosis </li></ul></ul><ul><ul><li>Cognitive or thought disorders </li></ul></ul><ul><li>Assessment of medications and its side effects </li></ul><ul><ul><li>Assess knowledge of the medications being taken </li></ul></ul><ul><ul><li>Assess for presence of medication side effects. </li></ul></ul>Follow-up Assessment
  9. 9. Follow-up Treatment Plan <ul><li>Individual Treatment Plan </li></ul><ul><ul><li>Continue medication treatment </li></ul></ul><ul><ul><li>Psychoeducation on illness and medications </li></ul></ul><ul><ul><li>Counselling when needed </li></ul></ul><ul><ul><li>Give new appointment date and record in Buku Daftar Kedatangan Pesakit. </li></ul></ul><ul><li>Family treatment </li></ul><ul><ul><li>Psychoeducation to the family members </li></ul></ul>
  10. 10. Monitoring Compliance to Follow-up Attendance <ul><li>Check Buku Daftar Kedatangan Pesakit PKM3/2001 </li></ul><ul><li>Register the defaulter in Buku Daftar Kes Cicir PKM4/2001 </li></ul><ul><li>Give defaulter a telephone reminder. </li></ul>
  11. 11. Monitoring Compliance to Follow-up Attendance <ul><li>Home visit - 1 week after phone reminder / 2 weeks after defaulting on follow-up date. </li></ul><ul><li>Psychoeducation given to patient and family. </li></ul><ul><li>Provide new appointment date. </li></ul>
  12. 12. WHEN TO REFER ?
  13. 13. Patient with potential <ul><li>       </li></ul><ul><li>to danger himself / herself. </li></ul><ul><li>to danger others. </li></ul><ul><li>too destructive. </li></ul>
  14. 14. Changes In <ul><li>Emotion </li></ul><ul><li>Thought </li></ul><ul><li>Behaviuor </li></ul>
  15. 15. Patient whom danger self / others <ul><li>Poor /refused eating </li></ul><ul><li>- Bulimia </li></ul><ul><li>- Anorexia Nervosa with Psychosis </li></ul><ul><li>Acute psychosis </li></ul><ul><li>Catatonic state </li></ul><ul><li>Severe depression </li></ul><ul><li>SCHIZOPHRENIA </li></ul>
  16. 16. Patient whom danger self <ul><li>Severe manic </li></ul><ul><li>Dementia - with uncontrollable agitation. </li></ul><ul><li>Physical cause of dementia requiring specialist treatment (e.g. syphilis, subdural haematoma) </li></ul>
  17. 17. Suicide/homicide/infanticide <ul><li>Acute psychosis </li></ul><ul><li>Puerperal psychosis </li></ul><ul><li>substance abuse – alcohol, </li></ul><ul><li>- amphetamine </li></ul><ul><li>Schizophrenia </li></ul><ul><li>Severe depression </li></ul><ul><li>Delirium </li></ul>
  18. 18. Severe Drug Side Effect <ul><li>- Acute dystonic reaction </li></ul><ul><li>- Akathisia </li></ul><ul><li>- Neuroleptic malignant syndrome </li></ul>
  19. 19. SEKIAN TERIMA KASIH

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