Phone of urgent psychiatric care. About emergency psychiatric care

To be near inadequate man is dangerous. But what to do, if this is your relative? And in fact, he never suffered mental disorders. Just at the moment behaves somehow strange. Maybe it will pass?

Psychiatric help? How to do it? About this in the article.

All white, hot

Remember this phrase from the cult Soviet comedy? Everything is clear, white hot. From the side it seems that it is ridiculous. If it were not so scary.

When the alcoholic "caught a squirrel", he behaves inadequate. He can see something. He hears the voices calling for something dangerous. Sees non-existent people, animals and creatures. Someone talks.

What to do those who ended up at such a moment? Where to run wife and children, if the alcoholic father ran to the kitchen behind the knife? Instead of close devils, he was encouraged, so he decided to deal with them.

First, close from it. In the bathroom, in the toilet, in the room - anywhere. If only the castle was reliable. Secondly, call the "Emergency" psychiatric. And how to call an ambulance psychiatric help? This further, in while we consider cases when such an ambulance is simply necessary.

They are not only in alcoholics. There was a family. Successful on modern standards. Son - high school student. He studied on "excellent", visited many circles. At some point I came home. And the guy sits on the sofa, the ears snapped his hands, and shouts. Voices heard him who were forced to jump out from the window.

But there was nothing bit foreshadowed. Perhaps it happened from the body overload.

Consider what visual hallucinations are, and how to cause a rag out of emergency psychiatric care if this happened to your loved ones or acquaintances.

So, the person of someone or something sees something, begins to talk with the fruit of his fantasies and is surprised when the closest begin to prove that there is no one near.

Depressive states

How to call an ambulance psychiatric help and in what cases do it need to be done in depressive states?

If close says that he has depressed, it does not mean that you need to immediately run to the phone.

When a person loses interest in life, refuses to eat, sits for a long time, staring at one point, he needs help. It seems that it will pass and so? No, it will not pass. Just aggravate.

Postpartum depression

Many mammies face this phenomenon, just gave birth to the baby. Nowadays, it is found quite often.

The parent has no interest in the child. He doesn't need it. The kid can scream to come, and mommy will make TV pogrom and looks. In some cases, the behavior of a young woman in relation to the sibling aggressively. She says he will kill him, threaten to give away in the orphanage. Refuses to feed the baby, care for it.

At the peak of exacerbation, if not take action earlier, the woman is able to grab the pillow or knife to get rid of the baby. There is nowhere to pull, you will have to cause psychiatric care.

Can I stop the attack?

Everything can happen in life. The main thing is not to panic and quickly navigate in the situation. It will not be superfluous to learn emergency rooms: firefighters, police ambulances. It will not hurt to know how to cause ambulance psychiatric assistance in Moscow and other cities of Russia.

Consider how the brigade should act. Causeing a "psychosha", as they call such a brigade in the people, do not think that it costs simple shock and pills. The brigade has no right to stop the attack, leaving the patient at the time of exacerbation of the house. Yes, and not every attack can be eliminated at home. Be prepared for the fact that an inadequate household will be taken to the hospital.

The patient does not want to go

How to call an ambulance psychiatric assistance to alcoholics, people in a state of depression or those who have signs of schizophrenia? This can be done if a person represents a threat to himself or society. That is, if he says that it will be thrown into the window now, - these are only words. And the "mental hospital" will not go to such a challenge. If it is on the windowsill, then it's time to act. Only to have time to also take this comrade from the window sill before the help will sing.

Let's go back to the question of what to do if the patient refuses to go with doctors, locks out in the room, trying to escape, screaming and behaves inadequate. There is a notion of involuntary hospitalization. Patient is dangerous for society? It will be taken despite the protests.

"Squirrel" ran away

You called psychiatric assistance, seeing that a person has acute exacerbation. And by the time the brigade arrived everything. How to proceed? You know how an alleged patient behaved, but did not see the doctor.

Explain the situation to the doctor. He will tell you how to act further. It is possible that the patient will be invited to speak by telephone with a psychiatrist. For this, the brigade is associated with a duty psychiatrist. That after a conversation with the estimated Psychic will make a further decision, how to act an exit brigade.

It will be registered

Often the relatives of the patient are afraid to communicate with emergency psychiatric help. They say, we will control our composure in a mental hospital, register. And all - a cross throughout. Where to take it to work? Who wants the family with such creating? In general, problems are guaranteed.

In fact, everything is not so scary. Do not always put such people registered. Only in some cases. And whether your relative is suitable for one or another case will solve the medical commission.

Paid or for free?

So, how to cause ambulance psychiatric help? And who is better to contact: to paid doctors or free?

Many believe that paid medicine is better. This is not true. Doctors themselves recognize that the patient is in paid hospitals - This is a wallet on the legs. It is possible that your relative will be treated with the purpose of staying in the hospital longer. So, it will be submored for him to pay. And doctors who treat for free, do not want to do anything. This is a deceptive misconception. Among them are professionals in their case.

In general, the dispute over this issue is infinite. There is an opportunity and means, call paid psychiatric care. No - contact "free" doctors.

Can I go with the sick?

Relative is hospitalized, and you want to go with him? Alas, but state psychiatric care does not provide such an opportunity. Only private fast psychiatric brigades are allowed to go with the patient. For a fee, a relative of the patient can also be in the hospital with him.

Where to call?

So we got to the most important question: "How to cause psychiatric care for a house in Moscow and other cities?"

If you call from a landline phone, you dial 103. The dispatcher say that you need to call a brigade to a person suffering from the psyche disorder. You will be switched to a psychiatrist doctor.

Tell me as much as possible about the patient: how does it behave, what does, whether it threatens others or himself. A further decision will take a doctor depending on the severity of the situation. Help will be sent. Or will arrive "Emergency" if the case is particularly heavy. Or call forward psychiatric Brigade "Ambulance".

Name the address where the specialists call. Be sure to stay next to the patient before the arrival of the brigade.

And from mobile how to cause psychiatric home care? The phone is one - 112. You dial it, and then act in accordance with the instructions of the answering machine. It will be proposed to click on the figure 1, 2 or 3, depending on which service it is necessary to contact. Press 3, and act as indicated above.

Do I need to call the police?

We dealt with how to cause ambulance psychiatric assistance. If the patient is completely inadequate and behaves aggressively, call two services at once: "Psychoshushka" and the police. The latter will help to neutralize Buyan and follow the brigade before the arrival of the brigade he did not show aggressive actions.

Often the police themselves cause psychiatric care.

Conclusion

We looked at how to cause ambulance psychiatric assistance and in what cases it can be done. And also, as a brigade comes, if the patient for her arrival "came to himself", and much better contact, in a private clinic or to the state.

Ministry of Health of the Russian Federation

About emergency psychiatric care

In order to implement the Law of the Russian Federation "On psychiatric care and guarantees of citizens' rights in its provision", improvement and further development emergency psychiatric care

order:

1. Organize the work of the emergency mental hospitality in accordance with:

1.1. The Regulations on the medical and medical hospitals of emergency psychiatric care (Appendix 1).

1.2. Full-time regulations of medical personnel team of emergency psychiatric care (Appendix 2).

1.3. An exemplary list of special equipment of the ambulance brigade (Appendix 3).

2. Heads of health authorities of the constituent entities of the Russian Federation:

2.1. Organize the systematic studies of emergency psychiatric care staff.

2.2. Ensure regular conferences of medical personnel of psychiatric institutions and ambulance brigades to discuss the practice of psychiatric examination and hospitalization in an involuntary manner.

3. Annex 9 Annex 9 to the Order of the USSR Ministry of Health from 12.12.80 N 1270, paragraph 4 of Appendix 10 and paragraphs 1.1.5, 1.2.7, 1.3.1. Appendices 11 to the order of the USSR Ministry of Health from 29.12.84 N 1490.

4. Control over the implementation of this order to shall be entrusted to the Deputy Minister Starodubova V.I.

Minister
TBDmitriev

Appendix 1. Regulations on medical and paramedic teams of emergency psychiatric care

Attachment 1

Russian Federation
from 08.04.98 N 108

POSITION
about medical and paramedic teams ambulance
psychiatric care

1. Medical and Feldscher Brigades of Emergency Psychiatric Aid (hereinafter referred to as psychiatric brigades) are organized as part of the station (substation, separation) medical care, psychoneurological dispensary, psychiatric hospital, as well as the Central District Hospital.

2. In its activities, psychiatric brigades are guided by the Law of the Russian Federation "On psychiatric assistance and guarantees of the rights of citizens when providing it."

3. The provisions approved by the Ministry of Health of Russia are subject to emergency medical care provisions approved by the Ministry of Health.

4. Psychiatric brigades provide ambulance psychiatric care at the patient's place of residence, including medical preventive institutions.

5. The tasks of psychiatric brigades are:

emergency psychiatric care;

exercise by a psychiatrist doctor examining a person without its consent or without the consent of his legal representative and hospitalization in an involuntary procedure in accordance with applicable law;

transportation of persons suffering from mental disorders in the direction of a psychiatrist, accompanied by a medium-sized medical personnel.

6. Psychiatric brigades are not eligible for issuing documents certifying temporary disability, forensic psychiatric and other expert opinions, including about the presence or absence of alcohol intoxication, do not issue any other written references. All necessary recommendations to patients, their legitimate representatives and medical Personnel Psychiatric institutions are given orally.

7. Psychiatric brigades carry out their work in cooperation with psychoneurological dispensaries (offices, offices), if necessary, send information and recommendations to their address.

8. Psychiatric brigades in the presence of medical testimony are obliged to carry out an ambulance psychiatric assistance to the persons voluntarily.

9. The service area of \u200b\u200bpsychiatric brigades is determined by the order of the health authority of the subject of the constituent entity of the Russian Federation.

10. Psychiatric brigades are provided by the necessary medicines, medical equipment and transport.

11. Psychiatric brigades are not sent to challenges without instructions for the intended patient mental disorders.

12. When providing emergency psychiatric assistance, when other methods cannot be prevented from a patient's action, representing direct danger to him or other persons, by decision of the psychiatrist, the measures of physical constraint in the most gentle forms are used, including using wide tapes from dense Cotton fabric. These measures are carried out when monitoring medical personnel, their form and duration are indicated by a psychiatrist in medical documentation.

13. When receiving information about the patient of aggressive actions, that he is armed, barricaded, owns the teles of struggle, hand-to-hand combat, etc., the psychiatrist makes a psychiatrist in advance about this police officers who take the necessary measures in the manner prescribed by the current legislation. .

14. In the implementation of hospitalization, an inventory available in patient values, money, documents, as well as subjects that can be used as a weapon, is made by a psychiatrist doctor of the brigade into medical records. All of the listed is transmitted on receipt of the doctor's reception office.

15. The number of medical psychiatric brigades is established in accordance with the staffing regulations approved by the Ministry of Health of Russia. The number of paramedic brigades is determined by the health authorities of the constituent entities of the Russian Federation.

16. Medical (as part of a doctor and two paramedics or doctor, Feldscher and Sanitar) and the paramedic (as part of three paramedics or two paramedics and sanitation) psychiatric brigades are provided by a specially equipped sanitary car and special equipment on the approximate list approved by the Ministry of Health of Russia.

In the absence of the required number of paramedics, brigades can be equipped individually to other Middle Medical Personnel.

17. In large cities (with a population of over 1 million inhabitants), independent specialized stations (substations) of emergency care or separation of psychiatric and psychoneurological institutions may be organized from the Psychiatric Assistance Brigades. When organizing such stations, substations and departments on them, in addition to approved regular standards approved for them, regular emergency standards are distributed.

18. The general management of the activities of psychiatric brigades is carried out by the Administration of the institution, which are organized. Methodological management of the activities of psychiatric brigades is carried out by the chief psychiatrist of the health authority.

Head of Department
medical organizations
aid population
A.I.Velkov

Appendix 2. Full posts of medical personnel team of emergency psychiatric care

Appendix 2.
to the order of the Ministry of Health
Russian Federation
from 08.04.98 N 108

1. Medical staff:

1.1 Psychiatrian doctors posts are established at the rate:

a) 1 round-the-clock post for 300 thousand people in cities with a population of over 100 thousand inhabitants, but not less than 1 round-the-clock post per city;

b) 1 round-the-clock post per 50 thousand inhabitants of cities with population up to 100 thousand inhabitants and township settlements together with a rural population adopted for service under a contract with municipal executive authorities.

2. Middle Medical Personnel:

2.1. Position posts are established according to the posts of psychiatrists, provided for by paragraph 1.1.

2.2. Positions of Feldscher or medical sister According to calls and the transfer of their brigade if the ambient psychiatric assistance operates as part of a psychiatric (psycho-neurological) institution, is established at the rate of 1 round-the-clock post.

3. Junior Medical Personnel

3.1 Sanitar posts (Sanitary) are established according to the posts of the doctor or paramedic for each medical or paramedic brigade.

Head of Planning Management
financing and Development
N.N. Tocilov

Appendix 3. Approximate List of Special Equipment of the Might Psychiatric Aid Brigade

Appendix 3.
to the order of the Ministry of Health
Russian Federation
from 08.04.98 N 108

Disposable syringes 10 pieces

Cups for taking drugs 5 pieces

Tapes of dense cotton fabric
(200 x 10 cm) 3 pieces

Aminazine Table. 0.025 2 packs

AMP 2.5% - 2.0 5 packs

Tisercine Table. 0,025 1 Packaging

AMP 2.5% - 1.0 10 packs

Chlorprotine table. 0.015 1 Packaging

Table. 0.05 1 Packaging

TRIFTAZIN Tab. 0.005 1 Packaging

Stelzine AMP. 0.005 1 Packaging

Galoveleridol Table. 0.0015 1 Packaging

Table. 0.005 1 Packaging

AMP 0.05% - 1.0 5 packs

Sonapaks Tab. 0.01 2 packs

Relanium table. 0.005 2 Packaging

Seduksen AMP. 0.5% - 2.0 10 packs

Fenazepam table. 0.0005 1 Packaging

Table. 0.001 1 Packaging

Amitriptin Table. 0,025 1 Packaging

AMP 0.025 2 packs

Melipramine Table. 0,025 1 Packaging

AMP 0,025 1 Packaging

Cyclodol table. 0.002 1 Packaging

Akinton AMP. 0,025 1 Packaging

Phenobarbital table. 0.1 2 packs

Carbamazepine (Tegretol, Finlepsin)
Table. 0.2 1 packaging

Head of Department
medical organizations
aid population
A.I.Velkov

Appendix 4. Methodical recommendations for organizing the work of the emergency mental hospital

Appendix 4.
to the order of the Ministry of Health
Russian Federation
from 08.04.98 N 108

Mental psychiatric care is a type of mental health care guaranteed. In the psychiatric service system, it owns a particularly important role. Specialized rapid psychiatric care teams operate in our country since 1928. In the late 50s - early 60s, they got wider distribution. Currently, ambulance in cities are carried out in most regions of Russia. At the same time, the organization of this type of assistance is given not enough attention.

The main task of a psychiatric brigade is to provide emergency psychiatric care in cases of sudden development or exacerbation of mental disorders anywhere in the patient's stay, including medical institutions. Help can be limited to medical events after examining the patient, the recommendation of the appeal to the psychoneurological dispensary (separation, office) or accompanied by hospitalization in a psychiatric hospital. In addition, the psychiatric team fulfills the task of transporting mentally ill in the direction of a psychiatrist using special vehicles and, accompanied by a prepared medium-sized medical personnel.

Ambulance is functioning around the clock.

Of particular importance, the work of psychiatric brigades acquires in modern conditions in connection with the introduction of legal norms relating to psychiatric examination and hospitalization in a psychiatric hospital in an incomparable order. In this regard, the responsibility of the doctor of a psychiatric brigade for making a decision on hospitalization was significantly increased, and the work of psychiatric brigades was significantly complicated. Ambassadoric care was at the forefront of the implementation of legislation in the field of psychiatry.

On the other hand, the strict criteria of involuntary hospitalization associated with the congestion of the danger of the patient for themselves and others, in the form of, for example, directly physical threat, require often close interaction of a psychiatric brigade with police officers. More than before, the doctor needs a police support to comply with legal norms and creating safe conditions for the patient inspection.

Other issues of emergency psychiatric care are also the urgent. First of all, it is the creation of prerequisites for its further development; It should not be destined only for the population of large cities. Taking into account local conditions, the question should be solved whether a psychiatric team is included in the ambulance station structure or is an integral part of the psychoneurological dispensary. There is a non-uniform load of the brigades. To a certain extent, this is due to the problem of improving the quality of assistance: strict observance of legality, the time of arrival to the place of call, the volume and nature of the assistance provided, the equipment of the brigades and vehicles, etc.

Appeal for emergency psychiatric help. Structure
contingent patients. Hospitalization

The analysis shows that the frequency of appeals for this type of assistance reveals fluctuations: persons annually examined by psychiatric brigades are 16.0 - 19.0 per 10 thousand population per year. Among these persons, a certain part is non-resident, as well as persons without a certain place of residence. For one way or another in cities attractive for mentally ill migrant migrants, for example, in order to appeal to various instances, can reach 20% of the total number of patients to which a psychiatric brigade is caused.

Challenges come from different sources; The latter reflect the acute nature of development mental pathology. The psychiatric brigade most often cause family members and close patients (approximately 40%), less often - police officers (30%), work staff (5%), the tenth interests of the percentage are challenges to patients coming from random individuals. Practice shows that in the presence of deliberately false calls, receiving calls from officials or from relatives of the patient (calling themselves and reporting their coordinates). In doubtful cases, it is proposed to those who cause a psychiatric brigade, to first contact the police, housing offices, etc., independently patients are treated for emergency psychiatric help only in 1 - 2% of cases. Calls to patients with psychoneurological dispensary doctors make up about 20%. In these cases, the role of emergency mental hospital is usually reduced to the transportation of patients in the direction of the dispensary psychiatrist.

The nosological structure of the contingent of patients annually inspected by psychiatric brigades depends on the characteristics of the region. The share of patients with alcoholism and alcohol psychosis reaches 20 - 40%. There is a tendency to increase the number of persons with drug addiction and toxicomicia, but their share in regions that do not differ in the large prevalence of these types of dependence remains within 1 percent. The largest part of the calls is to schizophrenia patients (more than 40%), organic brain lesions, including atherosclerotic and senile dementia (more than 20%).

Among the persons who are called a psychiatric brigade, the number of men usually slightly exceeds the number of women.

Challenges come to the persons of all ages, but more often - to the persons of working age.

The procedure for receiving calls.

All references (without exception) for emergency psychiatric help are recorded by the dispatcher. Taking a challenge, the dispatcher finds out the data on the location of the person to which the brigade is called, its name, name, patronymic, age, and surname, name, patronymic of the causing, his attitude to the specified person - relative (degree of kinship), employee (position), Neighbor, housing worker, etc., his phone. The dispatcher, interviewing the causing, clarifies the reason for the appeal, was observed (treated) whether the alleged patient was previously about mental disorder, which features behavior and statements at present, which may indicate the presence of a mental illness, including indicating dangerous or surrounding , helplessness, dynamics, in particular, weighing the state. The dispatcher makes the received data into the emergency recording log of emergency medical care and transfers all the information that has become well-known to the doctor who decides on the direction of the psychiatric brigade at the place of call or the refusal of this. In the latter case, depending on the situation, it informs the causing, where to appeal (for example, to the police or, in accordance with the law, with a statement in a psychoneurological dispensary to obtain a sanction judge to a psychiatric examination, etc.). If you refuse to send a brigade to a call, the reasons for refusals are made by a doctor to record emergency medical challenges. Taking a challenge, the doctor instructs the calling about required measures Before the arrival of the Brigade (if possible, ensure supervision, warning dangerous actions, move from production room to a safe place, etc.). When departing to the detained bodies of the Ministry of Internal Affairs, the doctor team must be familiar with the written report about the circumstances and the causes of the detention. At the same time, measures should be taken to establish the identity of the detainee, its inspection was carried out with the preparation of relevant documents.

In the case of a call to the medical and prophylactic institution, information should be obtained from a doctor of this institution that has the necessary patient data. In these cases, in addition to the data on mental state, Detailed data on somatic (neurological) disorders are required, in connection with which the patient is in inpatient treatment, data on consultations conducted with specialists.

The dispatcher also accepts challenges to transport patients from medical institutions (for translation into a psychiatric hospital), from a psychiatric hospital (for translation to another psychiatric hospital), from a psychoneurological dispensary (separation, office) for the premises of a patient to a psychiatric hospital. When writing an appeal to this regard, the dispatcher shall indicate the patient's passport data, information on the holding of a psychiatric examination (the date, time spent), the nature of hospitalization (voluntary, unfounded). If the patient is in a somatic hospital and examined by a psychiatrist - data on the presence of a psychiatrist, the name of the institution, where the patient should be delivered, the presence of a direction, as well as recommendations, if they are in the organization of transportation, surname, first name, the patronymic of the employee who submitted Call, his phone.

In the case of involuntary hospitalization, the Feldscher team can only be used for transportation only if it is sent to the patient no later than the day after its inspection by a psychiatrist.

Hospitalization of patients

The share of hospitalized psychiatric brigades in the total number of patients placed in psychiatric hospitals in different regions of different regions and reveals various dynamics in recent years. It varies from 10 to 30% of all hospitalizations.

An increase in this indicator indicates a decrease in the activity of the psychoneurological dispensary in the early detection of attacks and exacerbations mental diseasessubject to inpatient treatment, on less active outpatient therapeutic work. Most of the patients inspired by psychiatric brigades are hospitalized (60-70%).

Legal regulation

Psychiatric examination and hospitalization, usually carried out with the participation of psychiatric brigades, can be voluntary when the patient himself draws or does not object to inspection of a psychiatrist, hospitalization, or unscrupulous when the patient is examined and proposed contrary to his desire. The law of the Russian Federation "On psychiatric assistance and guarantees of the rights of citizens in its provision" provides that the involuntary examination is carried out in the event that the subject of the person surveyed performs actions that give reason to assume, and the involuntary hospitalization - in the event that he has a heavy doctor Mental disorder that determines:

a) his immediate danger for himself or others, or

b) its helplessness, that is, the inability to independently satisfy the basic vital needs, or

c) significant harm to his health due to the deterioration of the mental state, if the person is left without psychiatric care.

With the same criteria for incomprehensible examination and hospitalization there are differences in a legal procedure. The decision on the involuntary hospitalization is adopted by the doctor, and the decision on the involuntary examination of the doctor takes only in cases of conformity to the state of the criterion "A". If we are talking about the criteria "B" and "B", on an unscrupulous examination, it is necessary to obtain a sanction judge.

However, it is necessary to point out the legal aspects associated with the peculiarities of the work of the ambulance brigade and emergency psychiatric care. This work is based on the maintenance of urgent cases; the brigade is called to a previously not an inspected psychiatrist, and not under dispensary observation Persons.

1. The challenge of a psychiatric brigade must be adopted if the patient is in adverse living conditions and the "severe mental disorder" in him corresponds to any of the three criteria. When the conditions are unfavorable (lack of observation, patient care, staying outside the family, on the street, etc.), helpless patient (Criteria "B") and a patient with a bad clinical prognosis in case of leaving it without psychiatric care (criterion "in ") become dangerous for themselves. In these cases, the criteria "B" and "in" Article 23 coincide with the criterion "A" and the patient should be inspired by the emergency psychiatrist.

Refusal to render emergency care Such patients becomes equifiable to the failure of medical debt.

It is unacceptable shifting by the psychoneurological dispensary of all work on the involuntary examination at the Psychiatric Aid Brigade. The dispensary should be carried out in accordance with Articles 23, 24 and 25 of the Law, receiving the judge's preliminary sanction. However acute manifestations mental disorder that demanded an emergency psychiatric help when the patient cannot be left without help, subject to the conformity of the mental state of the criteria of involuntary hospitalization, the dispatcher (duty doctor) is guided not only by Article 23, but also 29 articles, and the latter is decisive .

2. The dispatcher (duty doctor) of emergency psychiatric care, taking a challenge, may be disoriented by the fact that the appeals were mistakenly appreciated and presented the actions of the person as painful or biased the facts. In such cases, if this person refuses psychiatric care, a psychiatrist, arriving at the place of call and assessing the situation, independently solves the issue of holding a psychiatric examination and may refuse to hold it or, having a conversation with this person, can only establish that it is not Need emergency psychiatric assistance in an incomplete manner, since such assistance, with a negative attitude towards it, can only be provided with the help of the involuntary premises to the hospital, and signs of conformity to the state of the person criteria for incomprehensible hospitalization (Article 29, Criteria "A", "B" "B") No. At the same time, the psychiatrist does not solve the issue, whether the person suffers the mental illness and in what form of psychiatric care it needs. It only establishes that this person does not need emergency psychiatric assistance in an incomplete manner. It is about this that he makes a record in medical records, justifying it by the data obtained at the point. In these cases, the involuntary examination is considered not conducted, and the doctor does not violate Art. 23 of the Law on Psychiatric Assistance. The patient, the applicant who made a challenge of a psychiatrist, and other present persons should be explained that circumstances refined in conversation are necessary to make a decision on the need for examination.

You also need to pay attention to some legal Statesnot exercising only from the specifics of emergency psychiatric care, but having great importance in its provision.

1. The law does not allocate any of the three ("A", "B", "B") criteria of involuntary hospitalization as the main one. In order to avoid non-fulfillment of medical debt, the absolutization of the danger criterion for themselves is unacceptable for himself and others ("A") as the most evidentiary and ignoring of the other two criteria. It is important that the decision of the doctor is always quite motivated by the description of the patient's mental state.

2. In cases where the patient in his mental state cannot express its attitude towards hospitalization (apply or give consent), when it, for example, is in a state of changed consciousness (delirium, onseed, twilight state), or when Acute psychosis with a pronounced confusion, extreme loading of psychotic experiences, or expressed dementia, in which the personality attitude towards the fact of hospitalization is impossible to establish (but it is easy to incline such a patient to the signature under a document on harmonization) - in all these cases, the hospital should be issued only As unfounded.

3. Invalid hospitalization begins from the moment of the implementation of a psychiatrist adopted by a psychiatrist, a decision on the patient's premises to the hospital, regardless of his desire after his survey at the call site, since from this point on, if necessary, coercion measures are taken.

4. In the direction of hospitalization, the psychiatrist should give a substantive and evident description of the mental state of the patient, from which it is rather definitely possible to conclude that it corresponds to one of the three criteria of incomparable hospitalization; It should be indicated that the patient is incomprehensible, as well as the criterion of Art. 29 ("A", "B", "B") his state corresponds.

5. In accordance with Part 3 of Art. 30 The law police officers take measures to prevent action, threatening life and health surrounding from the hospitalized person or other persons, as well as if necessary for the search and detention of the person to be hospitalized. Police officers are obliged to promote medical professionals in the implementation of involuntary hospitalization and ensure safe conditions for access to the hospitalized person and inspection. It also follows from more general provisions Art. 2 and 10 of the Law of the RSFSR "On the Militia", where it is indicated that the Militia tasks include ensuring the personal safety of citizens, the protection of public security, as well as assisting officials and institutions in the implementation of their legal rights and interests. It is also noted that the police must provide assistance to citizens in a helpless or other state, dangerous to their health and life, accept reports of events that threaten personal and public security and take measures in a timely manner. Therefore, assistance to medical workers if necessary emergency hospitalization - One of the forms of fulfilling his duties.

Organizational aspects

With the introduction of the legal foundations of the psychiatric service, adequate importance is important modern conditions Organization of the work of emergency psychiatric assistance in different regions Russia.

1. Currently, the ambulance psychiatric assistance is mainly (almost 84%), it is underway to overall emergency medical care and much less often in the structure of institutions of psychiatric service.

The inclusion of emergency psychiatric assistance in the structure of psychiatric service institutions allows:

to quickly get acquainted with the information about the patient in the psychoneurological dispensary before leaving the brigade to the call site, the data on its inclination to socially dangerous actions, etc.;

receive information from district psychiatrists, cooperate with them in the implementation of hospitalization, promptly using paramedic brigades, as well as obtain information from the hospital, allowing to assess the correctness of the decisions taken;

support more high level psychiatric qualifications of psychiatric brigades; be aware of all new requirements, regulations; Use new psychotropic agents and treatments.

The loss of these advantages of cooperation with other institutions that provide psychiatric assistance can particularly adversely affect the decentralization of emergency psychiatric assistance in the largest cities in the inclusion of psychiatric brigades in the substation of the general medical ambulance. The lack of communication and close contacts with the psychiatric service leads them to professional isolation.

In other cases, the following arguments should be taken into account in favor of including psychiatric brigades into the general medical ambulance:

the best conditions for technical support for vehicles;

the presence of some general aspects of assistance;

approaching general medical practice and greater acquaintance with somatic pathology, in the practice of work of some psychiatric brigades often playing an important role (with mixed pathology, solving the issue of transportability of patients, etc.).

The determination of the structural affiliation of a psychiatric brigade may be solved depending on local conditions and capabilities. However, with any options, attention should be paid to the organization of emergency psychiatric assistance from the chief psychiatrist and the organizational and methodological department on psychiatry. All the advantages of establishing closer bonds of brigade with psychiatric institutions should be implemented, up to the use of a computer bank of data on patients of the psychoneurological dispensary. In large cities, it is possible to organize an independent station of emergency psychiatric care.

Chief Psychiatrist and Organizing Mental Psychiatry, it is necessary to organize:

systematic studies of medical personnel emergency psychiatric assistance;

participation of doctors and parachicers of psychiatric brigades in conferences of psychiatric (psychoneurological) institutions;

regular discussion of cases of involuntary hospitalization, especially controversial, or mistakes that were, for example, the cause of lawsuits;

providing brigades with permanent consultants - staff of the Department of Psychiatry Research Institute, the most experienced doctors.

2. More than half of the regions of Russia, the response indicator of the population by ambulance crews is within the boundaries defined by current standards. However, this type of care is concentrated mainly in large cities. Its further development should occur in cities with an average and small population, as well as in rural areas, where the psychiatric brigade more often performs the functions of transportation, delivering patients in the direction of the district psychiatrist in mental asylum.

It is necessary to use existing standards not only for urban, but also for the entire population of the service area. If there is a medical ambulance in rural areas, it is possible to go along the path of specialization in psychiatry at least one of the on-site teams of the general profile, conducting the appropriate specialization of the doctor, as well as tracing another medical staff of the brigade.

The organization of the work of psychiatric brigades should contribute to the implementation of legislation in the field of psychiatry, taking into account the fact that only a psychiatrist can solve the issues of involuntary examination or hospitalization.

3. The psychiatry manner must examine the load on the brigade. It is usually traced inverse relationship between the radius of the service area and the number of calls. The greater the service radius, the less the number of the departures of the brigade. Under the excess number of the ragled and emergency psychiatric care, they begin to perform the unusual functions of them: to carry out so-called non-core challenges, to assist the psychoneurological dispensar in the maintenance of patients. Both are not rational.

The number of calls performed by a shift brigade may affect the population of the population associated with the insufficient activity of the psychoneurological dispensary.

An optimal average load should be recognized with the implementation of a 4 - 6 calls to a daily shift. However, deviations are allowed from this number depending on the local conditions, which should be established by the calculations of the organizational approach, taking into account the number of brigades, the radius of service, time spent on the road, and other factors.

Experience shows that in cities with a population of more than 1 million. It is not always advisable to use the fully qualitative of the creation of the same type of psychiatric brigades. Their partial additional profiling is more adequate. Thus, a team of emergency-teen psychiatric care, aid to the patients of a somatopsychiatric profile (with mixed pathology, the implementation of calls to multidisciplinary somatic hospitals), a resuscitation and psychiatric profile (to assist in cases of febrile catatonium, malignant neuroleptic syndrome, heavy alcohol deliries and etc.).

4. In order to improve the quality of emergency psychiatric care, the population should first of all pay attention to its indicator, as the time during which the patient expects the arrival of a psychiatric brigade. According to reports, more than half of the cases of the brigade arrives at a call with a significant delay. The gap between the inspection of a patient with a district psychiatrist, who has decided on the involuntary hospitalization, and the implementation of this hospitalization by the Feldscher Brigade in such cases may lead to serious consequences.

5. An important aspect of organizing the work of psychiatric brigades is the work of the dispatcher, since decisions on the refusal are taken in 10 - 13% of cases: non-core challenges; Obtaining a dispatcher of information from which it is not obvious that we are talking about mental disorders, and it follows, for example, to contact the police bodies; In the absence of data on emergency need, it can be limited to a professional council and others.

In a significant part of these cases, only a psychiatrist can qualify and responsibly assess the situation by receiving information on the phone, and decide on the refusal.

6. An important aspect of the work of the Brigades is to organize the interaction of psychiatrists and paramedics of the brigade with employees of the Ministry of Internal Affairs, in whose help they often need when performing their professional duties.

The path to solving the difficulties of joint work of emergency psychiatric care and police bodies existing in some regions in strengthening the contacts of psychiatric services with the Ministry of Internal Affairs, the organization of joint meetings with the discussion of interaction. Where these contacts exist, difficulties arise less often.

7. Improving the organization of the work of the psychiatric brigade contributes to a careful selection of qualified personnel (it is advisable to work on the work of at least three years of psychiatric experience), complete staffing of the brigade.

8. It is necessary to improve the material and technical support of emergency psychiatric care. Many psychiatric brigades have so far been placed in small, poorly adapted premises, need tools to hold excited patients, radio communications, motor vehicles with modern technical support. Improving the provision of psychiatric brigades by drugs is necessary.

Medical events

Two types are distinguished medical events With acute and urgent states in the practice of emergency psychiatric care.

1. The first is associated with the fact that the doctor decides on the hospitalization of the patient. In this case, the purpose of drugs primarily applies to relieve or reduce the severity of psychomotor excitation.

Application psychotropic products To reduce affective tensions covered by psychopathological experiences, mitigating anxiety and fear contributes to greater safety in the transportation of the patient and leads to a decrease in the use of retention measures, fixation, immobilization of the excited patient in accordance with the Law on Psychiatric Assistance (Article 30, Part 2). The physical constraint measures are applied only in cases, forms and for that period of time, when, in the opinion of a psychiatrist, other methods, it is impossible to prevent the actions of the hospitalized person who are dangerous for him or for others.

The introduction of a law on psychiatric care has led to a decrease in the use of psychotropic drugs with the above objectives in the practice of emergency psychiatric care, since the psychiatrist is often afraid that sedative effect The drugs disguises the sharpness of the state and when delivering a patient, the adoptive department is more difficult to prove the legality of the decision taken on the involuntary hospitalization. In such cases, the psychiatrist of the hospital reception unit should evaluate the patient's condition in dynamics, taking into account the temporary nature of the achieved improvement after one-time reception of the drug. The relief or decrease in psychomotor excitation with medicines is especially shown in cases where the patient's transport takes considerable time. It should also be indicated that at this stage, if necessary, therapeutic measures are carried out, aimed at the correction of concomitant disorders (the development of convulsive seizures, the phenomena of brain edema, hemodynamic disorders, etc.).

2. Another type of urgent medical measures is associated with the need to assist not accompanied by the patient's hospitalization. We are talking about faces with a wide range of states, including not a serious mental disorder that need emergency care psychiatrist, which can be provided to outpatient. This includes, in particular, disorders of non-psychotic level (neurosis, psychogenic reactions, decompensation in psychopathy), some cases of transient and rudimentary exogenous-organic mental violations (Transient psychosis of vascular, intoxication genesis, neurosis-like and part of affective, psychopath-like states in chronic mental illness, side effects of psychotropic drugs appointed by patients in psychoneurological dispensaries).

Challenge mental psychiatrist, besides medicinal purposesAs a rule, accompanied by a psychotherapeutic conversation, as well as recommendations, for example, the need to appeal to a psychoneurological dispensary for further systematic treatment.

In arsenal mandatory for psychiatric brigade medicinal preparations There should be neuroleptics of sedative action (aminazine, tisercine, chlorproticisene), antibred, anti-populotic action (triftatazine, haloperidol), small neuroleptics (Sonpax), from antidepressants - a drug with a sedative component of action (amitriptyline), tranquilizers (relaignation, phenazepam), proofreaders ( Cyclodol, Akinton), anticonvulsants (phenobarbital, carbamazepine, relaignation).

Some of the most significant therapeutic measures

Security

The ambient psychiatric assistance turns out to be patients who often suffer from severe mental disorders and in their mental state can be dangerous both for themselves and for others. At the same time, such measures like gas cans, handcuffs are not applied. Features of assistance are needed at the same time strict implementation of a number of measures aimed at preventing suicidal actions, aggression, damage to the patient himself, others, as well as assisting medical personnel.

1. Medical Personnel of the Psychiatric Brigade, who arrived at the call site, it is necessary to remember that the behavior of the patient under the provision of psychiatric care under the influence of psychopathological disorders can suddenly change, wearing an unforeseen, impulsive nature and acquire extreme danger for both the patient and for others.

2. In this regard, the dispatcher (duty doctor), having received information about the patient who committed dangerous actions or expressing threats, adopting a challenge, is obliged to inform the doctor's doctor, informing the details of the patient's behavior. In accordance with the degree of danger, especially in cases where the patient is armed, barricaded, owns the faults of the struggle, hand-to-hand combat, the doctor before departure transfers the call to the police officers.

3. When examining the patient, the behavior of the team members should be calm, restrained, without fussiness, excessive movements that can provoke aggression. The conversation must be carried out in a respectful, friendly, correct form with both sick and with others.

4. The doctor taken by the brigade as directed by the doctor, determined by the specific situation and the peculiarities of the patient's condition, must be carried out quite quickly, coordinated and accurately.

5. Orders of the doctor who are related to the patient can not always be done openly, sometimes they are given in conditional form, in a quiet voice, along the conversation. In connection with this medical personnel, it is necessary to be permanently attentive, not distracted, monitor the course of the doctor's conversation, immediately performing instructions.

6. In the event that the patient is excited, tense, suspicious, paramedic (paramedic, sanitary) brigades occupy places in close proximity to the patient in such a way as to prevent a possible dangerous act or escape. It is necessary to closely monitor the behavior of the patient (the direction of the view, the movements of the hands, faithful, etc.). Cutting, heavy items, vessels with an unknown liquid are deleted to a safe distance. The patient is inspected for the presence of weapons, hazardous substances, medicines; Attempts to take the patient to take advantage of them or snatch any of their pockets and others.

7. Inspection of mentally ill in institutions, in production is carried out if possible in a separate room, in the absence of employees, without excessive publicity (that is, if possible, it is necessary to take measures to avoid the situation that, in the opinion of the patient, can compromise it in the eyes of others , as well as far from working units.

8. Inspection of the patient for the detection of arms hidden by him, hazardous items, as well as documents, are made at the direction of the doctor (usually before transportation) and in all cases carefully. In cases where circumstances require, the inspection should be made without delay.

9. If the patient locked in the room, barricaded, it should be found out from others, whether the patient has a weapon where the windows are published, the physical possibilities of a sheltering and others. In the necessary cases, the doctor decides on the challenge of the police, firefighters.

10. Before the use of retention measures (immobilization), if necessary, at first it is advisable to try to persuade the patient, using the help of others, especially those who enjoy him confidence. In some cases, due to the peculiarities of the patient's condition, immobilization should be carried out immediately.

11. When the patient is excited, prone to aggression to avoid direct impact (especially foot), always try to be on the side or a few rear from it. If the need forced to be ahead of the patient, it is recommended to turn a few sideways to him, putting a foot forward, thereby mitigating a possible blow.

12. To accompany the excited and aggressive, the following techniques can use the patient resistance:

a) Being on the side of the patient, each of the workers of the brigade covers his corps by hand, holding his wrist;

b) going on the side or behind, quickly and energetically take his hands the cross - inhibit behind the back (standing on the left takes the right hand of the patient, right - left). Transferring the patient, go on the side from it, not from behind (danger of kicking foot);

c) the false patient is trying to turn on the stomach, fixing their hands behind his back. It is prohibited to put the knee on chest (danger of rib fractures), grabbing for the throat or the use of other coarse measures of physical impact;

d) if the patient is armed with cold weapons, stick, etc., the best way Go to it - holding any item (blanket, coat, mattress, chair, etc.).

13. The paths of pedestrian support of the patient should not be large (according to the transitions of hospital buildings, institutions, etc.).

14. When landing a patient in transport, caution should be exercised due to the possibility of traumatization.

During transport, you constantly need to control the behavior of the patient. The conversation (with the possibility of establishing contact) should not affect its painful experiences, it must be distracted and soothing.

When transporting at night, if it is determined by the condition of the patient (delirium, etc.), it is necessary to include lighting in the car. It should be remembered that when disembarking from the car immediately before the adopted compartment of the psychiatric hospital, patients attempt to escape, show due to this aggression.

15. Motor transport should be located on a simple distance to the room insert, convenient to quickly land or landing the patient.

The state of the vehicle must comply with technical and sanitary and hygienic requirements (good heating, the absence of foreign objects, any posters, gaspace should not include music and others).

16. Transport in the car if there is no more than one patient in the patient of the excitation state.

17. Upon arrival, it is necessary to inform the personnel of the reception unit on the peculiarities of the state of the patient representing the danger; In the necessary cases assist the personnel of the reception office.

18. The clothes of the staff of the psychiatric brigade should not prevent the movements, there should be no solid objects in the pockets, which may cause injury when immobilizing the patient.

19. The measures applied to hold the patient, its immobilization should be reflected by the doctor in the direction of hospitalization (character, duration of use).

Head of Department
medical organizations
aid population
A.I.Velkov

The text of the document is drilled by:
"Health",
N 8, 1998

As the great Russian poet of the 19th century said: "Do not give me God to go crazy, it's better a staff and soum ..." At all times, the deviation from the mental norm caused fear and misunderstanding from ordinary people. The need to premise a mental person to a specialized medical institution is still perceived as a lifelong sentence. Doctors are constantly faced with myths and speculation relative to mental illness and methods of their treatment. Thanks to modern science and medicine, methods of therapy of various mental diseases have achieved unprecedented efficiency. But people living in ignorance are still afraid to apply for specialized psychiatric help. Some believe that schizophrenia should be treated in the church, others go with the problems of the depressive spectrum to the fortuneteller, being in full confidence that they are "smoothed." To help mentally ill relatives, many are not applying to a doctor, but to those who have no attitude towards medicine. It is not difficult to explain this phenomenon. On the one hand, the experience of the Soviet era is still alive in mind: people were taken to a mental hospital just on the complaint of neighbors. On the other hand, many simply do not trust doctors, doubt the competence and ability to really help. And yet, do not forget about the influence of the media: "Battle of psychics", "Gadalka", "mystical stories" ... Modern Russian television is a polygon for charlatans of all stripes and calibers. There they explain that the mental disorder is the result of sins of ancestors or its own unrighteous life. And on the question, what to do? Offer to pay out, make the rite of expulsion of an evil spirit, drop dead and so on. Skill using manipulation for their own purposes, "Mages" are made on relatives of sick people. Therefore, psychiatrists besides their direct activities, it is necessary to conduct educational work with visitors, explaining that superstitions are harmful and convincing that the effectiveness of psychiatric assistance in stationary conditions of a specialized type is much higher than what is considered.

The provision of psychiatric care is carried out anonymously

Especially acute is the question of when you need to raise mental psychiatric care. The diagnosis itself cannot be the main cause of hospitalization. The aggravation of the disease may arise in cases where an outpatient treatment does not give a positive result. Unfortunately, many people are in such a deep delusion regarding psychiatric hospitals and psychiatrists, which prefer to hide their illness, even from loved ones, which ultimately leads to deplorable consequences. It is proved that most mental disorders are successfully treated in the early stages. Consequently, the earlier person to ask for help, the more favorable will be the forecast for recovery or long-term remission. However, it is ideally, but in reality, it is necessary to call a psychiatric team of ambulance due to the aggravated symptoms of the disease. If a person neglects treatment, then at some point the disease turns out to be stronger, the patient loses control over his own consciousness and actions. In such cases, emergency psychiatric care is required. Most often, a person needs help with doctors when he is in an inadequate condition: trying to commit suicide, aggressively behaves, threatens physical violence around, is in a state of nonsense, hallucins. Such states are classified as acute, and require immediate hospitalization of the patient. In front of the relatives or neighbors of the patient, the question arises: how to cause psychiatric ambulance? Call the specified phone number. The operator will ask about the reason for the appeal. It should be described in detail what happened in what state a person will be sent to you a medical psychiatric ambulance. Many doubt whether to call the public service, or still contact the paid psychiatric ambulance. About the advantages of calling a paid psychiatrist to the house read on.

It is known that our medicine is experiencing not better than the best times. Psychiatry, as a separate area of \u200b\u200bmedicine, is also not in the best condition. State financing is constantly declining, it naturally affects the quality of services to the population. Alternative was the private ambulance aid. The first plus of this service is complete confidentiality. Turning to a private clinic, for example, our medical CenterYou ensure absolute anonymity. No one ever learns that a person suffers from a mental illness. The second plus is high qualifications and professionalism of doctors. A psychiatrist, an experienced doctor, attentive and tactful specialist will come to your house. Already in place after the collection of anamnesis, the patient survey and his relatives will be decided on the need for hospitalization. The patient will be delivered to the comfortable chamber of a specialized hospital, where he will be given medical care. Treatment is carried out on new highly efficient programs developed abroad with advanced psychiatrists of our time. The greatest value is human life. The task of modern psychiatry makes the lives of people with mental disorders worthy and full, not to isolate them from society, but to teach to be part of the team. Guided by high international standards for emergency psychiatric assistance in Moscow and beyond, our clinic has reached a new level of efficiency in the treatment of mental disorders and various kinds of dependencies. We provide round-the-clock ambulance care, our brigades are ready to go to the challenge at any night or day. The brigade includes a psychiatrist narcologist, Feldsher, two Sanitary and Driver. The car is fully equipped with the necessary equipment and medicines. You see the number of our emergency psychiatric care on the site, write it down in order not to look for the most responsible moment.

Specialized Ambulance Psychiatric Help

Consider the most common mental illness and their symptoms in which specialized medical care is required. Most often, we are talking about the provision of emergency patients in a state acute psychosis. This may be due to the alcohol or drug addiction of the patient, as well as with the exacerbation of schizophrenia, when the patient stops the reception of drugs. The state of a person accompanied by the permanent of consciousness, excessive excitement, expressed by emotional disorders, confusion, shaped delirium, deception of perception, requires an appeal to ambulance. Mentally sick people who are dangerous for themselves and others should be aimed at treating a specialized institution. This is advised by the Law on Psychiatric Aid. The decision on hospitalization takes a psychiatrist, who arrived at the challenge. Also assistance to the mentally illness can be at home, if a specialist deems it to avoid hospitalization. Most often, ambulance urgent psychiatric care cause people suffering from schizophrenia, senile dementia, disorders associated with organic changes in the brain, alcoholics in the development of alcohol delicacy. Recently, they have become increasingly calling the crew of emergency psychiatric care to spice smokers. People, under the action of the synthetic drug, behave unpredictably, often aggressively, detect cravings for suicide, membership, manual attack, attack others. Such patients cannot be called mentally ill people, but at a particular point in time, being in narcotic intoxication, the behavior of patients is classified as a psychotic spectrum disorder, and, consequently, they must be provided with relevant assistance. If you witnessed the inadequate behavior of a person related to the use of prohibited substances, type the phone of psychiatric ambulance. By this you will protect him and yourself from unpredictable consequences.

For psychiatric brigades, it was already a classic to save alcoholics in a state of alcohol delirium, or delirium. The so-called "squirrel", the favorite theme of jokes, is not at all fun in reality. It is important to understand that white maritime comes from a man after a binge, that is, it's not about a drunk ugar. Man, on the contrary, absolutely sober. Therefore, with a "protein" you need to call psychiatric care. How to cause psychiatric ambulance alcoholics? The state of alcohol delicacy develops gradually. At the peak, a person suffers from nonsense, deception of perception, he appears conspiramic ideas. It seems to him that he is followed that he is overtaken by aliens, rats, devils (images of persecutors are in direct connection with patient fears). In such a state, a person sees the only way out - suicide. This is really very heavy syndrome, requiring specific treatment and appeal to a psychiatrist narcologist. At home you can conduct a detoxification procedure, use sedatives. But you should not contradict the doctor if he insists on hospitalization. Organism for a long time The poisoned alcohol and its surrogates can give an unpredictable reaction to the most innocuous drugs. The treatment is better carried out in a specialized clinic under the control of experienced doctors. A serious barrier to appeal to the public service of psychiatric assistance is the fear of publicity. Abstineent syndrome is not always the consequence of many years of alcoholism. A person who survived the loss, against the background of the strongest stress, can leave in the cock. On time, medical and psychological assistance has prevented further development of addiction. Therefore, you should not hide the problem. If you are afraid of public resonance, then an anonymous paid psychiatric ambulance is available. Prices in Moscow for this type of services are above average and correspond to the effectiveness of treatment. This is justified by the fact that the organization of psychiatric care is engaged exclusively highly qualified doctors using the advanced technique and newest drugs. Stationary conditions correspond to the "Premium" class.

Hospitalization in paid psychiatric hospital

In paid hospitals, much attention is paid to the organization of leisure of patients, art therapy, outdoor walks, restoration of social and communicative skills. Modern approach In the treatment of mental disorders, it allows a person to return to the old profession or choose a new generation, more suitable for his character's warehouse. Assistance to mentally ill people in a private clinic is much more efficient, thanks to individual work with each patient. Unfortunately, one cannot say about state medical institutions. "Psychoshushka", as people called the budget medical organization providing psychiatric assistance. The hospital for mentally ill is associated in the consciousness of people with the place of torture, torment, bullying. In horror films, a mental hospital often becomes the place of the most terrible events. The gloomy image of a medical institution, where they contain people with mental disorders, partly truthful. Who at least once visited the state boarding school for mentally ill, he knows under what conditions patients are contained. Often, the building requires overhaul, in the cabinets doctors there are no elementary office equipment and air conditioners, treatment is carried out exclusively with medical drugs, most of which have long been prohibited for use abroad. This is the situation in state psychiatric care. However, in Russia there is an alternative in the form of a private clinic for mentally ill. On the example of our medical center, you can talk about what a private psychiatric hospital is. The center is located in an ecologically clean area of \u200b\u200bthe Moscow region. New buildings with fresh repairs. Clean, bright, spacious chambers, with an individual bathroom, a TV needed to be furnished, rather resemble a single room of an elite hotel than the hospital ward. Organizing aid to mentally ill people meet international standards, humane and effective. It is important that after the primary reception at a psychiatrist, the patient independently decides on hospitalization, the room in the clinic occurs only on a voluntary basis. The clinic provides assistance to relatives of mentally ill people. The specialist explains what features of behavior and communication should be taken into account so that the person does not lose his sincere equilibrium. Family psychologist works with relatives. Such a multifaceted large-scale approach allows to achieve high results in the therapy of various mental diseases.

In cases where a person for any reason refuses the placement in the hospital, the organization of outpatient psychiatric care is necessary. Often, the help of a psychiatrist can be rendered at home. With such symptoms, like a long insomnia, headaches, panic attacks, depression, bad mood, pathological fatigue, anxiety and fears of ambulance psychiatric care is not required. Typically, patients are recommended to go to the district psychiatrist. However, there is a more comfortable way to get a qualified help of a specialist, without leaving the house, is a challenge of a psychiatrist to the house. This service is very relevant, because a person does not need to go to the hospital, stand in line, attend the uncomfortable cabinet of the district psychiatrist, just call our clinic and order a psychiatrist consultation at home. The doctor will examine the patient will talk to him, will give recommendations to relatives to care for the patient. Depending on the diagnosis, treatment will be assigned. The patient receives the whole range of psychiatrist services, only not in the hospital, but at home. This option is very in demand in people in disabilities and disabled. It is important that the service can be ordered at any time convenient for the patient and its relatives. It is important that the psychiatrist comes to the house only subject to the presence of the patient's relatives during inspection. Our clinic provides the departure of psychiatrist to the house not only in Moscow, but also in the Moscow region. Turning to us for help, you get complete anonymity, guaranteed quality of services provided, consulting a psychiatrist doctor of the highest category, round-the-clock support throughout therapy, the possibility of rehabilitation in a specialized private pension for mentally ill.

Mental psychiatric care for older people

Special attention in our clinic is given to the provision of psychiatric assistance to the elderly. We convincingly ask relatives without tightening with a challenge of a psychiatrist to the house, since with age the number of diseases increases, the nervous system is depleted, the person becomes a capricious, demanding, aggressive, it seems to him what is really not. At the first signs of the disease, hurry to invite a psychiatrist for an elderly person. The doctor will come to the house and, above all, polls the relatives of the patient, then go to the inspection of the patient, hears his complaints. Collecting anamnesis and receiving clarification of relatives, regarding the problems encountered in the behavior of grandparents, the doctor puts the diagnosis, constitutes a treatment plan, discharges drugs, assigns additional forms of the survey if required. The sooner you invite a geronologist to the house, the more effective will be the treatment. Mental Diseases B. senior age Not unusual. Depending on the nature of the illness, the rapid progression of the symptoms of the disease may be observed. Just yesterday, the pensioner was Bodr and served independently, and today it is already confused by a window with a door, hides documents and money, going to leave home and so on. It is impossible to leave on sidelines such precursors of senile dementia as insomnia, headache, dizziness, moods, weakening of memory, complexity in the perception of information, a slow reaction, a missing look. Calling a psychiatrist to the house is the ability to avoid additional stress for an elderly person. Friendly and attentive specialist will inspect and listen to the patient, tactfully and gently explain the need for therapy. Psychiatrist for the elderly at home is not only assistance to mentally ill people, but also advisory support for the whole family. Finding out the circumstances, the doctor can recommend how to organize the patient care best. If we are talking about accommodation in the hospital (at the first stage of treatment it is often the need) will give direction good clinic. Not to the state hospital for mentally ill, from where the pensioner will not return, and in a modern specialized medical institution, where a person will restore and lead to normal.

Ambulance Psychiatric Help Children and Teenagers

There is another category of people with mental violations that need a permanent observation of an experienced specialist. These are ardent children. The beginning of many severe mental disorders, such as schizophrenia, neurosis, bipolar disorder, is often accounted for by adolescence. The complexity of the diagnosis at an early stage of development of the disease is that the child is not able to formulate his problem, explain what happens to him that he feels. Therefore, if parents noticed the strangeness in the behavior of the child, it makes sense to call a psychiatrist doctor for a consultation. Many diseases and mental disorders are well-treatment at an early stage of formation. This allows you to preserve social skills, learn professions and lead a full life for children with a diagnosed mental disorder. On the other hand, children's psychiatrists are concerned about the growth of children's suicides, an increase in the number of drug addiction among adolescents. Parents should be attentive to changes in the behavior of a teenager, and invite children's psychiatrist to the house, if there are reasons for concern. In particular, suicidal attempts can be as a symptom of mental illness and a sign of severe psychological injury. During the telephone consultation, such issues cannot be solved, a personal conversation with parents and adolescent is required, so you can make an appointment with a doctor or invite a psychiatrist for a child to the house. It is imperative to recognize signs of the disease, to conduct competent diagnosis and appoint adequate treatment (drug or psychotherapeutic). Help psychiatrist at home for adolescents is the most gentle presence of child psychiatric care. The child does not experience undesirable stress and pressure, all conversations occur in a calm, habitual atmosphere, which makes it much more successful to establish trust relationships between the patient and the doctor. Is it possible to call a psychiatrist to the house if the child behaves strangely, closed, or, on the contrary, is aggressive, alarmed, overwritten? Our clinic provides an opportunity to receive a consultation of a competent specialist around the clock not only by phone, but also personally. Qualitative organization of psychiatric care for children suffering from diseases such as schizophrenia, epilepsy, psychosis, psychopathy, neurosis, encephalopathic manifestations, makes it possible to significantly ease life not only by patients themselves, but also their parents.

Planned Psychiatrist Call for Home

Often, the debut of a psychiatric disease cares for surprise. People are just lost, they begin to panic and do not know how to cause a psychiatrist to the house. To do this, it is enough to dial the number of our 24-hour service. Just write down the phone of urgent psychiatric care so that if necessary, to be able to get operational and high-quality medical care at home. The price of a psychiatrist call to the house is higher than the average for the market, which is explained by the extremely high level of qualifications of specialists, round-the-clock accessibility, response efficiency to the request, using only high-quality foreign medicines. It is important to emphasize the specificity of the work of a psychiatric brigade, since often people are in the literal sense of the word "shoot" from the roof. Aggressive and violent patients can defend themselves, resist, trying to strike on sanitation and doctor. Most often, these are patients with schizophrenia diagnosis. Emergency assistance in schizophrenia implies a mandatory hospitalization, since at home the patient's treatment is impossible. With schizophrenia exacerbations, the challenge of a psychiatrist at home is simply necessary. When is the first help in schizophrenia? If the patient represents a threat to himself and others, suicidal intentions and actions are manifested, the patient is in the changed state of consciousness, refuses food and drink, in such cases urgent therapeutic measures are needed. Helping schizophrenia patient with exacerbation and psychosis is, first of all, in establishing contact, trusting relationships between the patient and the doctor, then the specialist is diagnosed on the syndroma level, develops a plan for further health care facility. During this time, the doctor should not lose the "psychiatric" vigilance, soberly assess the situation, not allow the patient to approach the window, ensure that there is no potentially dangerous items next to the patient, which he could harm or others. Qualified medical care psychboles during the exacerbation of the disease provided by a competent specialist who complies with the right psychiatric tactics can replace drugs. Calling a private psychiatrist at home with a brigade will make it possible to make the most gently to make hospitalization without the use of hard measures and coercion.

Frequently often relatives of a mentally sick person listen to neighbors complaints. The behavior of a person with obvious mental disabilities may cause dissatisfaction of all residents of an apartment building, and they will demand to send a person to forced treatmentmay contact the precinct. In this situation, it is necessary to call a psychiatrist so that he will examine the patient at home. Most often, a mentally ill person does not recognize himself, does not consider it necessary to be treated, refuses hospitalization, at the same time, continuing to violate the rules of residence in the house. The family of a mentally ill person clearly requires help. Invalid examination can be applied if:

• The sick person represents a threat to himself and the surrounding (aggressive behavior, suicide attempts, immoral behavior);
• The sick person cannot serve himself independently (is helpless, can not cook food, perform hygienic procedures);
• The health state of the patient is significantly worsened, it cannot be left without treatment and medical care.

If you know that the patient will resist, hide, closed the room, then to the process of involuntary examination, it is necessary to attract the precinct. Often, it becomes necessary to break the door, this does not do this psychiatrist. By ordering a paid challenge of a psychiatrist to the house, let us know the operator of our clinic features your relative, who requires psychiatric care. Perhaps you need not only a doctor, but also a psychiatric brigade in full. If a doctor considers it possible to leave a patient on home treatment, it may be necessary to help care for a mentally ill person. It is important to understand that a mentally ill person needs a special approach, taking into account his disease. The doctor will explain how to behave with the sick, what are the basic safety regulations. The best way to avoid unexpected injuries and complications is a vigilant supervision for the sick. If the family cannot provide this, then it is worth considering the possibility of hiring a nurse or hospitalization of the patient. All questions and concerns can be discussed with a psychiatrist who arrived on your call. Once again, I want to emphasize that it is not necessary to grind and conceal the disease, at the first signs of mental disorder, call our clinic, we will help you.

The system of providing psychiatric care at the state level is hopelessly outdated. Unlike the European psychological clinic, our dispensaries and hospitals look the wise heritage of the Soviet Union. Those methods and medicines that have been used 50 years ago are used in the treatment of mentally abnormal people to this day. This cannot but cause a skeptic look at the level of emergency medical psychiatric care services. When a psychiatrist arrives, the patient most often responds negatively to the appearance of physicians. A picture from the film "Caucasian Captive" immediately arises into the brain of an unfortunate person, where two inclusive Sanitar with missing persons tightly hold the slightly resistant shurric. It can cause a smile in a healthy person, but the opportunity to get into the hands of such health workers does not really cause any fun.

According to the prior arrangement for psychiatric challenges, Dr. Medical Sciences - Imanbaev Erken Madimarovich can go. Cost Consultation Specify.

It is also worth saying a little about what labor is in psychiatry. This is the daily tense job of dispatchers, sanitary, doctors. A psychiatric ambulance team, traveling to a challenge, is strictly limited in arrival time and departure. Doctor need to decide in a few minutes that with the patient? Does hospitalization need? What medicines can be applied immediately? The diagnosis is also included in the duty of a specialist. But we will be objective, and imagine that the doctor has to talk with an aggressive person who is not informed about the arrival of the brigade and refuses to answer questions, and the doctor must already go to the next challenge.

The arrival time of the brigade in Moscow is 10-30 minutes, in the Moscow region 20-40 minutes.

Our paid psychiatric ambulance operates around the clock and can offer you the following specialized services:

• Paid ambulance psychiatric care. At the first signs of mental disorder, call the specified phones and the brigade will be within 10-30 minutes. Our brigade, as a rule, consists of a psychiatrist doctor, paramedic and sanitation. Our employees are always polite, careful, professional. We will spend so much time with you as it takes!
• Psychiatrist help in hospital or home. If you do not need an emergency (immediate) psychiatric assistance, you can order the service "Help of Psychiatrist at home" or psychiatric treatment in our hospital. We can also hospitalize you in any psychiatric hospital. If you need a psychiatrist doctor help call us! We can help you!
• Transportation of psychiatric patients in ambulance. At will and with the consent of the relatives of the patient, our brigade can also apply forced methods of hospitalization or transportation of psychiatric patients. We can deliver the patient both in the hospital and anywhere at your request.
• Organization of psychiatric assistance to citizens (We provide ambulance in Moscow and the Moscow Region, in accordance with the Law of the Russian Federation on Psychiatric Aid and Citizens' Rights when it is provided, you can call for mental psychiatric assistance on the specified phones and around the clock, our brigade will help house help, or hospitalizes in a psychiatric hospital).
• Emergency psychiatric help (We provide both planned stationary and emergency psychiatric assistance, psychiatric assistance in stationary conditions can be provided with the consent of the patient or without any, urgent psychiatric assistance will also be provided with the consent of relatives (guardians) of the person who has been given a psychiatric diagnosis).
• Psychiatric care for children (Our medical center for the provision of round-the-clock psychiatric assistance can take as children, so adults and adolescents, we will assist any segments of the population, children's paid psychiatric care is more accessible if you contact our medical center).
• Forced psychiatric help (The challenge of the brigade to provide forced psychiatric care is carried out only if the patient has already been diagnosed by calling the phone hot line You can get answers to all your questions).
• Specialized Psychiatric Help (This category includes emergency psychiatric care for children and adolescents, psychiatric and psychological assistance, outpatient assistance to older patients, an anonymous psychiatric care service without the consent of the patient, psychological and psychiatric care.
• Ambulance in schizophrenia, psychosis, neurosis, if the patient is in delusion, ambulance with depression or panic attack, with anxiety and disturbing states, with pronounced feelings of fear, phobias, neurasthenia and other mental disorders.

Moscow is a huge city living in a tense life, so there is a high level of people with mental disorders. But not any manifestation of the disease requires immediate hospitalization. When and how to cause psychiatric ambulance? First, let's talk about the states requiring the intervention of a psychiatric ambulance brigade, the phone is best to have at hand or write in a prominent place. So, the exacerbations of psychosis, schizophrenia, depression with suicidal intentions and abstineent syndrome (white hot, "protein") in alcoholics and drug addicts, accompanied by auditory and visual hallucinations, nonsense, fainting and attempts to cause harm or others, all these states require immediate hospitalization . Causeing a state psychiatric brigade, relatives often face that due to the dense schedule and the workload, the doctor does not arrive immediately, and after a significant period of time, the patient's examination occurs running, the diagnosis and recommendations for hospitalization are made automatically. Nobody will persuade the patient - no time! Enforced methods of hospitalization are applied (Schurik is remembered), soothing medicinal products with strongest side effects (In Europe, they have been banned out for several decades ago).

This is what you have to face a mentally ill to man and his relatives. Separately, it is worth describing the conditions of state hospitals for people with deviations, but it requires a special article, because the conditions of detention in multi-seat chambers are extremely heavy (smell, antisanitarian, rude staff, lack of repair, the inability to go beyond the chamber). Many relatives of people with mental disorders for a number of reasons have long cause our paid psychiatric ambulance. Our doctors are polite and competent, pay a patient as much time as its condition requires. Medicines are used as a last resort, only after a long conversation. Rough power and violent hospitalization methods are not applied. Since in our country a very large percentage of people suffering from a severe form of alcoholism, it will not hurt to know how to cause psychiatric ambulance alcoholics. If an alcoholic snoop or he came out of him, then he most likely he has alcoholic psychosis. Need hospitalization and challenge psychiatric ambulance, otherwise anything can happen. Damage damage to yourself and others - the most harmless development of events.

If you see that a person does not come out of the binge several days, especially weeks, get ready for a responsible moment to dial the phone number of psychiatric ambulance. If there is an opportunity, then evoke a paid ambulance, the ratio will be humane, anonymity and hospitalization in a good hospital is provided. It is important to note that paid ambient psychiatric care leaves to the Moscow region. Wherever the patient, a paid psychiatric brigade will arrive at him as quickly as possible. Personality education and development difficult processwhich is individual and can continue the whole life of a person. From the very birth, the human psyche is tested for strength, for example, everyone knows about the middle-aged crisis, but in fact the first and strongest test - a crisis of newborn, which sometimes has a subconscious impact on the entire future life of the individual.

In severe, a person passes through many different turning and complex moments. For these reasons, at any age, when a person begins to experience difficulties, in overcoming psychological barriers, understanding independently or not aware of the difficulty of the psychological situation, it is necessary to cause a psychiatrist to provide psychiatric care at home, inpatient psychiatric assistance may be required in more severe cases. Unfortunately, there was a negative attitude towards psychiatry in our country. And such an assessment is not groundless. World history From the very beginning of the origin of psychiatry is full of horrific examples of not humane attitude towards mentally ill. Psychiatry, B. different times, surpassed the Inquisition, concerning the issues of graciousness of disadvantageous people.

The phone of psychiatric ambulance should always be at hand, if necessary, a mentally ill man is desirable to call a paid ambulance. However, any medal always has two sides. Currently, a psychiatrist's doctor fear is equivalent to the way that a person with the strongest dental pain was afraid to go to the dentist and he would try to snatch a sick tooth with a thread and door handle. It is ridiculous and not constructively. Especially in different everyday situations and for especially sensitive people There is always such a service as a challenge of a psychiatrist. . Calling a psychiatrist is more convenient when the doctor must be accepted with all family members. For example, the case, if the family has a seriously ill patient. And for a long time (usually a critical period of a year - a half), a member of the family has to fall out completely or partly from society to assist and serving a patient relative. Here you need consultation and assistance of psychiatrist at home for all family members.

In the patient, as a rule, a steady depression is developing against the background of a physical illness, and a relative careful for him, as it were, "burns" emotionally. And one and the second side independently do not get out of this closed Circle. You should not forget that depression is the same disease as everyone else, only causes damage to the psyche: emotional tension, poor mood, irritability, increased fatigue, problems with the concentration of attention, insomnia, a decrease or disruption of appetite. If the depression may not be treated or aggravated by somatic diseases, for example, bronchial asthma. Save money on your mental state and the health of your loved ones, relatives is not reasonable. The more the situation is launched, the stronger the illness and its complications are developing, and the more expensive and it is more difficult to get rid of the illness. Accordingly, by and large - a paid psychiatrist on the house will save your funds. If you do not know how to call psychiatric ambulance you can call the above phone, the brigade will be with you for half an hour. Calling a psychiatrist to the house is necessary and in cases of deep age-related changes in human psyche. Such changes may be caused by shocks caused by the loss of the spouse (s), sometimes, retirement, other spiritual shocks.

In psychology age-related changes The whole topic is devoted - gerontopsychology. Psychiatrist for the elderly to the house will help if "on the face" paranoid forms of the disease in other words, obsessive nonsense (jealousy, despite age, constant suspicion of relatives in theft of some little things, even desire to end with life). And of course, in such cases, as old nightly delicates (night anxiety of old men who are forgotten by them in the morning), a psychiatrist for a house for an elderly person is the only right solution. A psychiatric ambulance team will provide urgent and emergency both sick and relatives. Psychiatrist at home, in a family atmosphere, will not distort the usual routine of the life of your aged relative. And this is a very important aspect when extending full-fledged life Your old people. We must not forget about the imminent struck of all of us. And what an example of attitudes towards old men you will show your children now, the same appeal will get to your future. Some categories of people are peculiar to the deviation of the psyche associated with the abuse of various substances. Departure of a private psychiatrist at home to the house with a narcologist at such critical moments, is not only accelerating the help of the patient, but also a guarantee of anonymity.

One of the types of emergency psychiatric care is forced or not voluntary psychiatric assistance (psychiatric care without the consent of the patient). Ambulatory psychiatric assistance to the population can be provided in scheduled mode, by recording with a visit to the doctor's profile medical institution. Is it possible to call a psychiatrist to the house would seem in easy cases, such as, for example, a love disorder? If you feel your love, or manifestations of love close man Like mania - yes! Such personality changes related love: overestimated or understated self-esteem, bad Son., pity for yourself, pressure drops, etc., meet with other mental disorders. Any "modified state of consciousness" - work for a psychiatrist. Call a private psychiatrist on the house is difficult, and more correct in cases of psychological problems in children. In children and adolescents, all life is ahead, they know adults.

And the child facing the difficulties of growing up is quite different. For the absence of life experience and (or) due to psychological abnormalities, many children tend to incur any small incident to raise a catastrophe. And if the parents do not work independently to provide psychological assistance to the child, comes to the aid of the psychiatrist. "The psychiatric department of a neurological clinic" is even scary to pronounce, not what to take her child there. Especially if there is no serious visible reasons. Children's psychiatrist at home from a private clinic will help and soften all the tickness of the moment. In what cases use the call of a private psychiatrist doctor to the house?

To, not traumating the child, spend primary diagnosis manifestations of mental disorder in a child, namely: a changed perception of the surrounding world, or itself in this world or change behavior. Also, at your request, a paid children's psychiatrist is always not only guarding the mental health of his little patient, but when treating at home, all participants in this process are easier to maintain anonymity. The services and prices of psychiatrist at home are quite democratic and vary depending on the age of the patient and the severity of the case from 5 thousand rubles. In connection with the growing tendencies of the Company's Enlightenment, especially in large cities, this service is becoming increasingly popular. Already "not fashionable to cry in a vest" a friend of the arc behind a glass.