Introduction
The units in a hospital where critically ill or injured patients get admitted will be associated with an increased rate of mental impairments. A negative mentality is linked with critical illness in humans. Long-term and severe sickness can lead to the worsening of an existing mental health problem. Therefore, the service from a psychologist or a psychiatrist plays a valuable role in an intensive care unit.
What Is the Role of a Psychologist in Critical Care?
Critical patients receive less awareness about their medical conditions. They may also be in pain and suffering. Mindset, to an extent, plays a vital role in curing or bettering any illness. In most hospital units treating critical patients, a team of psychologists and psychiatrists may be appointed to care for the patient’s mental health. These professionals will consult the patient and assists them in identifying, addressing, and preventing or curing the mental health problems.
Caring for and curing mental health problems is important for the patient, the family, and the staff in an intensive care unit (ICU). The patient will be suffering, and their families will be stressed, confused, and mentally tired. The ICU staff may also get instability associated with their mental health due to pressure and stress. The ICU mental healthcare team tries to cure all such problems, which is essential for a better outcome.
What Is the Impact of Critical Care on Mental Health?
Critical care admission can severely affect psychological health. The patient may be under altered consciousness and lack the ability to communicate or move. This may develop extreme stress in the patient. In addition, the patient may develop signs and symptoms of post-traumatic stress disorder (PTSD). Emotional numbing, nightmares, hyperarousal, and feeling detached are some symptoms of PTSD.
The patients may also develop symptoms of anxiety and depression in an ICU. The patients may be subjected to constant and severe stress, which may slowly impair the patient’s memory. ICU admissions force the patient to stay isolated and witness the sufferings and death of the other inmates. In addition, constant pain, prolonged sickness, and sleep deprivation worsen mental health. The diagnostic or monitoring devices attached to the patient in an ICU may get intolerable to the patient. In addition, certain medications can cause side effects that may get hard for the patient to express, and the internal suffering can make their physical and mental health weak.
Why Does the Family of a Critical Patient Need Mental Health Care?
Both the physical and mental health of the family members of an ICU-admitted patient will get gradually impaired. The patient may get admitted unanticipatedly, and the episodes that occur in the hospital can impart stress and fear to the family members. Because of the anxiety, sleep deprivation, and pressure to make decisions, the family may get problems related to their mental health. This may further cause confusion and insomnia, gradually weakening their physical health. Therefore, the family of the critical patient also requires mental health care to overcome mental tiredness and confusion. In addition, conflicts may certainly develop between the family members regarding the treatments and other supportive care that are probably available for the patient.
How to Assess Mental Health Problems in a Critically Ill Patient?
The acute stress that a critical patient goes through stays undetected. This can lead to the development of symptoms like hallucination (perceiving something that is not present in real), mental confusion (inability to focus or think), delusion (a false belief about reality), and a feeling of insecurity. Certain assessment tools are used in an ICU to detect the development of confusion, delirium, or other mental health issues. Trained ICU staffs or ICU doctors perform these on the patients frequently. Some of the tools used for the purpose are:
-
Confusion Assessment Method for the ICU (CAM-ICU): Confusion assessment method for the ICU or CAM-ICU is an assessment tool that can be used in an adult patient admitted to an intensive care unit. The chances of the development of delirium are more in older patients under mechanical ventilation. It is a reliable, highly sensitive, and specific tool. It can be used in critical patients under any sort of medical condition. CAM-ICU test is done in stages. Using a consciousness scale or validated sedation, the consciousness level of the patient is assessed in the first stage. Based on the results obtained, the patient may be subjected to further assessment. The consciousness content will be assessed in the following stages.
-
Nursing Delirium Screening Scale (Nu-DESC): Nu-DESC is an easy-to-use five-item scale that rates disorientation, inappropriate behavior, inappropriate communication, hallucinations or illusion, and psychomotor retardation. Each characteristic feature will be given a score from zero to two based on the severity. It is designed for nursing staff and can be completely done within a couple of minutes after observing for twelve hours.
-
Delirium Detection Score (DDS): DDS is a scale that measures delirium by considering eight symptoms. Each symptom will be scored based on certain features. The scores will be given as 0,1, 4, or 7, based on the severity and the patient’s response. The one who examines the patient needs to be well-trained enough to understand and note down the accurate score.
-
Intensive Care Psychological Assessment Tool (IPAT): IPAT is a quick and simple tool that detects psychological morbidity in patients admitted to an intensive care unit. It is also helpful in screening or assessing the future risks of mental health problems in the patient. It can be used effortlessly by the intensive care unit staff to detect distress or delirium in the patient.
What Is Critical Care Psychology?
Critical care psychology focuses on taking care of the mental health of the people associated with intensive care units. It helps the patients, ICU staff, and family members deal with the mental health problems associated with the admission of the patient to an ICU. The ICU staff may also get influenced by the negative atmosphere that they are surrounded with. This may lead to burnout and stress. The critical care psychology staffs help to assess mental health issues and provide care to prevent and cure such conditions.
Conclusion
The entire people associated with the intensive care unit of a hospital will be under extreme stress and pressure. The patients, their families, and the ICU staffs require mental health support to overcome their confusion and tiredness. This will help the patient to get cured of the illness, the family to make better decisions, and the ICU staff to serve efficiently.
