Managing Self-Harm and Suicidal Ideation during the Coronavirus outbreak, (CD19-024.-001 V2./09_04_2020)
To help reduce the spread of coronavirus (Covid 19) all patients should be encouraged to phone their GP or mental health service before they present at Emergency Department (ED) for assessment. For people who self-harm or have suicidal ideation key to management is ensuring the person receives a biopsychosocial assessment and a management plan addresses safety issues and linkage to next care. This is in line with the Model of Care for the Clinical Programme for the Assessment and Management of Patients presenting to the emergency Department following self-harm and is pertinent for patients presenting in all settings.
A recent systematic review of comparative studies Are there interactional differences between telephone and face-to-face psychological therapy? A. J Affect Disord. 2020; 265: 120–131. The most striking finding of this review is that, for the most part, they found no evidence of mode-related difference in a range of interactional features including therapeutic alliance, disclosure, empathy, attentiveness or participation. According to the results of this review, there is no empirical evidence to corroborate perceptions that the telephone mode, specifically its absence of visual and physical co-presence, is detrimental to alliance formation. The consistent finding is that alliance is rated similarly across modes.
Prescribing During Covid-19
The Medicinal Products (Prescription and Control of Supply) (Amendment) Regulations 2020 has facilitated a change in how prescription only medicines, including controlled drugs, can be supplied to patients by pharmacists during the COVID-19 pandemic to ensure continued care and treatment for patients.
The changes amend the Medicinal Products (Prescription and Control of Supply) Regulations 2003 (as amended) and the Misuse of Drugs Regulations 2017 (as amended). The purpose of these changes is to ensure continuity of care and access to treatment for patients during the Covid-19 pandemic and to reduce some of the burden on prescribers and the broader healthcare system.
To assist pharmacists and prescribers, the PSI, Medical Council and HSE have published joint guidance setting out the amendments to the legislation for supply of prescription-only medicines during the Covid-19 pandemic.
National electronic prescription transfer: The electronic transfer of a prescription between the prescriber and pharmacy is provided for through the use of the HSE Healthmail® system. This will remove the requirement for paper copy of a prescription to be forwarded to a pharmacy once this closed-system electronic service is used.
Maximum validity of prescriptions: This has increased temporarily from 6 months to 9 months from the date specified on the prescription (some restrictions continue to apply around the dispensing of Controlled Drugs); only where in the pharmacist’s professional judgement, after consultation with the patient, and if needs be the prescriber, continued treatment is required and it is safe and appropriate to do so.
Repeating prescriptions: The number of repeats which may be supplied for both S1A and S1B medicinal products has been increased temporarily to enable pharmacists’ continuity of patient care without necessarily requiring a new prescription.
Emergency supply provisions:
In addition to the existing provisions for emergency supply at the request of a prescriber, a prescriber can also request an emergency supply of the Schedule 4 Part 1 Controlled Drugs - midazolam, clobazam and clonazepam for the treatment of epilepsy.
Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies. J Affect Disord. 2020; 265: 120–131.
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