Formarrhoea

Abstract

to understand the genuine needs of psychiatry such as improving the training of the multi-disciplinary team, allocating more resources and improving the immediate environment of patients. Psychiatrists do not seem to be able to promote psychiatry and to be influential in decision-making.

Serious untoward incidents and their aftermath in acute inpatient psychiatry: The Tompkins Acute Ward Study

“…However, the use of containment methods (special observation, security measures, sedating medication, seclusion, etc.) can become excessive to the degree that they have a negative and harmful impact on patients (Dodds & Bowles 2001), or risk assessment can be emphasized to the point that it dominates practice and draws attention away from treatment (Hardwick 2003). Only when the SUI is as a result of containment itself does this work the other way (e.g.…”

Counterblast: Close Encounters of an Uncomfortable Kind

“…Scott's sound, and yet simple, advice has not always been followed. Hard‐pressed workers have to spend too much time filling in schedules and protocols – a practice described by one somewhat beleaguered psychiatrist as ‘Formarrhoea’ (Hardwick ). Denial is often regarded as the sole prerogative of the offenders/offender‐patients.…”

Risk management in public mental health

“…Risk assessment processes and documentation in many services appear to be cumbersome and unhelpful – a problem that is not confined to Australia. 2 Similarly, processes that separate risk assessment and management from care planning and delivery may lead to incoherent service delivery. An unanswered research question is whether such apparent privileging of the completion of process tasks (‘ticking the boxes’) over reflective practice and the development of therapeutic alliance actually impedes effective risk management.…”

“…This is happening in the UK, where a group of psychiatrists, physicians and general practitioners have written guidelines for the 'Management of Really Sick Patients with Anorexia Nervosa', which have been adopted by their medical colleges. 2 The working group was convened after a series of avoidable deaths and 'near misses' among patients with eating disorders in UK hospitals. They identified the main causes of fatalities as the unrecognised severity of the medical problems associated with eating disorders, inadequate capacity in specialist eating disorder services within the National Health Service and the poor delivery of liaison psychiatry.…”