PGIM MD Psychiatry key terms

England and Wales statute allowing compulsory assessment and treatment of mental disorder. It sets out the grounds, approved clinicians, nearest relative role and appeal routes to tribunals. Detention is lawful only when the disorder justifies it and appropriate care is unavailable on a voluntary basis.

Compulsory admission for assessment lasting up to 28 days. It requires two medical recommendations and an approved mental health professional application. Treatment can be given without consent for the first three months, after which a second opinion appointed doctor is needed for medication.

Compulsory admission for treatment for up to six months, renewable. It needs two medical recommendations, an approved mental health professional application and a statement that appropriate treatment exists. It is used when the patient's health or safety, or protection of others, requires detention.

A registered professional, usually a psychiatrist or senior mental health practitioner, specially trained and approved under the Mental Health Act to give medical recommendations and act as responsible clinician. They carry statutory duties for detained patients and must be independent of the assessing team where required.

A social worker or other qualified professional approved by the local authority to assess patients for detention and make applications under the Mental Health Act. They must consider the least restrictive option and consult the nearest relative where practicable.

A person defined by the Mental Health Act in a fixed order of precedence who holds rights to information, to object to detention and to apply to a tribunal. Patients can displace or appoint a replacement through the county court.

An independent panel that reviews the lawfulness and necessity of detention or a community treatment order. It can discharge the patient, recommend leave or defer discharge. Patients have automatic referral rights at set intervals, and the responsible clinician must provide a report.

An independent psychiatrist appointed by the Care Quality Commission to certify that continued medication without consent is appropriate for a detained patient after three months. They must consult two other professionals involved in the patient's care before issuing a certificate.

A supervised condition placed on a patient after discharge from Section 3 detention, requiring compliance with specified conditions such as attending appointments. Recall to hospital is possible if conditions are breached or the patient's condition deteriorates.

A four-stage test of whether a person can understand, retain, weigh and communicate a decision at the relevant time. Capacity is decision-specific and presumed unless evidence shows otherwise. If absent, decisions must be made in the person's best interests.

A decision made for someone lacking capacity, considering their past and present wishes, beliefs and values, the least restrictive option and consultation with relevant people. It must not be motivated by a desire to bring about death or to protect others.

A legal framework authorising deprivation of liberty for people lacking capacity in care homes or hospitals. It requires assessment by a supervisory body, with representation and review rights. It is being replaced by the Liberty Protection Safeguards scheme.

A legally binding refusal of specified future treatment made by a person with capacity, which applies when they later lose capacity. It must be valid and applicable, and cannot demand treatment or cover certain compulsory measures for mental disorder.

An advocate appointed to support and represent a person lacking capacity in certain decisions, such as serious medical treatment or accommodation changes, when no family or friend is available to consult. They do not make the decision themselves.

A structured process of identifying, analysing and mitigating risks of harm to self or others, including suicide, violence, self-neglect and exploitation. It combines clinical judgement with validated tools and is reviewed as circumstances change.

A collaborative explanation of a person's difficulties that links predisposing, precipitating, perpetuating and protective factors into a coherent narrative. It guides treatment planning and is shared with the patient rather than being a diagnostic label alone.

An approach that understands mental disorder through interacting biological, psychological and social factors rather than a single cause. It supports integrated assessment and treatment planning across medication, therapy and social interventions.

A philosophy emphasising personal meaning, hope, identity and social inclusion rather than symptom elimination alone. Care is oriented to the person's own goals, with shared decision-making and peer support as core components.

A structured assessment covering presenting complaint, history, risk and a mental state examination of appearance, behaviour, speech, mood, thought, perception, cognition and insight. It combines empathic listening with systematic observation to reach a working formulation.

A patient's awareness of having a mental health problem, its nature and the need for treatment. Impaired insight is common in psychosis and affects engagement, adherence and risk, but should be described dimensionally rather than as simply present or absent.

A collaborative process where clinician and patient exchange evidence and preferences to agree on a plan. It respects autonomy, improves adherence and is central to consent, medication choices and advance care planning.

A person-centred counselling style that explores and strengthens a person's own reasons for change by working with ambivalence. It uses open questions, affirmations, reflective listening and summarising, and avoids confrontation.

A structured conversation delivering significant information with empathy, checking understanding and allowing emotional response. Models such as SPIKES guide preparation, invitation, knowledge sharing, responding to emotion and planning next steps.

Collaboration among psychiatrists, nurses, psychologists, social workers, occupational therapists and others to deliver coordinated care. Clear roles, shared records and regular meetings reduce duplication and improve safety, especially at transitions of care.

A framework for coordinating care for people with complex mental health needs, involving a named care coordinator, a written care plan and regular review. It applies particularly to those under secondary mental health services with high risk or multiple agencies involved.

A structured method of transferring clinical responsibility using Situation, Background, Assessment and Recommendation. It reduces omissions and errors at shift changes and referrals, and should include risk information and agreed actions.

The process of protecting adults with care and support needs from abuse or neglect, including physical, financial, sexual and psychological harm. It requires raising concerns, multi-agency enquiry and making enquiries while respecting the person's wishes and capacity.

Action to reduce incidence and impact of mental disorder and its physical comorbidities through lifestyle advice, screening and early intervention. It includes smoking cessation, metabolic monitoring and addressing social determinants of distress.

Efforts to counter negative stereotyping, prejudice and discrimination against people with mental illness through education, contact and advocacy. It improves help-seeking, social inclusion and access to employment and healthcare.

Routine measurement of weight, waist circumference, blood pressure, glucose and lipids in people taking antipsychotics, which raise cardiometabolic risk. Baseline and regular checks, with intervention when abnormal, reduce premature mortality.

The system by which organisations are accountable for continuously improving quality and safeguarding standards of care. It includes audit, incident reporting, appraisal, revalidation and learning from complaints and serious incidents.

A quality improvement cycle comparing current practice against agreed standards, then implementing change and re-auditing. It differs from research because it evaluates existing care rather than generating new generalisable knowledge.

A structured, iterative effort using methods such as plan-do-study-act cycles to improve care processes. It uses measurement over time, engages frontline staff and aims for sustainable local change rather than generalisable research findings.

The integration of best available research evidence, clinical expertise and patient values in decision-making. It involves formulating a question, searching critically, appraising validity and applicability, and applying findings to the individual patient.

Systematic assessment of research validity, results and relevance, including risk of bias, confounding, precision and applicability. It allows clinicians to judge whether a study's findings should change practice for their patients.

A hierarchy ranking study designs by their susceptibility to bias, from systematic reviews of randomised trials at the top to expert opinion at the bottom. The ranking is a guide, not a substitute for appraising the specific study.

Deliberate review of one's own clinical experiences to learn from successes and errors, often recorded in a portfolio. It supports professional development, insight into emotional responses and improved future performance.

The limits that keep the clinician-patient relationship safe and therapeutic, covering self-disclosure, gifts, social contact and dual relationships. Boundary crossings should be recognised, discussed and documented to protect patients and maintain trust.

The requirement that doctors maintain the knowledge, skills, health and conduct necessary for safe practice, overseen by the General Medical Council. Concerns can trigger investigation, conditions or suspension, and doctors must engage openly with the process.