Key messages

  • When dealing with comorbid patients it is important to ensure they are receiving appropriate treatment for physical illness and continue to do after discharge.
  • It is important to ensure medical and psychiatric treatments are compatible.
  • Consulting with a consumer’s other healthcare providers is an essential part of managing their healthcare needs.

When managing diagnosed physical illnesses, the person’s circumstances, service setting, communication protocols with other providers and issues relating to consent to disclose information should be taken into consideration.

Managing diagnosed physical illnesses

In the management of a consumer who has a physical health condition:

  • Refer inpatients to the appropriate medical, surgical or specialist unit.
  • Refer consumers to outpatient services after discharge or to the person’s general practitioner.
  • Communicate with the person’s general practitioner to discuss any findings and referrals made.
  • If the person is in a community setting and is not accessing medical care, refer the person to a provider and help them engage with medical care.
  • If the person refuses to access medical care, for example, during a paranoid episode, document this in the clinical record and monitor the person for an opportunity to successfully refer them.

If a person under the definition of the Mental Health Act needs urgent medical treatment and is unable to consent, the authorised psychiatrist can consider using their powers under the Mental Health Act 2014 to make a treatment decision for the person.

Work with people with a mental illness to raise their awareness of long-term health risks associated with smoking, obesity and exercise levels.

Managing the interaction between medical and psychiatric treatment

The authorised psychiatrist must consider a person’s medical needs when choosing psychiatric treatment options.

Where possible, select treatments that do not affect, or are not affected by, known medical conditions.

Communicating with other service providers

Communication with other healthcare providers is an essential element of managing a consumer’s physical healthcare needs.

In managing an individual’s physical healthcare needs:

  • Seek the person’s consent to disclose information.
  • Most people will agree to providing information to other treating clinicians or services if time is taken to discuss the reasons and the benefits.
  • People may wish to place limits on the disclosure of some information, particularly sensitive matters. These wishes should be respected whereever it is feasible and appropriate.
  • The Mental Health Act 2014 permits disclosing information without consent in specific circumstances. See the Mental Health Act 2014 handbook entry on ‘Disclosure of health information’.

Mental health services should liaise with general practitioners when:

  • a person is admitted to or discharged from an inpatient unit
  • the mental status of a person significantly alters
  • the physical health of a person significantly alters
  • medication is significantly altered, especially where there is a significant risk of physical side-effects (for example, Clozapine)
  • physical treatment such as electroconvulsive therapy (ECT) is being considered.