20 results on '"Wand, Anne"'
Search Results
2. Considering Culture in the Psychiatric Assessment of Aboriginal and Torres Strait Islander Peoples
- Author
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Wand, Anne PF, Eades, Sandra J, and Corr, Melissa J
- Published
- 2010
3. : need and opportunities to improve implementation of clinical elements for older adults.
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Wand, Anne, McKay, Roderick, and Pond, Dimity
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OLDER people , *SUICIDE , *HELP-seeking behavior , *SUICIDE victims , *AGEISM - Abstract
Objective: The Zero Suicide (ZS) framework is increasingly used in Australia, but without published adaptations for older people, and limited access by older people when implemented. The aim of this paper is to inform Towards Zero Suicide (TZS) implementations to benefit older adults by considering the key differences in older adults at risk of suicide according to each clinical component of the ZS framework.Conclusion: TZS aspires to reduce deaths by suicide for people within healthcare by refocusing interventions on suicidality rather than diagnosis alone, emphasising evidence-based practices and cultural change. For TZS to be effective for older people, it is essential to ensure practices are based upon evidence relevant to older people and to ensure ageism is effectively counteracted. Older adults have distinct patterns of help seeking and service use, accompanied by differences in risk factors, presentations, and outcomes of suicidal behaviours. Ageism affects assessment, decision-making and actions to address self-harm and suicide for older people. Immediate and longer-term actions are essential to effectively implement TZS in this population. [ABSTRACT FROM AUTHOR]- Published
- 2022
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4. DEMS-DOSS study: validating a delirium monitoring tool in hospitalised older adults.
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Montgomery, Amy, Todd, Jo-Anne, Jones, Cindy, Koroitamana, June, Grealish, Laurie, Wand, Anne, Billett, Stephen, and Teodorczuk, Andrew
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DIAGNOSIS of delirium ,STATISTICAL reliability ,RESEARCH methodology evaluation ,RESEARCH methodology ,MEDICAL screening ,INTERVIEWING ,PATIENT monitoring ,URBAN hospitals ,HOSPITAL care of older people ,GERIATRIC nursing ,DESCRIPTIVE statistics ,STATISTICAL sampling ,SENSITIVITY & specificity (Statistics) ,LONGITUDINAL method ,OLD age - Abstract
Objective to evaluate the sensitivity, specificity and test–retest reliability of the Delirium Early Monitoring System-Delirium Observation Screening Scale (DEMS-DOSS). Design prospective diagnostic accuracy study of a convenience sample of admitted older adults with DEMS-DOSS and reference standard assessments. Setting 60-bed aged care precinct at a metropolitan hospital in Sydney, Australia. Participants 156 patients (aged ≥65 years old) were recruited to participate between April 2018 and March 2020. One hundred participants were included in the analysis. Measurements Participants were scored on the DEMS-DOSS. Trained senior aged care nurses conducted a standardised clinical interview based on the Diagnostic and Statistical Manual of Mental Disorder (DSM)-IV delirium criteria, within two hours of DEMS-DOSS completion. The senior aged care nurse undertaking the DSM-IV interview was blinded to the results of the DEMS-DOSS. Results Participants' mean age was 84 (SD ±7.3) years and 39% (n = 39) had a documented diagnosis of dementia. Delirium was detected in 38% (n = 38) according to the reference standard. The DEMS-DOSS had a sensitivity of 76.3% and a specificity of 75.8% for delirium. The area under the receiver operating characteristics curve for delirium was 0.76. The test–retest reliability of the DEMS-DOSS was found to be high (r = 0.915). Conclusion DEMS-DOSS is a sensitive and specific tool to assist with monitoring new onset and established delirium in hospitalised older adults. Further studies are required to evaluate the impact of the monitoring tool on health outcomes. [ABSTRACT FROM AUTHOR]
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- 2022
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5. The use of opioids for chronic non‐cancer pain in older Australians.
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O'Brien, Michael David Cory, Wand, Anne Pamela Frances, and Draper, Brian
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THERAPEUTIC use of narcotics ,MORTALITY risk factors ,ELDER care ,CANCER pain ,CHRONIC pain ,CODEINE ,DRUG interactions ,DRUGS ,NARCOTICS ,RESIDENTIAL care ,DISEASE prevalence - Abstract
The article offers information on use of opioids for chronic non-cancer pain in older Australians. Topics discussed include information on rising prevalence of prescription opioid use; information on guidelines on the treatment of opioid dependence which aims to improve access to opioid treatment by expanding programs to the primary care setting; and need for clinical pain management guidelines including the use of opioids that are relevant to older people.
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- 2019
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6. An algorithm for managing adults who refuse medical treatment in New South Wales.
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Cheng, Kylie, Wand, Anne, Ryan, Christopher, and Callaghan, Sascha
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MEDICAL care , *PATIENT refusal of treatment , *PSYCHIATRY , *PSYCHOLOGY , *MENTAL health laws , *PATIENT refusal of treatment laws , *ALGORITHMS , *CAPACITY (Law) , *MEDICAL laws , *LEGAL status of psychotherapy patients , *DISEASE management , *LAW , *LEGISLATION - Abstract
Objectives: The assessment and management of a patient who refuses medical treatment requires clinical skill, and consideration of the relevant law and the patient's decision-making capacity. Psychiatrists are often asked to advise in these situations. We aimed to develop an algorithm describing the relevant legal pathways to assist clinicians, especially psychiatrists, working in New South Wales (NSW), Australia.Methods: We reviewed the academic literature on treatment refusal, relevant legislation, judicial rulings and NSW Health policy directives and guidelines. We consulted with clinicians and representatives of relevant tribunals.Results: We developed an algorithm for managing patients who refuse medical treatment in NSW. The algorithm emphases the evaluation of decision-making capacity and tracks separate pathways depending upon a person's status under the Mental Health Act 2007 (NSW).Conclusions: The algorithm provides a clear decision tree for clinicians responding to a patient refusing medical treatment in NSW. [ABSTRACT FROM AUTHOR]- Published
- 2018
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7. Using interpreters with culturally and linguistically diverse older adults: What do we need to know?
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Wand, Anne Pamela Frances, Pourmand, Diba, and Draper, Brian
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MEDICAL care for older people ,COGNITION ,COMMUNICATION ,DECISION making ,LINGUISTICS ,NOMADS ,NURSING care facilities ,CULTURAL pluralism ,HEALTH facility translating services - Abstract
An editorial is presented on the mobility of the older population with migration between and within countries, plus refugees and asylum seekers, has resulted in a growing number of older migrants in many countries such as Australia. It expresses the view that migrants bring their own culture, language, health beliefs and life experiences, and health services must be sensitive and responsive to all these factors.
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- 2020
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8. Utilisation of the Australian government initiative MyHealth Record to support the clinical approach to factitious disorder.
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Alchin, David R., Overton, Kristen, George, Duncan, Murphy, Michael, and Wand, Anne P. F.
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GOVERNMENT agencies ,DOCUMENTATION ,FACTITIOUS disorders ,MALINGERING ,DISEASE management ,ACCESS to information ,ELECTRONIC health records - Abstract
Recently, the Australian Digital Health Agency launched MyHealth Record to the public. As of July 2019, 90.1% of Australians hold records with this service, allowing 16 400 health organisations access to >28 million clinical documents. The streamlining of patient data was intended to facilitate sharing of information and improve communication between medical providers, while promoting efficiency in clinical practice. We have identified a hitherto unrecognised application of this infrastructure in the identification and management of factitious disorder, a rare yet highly diagnostically challenging condition involving intentional feigning of illness, which presents a significant resource burden to the Australian health system. [ABSTRACT FROM AUTHOR]
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- 2020
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9. The Zero Suicide Framework requires adaptation to include older adults.
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Wand, Anne P and McKay, Rod
- Subjects
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SUICIDE prevention , *MEDICAL care , *CONCEPTUAL structures , *HUMAN services programs , *SYSTEM analysis , *MENTAL health services - Published
- 2021
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10. Liaison psychiatry with Aboriginal and Torres Strait Islander peoples.
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Wand, Anne P. F., Corr, Melissa Jane, and Eades, Sandra J.
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CONSULTATION-liaison psychiatry , *INDIGENOUS peoples , *PSYCHIATRY -- Social aspects , *TORRES Strait Islanders , *MENTAL health , *ETHNOPSYCHOLOGY , *PSYCHIATRIC referral - Abstract
Objective: The aim of the present study was to describe the referral patterns, assessment and suggested management of Aboriginal and Torres Strait Islander peoples referred to an inner-city general hospital psychiatry service. The overarching goal was quality improvement. Method: Participants were identified from the consultation-liaison psychiatry database of all referrals to the service from the general hospital and Emergency Department. All people over 18 identifying as Aboriginal and/or Torres Strait Islander seen during the period 1 July 2004-30 June 2007 were included. Information regarding referral and liaison patterns, suggested psychiatric management, disposition and follow up were gathered retrospectively from the medical records, with a particular focus on cultural references. Results: There were 162 referrals to the consultation-liaison psychiatry team of people identifying as Aboriginal and/or Torres Strait Islander. The rate of referral to consultation-liaison psychiatry was 3%. The Emergency Department had the highest rate of referral followed by Obstetrics and Gynaecology. The most common reason for referral was assessment of risk. The patient's Aboriginal ethnicity was mentioned in 52.5% of consultation-liaison assessments. An Aboriginal health worker was consulted in 48.1% of cases. The most common management approach involved pharmacotherapy. The consultation-liaison service instigated legal interventions in 25% of cases. Forty-five patients were referred for psychiatric admission following their assessment. Mental health follow up was arranged in 43.8% of cases. Conclusions: The range of mental health problems referred and types of diagnoses made in Aboriginal and Torres Strait Islander peoples reflect what has been previously reported, particularly in relation to comorbidity. Aboriginal ethnicity was variably identified and Aboriginal health workers, general practitioners and families were not routinely involved in consultation-liaison psychiatry assessments, highlighting an opportunity to improve communication and the quality of patient care. [ABSTRACT FROM AUTHOR]
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- 2009
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11. Standards, efficiency and effectiveness in consultation-liaison psychiatry.
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Wand, Anne PF, Wood, Rebecca, Fossey, Matthew J, and Aitken, Peter
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MEDICAL referrals , *MENTAL illness , *PSYCHIATRY , *ACCREDITATION - Abstract
The article discusses developments concerning the evaluation of standards, performances and effectiveness of consultation-liaison psychiatry (CLP). Topics include the establishment of the Psychiatric Liaison Accreditation Network (PLAN) by the British Royal College of Psychiatrists and the proposed measures for evaluating CLP services which include the Patient Reported Outcome Measures and the Patient Reported Experience Measures.
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- 2015
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12. Firearms, mental illness, dementia and the clinician.
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Wand, Anne P. F. and Peisah, Carmelle
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FIREARM policy ,MEDICINE ,MENTAL health of older people - Abstract
A response from the authors of the article "Firearms, mental illness, dementia and the clinician," which discusses the need for the medical profession to play a more active role in the regulation of firearm licences held by older Australians is presented.
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- 2015
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13. Risk factors for dementia and self-harm: A linkage study.
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Walker AR, Srasuebkul P, Trollor JN, Wand APF, Draper B, Cvejic RC, Moxey A, and Reppermund S
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- Male, Humans, Risk Factors, Australia, Self-Injurious Behavior epidemiology, Self-Injurious Behavior etiology, Dementia epidemiology
- Abstract
Introduction: People living with dementia experience poor mental health and high rates of self-harm. We investigated risk factors for self-harm in people aged > 40 years living with dementia and risk factors for dementia after self-harm., Methods: Using linked hospital data from New South Wales, Australia, we defined a dementia cohort (n = 154,811) and a self-harm cohort (n = 28,972). Using survival analyses, we investigated predictors of self-harm for the dementia cohort, and predictors of dementia for the self-harm cohort., Results: We found self-harm or dementia diagnoses occurred most often within 24 months of a dementia diagnosis or initial self-harm presentation, respectively. Men living with dementia, and people with complex psychiatric profiles, had the greatest risk of self-harm. Men who had self-harmed had the greatest risk of dementia diagnoses., Discussion: Men and people with complex psychiatric profiles and dementia may particularly benefit from post-diagnosis mental and behavioral support to reduce risk of self-harm., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2023
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14. Educating Crisis Supporters About Self-Harm and Suicide in Older Adults.
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Wand APF, Jessop T, and Peisah C
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- Aged, Australia epidemiology, Humans, Suicidal Ideation, Volunteers, Self-Injurious Behavior, Suicide Prevention
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Objectives: This study aimed to describe existing knowledge of crisis supporters (volunteers responding to crisis calls/texts/messages) regarding self-harm and suicide in older adults and investigate knowledge translation through use of a novel online adaptive learning tool., Methods: The online educational tool was tested in an Australian national sample of crisis supporters (trained volunteers) aged 18+. Knowledge Transfer was evaluated utilizing a pre/post intervention methodology for data collection. The collaboratively developed online educational tool comprised a pre-test (10 questions), middle learning module (individualised for participant's incorrect pre-test responses) and post-test (10 questions) on suicidal behaviours in older adults. Data analysed included the demographic characteristics of the participants, individual question scores, and summed pre- and post-tests scores. Group differences in change scores were assessed with either one-way between subjects ANOVA or independent samples t-test, depending on the number of groups within each variable. Pre-post education comparisons on individual change in scores were made using a paired samples t-test. Statistical significance was defined as p <0.05., Results: 104 crisis supporters completed the tool (pre-test, middle lesson and post-test). There was significant improvement in knowledge of crisis supporters after the intervention (pre-test scores Mean (M) = 4.56, SD = 1.62 and post-test scores M = 7.61, SD = 1.60; t (103) = 17.242, p <0.001.)., Conclusion: Dedicated training about suicidal behaviors in older adults is needed given their high rates of suicide and differing underlying reasons and needs compared to younger adults., (Copyright © 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)
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- 2022
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15. Older Australians are the most vulnerable consumers of community mental health teams during the COVID-19 pandemic.
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McKay R, Aquilina C, and Wand A
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- Australia epidemiology, Humans, Mental Health, SARS-CoV-2, COVID-19, Pandemics
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- 2021
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16. Navigating the Minefield: Managing Refusal of Medical Care in Older Adults with Chronic Symptoms of Mental Illness.
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O'Cionnaith C, Wand APF, and Peisah C
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- Aged, Aged, 80 and over, Australia, Chronic Disease, Female, Human Rights, Humans, Male, Mental Competency, Health Personnel psychology, Mental Disorders therapy, Professional-Patient Relations, Treatment Refusal
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Purpose: The purpose of this case series is to illustrate the complexity of considerations across health (physical and mental), ethical, human rights and practical domains when an older adult with chronic symptoms of mental illness refuses treatment for a serious medical comorbidity. A broad understanding of these considerations may assist health care professionals in navigating this challenging but common aspect of clinical practice., Case Presentation: Three detailed case reports are described. Participants were older adults with an acute presentation of a chronic mental illness, admitted to a specialized older persons mental health inpatient unit (OPMHU) in an Australian metropolitan hospital. Significant comorbid medical issues were detected or arose during the admission and the patient refused the recommended medical intervention. Data extracted from patients' medical records were analyzed and synthesized into detailed case reports using descriptive techniques. Each patient was assessed as lacking capacity for healthcare and treatment consent and did not have relatives or friends to assist with supported decision-making. Multifaceted aspects of decision-making and management are highlighted., Conclusion: There are multiple complex issues to consider when an older adult with chronic symptoms of mental illness refuses treatment for serious comorbid medical conditions. In addition to optimizing management of the underlying mental illness (which may be impairing capacity to make healthcare decisions), clinicians should adopt a role of advocacy for their patients in considering the potential impact of ageism and stigma on management plans and inequities in physical healthcare. Consultation with specialist medical teams should incorporate multifaceted considerations such as potentially inappropriate treatment and optimum setting of care. Equally important is reflective practice; considering whether treatment decisions may infringe upon human rights or cause trauma., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 O’Cionnaith et al.)
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- 2021
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17. Firearms, mental illness, dementia and the clinician.
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Wand AP, Peisah C, Strukovski JA, and Brodaty H
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- Australia, Dementia psychology, Humans, Mandatory Testing, Mental Competency, Mental Disorders psychology, Physician's Role, Risk Assessment ethics, Risk Assessment legislation & jurisprudence, Violence legislation & jurisprudence, Violence prevention & control, Dementia diagnosis, Firearms ethics, Firearms legislation & jurisprudence, Mental Disorders diagnosis, Physicians ethics
- Abstract
Clinicians have an obligation to report to state or territory police any concerns about risk of harm from patients with access to firearms. Dementia is an under-recognised medical problem which may increase the risk of firearm injury or violence in those with such access. There are no guidelines for clinicians regarding mandatory screening for access to firearms, and currently the onus is on the firearm licence holder to declare any relevant medical conditions. We propose that clinicians should screen patients for firearm possession and use a combined capacity and risk assessment approach to evaluating fitness for firearm licences.
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- 2014
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18. Dharan or Nabhi Sarakna: a cultural syndrome presenting with unexplained medical symptoms.
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Wand A and Kaur R
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- Abdominal Pain, Anorexia, Australia, Constipation, Dehydration, Female, Humans, Nausea, Pakistan ethnology, Somatoform Disorders psychology, Syndrome, Young Adult, Culturally Competent Care, Culture, Somatoform Disorders ethnology
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- 2014
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19. 'Admit voluntary, schedule if tries to leave': placing Mental Health Acts in the context of mental health law and human rights.
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Wand A and Wand T
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- Australia, Civil Rights legislation & jurisprudence, Education, Medical, Graduate legislation & jurisprudence, Human Rights education, Humans, New Zealand, Health Services Accessibility legislation & jurisprudence, Hospitalization legislation & jurisprudence, Human Rights legislation & jurisprudence, Mental Health legislation & jurisprudence
- Abstract
Objectives: Most postgraduate training for clinicians in Australia and New Zealand regarding mental health legislation focuses on the relevant Mental Health Acts (MHAs) rather than the broader principles of mental health law. Key concepts include treatment in the least restrictive environment, voluntary access to mental health services, treatability, reciprocity and due process. Lack of awareness of these principles may result in a more risk-averse interpretation of MHAs, which is inconsistent with the spirit of mental health law and the promotion of human rights. The aim of this paper is to present some fundamental principles of mental health law, which are essential to proper clinical application of MHAs, and to demonstrate why they should form part of the curriculum for psychiatry training and continuing professional development for psychiatrists., Conclusions: A sound understanding of the principles of mental health law is essential for all clinicians who may be enacting aspects of MHAs. This provides the necessary platform to safeguard human rights and optimise the care of people with a mental illness.
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- 2013
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20. Preparing for consultancy: setting up a new psychiatry service as an advanced trainee.
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Wand A and Orr F
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- Australia, Communication, Health Services Needs and Demand, Humans, Leadership, Practice Guidelines as Topic, Quality Assurance, Health Care, Teaching, Mental Health Services organization & administration, Psychiatry education, Referral and Consultation standards
- Abstract
Objectives: The aim of this paper is to describe the experience of an advanced trainee establishing a new psychiatry service, and to demonstrate how such an activity is a viable option for advanced training and helps develop consultancy skills. A detailed description of this process is provided, with a particular focus on consultation, training issues, service evaluation and the challenges encountered., Conclusions: Involvement in establishing a new psychiatric service provides an advanced training experience which may prepare the trainee for consultancy by developing core skills such as communication, administration, leadership, teaching and experience in quality assurance.
- Published
- 2010
- Full Text
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