Mental Health

Question 1

Step one of the model

Answer 1

Recognition and assessment
Every appointment
-Patient health questionairre + GAD 2
If positive for depression then as Edinburgh depression scale (often false positives) Score 13 requires referral
If positive for anxiety then GAD 7 ( 5 mild, 10 moderate, 15 severe)

Question 2

Step two of the model

Answer 2

Primary care

Health promotion, support groups, self referral.

Question 3

Step three of the model

Answer 3

Review and alternative treatment
Talking therapies, CBT, IAPT referrals.
Medication- Lowest dose for the least amount of time.

Question 4

Step four of the model

Answer 4

Individulaised care plan and case manager

Mental health specialists, when two evidence based interventions don’t work.

Question 5

Step five of the model

Answer 5

Admission to hospital

Mental health has become chronic and treatment resistant. High risk to self and others.

Question 6

Medication

Answer 6

SSRI’S - depression and Anxiety - Sertraline and Amitriptiline lowest in breast milk
Generally: antidepressants cause pre term delivery and respiratory distress.

Question 7

Severe mental health

Answer 7

Bipolar, Schizophrenia, Psychosis
Medication: If on anticonvulsant such as valporate must stop. Lithium can be used despite its side effects, cant breast feed.
Onlanzapine- Antipsychotic
stop Valporate