Discharge summary for psychiatric patient

  1. Hi!

    Does anyone out there have a acronym or mnemonic to help formulate a discharge summary for a psychiatric patient? Or, what do you include in your discharge summary?

    Thanks for your help!

  2. Visit Boston64 profile page

    About Boston64

    Joined: Apr '06; Posts: 22


  3. by   GingerSue
    this is from a comprehensive mental health assessment in a textbook of a few years ago:
    A. Life functions
    1. Physical Health
    Current medical care (family physical or medical clinic, medications)
    2. Self-Acceptance/Self-Esteem
    3. Vocational/Occupational
    4. Immediate Family
    5. Intimate Relationships
    6. Residential
    (living situation)
    Significant Other Information
    7. Financial
    (source of income)
    8. Decision Making/Cognitive Functions
    9. Life Philosophy/Goals
    10. Leisure Time/Community Involvement
    11. Feeling management
    B. Signals of Distress
    12. Lethality (self)
    (history of self-injury, method, within last month, within, last 6 months, last year, over 1 year ago, high lethal, low lethal, outcome, total number of suicide attempts, date of last attempt)
    13. Lethality - other
    (history of injury to other, method, within last month, etc, outcome,
    total number of assaults, date of last assault)
    14. Substance use (drug and/or alcohol)
    (other drug use: type, present use, past use, duration)
    15. Legal
    (pending court action, on probation, on parole, conditional discharge, where, when, probation officer, parole officer, judge)
    16. Agency Use
    (previous mental health service contacts: outcare: name of agency, phone #, contact person, address, date of last contact
    incare: same info, reason for admission, how often, how long, average length of stay)
    17. Optional information (religious concerns, ethnic cultural background problems)

    hope this is some help
    Last edit by GingerSue on Sep 13, '07 : Reason: typo
  4. by   Boston64
    Hi! Gingersue,

    Thanks, so much, for your reply!! This information will be extremely helpful!!