Can you tell us a little bit about your training and what you specialise in?
“I am a mental health nurse and qualified in 2003. I have specialised in psychosis working with patients who have severe and enduring mental health issues, and working in the community under CPA, and in assessment services. Now I work for the tribunal services sitting as a judge on the mental health tribunal and also as a best interest assessor, assessing the capacity of individuals and safeguarding their rights through the deprivation of liberty safeguards (DoLs) and The Mental Capacity Act.”
Would you say mental health is generally being prioritised more now than it was even a few years ago? Or do you think we have some way to go?
“It is definitely being prioritised now more when I first qualified, but funding limitations, and lack of staff and resources continue to have a huge impact on service provision.”
Can you give us an example of the types of cases you are being instructed on and how you experience can help you with them.
“I have been instructed so far on cases so far relating to service provision and liability issues such as the family who have lost loved ones to suicide and have claimed against services. I have had a lot of experience being involved in assessing serious untoward incidents in the trust previously, and the amount of experience I have had in different community settings ensures I have working knowledge of the policies, law and systematic procedure that should be being undertaken by organisations. Therefore, I feel I have been able to undertake a fair assessment of liability.”
Could you give us a little background on why crisis prevention is important following a traumatic injury?
“Following a traumatic injury often the immediate physical pain an individual is experiencing is focused upon. The life changing effects of such an injury is often overlooked. However, at times like these individuals can feel hopeless, confused and have increased suicidal ideation. A thorough assessment of a person’s mental health can ensure that interventions are provided prior to any deterioration in their mental health. Also, when an individual does start to struggle with their mental health crisis intervention is vital, as often these individuals are displaying high risk factors, especially in relation to suicide.
In addition should cognitive impairment result from the injury it is often that individuals can no longer articulate their feelings and experiences the same, and mental health crisis input is vital.”
Can you share some information around the impact a traumatic injury can have on an individual, and their friends and family?
“Often there are huge senses of loss. The impact is huge. Individuals can lose their employment and suffer huge financial consequences. The life they had before can become unrecognisable as they can no longer enjoy the hobbies, holidays or past times they once did.
They may need full time care and need assistance with cleaning, washing, dressing and all activities of daily living. The carer stress can be immense with family and friends reporting their loved one as being a shadow of their former self.
Overall, the mental health of an individual and their family often declines with people needing intense psychological interventions to adapt to the change of lifestyle. Many relationships often break down, especially friendships when individuals can no longer engage with people as they did before.”
In your experience, how common are suicidal thoughts following an injury, and what steps should be put in place to ensure people are getting the right kind of support so that they don’t begin to have these thoughts?
“It is very common to have suicidal thoughts when an individual begins to feel low. However, I feel that mental health assessment and support should be offered in a quicker time scale rather than on a crisis led basis to use prevention techniques to stop an individual deteriorating.
In particular psychological support to allow an individual to adjust and cope with the way they present, what has happened to them and assist them to look at ways to move forward is vital.”
What are some of the other mental health problems people can face after sustaining a catastrophic injury?
“Some injuries are sustained after traumatic incidents. People can suffer with severe PTSD following an injury , experiencing flashbacks, nightmares, and physical symptoms such as sweating and palpitations.
People’s anxiety can increase, and they may avoid events and people due to what they have experienced. In some cases, the trauma is so severe the incident can cause people to suffer with psychotic symptoms of a more severe nature, which needs specialised treatment.
The majority of individuals, report depression and low mood and described symptoms of adjustment issues as they adapt to the change in their life.”
Why is mental health so prominent within care reports, and how is mental health assessed?
“Mental health is assessed by addressing the individuals pre morbid functioning, thoughts and feelings and comparing it to how they feel today.
Assessments look at periods of low mood, anxiety and any physical symptoms that run alongside this. In assessing an individual’s mental health we would look holistically at their circumstances and discuss current appetite, sleep pattern, withdrawal from society (friends, family, work) and any increased suicidal ideation. The level and intent of the suicidal ideation would also be addressed by looking at risk factors, such as age, loss , drug and alcohol use, and intent.
In more complex cases PTSD symptoms would be examined and any psychotic features would be examined.”
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