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Taking Care of Yourself While Working in Mental Health. Jacob Alexander. Introductions- Getting to know your batch!!!!!. Take 2 minutes to talk to the person next to you. Introduce this person by name Tell us something about them that they think nobody else knows. Working in Mental Health.
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Taking Care of Yourself While Working in Mental Health Jacob Alexander
Introductions- Getting to know your batch!!!!! • Take 2 minutes to talk to the person next to you. • Introduce this person by name • Tell us something about them that they think nobody else knows
Working in Mental Health • After hours roster • Constant Appraisal • Exams and Training • Applying for Fellowship/ Training “When we are tired we are attacked by ideas we conquered a long time ago” Nietzsche
Some Do’s • Protect your Privacy • Know thyself • Get organised and have routines • Get involved, participate and take charge of your training • Foster healthy clinical curiosity • Form study groups • Read about what your seeing at work • Train on the job • Know yourself and your limits • Share your successes and frustrations
Some Don’ts • Expect everything to be perfect • Become isolated or avoidant • Succumb to your own anxiety, depression, paranoia • Blur the boundaries • Miss opportunities to position yourself strategically for future career opportunities
Balance • Family and friends • Other interests • Physical health- have a GP • Relaxation
Supports • Workplace • Peers • Supervisors • Director of Clinical Training/RMO Medical Education Unit/ Psychiatry RMO group • Wider network of friends and family • Own health professionals- RMO societies, SAIMET
How we could model this training program • An exposure to the breadth and scope of psychiatry • Developing clinical knowledge • Developing some clinical skills • Experimenting with schemas that help you process information • Understanding why we do what we do • Understanding yourself and exploring opportunities for yourself • Strategic positioning-CBFP, future opportunities
Why be part of the RMO program at the Adelaide Health Service • Devising a program that sets standards of excellence for others • Exploring while you have the luxury of unstructured professional development • Getting to know the system that could be a potential employer
Reading Resources • Kaplan and Sadock’s- Synopsis of Psychiatry: Behavioral Sciences/ Clinical Psychiatry. 10th Edition • Psychiatric Clinical Skills. David S. Goldbloom • Emergency Psychiatry: Principles and Practice. Glick RL, Berlin JS, Fishkind AB, Zeller SL • The Prescriber’s Guide. Stahl’s Essential Psychopharmacology. 4th Edition Stephen M. Stahl • A Resident’s Guide to Surviving Psychiatric Training. 2nd Edition. Foreman T, Dickenstein LJ, Garakani A. www.psych.org • Mental Health Library, University of Adelaide- Maureen Bell
Other Resources • SANE www.sane.org • MIFSA www.mifsa.org • Beyond Blue www.beyondblue.org.au 1300 22 4636 • Black Dog Institute www.blackdoginstitute.com.au • NIMH www.nimh.nih.gov • MIND www.mindaustralia.org.au • Royal College of Psychiatrists, UK • American Psychiatric Association • National Centre for PTSD • www.medscape.org/psychiatry
Australian and New Zealand College of Psychiatrists • www.ranzcp.org • Free and password protected resources • Consumer and carer guidelines • Student portal • Australian and Indigenous Mental Health • Chronic condition self-management • MHPN-mental Health Professionals Network • Rural Station • Policy and Advocacy-ethics, therapeutics and interventions
Other Resources • DASSA- ADIS line • www.borderlinepersonalitydisorder.com • www.behavioraltech.org • www.dbtselfhelp.com • Pharmacist at WCH • www.otispregnancy.com • Yarrow Place www.yarrowplace.sa.gov.au • www.mensline.org.au 1300 78 99 78 • Relationships Australia www.relationships.org.au • Gambling Hotline www.problemgambling.sa.gov.au 1800 060 757
Crucial Areas of Work • Reconciling the differences between a Maudsley interview and the “therapeutic interview” • Focus on- Mental Health Act, Risk Assessment (Clinical vs Corporate) and Mandatory reporting
Some commonly Encountered Emergency Scenario’s • OD and situational crises • BPD in crisis • ASPD in crisis • Intoxicated patient • Resistant psychotic or manic patient • Anxious or somatising patient • Elderly patient (Psychogeriatric and Organic) • Co-morbidity with D&A problems • Co-morbidity with intellectual disability and PDD • Other crises- dissociation, conversion, catatonic, NMS, serotonin syndrome
Alexander J. Delirium as a symptom of Quetiapine Poisoning. Aust N Z J Psychiatry 2009 ; 43 (8): 781 • Alexander J Delirium in a middle aged individual on non-toxic, therapeutic doses of Olanzapine.Aust N Z J Psychiatry 2009 ; 43 (10): 981-982. • Alexander J De Novo induction of Obsessive Compulsive symptoms with Quetiapine in a patient with Borderline Personality Disorder. Aust N Z J of Psychiatry 2009; 43 (12): 1185. • Alexander J, Lattanzio A. Utility of telepsychiatry for Aboriginal Australians.Aust N Z J of Psychiatry 2009; 43(12): 1185 • Alexander J SSRIs as a treatment alternative for monosymptomatic delusional disorders. Aust N Z J of Psychiatry 2010; 44 (3): 295-96. • Boyd AM, Alexander J. Diogenes’ syndrome and intellectual disability: an uncommon association or under diagnosed? Aust N Z J of Psychiatry 2010; 44 (5):488-89. • Alexander J, Peak MM, Ladipeerla N, Premkumar TS. Panhypopituitarism and psychosis. Aust N Z J of Psychiatry 2010; 44(4): 393-94. • Wallett A, Alexander J Mobile phones, suicide and prognostication. Aust N Z J of Psychiatry 2010 Oct; 44(10):958-9 • Staugas R, El-Domeiri O, Alexander J. Khat concerns in Australia: Hyperbole or understated. Aust N Z J of Psychiatry 2010 Oct; 44(10):960-1 • Tibrewal P, Alexander J. Quetiapine induced Neutropenia.Aust N Z J of Psychiatry 2010, ,44(8): 767–768. • Nillsen A, Alexander J. Venlafaxine induced delirium. Aust N Z J of Psychiatry Jul 2011, 45(7): 598-598 • Cheng YH, Alexander J, Chaudhary J, Dinesh A. Phentermine (Duromine) induced psychosis. Aust N Z J of Psychiatry Aug 2011, l. 45 (8): 684-685. • Lecamwasam D, Alexander J. Aripirazole induced hyponatremia. Aust N Z J of Psychiatry Aug 2011, 45(8): 686-687 • Petersen Tym M K, Alexander J. Nitrous oxide induced manic relapse. Aust N Z J of PsychiatryNov 2011,45(11):1002-1002. • Whittchurch F, Alexander J. Psychogenic polydipsia: hidden or under diagnosed? Aust N Z J of Psychiatry Sep 2011, 45(9): 789-790. • Alexander J, Tibrewal P, Fantasia R. Temazeapm withdrawal induced psychosis. Asian Journal of Psychiatry 4 (2011), pp. 224-225 • Skimming A, Dham P, Dinesh A, Alexander J Peripheral Oedema in Quetiapine Therapy. Aust N Z J Psychiatry 0004867411434721, first published on January 5, 2012 as doi:10.1177/0004867411434721 • Bretag-Norris R, Alexander J.Atypical Antipsychotic Medication: Aust N Z J Psychiatry 0004867411434335, first published on January 10, 2012 as doi:10.1177/0004867411434335