What Is A Mental Health PICU Assessment?

“It is best that the Assessing RMN meets the service user in quiet room with minimal furniture, introduces themselves and explains the reason for their visit.”

In this piece, Plaxedes Makonise takes us through how to conduct a PICU Mental Health Assessment, step by step.

Topics covered in this article

Introduction

What Is A PICU Mental Health Assessment In A Mental Health Setting?

Who Conducts The PICU Mental Health Assessment?

Where Does One Conduct A PICU Mental Health Assessment?

What Preparation Is Required For A PICU Mental Health Assessment?

How Does The RMN Conduct PICU Mental Health Assessment?

What Does The RMN Do After The Interview?

Introduction

Having worked in mental health settings, I have been involved in dozens of assessments.

Working as a PICU Mental Health Nurse requires multiple skills but there is one speciality skill an RMN needs, the PICU Assessment.

A mental assessment is a process of evaluation of a person who is believed to be suffering from or experiencing a mental health disorder or has become violent, putting themselves and others at risk, as directed by the Mental Health Act 1983 (Revised 2007).

What Is A PICU Mental Health Assessment In A Mental Health Setting?

A PICU Assessment is conducted prior to admission into the Mental Health PICU ward or when situation changes, and the service user requires urgent admission into more secure unit or PICU.

Who Conducts The PICU Mental Health Assessment?

A qualified RMN can be accompanied by a colleague from the Ward and other professionals who include the Social Worker, Care Co-ordinator, Community Psychiatry Nurse and Medical and Section 12 Doctors.

Police may be present in some instances where there is likelihood of Violence and Aggression.

Where Does One Conduct A PICU Mental Health Assessment?

Mental Health Assessments can be conducted both in inpatient settings and public places, courts and people’s homes.

In inpatient settings referrals are made from other units requesting an assessment.

A designated Referral Form has to be completed in line with local Trust Guidance noting all patient ‘s details, date if admission, mental health act Section and full details of reasons for referral, level of current risk and historical, medication and what interventions were implemented prior to referral.

I have mostly been involved in PICU assessments, formal or telephone assessments where the RMN has to be obtain full details of circumstances on the phone.

What Preparation Is Required For A PICU Mental Health Assessment?

I am going to focus mostly on the inpatient setting, which I am familiar with.

Mental Assessment is not as daunting as one could imagine but can be tricky hence the need for the opinion of other professionals, because at times the services user’s mental state fluctuates.

Besides the skills the RMN will need to plan by liaising with the referring ward though referrals are always urgent.

Having details of the person you are going to assess is vital.

The RMN will meet with the referring ward team for a brief verbal handover before approaching the service user.

The RMN will look at the medication charts for prescribed medication to check compliance and use of as required medication.

There might be no time for formal assessments in an emergency, but thorough documentation has to be completed later, when the service users and others are safe.

How Does The RMN Conduct PICU Mental Health Assessment?

The RMN has to remain vigilant and be wary of their safety and others and continue to be wary of Infection Control and Prevention Procedures at all times in line Covid-19 Policy Guidance.

A chaperone depending on gender or service user preference is advisable.

It is best that the Assessing RMN meets the service user in quiet room with minimal furniture, introduce themselves and explain the reason for their visit.

It is then a good idea to explain that they will taking some notes during the interview and they will need to document the notes on the main patient notes entry later.

The RMN has to remain calm and maintain eye contact.

The RMN will observe the service user on their general appearance taking note on evidence of self-care and general wellbeing.

The RMN will also observe on their response, slow or pressured speech and mood and if they could rate their mood between 0-10.

The RMN should ensure the assessment is swift taking note of the overt psychotic symptoms, insight, cognitive processes, auditory and visual hallucinations.

The RMN will ask questions, for example if the service user believes there were people talking about him/her or intend to harm them and if they believe they have special powers.

The Nurse should remain calm and non-judgemental.

The RMN will also ask about their sleep pattern and if they had s good sleep the previous night and if the service user has had anything to eat and how their appetite was on different days.

Trying to get details of what led to an incident requires tactful questioning with the RMN listening to the service user very closely without interrupting or judging.

When the service user is getting aroused the interview night have to be discontinued to avoid further escalation.

The RMN will explain to the service user that they will discuss the interview with other team members before decision is made and they will document everything.

At the end the RMN will thank the service user for meeting with them.

What Does The RMN Do After The Interview?

They will feedback to both Teams then discuss the outcome and document the assessment details using the SBAR Tool, noting situation, background, assessment and recommendation.

They may accept or decline the referral, advise on medications review and re-referral when situation escalates.