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Mental Health- Consent, the law and depression- management in emergency settings
  1. Rosie Doy1,
  2. Derek Burroughs1,
  3. John Scott2
  1. 1School of Nursing and Midwifery, University of East Anglia, UK
  2. 2East Anglian Ambulance NHS Trust, UK

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    This article has been written with reference to the mental health legislation in England. Variations in this legislation occur in other countries of the UK. Practitioners working in other countries of the UK will require knowledge of the specific legislation for their country.

    Mental health problems present in between 30% and 60% of primary care consultations.1 One in six men and one in four women will suffer from a mental illness at some point in their lives.2,3 GPs, for example, find that at least 30% (or 1.5 days per week) of their working week concerns mental health consultations. For depression alone, prevalence amongst the adult population in the UK varies between 17–71 per thousand for men and from 25–124 per thousand for women.

    The standards of the Mental Health National Health Service Framework (MHNSF) aim to support more consistent access and delivery of primary care services including out of hours and non-scheduled care at times of complex need and mental health crisis.

    Mental health presentations in primary care are frequently complex and do not always fit easily into diagnostic categories.4 This article will specifically consider depression and deliberate self harm; patients with psychoses will be considered in a second paper to follow.


    • To clarify definitions of mental disorder

    • To consider key aspects of the Mental Health Act (1983) and assessment of valid consent and capacity

    • To discuss the recognition of primary survey positive patients and those with complex but not immediately life threatening presentations (primary survey negative patients)

    • To describe mental health assessment and differential diagnoses with specific reference to depression and deliberate self harm

    • To discuss alternatives to admission, treatment, and options for referral


    Just as in other aspects of illness, adequate and accurate description of the signs and symptoms aids communication and …

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