[Accepted] Make a clear OOC guideline on who can prescribe psychiatric medication / diagnose psychiatric disorders.

[Zaeperry99]

I've seen a lot of disagreement on who can prescribe psychiatric medication or diagnose mental traumas (and thus prescribe the medications) I up until recently figured it was only psychiatrists who would do so before realizing that doesn't make a whole lot of sense (though that'd be another thread entirely), and I've heard from others and believed for the most part that only psychiatrists can prescribe psychiatric medication or claim that somebody has a specific trauma. Regardless as to which of these is the case, a quick addition to the wiki / rules clearly stating "[Role x]. [Role y], and [Role z] may diagnose and prescribe medicine for mental traumas" or "Only [Role/s] may diagnose and prescribe medicine for mental traumas" would clear up confusion as well as prevent any future confusion. Thanks for taking the time to read.

[Azande]

IRL. Any doctor can.

There is no needed guideline, doctors IRL can prescribe any medication. My GP has prescribed my family all of our anti-psychotic type medications.

[Aceofspades1228]

I think the importance here is to have the guideline simply so it's firmly stated that any doctor can prescribe medication for psychological trauma, and it can be pointed to anytime this discussion comes up in the future. From a gameplay perspective, a lot of the medications are meant to be a delaying measure instead of a cure themselves- they won't heal the trauma for the whole round, but it'll keep the player from having to truly deal with it for a bit of time until a psychiatrist DOES arrive.

A lot of people have it in their head however that only a psychiatrist is allowed to prescribe, as we've mentioned, and the issue arises when even the admins don't know for certain. A few admins already admitted they didn't know an MD is allowed to prescribe psychiatric medication IRL on discord, and to expect them to search up and research information like that on their own time is silly, they're busy and can't go fact check every situation that comes up, especially when realism is thrown out the window a lot in SS13 for the sake of the game still being fun for the community.

Having it clearly stated on the wiki *somewhere* would help solve this problem, as it'd give a player backing evidence in a easy-to-access location that would give them the answer they need on the matter. Whether it should go on the psychiatric page or the 'guide to medicine' page is another matter entirely, but having it at least said somewhere that a medical doctor is allowed to prescribe psychiatric medicine would be a big help.

addendum: I do distinctly believe long-term treatment of mental trauma's should be handled by a psychiatrist, I can also imagine a medical doctor would, for example, be completely capable of diagnosing a patient as having occipital lobe trauma, cerebral paralysis, or a concussion, all of which are mental traumas.

[Faris]

I think I'm fine with MD's being able to prescribe such medication. I'm not wholly sure about them doing other things related to the psych job.

Can anyone link me or provide me with the general step by step procedure for mental trauma procedures?

[Scheveningen]

Sadly this isn't really linked anywhere aside from vaguely described in an IC guidebook.

Inside the code, though, it is a totally different story.

https://github.com/Aurorastation/Aurora.3/tree/33a87ea4fab5c42ea72c765000026b63a7ebfe90/code/datums/brain_damage

All mental traumas are categorized variously into the ways that they're cured. The current cures are through hypnosis, through solitude, through electroshock that one crystal pod thingy, and through surgery.

Hypnosis is a cure to fix behavioral patterns. Examples such as phobias. You stick these nerds with the hypnotic pocket watch or in the isolation room.

Solitude is a cure to fix hallucination issues. Examples such as imaginary friends or etc. You stick these nerds in the isolation room in the psychiatry wing.

Electroshock zaps the physical gay out of you the crystal pod treatment fixes physical coordination issues such as stuttering, speech impediments, and many other issues.

Surgery fixes lots. I forget what the specific treatment is, it's probably just opening up their head and smearing the green trauma kit all over it and then that's a wrap. I haven't cured the surgery-specific ones before simply because of how RNG-intensive the traumas are.

[Faris]

So the medication is only short term and proper cures for the most part are limited to the psych? The only cure that is not limited to the psych presently seems to be surgery.

[Zaeperry99]

As of lately, this situation's evolved a bit larger in my eyes, as I was told in-character that 'Cloning without a psychiatrist will have your license suspended'.

Since the addition of mental traumas, the basic mindset has been 'Do not clone unless there's a psychiatrist'. This is (In my opinion) people believe only psychiatrists can prescribe psychiatrical medication. The things I most want clarity on are:

Who can prescribe medication for mental traumas?

Secondly, as a new issue (do let me know if this needs to be a new threat)

Do you HAVE (or even need) to have a psychiatrist/psychologist aboard in order to clone people?

And thirdly, could the answers to these two be added to the wiki / rules / what have you in order to clear up the common misconceptions either I have or others have?

[Faris]

So as it stands. Short term medications is not better than proper long term cures, but it is something.

MD/Surgeons can prescribe medications for the traumas.

Surgeons can cure traumas that can be permitted via surgery.

So per the previous two statement, should they be allowed, this allows cloned people to be able to function well enough? Sure, it's not as optimal as a psych, but would this be enough for them to be back and act at least for the most part sane? Excluding any personal PR shenanigans.

[Zaeperry99]

The best outcome for this, in my opinion, would be exactly that. The ability to clone a person with just a chemist and medical doctor trained in informing, as it was previously, rather than the now regularly believed staffing of medical doctor, chemist, psychiatrist, and sometimes surgeon, which is more than we usually have at peak hours, and more than we ever have during dead hours. As I can't stress this enough, putting this clearly somewhere other than the forums would be the best, since it seems almost every dispute in the medbay comes from policy disagreements.

[Faris]

Ideally for me, medical should have sort of overlap. I feel that MD's should be able to diagnose these traumas. I also believe MD's should also prescribe the medication and the surgeons being able to conduct surgery on the other traumas. I'm not saying they cannot now, more that I'm writing what would be clarified in this guideline. I feel this would not completely cripple medicals capability of handling cloning while at the same time still retain the psych as the leading authority, as they do have access to tools and treatment the rest of staff do not have.

There's only a few traumas that can only be cured by psych, and I don't believe anyone of them are too severe. They can still be diagnosed and some form of care/treatment can be given to them. So, let me just outline the draft of this policy.

 

1) Doctors can diagnose traumas.

2) Doctors can prescribe chemical medication as well as surgery, if they have the training for it.

3) Psychiatrist/Psychologists are still the leading specialist. They should be handling these cases first.

 

I don't think this would sideline psychiatrist/psychologists, as their measure of treatment/cure is still the best. It just makes it so that their absence isn't so punishing. I'd like some opinions before I move forward with this.

[cloud]

I think this is really needed!

IC'ly I got in a lot of trouble for cloning someone and treating their mental trauma, and as far as I knew, you could ic'ly have your medical license revoked for doing so. (it's not that round, Resilynn!) so as a result, I've been telling people to not clone without an active psychiatrist or else they could have their license revoked and such.

Without clear guidelines, for now, I'm going to start getting people cloned and then just try and fix whatever they have through surgery straight away or prescribing them risperidone in 1u pills, because not being able to put people back in the game sucks.

I think doctors should be able to prescribe medication, as a note, like they can in real life.

The question is though, even with medication to suppress the memes, should they be allowed to return back to work if a psychiatrist is not able to evaluate them? Should medical/whoever cloned them be held responsible if the player decides to go full schizo because of the red messages and start attacking people, etc. Or should they just be bwoinked instead by staff?

Also, if we could, having mental traumas listed as a separate category like surgery and stuff would be useful. Having to go into job guides like we do at the minute, assuming medical doctors are going to treat them, is a bit arduous.

[Aceofspades1228]

Ideally for me, medical should have sort of overlap. I feel that MD's should be able to diagnose these traumas. I also believe MD's should also prescribe the medication and the surgeons being able to conduct surgery on the other traumas. I'm not saying they cannot now, more that I'm writing what would be clarified in this guideline. I feel this would not completely cripple medicals capability of handling cloning while at the same time still retain the psych as the leading authority, as they do have access to tools and treatment the rest of staff do not have.

There's only a few traumas that can only be cured by psych, and I don't believe anyone of them are too severe. They can still be diagnosed and some form of care/treatment can be given to them. So, let me just outline the draft of this policy.

 

1) Doctors can diagnose traumas.

2) Doctors can prescribe chemical medication as well as surgery, if they have the training for it.

3) Psychiatrist/Psychologists are still the leading specialist. They should be handling these cases first.

 

I don't think this would sideline psychiatrist/psychologists, as their measure of treatment/cure is still the best. It just makes it so that their absence isn't so punishing. I'd like some opinions before I move forward with this.

 

I am all for this being the official policy on mental trauma's, as it deals with pretty much every issue I brought up in my first post here. While a chemist is needed at the very least to properly clone someone and not risk leaving them an utter mess if they end up with a mental trauma like monophobia, it still leaves medical *considerably* more able to deal with the brain damage system that we currently have.

Cloud does bring up a good point though in whether a patient should be marked down as mentally sound afterwards by a Medical doctor, or if you'd need a psychiatrist to give them an evaluation before allowing them to go back to work. While a psychiatrist being the only one to do it would make sense from a IC and lore perspective wise, the biggest issue would be that, if a doctor is left unable to do the check themselves, it would be only a bit better than not cloning them at all during most rounds- yes, they're back to life, but they have to have all their access and equipment taken away from them and have to go spend time in the bar for the rest of the shift. While that might be a good punishment for dying in the first place (You're brought back, but can't just walk back onto the job like nothing happened), it would still be unsatisfying to the player themselves as they're still left in a position they can't do the job they wish to do, not out of any fault of their own (sans getting killed), but because another player decided they didn't feel like playing psychiatrist that day.

Alright, with all that said I would recommend letting a doctor, *if there isn't a psychiatrist onboard* do the mental evaluation so the cloned and/or brain-damaged player can get on with their game and not have to go cyro immediately after being released due to their round being more or less over.

[Zaeperry99]

The question is though, even with medication to suppress the memes, should they be allowed to return back to work if a psychiatrist is not able to evaluate them? Should medical/whoever cloned them be held responsible if the player decides to go full schizo because of the red messages and start attacking people, etc. Or should they just be bwoinked instead by staff?

 

The most dangerous-to-others disabilities are schizophrenia (which can be diagnosed from the patient's hallucinations) and possibly imaginary friends. Before the addition of mental traumas, average doctors (with experience / basic training) were able to inform and release cloned patients, but were usually told to either heavily suggest they see a psychologist/psychiatrist or schedule an implied appointment. I'd say that if the mental traumas were diagnosed and had medicine prescribed for them, somebody would be able to return to work immediately so long as they saw a psychiatrist within the week. However, that could vary from role to role.

For the most part, I worry that making them unable to work would be another way of cloning without a psychiatrist essentially removing somebody from the round, though there's a fair bit of wiggle room in my opinion of that.

On the attacking people, that'd be beyond me to say, though I'd probably take the stance of "Aggression and anger is okay, outright attacking people isn't (without admin approval first)".

By the way, I appreciate the feedback from you two! I was worried this thread wasn't going to go anywhere.

[Faris]

I'd leave the releasing of cloned individuals to work dependent on the Doctors discretion.

If any issues can be handled by proper doses of medication, why not?

However, if a person has some trauma that can't be treated and say makes it dangerous for them to EVA. Maybe just have them reassigned to something on station. I don't see why HoP/Captain wouldn't facilitate Doctors orders. I'm going to get some last minute feedback from others and see about implementing this in 24 hours.

[Faris]

Sorry for this delay. This can be considered now accepted and will begin the process of implementation.