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Academic Word List: Exercise 13

Read the following text, paying particular attention to the highlighted words.

Indications for Psychiatric Inpatient Care

The types of patients likely to require psychiatric inpatient treatment were discussed in Chapter 4. To summarise, broadly speaking there are three main categories of such patients.

  1. Those with serious psychiatric disorders, especially depression with serious suicidal ideation or significant impairment of insight. Also patients with schizophrenia, organic states, and some suffering from alcoholism.
  2. Those at risk of suicide. The characteristics of such patients were described previously (p. 66). This group includes "failed suicides". It overlaps to a large extent with the first category.
  3. Patients who require a short period of removal from stress. These include patients whose coping resources are temporarily exhausted, those who require further assessment, and patients for whom the mobilization of additional help is necessary before they can begin to cope with their difficulties.

The following case example is of a patient who was admitted to a psychiatric hospital because of reasons which placed her in both categories (1) and (2).

Margaret, a 58-year-old housewife, was admitted deeply unconscious to a general hospital after having taken a very large overdose of a mixture of tranquillisers, antidepressants, and paracetamol, together with half a bottle of vodka. She spent 5 days in the intensive care unit before recovery. On the day of the overdose, after her husband and daughter had gone to work, she had finished writing a suicide note which she had started a week before. After leaving the letter in a drawer she had gone to a nearby town and booked in at a hotel. Having asked that she should not be disturbed she had taken the overdose in her room. When her husband and daughter returned home they had been distressed at not finding Margaret. Eventually, they discovered the suicide note, which mentioned the name of the hotel. The police were contacted and they managed to find her.

During the assessment interview Margaret claimed she took the overdose intending to go to sleep and never wake up again. She was evasive when asked if she still felt like killing herself. However, she admitted that she had felt very miserable for 3 or 4 months. Recently, she had started thinking the future was hopeless and that she was no longer able to look after her husband and daughter properly. Her thoughts seemed slow and she complained of lack of energy and difficulty in staying asleep at night.

The therapist judged that Margaret had made a very serious attempt to kill herself, that she was severely depressed and a continuing suicide risk, Although Margaret felt that nothing could be done to help her she agreed to be admitted to a psychiatric unit.

For a few patients, compulsory admission to a psychiatric inpatient unit under an order of the Mental Health Act will be deemed necessary. Description of the types of patients for whom this might be indicated, and guidance on how to proceed were provided in Chapter 4 (p. 75). In addition, a summary of those sections of the Act concerned with admission of patients to hospital, or detention of patients already in hospital, which are relevant for attempted suicide patients was provided in an Appendix to that chapter.

Now try the exercises. Exercise a

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