Psychological assessment?

celticroots · Feb 18, 2015

There is a scene in my WIP, where my MC cuts too deep and needs stitches. Aside from the procedure, she is assessed by a hospital psychologist to make sure she's not suicidal. She refuses to talk to him except to answer yes or no questions because she feels as if the psychologist sees her as a burden.

I've never been to the ER for self-harm, although I have been for illness and found the staff to be rude. If I was there for something like that, I can imagine that my MC would be treated rudely by staff for harming. That isn't to say, however, that all ER staff are insensitive when it comes to self-injury, ( or other things). But many who harm have reported being treated badly by doctors and nurses.

What kind of questions are asked to the patient during an assessment? Is an assessment required? Can it be ordered by the parents if the person is a minor?

I want to make sure I am getting this right

Thanks!

veinglory · Feb 18, 2015

In many cases an assessment would be done by a staff psychologist, and any psychologist who was rude to someone because they were showing symptoms of being mentally ill would be grossly incompetent and very unsuited to their job.

Neegh · Feb 18, 2015

Do a Google search for a list of standard psychological assessment questions.

King Neptune · Feb 18, 2015

There are psychological screening questionaires posted online that are derived from screening questions that are regularly used.

veinglory · Feb 18, 2015

There seems to be a lot of research in this area. E.G. http://bjp.rcpsych.org/content/186/1/60.full

celticroots · Feb 18, 2015

Thank you to all who answered. And I am sure a psychologist wouldn't be rude (just guessing) but after being treated badly by nurses stitching her, I feel the MC would be more likely to not trust anyone. For fear of being insulted again.

boron · Feb 18, 2015

Psychologist does not need to be rude in the aggressive or insulting way to offend someone. It can be patronizing, routinized, pitying, excessively optimistic, smiling for no reason (why would someone who doesn't know you smile to you), "smart." Also, why would you trust someone who doesn't trust you.

You don't trust someone who is officially above you and judges you are you good or bad, no matter how polite he/she is.

Deb Kinnard · Feb 19, 2015

I've not had the personal experience, but I've worked in large hospitals all my life, so I can see the staff being dismissive to the patient who cuts, if not downright rude. I've had to translate for psychologists who don't speak Spanish, and although none of them was rude, it did seem that they were more interested in asking their standard set of questions than in listening to the answers.

Studies have been done lately showing medical professionals that it is listening to the patient that provides the highest quality experience for that patient. If you choose to show your staff simply being non-listening types, I feel that's disrespectful enough to give your character/patient a bad experience.

cornflake · Feb 19, 2015

boron said:
Psychologist does not need to be rude in the aggressive or insulting way to offend someone. It can be patronizing, routinized, pitying, excessively optimistic, smiling for no reason (why would someone who doesn't know you smile to you) Why wouldn't they? They're friendly? Polite? , "smart." Also, why would you trust someone who doesn't trust you.

You don't trust someone who is officially above you and judges you are you good or bad, no matter how polite he/she is.

Psychiatrists aren't, in a general sense, judging whether patients are good or bad, for goodness sakes. Nor are they 'officially above you.' What does that even mean?

If you mean that a psychiatrist in an ER (or two, depending) can decide to hold you against your will, then yeah. In a general sense, I don't know what you mean.

There's no general reason that psychiatrists (who you'll usually find in hospitals, as they're medical doctors and psychologists are not), would offend people. Some people, especially people upset, fearful, in crisis, etc., are not in a particularly friendly or accepting state of mind when they encounter a psychiatrist in an emergency setting, obviously. The professionals in question know that. Some of them might be having a long, crappy day, but most doctors and nurses know people landing in an ER aren't their best selves and need comfort and understanding, and they try to provide it.

veinglory · Feb 19, 2015

What they are more likely to be is a bit stuck in a rut and doing some parts of the job by rote. Then people project things onto that demeanor.

Neegh · Feb 19, 2015

cornflake said:
Psychiatrists aren't, in a general sense, judging whether patients are good or bad, for goodness sakes. Nor are they 'officially above you.' What does that even mean?

If you mean that a psychiatrist in an ER (or two, depending) can decide to hold you against your will, then yeah. In a general sense, I don't know what you mean.

There's no general reason that psychiatrists (who you'll usually find in hospitals, as they're medical doctors and psychologists are not), would offend people. Some people, especially people upset, fearful, in crisis, etc., are not in a particularly friendly or accepting state of mind when they encounter a psychiatrist in an emergency setting, obviously. The professionals in question know that. Some of them might be having a long, crappy day, but most doctors and nurses know people landing in an ER aren't their best selves and need comfort and understanding, and they try to provide it.

Psychologists/Psychiatrists can hold you for 72 hours; though, they have to prove they had reason to do so.

cornflake · Feb 19, 2015

veinglory said:
What they are more likely to be is a bit stuck in a rut and doing some parts of the job by rote. Then people project things onto that demeanor.

Indeed this.

Neegh said:
Psychologists/Psychiatrists can hold you for 72 hours; though, they have to prove they had reason to do so.

They can hold you for 72 hours, in at leasr most states, primarily. They can hold you longer, in at least most states, as well. They only have to prove they have reason to if they're challenged or, dependent on the state, at times on a prolonged hold (sometimes some lengths of prolonged holds trigger an automatic hearing).

boron · Feb 20, 2015

cornflake said:
Psychiatrists aren't, in a general sense, judging whether patients are good or bad, for goodness sakes. Nor are they 'officially above you.' What does that even mean?

If you mean that a psychiatrist in an ER (or two, depending) can decide to hold you against your will, then yeah. In a general sense, I don't know what you mean.

Yes, that's what I meant.

cornflake said:
There's no general reason that psychiatrists (who you'll usually find in hospitals, as they're medical doctors and psychologists are not), would offend people. Some people, especially people upset, fearful, in crisis, etc., are not in a particularly friendly or accepting state of mind when they encounter a psychiatrist in an emergency setting, obviously. The professionals in question know that. Some of them might be having a long, crappy day, but most doctors and nurses know people landing in an ER aren't their best selves and need comfort and understanding, and they try to provide it.

It can be the most polite and understanding psychiatrist, but when he is in charge to decide to take someone's freedom I can clearly imagine that the person questioned would not necessary be very chatty.

celticroots · Feb 20, 2015

Thank you for the answers. The links you provided look good.

Rufus Coppertop · Feb 21, 2015

Neegh said:
Psychologists/Psychiatrists can hold you for 72 hours; though, they have to prove they had reason to do so.

Psychologists can't and there's no slash because the terms are not interchangeable.
Psychologists are not psychiatrists and they don't have that kind of power. Not in most parts of the world at least.

MDSchafer · Feb 22, 2015

celticroots said:
Thank you to all who answered. And I am sure a psychologist wouldn't be rude (just guessing) but after being treated badly by nurses stitching her, I feel the MC would be more likely to not trust anyone. For fear of being insulted again.

Okay, so, first off nurses don't do stitches. That's something MDs and PAs have held pretty tightly on. RNs can take a few classes and get certified, and some Nurse Practitioners can and do put in stitches but MDs have been fighting letting mid-level providers suture.

Also, it's not going to be a psychologist who sees a patient in the ER. It would be as social worker or case manager who makes the initial assessment and if they decide that the patient needs psychological services. Honestly psychiatrists are more common in emergency settings because they have more of a medical background and have prescriptive powers.

Now what would happen most of the time it's not going to really matter what she says, the hospital is going to 10-13 her anyway because of the fear of lawsuits. In situations like this you're suicidal until proven otherwise. Since it doesn't cost them anything to discharge them to a crisis center 9 times out of 10 someone comes in with cut wrists are going to be 10-13ed.

Psychological assessment?

celticroots

veinglory

volitare nequeo

Neegh

King Neptune

veinglory

volitare nequeo

celticroots

boron

Health writer

Deb Kinnard

cornflake

practical experience, FTW

veinglory

volitare nequeo

Neegh

cornflake

practical experience, FTW

boron

Health writer

celticroots

Rufus Coppertop

MDSchafer