Opening up the Mental Health

Question 1

What are the ‘red flags’ for potential mental health problems?

Answer 1

• Unexplained chronic pain or fatigue
• Recurrent presentations
• Changes in eating or sleeping problems
• Signs of impairment in work, school or home life
• Signs of past or present use of alcohol or drugs
• Previous mental health problem
• Chronic physical health problem

Question 2

What questions should be asked when screening for depression?

Answer 2

• During the last month, have you often been bothered by feeling down, depressed or hopeless?
• During the last month, have you often been bothered by having little interest or pleasure in doing things?

If yes to either of these questions needs a mental health assessment

Question 3

How can you assess depression?

Answer 3

(DSM-IV)
Key symptoms:
• persistent sadness or low mood; and/or • marked loss of interests or pleasure
At least one of these, most days, most of the time for at least 2 weeks.

Question 4

What are the associated symptoms of depression?

Answer 4

• disturbed sleep (decreased or increased compared to usual)
• decreased or increased appetite and/or weight
• fatigue or loss of energy
• agitation or slowing of movements
• poor concentration or indecisiveness
• feelings of worthlessness or excessive or inappropriate guilt
• suicidal thoughts or acts

Question 5

What are the associated symptoms of generalized anxiety disorder?

Answer 5

• restlessness
• being easily fatigued
• difficulty concentrating
• irritability
• muscle tension
• disturbed sleep

Question 6

Define the Stepped care model for management of generalized anxiety disorder.

Answer 6

Step 1: Identification and assessment; education about GAD and treatment options; active monitoring

Step 2: Low-intensity psychological interventions; individual non-facilitated self-help; individual guided self-help and psychoeducational groups

Step 3: Choice of a high-intensity psychological intervention (CBT/applied relaxation) or a drug treatment

Step 4: Highly specialist treatment, such as complex drug and/or psychological treatment regimens; input from multi-agency teams, crisis services, day hospitals or inpatient care

Question 7

What is psychosis?

Answer 7

• Occurs in a number of serious mental illnesses e.g. schizophrenia, depression, bipolar, puerperal psychosis, some neurological conditions, - Interferes with ability to function – can be very disabling
• Symptoms include delusions and hallucinations
• Often present through concerns of others

Question 8

What are delusions?

Answer 8

• A false, fixed, strange, or irrational belief that is firmly held. The belief is not normally accepted by other members of the same culture or group.
• Certainty, incorrigibility, impossibility
• Consider in cultural context
• Examples:
  Delusions of grandeur
  Delusions of paranoia
  Somatic delusions