UNIT ( D):

1.Pengenalan kepada tugas dan tanggunjawab Pembantu Perubatan di Jabatan Psikiatri. 2. Merebiu masalah psiko sosial pesakit. 3. Merebiu dan memberikan ubat kepada pesakit rawatan susulan Peranan dan Tanggungjawab PPP.

4. Mengeluarkan surat rawatan susulan dan mengatur pertemuan dengan Pakar Perubatan dan Pegawai Perubatan. 5. Mengenal pasti pesakit-pesakit yang berisiko defaulters. 6. Menilai masalah Fisikal dan Psikiatri Pesakit.

Peranan dan Tanggungjawab PPP dalam Psikiatri Komuniti 1.Pengenalan kepada perkhidmatan- perkhimatan yang disediakan oleh Unit Komuniti. 2. Memeriksa temujanji pesakit setiap masa. 3. Memeriksa ubat-ubatan untuk lawatan susulan rumah-kerumah.

4. Merekod data dan statistik pesakit rawatan susulan. 5. Membuat laporan lawatan susulan. 6. Memonitor pesakit-pesakit yang tidak datang pada temujanji. 7. Menyediakan jadual lawatan susulan.

1.Mental Health Care The objective is to provide appropriate Mental Health care to new and follow up patients as well as to monitor and to trace defaulters. 2. Roles of the Asst.MO  Detection of medical Health problems in the community.  provide initial management of patients suspected to suffering from mental health problems.

 provide follow up care of psychiatric patients attending the clinic.  to refer all relapse or uncontrolled psychiatric cases seen at the clinic to the nearest District Hospital or psychiatric facilities.  To ensure that psychiatric drugss are availabe for follow up patients.  To forward statistics to DHO’s Office for compilation before sending to Sarawak Mental Hospital “Hosp. Sentosa”.

3. Management Guidelines a.For new patients suspected to be suffering from mental problems.  The AMO must be able to distinguish neurotic disorder from psychiotic disorder.  In neurotic, to give simple support at the clinic level and to refer to the District Hospital if there is no improvement.

 If psychotic, the AMO must be able to distinguish organic disorder from functional disorder.  Any case of organic disorder must be referred to the District Hospital for futher assesment and treatment.

 All manageable functional disorder should be managed at local level. Referral is necessary when there is no improvement.  All unmanageable cases must be transferred to the nearest Dist. Hospital or Mental Hospital after the iniatial emergency treatment.

b.Follow up Psychiatrict Patients. l. The AMO must continue the same treatment and to send the patient back for review to the referring centres every 6 months or 1 year as prescribed, if the patients are stable. 2. During the follow up visit, the AMO must assess the follwing areas:  Level of fuctioning.

 social functioning  Self care  behaviour  side effects  pysical problems  compliance with medication  relapse of acute symptoms. 3. The AMO must try to stabilize the patient as the local level after consultation with the nearest available doctor.

4. If it is not possible to stabilize the patient, the AMO should refer the patient to the nearest hospital or psychiatric facility for further management.

4. Registeration and Monitoring a.All follow up notes and referral letters from Hospital Sentosa, Pschiatric Units or Dist. Hospitals must be filed in alphabetical order. b. All KD must keep a Registration Book to register all patients with mental health problems.

C. The registration Book must be standardised and must have the following information as shown below: Indentification January February..Dec Name/NRIC: Address; HSK RN(if any): App date Att. date App date Att. date Name/NRIC: Address; HSK RN(if any): Note: AP-Appintment Att- Attending

d. The AMO in charge must record the next appointment date and to monitor the patient’s attendance at the clinic. e. All patients who did not turn up more than 2 weeks after the last appointment dates are considered as defaulters..

f. The AMO must determine the best way to trace these defaulters. g. The general out patient card will be used for documentation. h. The AMO will use either the home based or clinic based approach of management

5. Administrative Fuction a.Medication 1. The copy of the follow up notes/referral letter from HSK, Psychiatric Units or Dist, Hospitals must be attached when ordering medication not in AMO list. 2. In case of urgency, Supplementary indent must be used. b. Monthly Return. AMO must forward monthly returns to the DHO’s Office regularly.

Terima Kasih..