Mental health glossary 2

North East London NHS
Designed and printed by Visualize 020 8527 6225 Dr Heather Shearer (North East London Mental Health Trust), Kirsty MacLean Steel and Lucy Calas-Prolingheur (East London and The City Mental Health Trust) developed this glossary. We would like to thank everyone who contributed to its production.
This glossary can be used and replicated for non-profit making purposes as long as appropriate acknowledgement is made to North East London Mental Health Trust and East London and The City Mental Health Trust. This glossary is for reference and education only and is not intended to be a substitute for independent research and judgement. Clinicians may find it useful to help explain terms to service users however it should not replace essential communication between clinician and service user.
This glossary is not designed to be a definitive guide and neither East London and The City Mental Health NHS Trust nor North East London Mental Health NHS Trust accepts responsibility or liability arising from any outdated information or from any error in, or omission from, the glossary. We would be grateful if readers who notice any omissions or errors could contact us.
North East London Mental Health NHS Trust
A&E (Accident & Emergency) liaison A service within A&E departments for mental healthassessments and referral to specialist services.
ADHD(see Attention deficit hyperactivity disorder) An assessment by an external agency of an individual ororganisation against defined criteria. For example,services providing ECT (see definition) must meet thestandards set by the Royal College of Psychiatrists. If thestandards are met satisfactorily the service is accreditedby the Royal College of Psychiatrists.
An acute illness is one that occurs quickly, is intense orsevere and lasts a relatively short period of time.
The point at which a person begins an episode of care(see definition), e.g. arriving at an inpatient ward.
There are various types of advance statement/directive.
They can include statements of an individual’s wishes incertain circumstances, for example instructions to refuse some or all medical treatment or requests for certain types of treatment.They can also state someone to be consulted at the time a decision needs These are therapies that are not part of current to be made.The individual should seek advice about standard medical practice (for example acupuncture, the legal status of these statements/directives.They reflexology or aromatherapy).Therapies are termed as complementary when used in addition to conventionaltreatments and as alternative when used instead of An advocate is a person who can support a serviceuser or carer through their contact with health services.
Advocates will attend meetings with patients and help service users or carers to express concerns or wishesto health care professionals. Although many people canact as an advocate (friend, relative, member of staff) there are advocacy services available that can be This is an illness that is characterised by a refusal to eat, accessed through the Trust.These advocates are trained an avoidance of eating or a careful and low intake of food.The person can become malnourished to thepoint of starvation.Their perception of their own body size may become distorted and they will continue to Affective disorders are also known as mood disorders.
They are marked by changes in affect (mood/emotion).
The term may be used to describe depression, bipolar disorder and mania (see definitions).
Antidepressants aim to treat the symptoms ofdepression and can help people experiencing depression to feel more motivated and energetic.This This is the support or care that a person can expect to group of medication may also be used to treat receive once discharged from inpatient care.Typically a obsessive-compulsive disorder, anxiety and eating disorders.There are different types of antidepressants multidisciplinary team with the service user which will including tricyclic and selective serotonin reuptake make clear what care and support will be provided.
Anti psychotic medication is normally given to treat the Agoraphobia is defined as a fear of open spaces. It also symptoms of schizophrenia and, in some cases, manic includes related fears such as fear of entering shops, depression and manias.The two main types of fear of crowds and public places, or of travelling alone.
antipsychotics are called typical and atypical (see A person may feel an intense fear of being caught or definitions).The main difference between the two trapped in a situation when they can’t get help. It is often associated with panic attacks.
This is the term used to describe experiences such as Aromatherapy involves the use of therapeutic oils chronic fear, tension and panic attacks. Some people derived from plants to stimulate the body’s nerves to have an overwhelming feeling of dread that prevents help a person feel either more relaxed or energised. It them getting on with everyday life. Sleepless nights and is often used with massage or in the bath.Various oils recurring thoughts are common, as well as nausea, are available and are divided into different fragrance palpitations, dizziness and difficulty in breathing. Anxiety families: relax, body, energy, mind and soul.
is the most common mental health problem peopleexperience.
Art therapy aims to support people’s recovery using art as a creative process and as a therapy to help These are disorders that involve a continuous state of people resolve emotional conflicts, be more aware anxiety or fear, lasting at least a month, marked by about themselves, develop social skills, reduce anxiety constant apprehension, difficulties in concentration and a pounding heart. Physical symptoms may also bepresent, such as headaches, sweating, irritability, and nausea. Anxiety disorders include panic disorder and obsessive-compulsive disorder. Depression is commonin those with anxiety disorders.
Assertive outreach services aim to support people inthe community who find it difficult keeping in contact When in a clinical situation, the expected benefits (e.g.
improved symptoms) of care outweigh the expectednegative effects (e.g. drug side effects) to such anextent that the treatment is worth carrying out.
Assessment happens when a person first comes into contact with health services. Information is collected inorder to identify the person’s needs and plan Approved Social Workers (ASW) have specialist training and experience in identifying disorders of mental healthand are familiar with the problems experienced by usersof mental health services and their families.They are employed by Local Authority Social Services and work in hospitals and in the community as part of the People with ADHD have three main kinds of problems: community mental health teams.They will organise social difficulty concentrating or paying attention, overactive care support for people in contact with mental health behaviour and impulsive behaviour. ADHD is a services, such as helping with housing and getting welfare developmental problem that usually starts in childhood.
benefits.They work closely with health professionals and, Some people have significant problems in concentration under the current Mental Health Act, they work with and attention, but are not necessarily overactive or two doctors to assess a person who may need admitting impulsive.These people are sometimes described as to hospital. Social workers can also act as care co- having Attention Deficit Disorder (ADD) rather than ordinators for people on care programmes.
This is also known as manic depression or bipolar Atypical antipsychotic medication is a group of new disorder. It is a disorder characterised by swings in a antipsychotic drugs that have a different set of side person’s mood from very very high (mania) to very effects from the older, typical, antipsychotics. In general they cause fewer movement disorders such as tremor,muscle stiffness and restlessness.
Bipolar Disorder(see Bipolar Affective Disorder) The process of carrying out a clinical audit project follows a cycle of identifying a topic, setting standards, This is a personality style marked by unstable moods measuring current practice against these standards, and unsatisfactory personal relationships.They often agreeing recommendations and implementing change.
have problems with impulsivity, substance abuse (see This cycle is repeated to ensure change has occurred definition) and impulsive spending.Those with BPD may also suffer from depression, anxiety and the fear ofbeing abandoned. (see also Personality Disorder) Autism is a lifelong developmental disorder that affects the way a person communicates and relates to people This is the professional body for psychologists.
around them. In the great majority of cases, autisticdisorders are present from birth or become apparentwithin the first three years of life.
People with typical autism have no interest in social Symptoms of bulimia may include chaotic eating, interaction, little or no language, and tend to live in their bingeing, vomiting and abuse of laxatives.
own world. Asperger’s syndrome often applies to thosewho are more able, who have better language development, and who have more social contact.
A senior healthcare professional in each NHS Asperger’s syndrome may first come to notice in adult life.
organisation is responsible for safeguarding theconfidentiality of patient information.The name comes from the Caldicott Report, which identified 16 A period of mild depression after childbirth, the baby recommendations for the use and storage of patient- blues tends to last a few hours or a few days and then disappears. Not to be confused with postnataldepression (see definition).
CAMHS(see Child and adolescent mental health services) A way of comparing a particular process and outcomes in one organisation with another organisation. Each This term means that a patient has the ability to organisation can then examine and change their own understand and retain information about their medical processes to achieve better outcomes.
condition and their need for treatment.
A care co-ordinator is the person responsible for making sure that a patient gets the care that they need.
Patients and carers should be able to contact their care co-ordinator (or on-call service) at any reasonable time.
Once a patient has been assessed as needing careunder the Care Programme Approach they will be toldwho their care co-ordinator is.The care co-ordinator is likely to be community mental health nurse, social CAMHS is a term used to refer to mental healthservices for children and adolescents. CAMHS are usually multidisciplinary teams including psychiatrists, A care plan is a written plan that describes the care psychologists, nurses, social workers and others.
and support staff will give a service user. Service usersshould be fully involved in developing and agreeing the care plan, sign it and keep a copy. (see Care A condition that develops slowly or lasts a long time.
The Care Programme Approach is a standardised way An alternative term for patient which emphasises the of planning a person’s care. It is a multidisciplinary (see professional nature of the relationship between a definition) approach that includes the service user, and, clinician or therapist and the patient.
where appropriate, their carer, to develop anappropriate package of care that is acceptable to healthprofessionals, social services and the service user.The care plan and care co-ordinator are important parts of Client-centred therapy emphasises the importance of this. (see Care Plan and Care Co-ordinator).
empathy in healing.The therapist provides anenvironment of empathy, unconditional positive regard, A carer is someone who looks after their relatives orfriends on an unpaid, voluntary basis often in place of A process used to measure the quality of aspects ofcare and services and to improve that quality.
Relative frequency of different diagnoses or conditions A person who provides advice and technical supporton the subject of clinical audit.
A reason or explanation for a problem or illness basedon analysis and/or investigation.
Clinical effectiveness focuses on ensuring that staff are This is someone who has a Psychology Degree providing the best and most effective care for people together with clinical training in psychology.They are using health services.This is done using a variety of trained in research, assessment and the application of methods including clinical audit and evidence-based A team of health care professionals from different A framework that ensures that NHS organisations disciplines (e.g. nursing, psychiatry, occupational monitor and improve the quality of services provided and that they are accountable for the care theyprovide.This is monitored by the Commission for Health Improvement (see definition).
A person who provides direct care to a patient such asa doctor, nurse, therapist, pharmacist, psychologist etc.
Clinical guidelines/clinical practiceguidelines Systematically developed statements, based on scientific research, which assist in decision-making aboutappropriate healthcare for specific clinical conditions.
This is an approach to treatment that involves working with people to help them change their emotions, Information about diagnoses, treatments and their thoughts and behaviour. A person’s personal beliefs are addressed in order to understand and changebehaviour.
A scheme for assessing a Trust’s arrangements to This is the professional body that represents minimise clinical risk for service users and staff.Trusts occupational therapists and produces guidance.
need to pay ‘insurance’ which can offset the costs oflegal claims against the Trust. Achieving CNST Levels (1, 2 or 3) is shows the Trust’s success in minimising clinical The presence of two or more disorders at the same risk and reduces the premium that the Trust must pay.
time. For example, a person with depression may alsohave co-morbid obsessive compulsive disorder.
Different ways of describing and/or prescribing a ‘plan’for providing a particular health service.
A multidisciplinary team offering specialist assessment, The Commission for Healthcare Audit and Inspection treatment and care to people in their own homes and (CHAI) is a new body that will exist from April 2004. It is being set up to help to improve the quality ofhealthcare by ensuring an independent assessment ofthe standards of services provided to patients, whether it is provided by the NHS or privately. By routinely CPNs are registered nurses who work with people in publishing information, it will also allow the public to the community.They work as part of a team and, like assess how well tax-payers’ money is being spent in other members of the team, may see people in a delivering healthcare. CHAI will take on the functions of variety of settings such as at a GP surgery, in a clinic or CHI (see definition) and other inspection bodies.
health centre or in a client’s own home.They workclosely with GPs (see General Practitioner definition) and other health professionals.They provide practical advice, ongoing support with problems, supervisemedication, give injections and help with counselling.
An independent body set up to monitor clinical They also work out care plans with other members of governance in NHS organisations. (see Clinical Governance).This body will be replaced by theCommission for Audit and Inspection in Healthcare(CHAI see definition) from April 2004.
These are therapeutic practices or techniques that are not currently considered an integral part ofconventional medical practice.Therapies are termed as Primary Care Trusts are responsible for buying complementary when used in addition to conventional (commissioning) specialist mental health services on treatments and as alternative when used instead of behalf of the people living in the district.They have an conventional treatment. (see also Alternative therapies) allocation of money and decide which services tocommission.The service provider is chosen and giventhe money to make sure the service is delivered according to the contract. Services may be This is a combination of medical needs (e.g. diagnosis, commissioned from the NHS or the voluntary or treatment and rehabilitation) and social needs (e.g.
housing, social care and independent living).
Community Care aims to provide health and social care This term means that written standards are met. It is services in the community to enable people to live as also used to refer to service users following agreed independently as possible in their own homes or in care plans (including taking prescribed medication).
other accommodation in the community.
This may occur when people experience loneliness or The way that an organisation checks that its policies are distress and use food for comfort. Food may make being carried out.This includes internal and external them happier on a temporary basis but as food audit for financial matters, employment policies and all increasingly dominates a person’s life, he or she areas in which the organisation interacts with the becomes more unhappy, finds it more difficult to exercise real control and, gaining more weight, puts hisor her own health at greater risk.
The CORE Outcome Measure is one way to find out if an intervention has been successful. It includes both the Where a restricted patient under the Mental Health service user’s and the clinician’s assessment of the Act is discharged subject to specific conditions and liable to be recalled by the Home Secretary.
Counselling is a talking therapy that usually deals with a This is a persistent pattern of behaviour that involves recent distressing event.The length of time that violation of the rights of others. Verbal and physical counselling is needed varies from person to person.
aggression are central features of conduct disorder.
The Court of Protection has several roles in looking If you are an informal patient, you have the right to after the financial affairs of people who cannot legally refuse any treatment you do not wish.You have a right do it themselves.These include making Enduring Powers to receive full information about the treatment, its of Attorney (see definition), making wills, and generally purpose and possible side effects. If consent is not giving directions and orders for the management of the obtained the treatment cannot normally be given.
A Consultant Psychiatrist is a trained mental healthdoctor with additional specialist training in psychiatry.
The consultant is medically responsible for the care of people receiving mental health services and also A crisis resolution team aims to respond to people in A situation in which medication should not be used. For crisis. It aims to provide an assessment and treatment example because of a physical condition, other service, 24 hours a day, wherever people are.
Where a person injures or harms himself or herself Depression is one of the most common forms of intentionally. Common forms are self-poisoning or cutting.
mental health problem and can occur to people of allages. Symptoms include feelings of despair, hopelessnessand worthlessness, an inability to cope, sleep problems and sometimes thoughts of suicide. Often people with A condition including severe confusion, disorganized depression will complain of physical problems (e.g for thinking, disorientation and restlessness. Delirium may example headaches, stomach problems) rather than be caused by physical agents such as infections, toxic depression when consulting their GP. Various substances, metabolic disorders or strokes. Delirium treatments are available for depression including Tremens, “the trembling delirium” is a type of delirium antidepressant medication, talking treatments such as that affects people on alcohol withdrawal after a long CBT (see definition), or counselling (see definition).
period of heavy drinking. Its main symptoms areuncontrollable trembling along with the symptoms Identifying an illness or problem by its symptoms andsigns.
This is a manual that classifies mental health problems Dementia is characterised by confusion, memory loss, and is used to diagnose people’s mental health poor problem-solving and poor concentration.There problems.The American Psychiatric Association are many diseases that lead to dementia, the most common being Alzheimer’s disease, Dementia usuallyoccurs in older people. Dementia in people under 65 isknown as early onset dementia.
Dementia with Lewy bodies (DLB) is a rarer form of Services in NHS organisations are usually grouped into dementia that shares characteristics with both directorates. Medical services (e.g. psychiatry) are Alzheimer’s and Parkinson’s diseases.Vascular dementia grouped into the Medical Directorate. Nursing staff and occurs when cells in the brain are deprived of oxygen.
services make up the Nursing Directorate.The way in Many symptoms are the same as other forms of which directorates are organised changes from Trust to dementia, however there are some differences.
Dependence refers to when a person is reliant on a The point at which a person formally leaves services.
substance or person to help them function on a day- On discharge from hospital the multidisciplinary team to-day level. It can also be used to refer to a person and the service user will develop a care plan. (see Care who has become reliant on a medication to function in on food. Most people who suffer from eating disorders are women although men can also suffer from them.
This is a disorder in which normal consciousness oridentity is split or altered, often as a result of an intense A specific, set amount of medication administered.
How well something works.This term is used to referto treatments in particular.
Drama therapy aims to help a person use drama aspart of their recovery process. It can give a person an opportunity for reflection and to tell their story to help In ECT a small, carefully controlled amount of electricity solve a problem and achieve a relief of strong is sent through the brain of a person who has been given an anaesthetic and muscle relaxant. This producesa mild seizure or convulsion. It is used for cases ofsevere mental illness, usually depression, where the patient has not responded to other treatments or Dual diagnosis refers to two or more disorders medication.The Department of Health has issued strict affecting one person. For example, mental illness and guidelines on the use of this therapy.
learning disability. It is also used to indicate that aperson who has been diagnosed with a mental healthproblem also misuses substances, such as illegal drugs, The powers to detain a person for an initial assessmentto determine whether the use of compulsory powers isappropriate. For example a Section 136 or a Section 5(2).
Early intervention services provide support andtreatment in the community for young people with psychosis and their families.The aim is to reduce the An Enduring Power of Attorney (EPA) is a legal period of untreated psychosis, which in turn, evidence document that enables someone to appoint one or shows, is likely to lessen future problems and improve more persons to manage their financial affairs and the person’s health and well being in the long term.
property, either now or in the future.
Examples of eating disorders are anorexia nervosa, The period when a service user enters the care of the bulimia and compulsive eating.They are often an Trust to when they are discharged from all services expression of deep emotional difficulties and low self- provided by the Trust.This care could be, for example a esteem. Depression, disturbed sleep patterns, combination of care provided by inpatient stays, restlessness and disturbance of bodily functions are outpatient attendances, a CPN, or use of services from some of the effects of eating disorders. People who have an eating disorder find their lives become centred Judging the value of something by making a comparison.
This is a person who has been detained in hospitalunder the Mental Health Act (1983).
This can be known as evidence-based healthcare,evidence-based medicine or evidence-based practice. It A recommendation of good practice usually based on involves using available evidence, particularly research, to plan how to treat specific conditions.The processaims to find a comfortable compromise between the evidence, clinicians’ views and experiences and service A family doctor, usually patients’ first point of contact A decision about management based primarily on They are disorders of perception or a perception evidence from scientific literature.
without a stimulus.There are various different types ofhallucinations including; auditory (hearing sounds or voices), olfactory (smells), tactile (sensation), visual Exposure therapy is a form of cognitive behavioural (seeing things) or gustatory (taste).The most common therapy used to help people who have experienced are hearing voices or seeing things that don’t really traumas. It uses careful, repeated and detailed experience exist. Hallucinations are common psychotic disorders.
of the real or imagined trauma in a safe and supportive Hallucinations may also occur after illegal drug use and environment to help the person face and gain control of some prescribed drugs (e.g. steroids).
the fear and distress that was overwhelming.
(can also be referred to as Health Care Support Workers) Health Care Assistants are non-qualified nursing staffwho undertake assigned tasks involving direct care in EMDR is a relatively new treatment to help people deal support of a registered/qualified nurse.There are two with trauma. It involves elements of exposure therapy grades of Health Care Assistants, A and B grade. A (see definition) and cognitive behavioural therapy (see grades would expect to be more closely supervised, definition), combined with other techniques.
while B grades may regularly work without supervisionfor all or most of their shift, or lead an A grade).
This form of therapy involves all relevant members of a family, placing importance on the family as a pathway toward helping to treat the patient.
HoNOS is probably the outcome measure most widelyused by English mental health services.The scales arecompleted after routine clinical assessments in anysetting and have a variety of uses for clinicians, researchers and administrators.They are designed to be used before and after interventions so that changes This is a less severe form of mania (see mania) that attributable to the interventions (outcomes) can be may or may not require hospital treatment. Hypomania is usually a symptom of bipolar disorder (see definition).
It may also result from illicit drug use.
A team usually consisting of a psychiatrist, nurse and social worker.The team provides a mobile service It is a psychosomatic (see definition) disorder caused by offering availability 24 hours, seven days a week and an a powerful psychological disturbance or need. Someone immediate response.The team provides a gate keeping with it is usually completely unaware of the function to hospital admission and enables earlier psychological basis of the problem. It is often impossible to convince the person that there is no physical basisfor the upset, even after many investigations have ruled out the possibility of a physical cause.This is called (see Health of the Nation Outcome Scales) denial.The strength of the denial in hysteria shows theenormous power of the subconscious mind. Hysteria isoften a defence mechanism of the mind to protect it against the effects of some traumatic and unpleasant This is a department found in most organisations that works to recruit staff, assist in their development (e.g.
providing training) and ensure that staff work in good ICD-10 (International Classification of Disorders) The ICD is a form of classifying mental health problemsand assists clinicians in diagnosing problems.The number 10 represents the 10th edition of the book.
Huntingtons Disease is a genetically inherited conditionthat causes both physical and mental problems. It also features alternating periods of aggression, anger, (see Information Management and Technology) excitement and depression, and progressive loss ofmemory and personality (Dementia).These psychiatricdisturbances may appear before the movement disorder or may develop later. Bizarre behaviour alone Incapacity means that a patient does not have the may be the first sign of the disease.
ability to understand and retain information about theirmedical condition and their need for treatment.
Hyperactivity is marked by high levels of activity and restlessness. It can be treated by medication or diet.
An informal patient is a person in hospital voluntarily.
Most people admitted to hospital are informal patients.
A temporary health or social care professional.Thisperson does not have a permanent contract with the This refers to the use of information held by the Trust, in particular computerised information.
These are impairments in a specific mental process that The responsibility of professionals across agencies to affects learning.The conditions can exist to varying share relevant information to ensure that everyone involved in a person’s care is informed.
Local Implementation Teams bring together a wide Integrated Care Pathways are a multi-disciplinary and group of stakeholders (see definition) in mental health, multi-agency approach to mapping patients’ care from including service users and carers, to plan and oversee admission through to discharge and ongoing care.The the development of mental health services in their local aim is pull together all the information into one file that area. In the future they will work closely with primary will make it easier for the clinicians involved to give the care, which is responsible for commissioning mental This refers to work or care that links across Mania is characterised by a person feeling overexcited, professional boundaries. For example, when doctors elated, physically overactive and rapidly changing their and nurses work together to provide care.
ideas (scattered or tangential thoughts). It is a symptomof bipolar disorder (manic depression).
Manic depression(see Bipolar Affective Disorder) This is a problem that usually occurs in people who have had severe, long-term alcohol abuse problems. It is The Mental Health Act (1983) is a law that allows the characterised by marked short-term memory loss.
compulsory detention of people in hospital forassessment and/or treatment for mental disorder.
People who are detained under the mental health act Mental Health Trusts provide services to several localities.
must show signs of mental disorder and need Localities are areas that have distinct boundaries.
assessment and/or treatment because they are a risk tothemselves or a risk to others. People who aredetained have rights to appeal against their detention.
Observing activity in relation to defined specifications, The Mental Health Commission (MHAC) has a legal standards or targets, directly or through reports or responsibility under the Mental Health Act (MHA) to indicators – did what was intended happen? For protect the interests of all patients detained under the example, monitoring the effects of antidepressants to For the purposes of the Mental Health Act (see Multidisciplinary denotes an approach to care that definition) Trusts are defined as Mental Health Act involves more than one discipline.Typically this will Hospital Managers. In practice, these are usually non- mean that doctors, nurses, psychologists and executive directors and/or lay people appointed by the occupational therapists are involved.
Trust to carry out the Trust’s responsibilities under theMental Health Act.
This form of therapy uses music and therapeutic approaches to help people attain goals.These goals can This is an independent panel of people. A detained be mental, physical, emotional, social and/or spiritual.
person can appeal against their detention to this panel.
The panel can discharge the detained person or make other recommendations. It is possible to appeal to High This is a ward nurse who will have a special Courts against Mental Health Review Tribunal decisions.
responsibility for a patient while they are in hospital.
This has been developed to collect person-centred A broad statement of principle about what constitutes information and record packages of care received by an individual.This is collected by the Trust and submittedto the Department of Health.The data reported is National Institute for Clinical Excellence It provides clinical staff and the public in England andWales with guidance on current treatments. It co- Mind is a leading mental health charity in England and ordinates the National Collaborating Centres from Wales. It works to create a better life for everyone whom it commissions the development of clinical MRCPsych is the entrance exam to the Royal Collegeof Psychiatrists and must be passed before a doctor canbecome a Consultant Psychiatrist.
have lived together for six months. A same-sex partner could only become the nearest relative if they had lived National Service Frameworks are issued by the government and provide guidance and standards forhealth services to be to working towards.There is an NSF dedicated to mental health that set standards (see National Institute for Clinical Excellence) around mental health promotion, treatment and serviceuser involvement.There is also an NSF for OlderPeople that has a section on mental health for older people.This term should not to be confused with the A person who is appointed to represent a patient in National Schizophrenia Fellowship, which is now called discussions in matters related to their care.
A Non-executive Director is a member of the Trust Board.They act as a two way representative.They bringthe experiences, views and wishes of the community and patients to the Trust Board.They also represent the These are psychotic symptoms characterised by a lack interests of the NHS organisation to the Community of expected behaviour, such as lack of energy, emotion,movement or motivation.
Neurosis is used to describe anxiety disorders such as OCD is a problem characterised by obsessive thoughtsand compulsive behaviour.The behaviour can take various forms such as cleaning or checking rituals in The term next of kin is widely used, but there is no which the person will repeatedly clean themselves or statutory definition. In practice the general rule has their house or check, for example, that doors are been to recognise spouses and blood relatives as next locked and/or electrical sockets are turned off.
of kin.The Mental Health Act 1983 defines a list of Dermatological problems are common in people who certain people who can be treated as the ‘nearest repeatedly wash their hands. People with OCD can be treated using cognitive behavioural treatment and/or A ‘nearest relative’ has a number of important powers and functions, including the right to discharge a patientwho has been formally detained in hospital, make an application for a person to be admitted for assessment, Occupational therapists use purposeful activities to treat treatment or guardianship and also to object to people with physical and/or mental health problems.
applications for treatment or guardianship being made They work as part of a team to identify problems caused by a social worker. Only certain categories of people by people’s conditions and find ways of coping with these can become a ‘nearest relative’. First in the list are to encourage independence and a better quality of life.
spouses, and then unmarried heterosexual couples who Occupational therapy uses goal-directed activities, Parkinson’s Disease is more common in older people.
appropriate to a person’s age and social role, to The disease affects the connections in the brain causing restore, develop or maintain the ability for independent them to malfunction.This results in movement disorders such as tremor and stiffness.The diseaseprogresses steadily over years eventually causing severephysical and mental disability. Symptoms can be treated A computer system used to record information about In health services this refers to any change in a person’s the care provided to service users.The data can only wellbeing following a period of treatment.The expected be accessed by authorised users. PAS will soon be outcome will usually be an improvement in symptoms Outcome scales and measures are standard ways ofassessing or evaluating the difference made to a person’s wellbeing by a course of treatment. A personwill usually rate himself or herself, or be rated by a It is common for someone with a personality disorder to health professional, against a set of questions or be impulsive, have high levels of sensitivity, be aggressive, standards about their symptoms, feelings and wellbeing.
attention seeking and overly dependent on others.
This is usually done at the beginning of, and after a However there is a lot of debate about this disorder.
period of, treatment. Any improvement or decline will The World Health Organisation defines them as be shown by changes in the outcome scale ratings. An “deeply ingrained and enduring behaviour patterns, example of an outcome scale is HONOS (see manifesting themselves as inflexible responses to a broad range of personal and social situations.” (see alsoBorderline Personality Disorder).
All NHS trusts are required to have a Patient Advice A healthcare professional who ensures that medication and Liaison Service.The service offers patients that service users receives are safe, effective and information, advice, quick solution of problems or The department that supplies medicines.
A team that visits hospitals to check on cleanliness.
Power of attorney(see Enduring Power of Attorney) This is an extremely common problem in the generalpopulation. Phobias are irrational and uncontrollablefears of an object or situation that most people can face without anxiety.The object or situation will trigger Primary care is the care that you will receive when you feelings of intense panic and the sufferer will go to first come into contact with health services about a great lengths to avoid them. Common phobias are fear problem.These include family health services provided of flying, spiders and enclosed spaces.
by GPs, dentists, pharmacists, opticians, and others suchas community nurses, physiotherapists and some social A service working closely with GPs for clients who Policies are produced by organisations to clearly outline cannot be effectively managed in an ordinary primary what staff must do, and not do, in certain situations.
care setting.The team takes a key role in theorganisation and delivery of service working closelywith statutory and non-statutory agencies and transferring patients between services as required.The Positive symptoms refer to psychotic symptoms such as team offers risk assessment of clients, advice and short false beliefs and hallucinations (see definition).
to medium term psychological therapies.
Postnatal depression can occur any time in the first year This is the organisation that looks after primary care after having a baby and most commonly occurs within (see definition). PCTs are commissioners (see the first six months. Symptoms include feeling low and unhappy most of the time, acute anxiety, irritability,sleeplessness, tiredness and a loss of enjoyment or desire to do anything.These can be made worse byfeelings of guilt about not being able to cope or look A procedure is a series of actions taken in a definite after the baby. Not to be confused with baby blues (see and established order.This can refer to a treatment plan Post-traumatic stress disorder (PTSD) is an anxiety A local policy or strategy that defines appropriate disorder that develops following an unusually threatening event. Symptoms include flashbacks,nightmares and intense distress when exposed to anobject or situation that is related to the traumaticevent.
A Psychiatric Intensive Care Unit (PICU) is a locked Psychosis, or psychotic disorders, involves distorted ward in a hospital where some people detained under perceptions of reality and irrational behaviour, often the Mental Health Act may stay. Patients are placed in accompanied by hallucinations and delusions.
PICU because they are assessed as being a risk tothemselves or others on an open acute inpatient ward.
In some illnesses, psychological factors seem to play a particularly important part.They can influence not only A doctor who specialises in the diagnosis and the cause of the illness, but can also worsen the treatment of people who are mentally ill. Psychiatrists symptoms and affect the course of the disorder.These have undergone specialist training and may diagnose illnesses are termed psychosomatic disorders. Because illness, prescribe medication and other forms of psychological factors are important in every illness, appropriate treatment.They also decide whether to there is lack of agreement as to what should be admit people to and discharge from hospital.
considered a psychosomatic disorder.
This is a type of therapy that focuses on unconscious Psychotherapists help people to be in more control of motives and conflicts.The use of dream recall and free their own lives by exploring emotional difficulties and associations can be used in psychoanalysis.
helping them understand themselves and theirrelationships with others.They provide consultation andintervention on a one to one basis and in groups.
This is a form of psychotherapy in which the patient talks and the therapist makes interpretations about thepatient’s words and behaviour.
The treatment of mental health, emotional andpersonality problems through talking with a therapist.
There are many different types of psychotherapy.
This is a general term for various methods of improving the quality of services that are provided to service users.
Psychologists have skills in the assessment andtreatment of mental illness and psychological problems.
Unlike psychiatrists they are not medical doctors, theirskills include assessing cognitive functions (for example, A type of research or experiment used to compare the speech and thought) and providing talking interventions effectiveness of different treatments. Patients are including psychotherapy and counselling.
randomly assigned to groups.The groups either receivethe treatment being assessed or are a control group.
The control group receive dummy (placebo) medication. RCTs offer the most reliable form of The management of psychiatric illness using medication such as antidepressants or antipsychotics.
When a person with bipolar disorder experiences four This is a professional body that represents the interests or more mood episodes (mania, hypomania or of nurses, and provides support in professional matters.
This is the professional body for psychiatrists as well as This is a type of alternative or complementary therapy the body that sets exams for those wishing to become that uses pressure points on the feet to promote The Society provides guidance for pharmacists (see Improving a person’s skills through treatment and/or training to enable them to live a more fulfilling life inthe community.
This condition displays symptoms of both schizophrenia The ability of a data gathering tool to obtain consistentresults.
This is a psychotic disorder marked by delusions, hallucinations, disordered thinking and speech The consultant psychiatrist with medical responsibility inappropriate emotions and/or lack of emotions. It is characterised by serious disturbances of thought andperception which cannot be attributed to brain damage.
Restriction orders can be added to some sections.Theperson must have been convicted of an offence for SAD is a form of depression linked to the seasons.
which imprisonment is a possible penalty.This order Sufferers become depressed during autumn and winter.
means that only the Home Secretary can allowdischarge or time away from the hospital.
Secondary care is specialist care, usually provided in hospital, after a referral from a GP or health Identifying aspects of a service which could lead to professional. Mental Health Services are included in injury to a patient or staff member and/or to financial secondary care (see also tertiary care).
This is used to refer to one of the sections of any Act Changing aspects of a service that could lead to injury of Parliament. A person who is detained in hospital to a patient or staff member and/or to financial loss for under the Mental Health Act (1983) is commonly Doctors who are approved by the secretary of State, This is a term used by many health organisations to having special knowledge of mental health and who are describe a serious incident or event which led, or may required to be involved in assessments under the have led, to the harm of patients or staff. Members of staff who were not involved in the incident investigatethese and the lessons learned from each incident areused to improve care in the future.
Section 17 of the Mental Health Act (1983) makes provision for patients who are liable to be detainedunder various sections of the act to be granted leave of This is someone who uses health services. Other common terms are patient, service survivor and client.
Different people prefer different terms.
This section of the Mental Health Act (1983) enables a police officer to remove a person from a public placeand take them to a designated place of safety, whichmay be a police station, a hospital, or other suitable The Single Assessment Process (SAP) for older peoplewas introduced in the National Service Framework for Older People.The purpose of the single assessment process is to ensure that older people receiveappropriate, effective and timely responses to their This is a type of antidepressant medication. An example health and social care needs, and that professional This is the position gained by doctors after they are SpR grade is a recognised training grade in the registered as a doctor by the General Medical Council.
progression of medical staff to Consultant status. It was It is the second tier of trainee doctor (after formally known as Senior Registrar. On completion of preregistration house officer) in a hospital.
the Senior House Officer (SHO) rotation, and passingthe MRCPysch, the Specialist Registrar continues training in their chosen area of psychiatry.
SEPIA is a computer package that is used to keepinformation about CPA (see definition).
SSRI(see Selective Serotonin Reuptake Inhibitor) Serious mental illness/Severe mentalillness These are mental health problems that are seriousenough to warrant contact with mental health services.
A range of people and organisations that are affected These are psychological treatments in which by, or have an interest in, the services offered by an improvement in a person’s symptoms or wellbeing is organisation. In the case of hospital trusts, it includes achieved by talking with a therapist or counsellor rather patients, carers, staff, unions, voluntary organisations, than, or as well as, taking medication.
social services, health authority, GPs, primary caregroups and trusts in England, local health groups in When a hospital consultant decides that more specialistcare is needed. Mental Health Services are included in A measure, specification or object to which objectsshould conform or against which others are judged. A This is a method of determining what substances are ina person’s system by testing bodily fluids. It can detect substances such as prescribed medication and also This refers to the abuse or misuse of non-medical or illegal substances such as drugs or alcohol. Dose ‘recreational’ drugs and/or alcohol. As well as physical titration means to slowly increase the dose of a drug to problems, some substance abuse can lead to psychological problems, such as depression, anxiety and,in some cases, psychosis.
Tolerance refers the body’s capacity to endure levels of medication over periods of time. It can also be used to refer to an addict’s capacity to consume levels of eitheralcohol or illegal drugs due to repeated use orexposure Support workers provide support for clients and their carers under the supervision of a care coordinatorwhich has been negotiated under the care programme TTAs are medicines supplied by pharmacy for service approach.They can help people regain lost skills and users going on leave from the hospital.
develop new interests to help regain confidence andself esteem.
User involvement refers to a variety of ways in whichpeople who use health services can be involved in thedevelopment, maintenance and improvement ofservices.This includes patient satisfaction questionnaires,focus groups, representation on committees,involvement in training and user-led presentations andprojects.
A data collection instrument’s ability to actuallymeasure or test what it is intended to measure or test.
This is the act of informing a relevant person in anorganisation of instances or services in which patientsare at risk.

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