Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T20:01:56.208Z Has data issue: false hasContentIssue false

Chapter 18 - Mentalizing and Emergency Care

from Part IV - Application of Mentalization-Based Treatment in Different Populations and in Different Settings

Published online by Cambridge University Press:  18 May 2023

Anthony Bateman
Affiliation:
Anna Freud National Centre for Children and Families, London
Peter Fonagy
Affiliation:
University College London
Chloe Campbell
Affiliation:
University College London
Patrick Luyten
Affiliation:
University College London
Martin Debbané
Affiliation:
University College London
Get access

Summary

Emergency care teams need to organize their response to crises around shared assessment procedures. This chapter describes how MBT can inform emergency care when a crisis is handled by the multidisciplinary team of mental health practitioners in psychiatric emergency settings. Development of the formulation according to mentalizing principles creates compassionate care in emergency settings. The chapter outlines the key factors that commonly contribute to the development of a crisis, and includes a discussion of the centrality of loss of mentalizing and collapse of agency of the self that are part of any acute crisis. Focusing on all of these aspects of a psychiatric emergency can de-escalate an immediate crisis and pave the way for planning how to prevent a recurrence in the future. Understanding of the triggers that can lead to a crisis and development of a plan for reducing the risk of recurrence are illustrated with clinical examples, and the four steps of MBT-informed emergency care are described.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bateman, A, Fonagy, P. Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry 2009; 166: 1355–64.CrossRefGoogle ScholarPubMed
Besch, V, Greiner, C, Magnin, C et al. Clinical characteristics of suicidal youths and adults: a one-year retrospective study. Int J Environ Res Public Health 2020; 17: 8733.Google Scholar
Besch, V, Debbané, M, Greiner, C et al. Emergency psychiatric management of borderline personality disorder: towards an articulation of modalities for personalised integrative care. Encephale 2020; 46: 463–70.Google Scholar
Prada, P, Cole, P, Bondolfi, G et al. Mentaliser en psychiatrie de liaison? [Mentalizing in liaison psychiatry?]. Rev Med Suisse 2017; 13: 363–6.Google Scholar
James, RK. Crisis interventions. In: Norcross, JC, VandenBos, GR, Freedheim, DK, eds. APA Handbook of Clinical Psychology, Vol. 3. Washington, DC: American Psychological Association, 2016; 387407.Google Scholar
Nizum, N, Yoon, R, Ferreira-Legere, L et al. Nursing interventions for adults following a mental health crisis: a systematic review guided by trauma-informed principles. Int J Ment Health Nurs 2020; 29: 348–63.CrossRefGoogle ScholarPubMed
Johnson, S, Lamb, D, Marston, L et al. Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial. Lancet 2018; 392: 409–18.Google Scholar
Henzen, A, Moeglin, C, Giannakopoulos, P, Sentissi, O. Determinants of dropout in a community-based mental health crisis centre. BMC Psychiatry 2016; 16: 111.CrossRefGoogle Scholar
Heyland, M, Johnson, M. Evaluating an alternative to the emergency department for adults in mental health crisis. Issues Ment Health Nurs 2017; 38: 557–61.Google Scholar
Fonagy, P, Gergely, G, Jurist, E, Target, M. Affect Regulation, Mentalization, and the Development of the Self. New York, NY: Other Press, 2002.Google Scholar
Jeammet, P. La violence à l’adolescence: défense identitaire et processus de figuration [Violence in adolescence: identity defense and figuration process]. Adolescence 1997; 15: 305–21.Google Scholar
Fonagy, P, Target, M. The mentalization-focused approach to self pathology. J Personal Disord 2006; 20: 544–76.CrossRefGoogle ScholarPubMed
Ferenczi, S. Confusion of tongues between adults and the child (the language of tenderness and of passion). Int J Psychoanal 1949; 30: 225–30.Google Scholar
Gergely, G, Watson, JS. The social biofeedback theory of parental affect-mirroring: the development of emotional self-awareness and self-control in infancy. Int J Psychoanal 1996; 77: 1181–212.Google ScholarPubMed
Fotopoulou, A, Tsakiris, M. Mentalizing homeostasis: the social origins of interoceptive inference. Neuropsychoanalysis 2017; 19: 328.CrossRefGoogle Scholar
Fonagy, P, Campbell, C. What touch can communicate: commentary on “Mentalizing homeostasis: the social origins of interoceptive inference” by Fotopoulou and Tsakiris. Neuropsychoanalysis 2017; 19: 3942.CrossRefGoogle Scholar
Walter, M, Genest, P. Réalités des urgences en psychiatrie [The reality of psychiatric emergencies]. L’Inform Psychiatr 2006; 82: 565–70.Google Scholar
Seletti, B. Situations psychiatriques dans un service d’urgence [Psychiatric situations in an emergency department]. Ann Méd Psychol Rev Psychiatr 2002; 160: 187–91.Google Scholar
Luyten, P, Fonagy, P. Integrating and differentiating personality and psychopathology: a psychodynamic perspective. J Pers 2022; 90: 7588.CrossRefGoogle ScholarPubMed
Li, X, Srasuebkul, P, Reppermund, S, Trollor, J. Emergency department presentation and readmission after index psychiatric admission: a data linkage study. BMJ Open 2018; 8: e018613.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×