Some of us just won't fade away. (ravenshrinkery) wrote in little_details,
Some of us just won't fade away.
ravenshrinkery
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Resource: Mental Health Severity and Treatment

Several questions have been coming up on the subject, so I wanted to make a resource post on the subject. Please note this information is specific to modern Western psychiatric practice. I am not a professional in this field, but am well versed in many areas of psychology and psychiatry (I am a student in the Human Services field). Feel free to comment additional information and links.

First, you need to decide just how screwed up your character is. The Global Assessment of Functioning and its counterpart for children, Children's Global Assessment Scale, assign a score from 1-100 based on the overall state of the patient. The two scales are mostly similar, but the latter adjusts for issues specific to children and adolescents. This PDF gives a detailed description of GAF. Keep in mind this does not indicate any specific disorder, but simply rates the symptoms according to how severe they are. A well-managed case of Bipolar Disorder can easily have a GAF score in the 70s and 80s, whereas anxiety can drop somebody very far down the scale.

Also keep these benchmarks in mind:

Anyone with a GAF lower than 80 can realistically expect to benefit from psychotherapy, although such is not strictly necessary.
A GAF of 70 or lower should at least seek the advice of some medical professional as to options, although again is probably not necessary.
A GAF of 60 or lower generally indicates therapy, often for the purpose of observation and ensuring that symptoms do not become more severe.
A persistent GAF of 50 or lower is grounds according to the Social Security Administration and other bodies for determining disability due to mental illness. It can also be grounds if the 51-60 band is the best one can achieve with all services available.
A GAF of 30 or lower requires some form of direct supervision by a professional on a consistent basis, which may include anything from a psychiatric care facility, group home, or in-home care with a family caretaker that has professional and para-professional assistance. If one is committed they won't be getting out of a care facility until they reach a GAF of at least 31.
A GAF of 20 or lower is considered acute emergency, and will likely be handled in a hospital, even if that point is only reached in transience. These standards mention of failure to maintain minimal personal hygiene means failure to use a toilet, among other things.

Medication is conceivable anywhere from 80 on down, although at 60 or lower medication is customary, and at 50 or lower is completely indicated.

For those looking for information on what drugs might be prescribed for specific diagnoses, the Texas Medication Algorithm Project provides sample medication paths for several common psychiatric disorders. Generally speaking they are reliable and used in the field, although many options aren't listed due to them being newer than the charts, or easily contraindicated under certain common circumstances (mostly physical). The site features information on Bipolar Disorder, Major Depressive Disorder, and Schizophrenia (Schizoaffective Disorder is a combination of Bipolar and Schizophrenia, so you can likely infer from the two separate charts reasonable courses of action). Forms of anxiety are not listed on this site, but as a general rule, benzodiazepines and SSRIs are first-line treatment.

Crazymeds is a great resource for anecdotal information on almost every medication in the psychiatric pharmacopoeia. Really, if you want to know what a drug can do to a person, this is where to look. You'll get your answer with a minimum of bull. The site is also great for finding side effects du jour for all of these medications, so if you need a drug to misbehave, you're in the right place.
Tags: #resources, ~psychology & psychiatry (misc)
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