week 11 + 12

Involuntary Admission - Mental Health

• Involuntary admission to a hospital is possible when a person poses a significant risk to themselves or others.
• This applies to those displaying irrational behavior and for whom no less restrictive care is available.
• A mentally disordered person is defined as someone with irrational behavior and a significant physical risk to themselves or others.
• A mentally ill person is deemed to have a continuing condition, including any likely deterioration, and no other less restrictive care is available.
• Formal admission includes involuntary patients admitted against their wishes and forensic patients who have committed offenses and are deemed unfit for trial or found not guilty due to mental illness.
• Community Treatment Orders (CTOs) are legal orders made by the Mental Health Review Tribunal, magistrates, or qualified professionals in hospitals or community services.
• CTOs are valid for 12 months and set out terms like medication, therapy, and rehabilitation for the individual.
• A CTO is ordered when a person is currently mentally ill, or judged likely to become mentally ill within 3 months, and is deemed the least restrictive alternative for treatment.
• There are five ways a person can be formally admitted: scheduling by medical practitioners, admission by police or ambulance, admission by a designated carer, admission by court order, and admission following a magistrate's order for a medical examination.
• Both mentally disordered and mentally ill individuals must undergo examinations within 12 hours of admission, followed by a second examination.
• A Mental Health Inquiry by the Tribunal is conducted ASAP after the second examination for both groups.
• Mentally disordered individuals can be detained for up to 3 days, while mentally ill individuals can be detained for up to 3 months or placed on a CTO for up to 12 months.
• All individuals must be reviewed by the Tribunal for potential further orders after the initial timeframes.

Mandatory Reporting

• Mandatory reporting is crucial for child safety in NSW, applying to children aged 0 to 15 at risk of significant harm.
• Reports should be made to the NSW Child Protection Helpline and Child Wellbeing Units (CWU).
• CWU can assist in situations where the harm might not be considered "significant."
• Reporting is not mandatory for unborn children or those aged 16 or 17, as they fall under the Department of Communities & Justice jurisdiction.
• AHPRA PBA Mandatory reporting, as outlined in the Health Practitioner Regulation National Law Act 2009, requires registered health practitioners, employers, and education providers to notify AHPRA if they believe another practitioner presents a serious risk to the public.
• Notifications made to AHPRA are then referred to the appropriate board, documented in a log book, and monitored annually.

Continuing Professional Development (CPD)

• CPD is mandatory for registered psychologists and comprises 30 hours of activities per year.
• Providing peer consultation to others counts towards CPD hours but cannot be counted towards one's own 10 hours of required consultation.
• Supervising interns does not count towards CPD.
• A CPD portfolio should include a learning plan with desired outcomes, descriptions of how CPD relates to professional development, and documentation of all activities undertaken.
• Approved areas of practice require at least 15 hours of CPD activities within the endorsed area.
• Punishments for non-compliance can include refusal of registration renewal, requiring completion of specified CPD activities, performance assessment, and examinations.

Self-Care and Burnout

• Self-care is crucial for psychologists and counselors, as their tools of trade stem from knowledge, experience, empathy, and communication.
• Poor self-care can negatively impact motivation, judgment, self-awareness, problem-solving abilities, and emotional regulation.
• Burnout is characterized by exhaustion, cynicism, and ineffectiveness.
• Exhaustion involves stress, anxiety, and worry, impacting cognitive capacity and leading to withdrawal.
• Cynicism is characterized by increasing detachment from clients and dehumanizing them.
• Ineffectiveness involves feeling incapable of achieving outcomes and experiencing a loss of purpose.
• Gabriela Tavella’s 6 dimensions of burnout encompass Maslach's 3 dimensions (exhaustion, cynicism, and ineffectiveness) and add 3 additional ones: loss of empathy, impaired work performance, cognitive impairment, withdrawal and insularity, and unsettled mood.
• The Sydney Burnout Measure assesses various aspects of burnout through a questionnaire. It measures exhaustion, loss of empathy, impaired work performance, cognitive impairment symptoms, withdrawal and insularity, and unsettled mood.
• Experiencing symptoms individually doesn't necessarily indicate burnout; a pattern of symptoms is crucial for diagnosis.

Factors Contributing to Burnout

• Situational factors: include type of occupation, working conditions (overload, insufficient resources), and nature of the employer (fairness, equity, alignment with personal values).
• Mismatch theory: proposes that burnout is more likely when there's a mismatch between the employee's needs and working conditions in areas like workload, control, rewards, community, fairness, and values.
• Individual factors: include demographics (younger individuals are more at risk), personality (low hardiness, external locus of control, poor coping styles, low self-esteem, stress-prone traits, and personality types like type A and feeling types), and attitudes (high expectations can increase risk).

Combating Burnout

• Organizational strategies: promote job engagement through fostering energy, effectiveness, involvement, enthusiasm, and inspiration. Actively promote well-being, and reduce mismatches between employees and their jobs.
• Individual strategies: include self-care practices (stress inoculation training, interpersonal and social skills training, relaxation training, time management training, meditation), peer support, prioritizing recreation and recovery, ongoing education and training, personal counseling and therapy, and adopting healthy practices at work (exercise, time alone, regular breaks, debriefing with colleagues).