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Non-medical prescribing considerations in emergency mental health services

02 July 2022
Volume 4 · Issue 7

Abstract

The emergency mental health practitioner's job involves providing immediate care to patients who are suffering a mental health crisis. Independent nurse prescribing supports this service through timely access to pharmacological and non-pharmacological measures or cognitive behavioural strategies. This case study involves a service user diagnosed with bipolar type II disorder who presents with suicidal ideation, and outlines the prescribing options available for short-term crises and long-term risk management. There is a complex balance of appraising physical and mental health including capacity, assessment of risk of self-harm and harm to others, and working in consultation to optimise adherence and concordance. The authors highlight the importance of using a person-centred approach, which includes family, carers and their wider support network, to develop a therapeutic relationship which promotes positive outcomes. This is further supported by utilising the most recent and up-to-date policy, guidelines and legislation, including local and national policies.

The role of the emergency mental health practitioner involves the immediate management of those who present in mental health crisis. The service provides mental health review, risk assessment and short-term input before referral to secondary care for ongoing therapy. Independent nurse prescribing supports this service through timely access to pharmacological treatments to manage symptoms and ease the distress associated with a critical episode (Inman, 2017). For the nurse prescriber, autonomous decision-making and the ability to discuss all treatment options with service users can optimise adherence and concordance (Kelly, 2018).

This case study aims to review the pharmacological management of a patient with bipolar type II disorder who presented in a mental health crisis. Bipolar disorder is a chronic recurrent condition which is characterised by fluctuations in mood state. Bipolar type II is associated with less severe manic symptoms of hypomania combined with depressive episodes (Grande et al, 2016).

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