A Laymans Guide To: Diagnostic Psychiatry

A Laymans Guide to: Diagnostic Psychiatry

 — Remember to play the text using a text to speech as in Microsoft edge or google voice.

By Ph. Bas. P. Coles; Auto-Didact

2023

     Introduction; 

     This is an introduction to an examination of the process by which clinicians use and how to fundamentally undermine the shortcuts taken in diagnostic psychiatry. As the field continues to grow in respects to the ideations by which the clinicians are trained to assess patients and the concept of treatment will hopefully become applicable to the scientific rationale as methodology adapts to the boundaries of scientific practice. We can safely begin to assess where there lacks scientific merit and sew the fruits as many do from others failure. 

        I, myself am not a psychiatrist, I am a psychometrist (I design and designate examinations for psychological and moral reasoning – In as well, varying types of aptitude and vocational tests) Where many have been trained to perform these assessments, I hold firm to the idea that as in music… “Practice makes permanent”. Thus, from a philosophical perspective; I will approach the concepts and address where the directions to take in specified cases stem from (and) from where to act in as so many cases are acknowledged. This field has been reputably tarnished by the inability to recognize the failures in treatment and the responsibility for the loss of quality of life – In as many of my loved ones have experienced the clinical aide. 

I hope that during this journey, you come to respect the exact efforts that should be taken in this field and the problems that clinicians do to assert in their opinions regardless of experience. The data and history of the experiments that go into the treatment of your loved ones or neighbors only reaches so far and so with the reach of my texts; So, I intend for this to be attacked by the practitioners in the field and address where I highlight in their practice. Aiming to bridge the gaps so many people fall backwards into. Their illness without either the support socially, medically or the scientific acknowledgements to where the disorders stem from – The treatment for these disorders and the methodology by which their inability to cite, cost society too much. I invite who would incite effective treatment that successors of those who will have had more data – To calculate decisions that will push them onto the battlements…

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        *The Diagnostic Symptoms Manual 5 is a lazy attempt at hacking away the work of performing the medical duties of practitioners and disables the effective path of treatment by instituting the ideation that “every ill has a pill”. I will be actively criticizing the use in practice and the dictation by which practitioners rely on this. There are consistent shortcomings where to perform an effective assessment would exceed the practical necessity of this book; In respects to both the patient and clinicians’ benefit* 

     One – Collection of patient history 

        It is of the utmost importance that before one can select a direction to address a patient, there must be the rapport built between patient and clinician. There is not one scientific paper you will ever read where manipulation of the control (which in this case is the patient) was an experiment conducted which yielded results which could effectively be replicated. As the patient is no different than a set of chemicals in a lab… By which the concoction behaves in such a way as it approaches you, one must first address the basic properties to be able to design the experiments around the patient. Identifying (metaphorically) PH levels, combustibility, color… So-fourth and without so much as to remove or causally change these properties before attempting to sort out what is in the mixture. This applies directly to the first patient interactions and even before initial interviews are conducted. 

        // A patient presents to an emergency room with suicidal thoughts and has not attempted self-harm. Noted dysthymic depression and situational factors present through overeating, lethargy and anxiety. The patient knows that there is something wrong and has needs to be addressed before the presentation of self-harm ensues. The patient is cooperative and is actively seeking help… 

         Do you administer medication before the initial interview takes place? Or do you perform the interview with the patient in as short a time as possible with the patient in the exact mental state that they were in when arriving at the emergency room? \\ 

This is a perfect example of where what is considered a normal initial interaction most often send the treatment off course. The CMHA states that a person exhibiting suicidal or risk-taking behaviour must be kept for examination – but before one can identify whether the treatment is going to be effective with the use of medication, there must first be an address of whether the patient can be treated without the use of such. Alteration to levels being a malpractice suit in the conditioning for false positives or negatives.

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        To be distressed by either biochemical interactions neurologically or the simply lacking coping mechanisms… To first interact with the suggestion of medication can often lead to either a dependency on the methods by which one actively alters their mental state chemically or where the patient must first meet a criterion where-in the interview must be objectively performed in a sober, uninhibited state. Perceptions of treatment are essential when establishing patient rapport. Without the established trust or (in worst case scenarios) the trust was never established before a specified treatment method were prescribed – There is no clinician capable of performing objective medical treatment without being liable to a lawsuit. 

In having first identified what mental and physical state the patient has arrived in, there must be given room for the patient to identify as much of their condition in their own word before there can be an effective interview conducted. It is in my experience – Giving the patient time to assess themselves can be the best first step in establishing trust. 15 Pages of lined paper and a pen, 45 minutes and a cup of decaf brew. Allowing the patient to best describe in their own words – What is going on, what has caused the distress and what they think they can do to help it; Allows for the patient to first identify with the treatment option they had in mind (further building trust) and in having allowed them to scribe their thoughts for you? You then see into their level of organized thinking, sentence structure, grammar, ability to self-identify with what is the problem and therefore help them address it alongside you. 

Without this, you have less concrete evidence by which you will put into your dictations – All and any case where you did not effectively communicate or help them to communicate is both a breach of trust and will effectively derail the consistency of treatment. You are depicting the initial background for the patient you have encountered. There is little of more importance than allowing the patient to personally identify with you and you must be willing to put things in as good an order as possible because if you misplace information, paraphrase for their medical records. Misinterpret or forget what it is exactly they have said then for the rest of that patient’s medical history – You will be the primary inconsistency between where they have had a problem to where you may have depicted otherwise. 

The backdrop for many people who seek medical help is that they fear the persecution for their train of thought, or they persecute themselves into believing that they are not worthy of help. Objectively in such circumstances – A clinician’s primary goal when collecting a background before initial interviews allows for the patient to speak not only of what it is they are thinking, but in all respects, tell you without the anxiety one may feel when addressed (As someone in distress may feel) 

Once there has been an effective background collected. (15 pages filled on lined paper) and you have allowed them to settle in as best as they can without assistance (Not having administered a medication) and having allowed them to identify with the circumstances for what they are (Opting for help over self-medicating or ignoring symptoms) You must then properly identify the setting… 

When you enter a restaurant, if you see unclean tables and people in some form of distress when the food approaches? Then the concept will come to mind that there is not an entirely satisfactory service provided. This is no different than that lodges in the memory of hospitals. The engagement with the staff and the environment – What is available and the consistency of interaction with the staff is crucial to allowing the patient to identify with the environment positively. You do not have to be nice, you have to be effective.

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          Manufacturing the safe environment where those who are not fundamentally happy must be entertained with the notion that this place will guide them back to health. In such case where someone likes to read, they must be provided with a book… In such cases where someone spends their time on a phone… They must be provided a cellphone. In such cases where someone plays video games… There must be the availability of video-games. These are all factors in identifying with the patient surround what they would normally do – While not doing it in their regular environment. In doing this you create a consistency between who they are in private and what they are able to adapt to in the setting of a hospital. Without this, there is not the same level of communication and trust that would lead someone to outpatient treatment where they if not addressed could in fact harm themselves. 

As well as allowing them to identify with the environment it promotes the patient to behave in such regard, they can effectively be assessed in the first place. It is of a great importance when you attempt to identify the root of an illness, the consequences of the hospitalization do not outweigh the direction of the treatment. As so penal facilities promote a sense of criminality and force on to act on the behalf of others where in the environment cultivates a mindset where the patient would as in prison identify as a prisoner – The patient must be able to collectively be assessed in no different a mindset as they were in the first place where in such case that an assessment were performed would as earlier referenced – be the same compound, which retains all the same properties and in the case where the parameters were met? You would even after 24 hours of preliminary assessments, be able to conduct an effective first interview as a psychiatrist. 

Defaulting on any of these prevents and deters effective treatment methodology in having denied the patient the opportunity to build trust, identify with the environment, develop effective patient history for the clinician and be effectively assessed when anxiety simply factors in – As well as removes the capacity to identify with treatment methods when exampled to the legal bias of CMHA regulations and the consistency of the state which people who actively seek psychiatric aid. In having followed these before initial interviews are conducted, you allow for the better assistance in giving direction to the patient, easing the patient in the first steps and building trust in moment. Having documented in their own words the disorder/symptoms and suspected reasons for such symptoms – you allow for the patient to be treated based on their ability to communicate henceforth and their record showing the exact degree by which one has been specifically declined and perceived examples of why for their next and eventually… final clinician to read in on. 

     Two – Initial Interviews 

     It’s more than simply a formality where one entertains a patient with situational banter to see where there is a lapse in judgment, communication or personal identity. The ability to effectively conduct an interview with someone in distress requires you to be adaptable. To effectively allow one to present themselves, while conducting as someone who can be effectively relied upon for medical guidance is the same relationship between a victim of a crime and an officer. If one side pushes too hard, if one side is too resistant to the other – If both sides simply present themselves as stubborn and won’t acknowledge the dynamic? Then the interview has failed. There in, this instance lacks the to open banter to effectively identify root causes when trust is not in mind. 

In short, one can fail an interview as the interviewer faster than one who is interviewed. It is about creating the dynamic of trust and dependency where in the service provider can guide the patient towards an effective treatment method where assertions of the capacity to break the autonomy of the patient has been consistently relied upon in the experience of most psychiatric patients I have corresponded with. 

To begin with a question and take 15 minutes of the 30 just allowing the patient to vent why they need the help, what the issues are and where the treatment is effectively targeting in the perspective of the patient (Identifying with placebo) where the ability to rationalize that the treatment is a give and take relationship. If there is an overstepping of boundaries – The treatment no matter how logically applicable, will not take. It must be an act of consent, where-in one opts for the direction and is willingly a participant or there will always be a doubt that it works and for such the patient will repeatedly decline, revert to old habits or simply opt out of the treatment whenever the opportunity presents. 

The way you communicate tells others more about you by how you speak than what you say. If you speak in a tone which undermines the direct communication with someone – you breach the trust and lose the rapport that will lead to a successful interview. If you simply express what you want without acknowledging the direction that the patient wants to take – You simply act as two differing opinions, where no trust seems apparent to build in the first place. If you patronize the patient – Allowing them to speak if only through your own narrative? Then you have ultimately failed and there is no longer an opportunity to build the trust – Leaving total liability to malpractice in prescription of mind altering drugs.

In cases such as these, if one clinician does not succeed? Then it is only appropriate that there be a transition of physician and once there is open communication between both parties, and never until there is open communication between both parties will there be the opportunity to have the patient accept the method and thus hold to the treatment in good faith. 

As well with the social interactions involved in the interview, there consistently lacks a direct correlation between the documentation, what is actually said and the interpretation through what is recorded in the notes (which further represent the patient in the future than they have say to speak of on their own behalf after the fact) Which, again breaches patient trust and degrades to interpretation of treatment from if not the clinician – Then the field effectively. 

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To iterate the solution along with the effective reasoning – When preliminary speculation is done, the interview should have at least one camera and a microphone recording the interview. The conversation should be one to one – for the sake of building rapport and allowing there to be a developed sense of trust, no notes should be taken. There should be a series of questions that the nurses ask before the interview, there should a separate set of questions that the clinician asks – separate from that there should be effectively a review of the quality by which the patient was engaged which is sent for review by an employee independent of the hospital. 

The interview after having been performed will be written in the dictations for case notes (directly from, not implicative – not paraphrased) from the recording and for sake of saving time? There is software from which you can take a recording and the software will effectively record the conversation in text format from an audio recording to save space in the records. (This being after the independent partner addresses the concerns relating to treatment) The dictation of the perceived condition of patient stored alongside the literal text of the conversation for fact checking then both sent to a second independent partner for statistical purposes relating to the effective treatments, the likelihood of treatment effectiveness and relation to the ability to treat illness with specified methods and so far as to be able to correlate the treatment in the moment to have updates from physicians in the future identify where things may have taken a turn for the worst such as resistance to treatment and the relationship with clinicians to effectively communicate with patients and deter in-cooperation in the case rapport had broken down and the situation had not been addressed leading to a faulty direction for treatment in the first place. 

The measures must be taken to ensure that the Hippocratic oath is up kept in socially dynamic field of medicine. It is simply the situation being relative to the communication on the behalf of clinicians working on behalf of the hospital – the paths of treatment available and the ability to meet the demands of patients where the ability to identify with the available methods are situational in nature in as much you would not order another person’s favourite food when you are effectively able to be treated with a specified path leading to a proposed end. In the end it is the data that identifies the exact relationship between the clinician, the treatment methods at their disposal, patient perception and the end by which the treatment was found to be effective or ineffective. 

That’s what big data does. It allows you to interpret the exact relation between a hundred things where this is effectively handled by 4-6 grad student varying in psychology, medicine and statistics per hospital. Redundancies that promote the scientific method are what endure the path of treatment is not condemning people with differential diagnosis are not confused for symptomatic relation in such case that the DSM were applied to many situations with variations specifically relating to patient history – medical history and treatment options that were not effectively explored. 

          Three – Primary interpretations 

          i.e. // You have just met with the patient after reading in on the patient history, there is a good sense of chronological order to the statements and the ideas are clear and concise. The only thing seems to be a lack of calamity, a generally mundane sense of ambition. Consistent work history, apparent family relationship and mentions of a partner who is presented as caring. The lack of interest in life described does not indicate a direct sense of melancholic absurdity and there are little mentions of historical thoughts of self-harm. Depression for the last year on a consistent downhill slope and no mentioned self-harm attempts in the history. 

The presentation was of concern as the patient appears to have trouble sleeping – She had a clear train of thought and remembered everything stated, she was open to questioning and provided a more detailed explanation of the symptoms and suspected reasons why she felt this way. Expressive facially, good eye contact but no real drive behind the emotions. // 

Exploration of the conscious mind momentarily allows us to see how these symptoms may present and the description of what the patient understands of them but as an iceberg may appear on the surface – The nature of it’s being is formulated below and surrounds it. I feel this would be the time to talk about blood, blood carries your genetic code, your drug history and traces of every chemical that keeps your mind and body in-sync with itself. Inconsistencies with blood panels and tests could signify that the patient is suffering from damage to organs altering perceptions mentally, and physically also significant to factor in that these tests are the first medical administration involved in treatment. This allows you to sort out who is suffering from a medical disorder before treating one mental in nature. 

To examine someone who has a history of substance abuse, is currently prescribed medications or has a history of kidney or liver failure can alter the ability to treat illnesses with medication. There is a broad majority of people who suffer from psychiatric disorders who have declined in physical and mental acuity due to a lack of sufficient exercise, inappropriate diet habits or the side effects of medications that are improperly prescribed (as in such cases that the medication outweighs its benefits with the side effects such as weight gain, lethargy and loss of concentration) causing a separate stream of disruption to the patients’ quality of life. The blood allows one to identify where some of the underlying causes of the symptoms and if effectively addressed – As earlier noted, self-care is the most important part of treatment. 

This may be tedious to have so many steps (but keep in mind, this is not how psychiatry is practised today – All so far in this text has been the correct method by which practitioners in the field should operate, not the way they do operate. The methods in place are not as effective, do not hold anyone accountable, are less consistent and have only changed in the matter of pharmaceuticals used in 20 years across all boards in Canada) 

To examine blood work after having collected patient history and having conducted initial interviews – Within 48 hours, you will have performed (to the current standard) nearly a weeks’ worth of evaluations. These first steps consume the essence of the practice as all things that come after the fact are built upon this pretense. Treating a person who loses faith in you is the ultimate failure in this field as the likelihood of follow up starts to crumble in a way that the clinician or staff disregard the trust or needs of the patient. 

While you now have effectively identified what may not be the problem vaguely. The only way to further specify is like a game of “Plinko” to a statistician; Keep track of patterns…  

The next step once there has been a full background on the patient is to begin testing for anomalies. If there are inconsistencies relating to the function of the mind or body and there is no recent use of drugs or medication, looking for swelling… Look for stimulation, autonomic or external. Anomalies in the development of the brain and its cohesive function with the body in youth can re-designate the mental faculties to an entirely different social, moral and vocational aptitude. 

          Four – Conducting Tests for Mechanical Failure 

          There is an importance to understand the state of the mechanical function in the body relating to the addressing of what could impede the best function of the body – Either the body resisting the operation of the mind through i.e. blood poisoning or the brain impeding the operation of the body i.e. untreated vitamin b12 deficiency – effecting the primary functions in the brain/stress disorders causing effective limbic dysfunction and furthering the decline of patient health through cardiovascular anomalies or other related action potential. 

An MRI will give a broad scope of the basic development of the brain, identify swelling and any other mechanical failure that could elicit a negative response such as Bi-polar schizophrenia or Major depressive disorder. Where-in the mapping of the brain is not getting correct blood flow, swelling or shrinking and in itself can be significant of specific disorders – Or more specifically be significant of the symptoms associated with disorders. Relation between the examinations and the diagnosis are 1/1 and furthermore to identify consistently during treatment of disorders which signify through with the noting of one anomaly, there should be regular exams determining relative paths of treatment and in such case that there be a break in what isn’t then it would symbolize in that specific circumstance what is. 

Such being the nature of the scientific medicine, differential perspectives of the field do not apply where the ability to rationalize the exact construct that allows the function to exist and, in this case; where the ability to exist do not meet. Where the “Plinko board” (Being a metaphor for the differential factors where the exact baseline is predicted but the symmetry to what is expected is not) stands with the factors relevant to the identification of the illness do not present, further specifying the exact nature of the illness. 

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          In combination with the first day having been spent running tests for the patient to wonder where their exact ends may land, to engage the patient directly during examination would stand to be both beneficial to the patients end goals as well as identify where for the clinician that the strengths in identifying where the symptoms become present outside of the strict solitude that so many tend to dwell in. Interaction does perform the best examination and that is for the patient to understand where the strengths and weakness in their conscious mind present, every patient is their best doctor. 

If you run a PET scan, after one hour simply sitting in a booth reading a book, there can be a consistent baseline if there has been sufficient stimulation in the time before entry for examination (this being within the hours of) and in such case that there has been consistent use of the mental faculties involving the motor function (Playing video games, writing or studying and regurgitating and other active occupying engagements) Allow for the baseline to be specifically in the case where there is no distractions while the stimulation is firmly at hand, anticipation is achievable but is not a prime narrative – As if removing a person from a task such as plowing a field or cleaning their garage. Not where there has been none… Not in the case where you have temporarily removed some of the stimulation… This being to accumulate a baseline in accordance tune with regular functions of the body – In tune with itself recently enough that to deviate does not create an inconsistency in the exam. All factors must be present and accounted for in their perception of the autonomy of their mind or you are judging the mind in its standing form of irregularity as presented by (in many cases) physician orders. 

Assessment of the patient in their standing form… That being in a close to if not in the exact tense of their mental faculties as they commonly – undisturbed by the social biases in seeking treatment, destimulation or application of stress such from the involuntary subscription to treatment. These are more than simply external factors; they can inhibit the presented decline without accounting for the baseline to begin with. 

The next step is (Once you have performed the PET scan to identify where the brain is stimulated whilst between chosen objectives) to find an activity that the patient identifies as occupying and of interest. Word searches, video games, writing and drawing are all valid mediums – In that the examination is to identify where when challenged, the brain retains effective function in both a matter of stress and when satisfied with the achievements related to the act of having been occupied. 

It’s necessary that one is examined for their ability to actively understand their current task and in having been assessed during the consistent completion of tasks to meet an active goal whilst being challenging enough that there is a stress trigger. This allows for the patient to explore where they are not functioning with the information relating to the exam and for the clinician to identify where the strengths are – further ruling out disorders that do not meet the effective criteria. 

          // I feel it important to note that when you actively relate to the patient with the course of treatment and allow them to participate of their own volition, there is not only a higher chance of the treatment being medically effective, but increases the duration of the period they will consent in the course of treatment and provide you time with the patient, where they effectively engage in how they are treated. This expands the range of which you will be able to moderate the risks whereas to coerce or misdirect can breach trust and nullify your effective upholding of the Hippocratic oath – They will be able to trust you enough to engage you after the fact where to deny them that participation will make you self-reliant and under those circumstances – Lose at least 50% of the honesty with them surrounding their perceptions and reasoning for how they identify with symptoms… Everyone lies. It’s your job to reduce their reason to. // 

Once you have the anatomical lay of the land, a standing layout of brain mapping and motor/cognitive function and the effective grasp of patient perceived symptoms as well as exhibited ones – By the end of the first week you should effectively be able to start addressing the concerns noted in these exams. Treatment should consist primarily of lifestyle adaptations. To allow the patient to perform cardiovascular exercise and find healthy forms of mental and physical stimulation in an environment where they are observed. Addressing the short-term aspects of any mental decline. The administration of PRN medications to allow the symptoms to subside while finding a more consistent method of subsiding distress not only aides in the collection of and engagement of coping mechanisms – It allows the patient to (once knowing the risks) be able to make the decision of whether there should be a prescribing specific medication in the long term or if there is a necessity as inability to manage symptoms using social, physical or cognitive coping mechanisms. 

There is also restraint in mind as the prescription of medications can create psychological dependency. Relation as to where the instruction of coping mechanisms as well as a lack of apprehension when there are the mechanical failures relating to physiological habits. If you are not getting enough exercise, eating right and sleeping in a rhythm then there is a definitive risk of mental decline before any specific illness can be addressed… 

Once there has been a medication administered for the duration of the assessment, having allowed for a scientific deconstruction of the symptoms during the progression of the illness in such cases that prevent the ability to function mentally or emotionally – The approach of the treatment must then follow. 

          Five – Addressing Exhibited Symptoms 

          It is not that you cannot treat illnesses without definitive proof of the illness specifically, but to ultimately justify a course of treatment as an endgame without addressing the specific disorder and the full cooperation to redirect the course of treatment towards that of other illnesses, let alone to leave the patient in the dark as to the broad nature of many symptoms which could signify disorders that are not effectively treated with a chosen course (and could potentially destabilize the patient if followed up with) for the illnesses that the D.S.M may have guided you to find significant. 

With this said, the ability to identify symptoms and their causes is what the profession is trained in the management of. There is no cure to depression that does not lie in the mechanical functions of the body. There is no psychosis that is not triggered by malfunctions and imbalances in the neurochemical concoction… Thus, this will be a series of methods and expectations in the address and the initial management of symptoms in patients – Further reducing the risk of misdiagnosis and therefore malpractice. 

Once situated with the significant symptoms which ail the patient, before you can create a plan for follow up and definitively decide where the full course of treatment lies. You must understand what you can effectively do to mitigate the harm caused by these symptoms. In administering medications before allowing the patient to function normally physiologically you deny the patient the best medicine – mechanical allowance. Exercise in the body promotes the metabolism, cardiovascular function, triggers for dopamine and serotonin and in every respect to the best use of the body, through use of the body. 

If you are administered medication and denied access to P.E equipment when there is a guise of diagnostic medicine presented? Then your will not fully appreciate the benefits that the medications can provide. In the short term after the last chapters have been addressed and the patient has been assessed for their malfunctions mechanically in the address of symptoms, then you must assess if their malfunctions are caused by the inability to fully adapt to their environment. Medication does not substitute exercise, medication does not substitute socialization, affection or companionship. Medication is not a cure – and with its malprescription, you will not address the illness, it’s nature or the proposed benefits in the long term for the suggested course of treatment – as you have not been treated, more than discarded and denied the effective upholding of the Hippocratic oath in the tense of a victim of the physician. 

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          If you are interested in medications. If you already do apply the functions of your body in an appropriate and effective way, the administration of short-term medications to allow you to integrate yourself with the treatment method will be therapeutic. I say this because there cannot be prolonged use of the majority of these medications in the doses applied – When to use as described, will shorten the average person’s life expectancy by more than 15 years and if the medication is not needed in the patients course of treatment then the side effects will further reduce not only the longevity of patients life, but the quality in the ability to best apply the faculties that need more pro-active treatment. 

With a medication administered, there should be a direct psychometric assessment first before and after the metabolizing of medication. The psychometric assessment should be last because in having sought treatment (being the only way the method will stick with patient identity intact) as the process thus far should have acclimated the patient into understanding the reasons and the depth of what the examination holds for prospect. The specific ruling out of other disorders and the psychometric exam itself is to identify where there are difficulties the application of ones’ faculties and the medications having not any without minor to severe side effects would not be scientifically justified – As to interview a sedated patient to identify where they lie in respects to their intelligence and adaptability to reasoning, memory, motor-function and cognition? Would as well, lack scientific justification. 

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The interpretation of this exam will allow the patient through the interview, identify if they meet the common expectation for the intelligence required to retrospectively correlate where their symptoms are most effecting their cognition. The psychometrists petition holds equal value to the patient in being able to effectively perform the examination, as one must be able to consistently identify where the patient stands with the test while the test is performed. Examination by a clinician who can be out performed and rendered unable to effectively read the exam nullifies the value if the interview is not recorded on video and audio for review in future. 

If effectively performed, then the exact nature of the illness must be reviewed with the psychiatrist, the psychiatrist reviews the interview with the patient and then a further adjustment to the course of treatment must be discussed. 

If the patient is not improving with consistent application of the physical faculties and the mental faculties do not seem effected then PET, MRI and blood panels should be significant of the root in combination with the patient history, symptom presentation and the proper socialization with those who are available. Social workers, medical staff, nursing staff and other patients. 

The psychometric exam should be able to be performed in the described order within the 14-day assessment, while if necessary… Fitted into a 28-day assessment if the pathology of the illness of becoming problematic from the cognitive aspect through behavior. Where-in the patient is not stable enough to simply perform the interviews in a calm, rational manner. 

Every other day, there should be a half hour interview between the patient and Nurse/Psychiatrist. Continually building rapport to establish a better grasp of patient decline and not to embellish on the ability for the clinician to address the illness of the subject. It’s not the problem being addressed that causes distress in patients, it is in the method by which the engagement of the patient is often pushed off and the patient trust nullified, implicit to many of the facilities that if the patient does not have faith in the doctor… they will not have to// 

          (Legally protected under the Canadian mental health act, clinicians are given an ungodly amount of authority over patients and even in cases of malpractice or breach of trust? The discourse with the doctor could lead to an increase in medication, prolonged stays and non-consensual adaptations in treatment as well as the modifications to the chart to imply that the patient is unstable; If there were to be a risk of litigation around the treatment of the patient in hospital – This is compulsory culpability)

          //Act in the best interest of the patient, and as so many people who have attended one of these facilities have been able to note, then the ability to build trust when there are laws protecting that it is a one-way street without any consequences for shortcoming or failure, the stress on the patient is multiplied if not effectively addressed by clinicians. 

With these avenues covered while the patient participates in group therapies, exercise and diet adaptations while there and during their acclimation prepare them with the mental coping mechanisms that would best prepare them – on personal basis.  

          Six – Outpatient Recovery 

          Based on interviews and their entry background/history – work out a plan for outpatient treatment that would best meet *their* needs. In compliance with current medical expectations (non-abbreviated short-cuts) and with access to a public psychologist – for them to decide if they need to seek a private councilor, to give them the tools they need to better grasp either being alive or condoning their choice to end their life in compliance with medical standards. 

If they do pass all the checks to find their footing in society, then they should have full support of the clinicians by their own decree. This gives the leniency on hospital costs, the time of the treatment and once they feel comfortable – The tools to approach either life or death in the time they see fit to enter. 

Never rule out the importance of the choice to end a body’s life. It is as crucial as considerations for how each person lives. In either case...

All are measured by failure... - Basil P. Coles