Putting it all together

It can be hard enough to deal with the complicated needs of individual patients in a busy medical practice. When psychiatric conditions are involved, it can make the job of the provider even more difficult. Add to this the multitude of information and changes contained in the DSM-5, and it can become overwhelming. As with any health condition, approaching the patient in a stepwise fashion is important so that nothing is missed.

Screening laboratory studies to rule out a physiological reason for symptoms while using screening tools and suicide assessments is the best place to start. When necessary, consider the choices for medication carefully, based on the patient’s presentation, age, and lifestyle.

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Always consider a referral to a mental health professional, especially to help your patients deal with the stressors in their lives, whether an “official” diagnosis of a mental health condition exists. Having a low threshold for involving a psychiatrist — even via telepsychiatry — is also important. Taking all these steps can improve your delivery of care for your patient with psychiatric disorders, and it can ease a job that is otherwise tough.

Deanna Bridge Najera, MPAS, MS, PA-C, NCC, is a physician assistant and certified counselor, splitting her time between an emergency department and a community mental health center. She also works seasonally with a migrant farm worker program in south central Pennsylvania.


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