Opening up to Mental Health Flashcards
Do’s
- Begin the dialogue and seem comfortable with it
- Active listening and open questions
- Be sensitive and encouraging, build relationship of trust
- Nonjudgmental
- Acknowledge how they are feeling, validate
- Good time and place to talk, not rushed
- Confidentiality, dignity and respect
- Take care of yourself to take care of your patient
Don’ts
- make dismissive comments like ‘snap out of it’, ‘cheer up’, ‘forget about it’, ‘pull yourself together”
- say ‘you know how they feel’ if you don’t
- point out that others are worse off
- blame the individual
- think of mental illness as a personal weakness or failing
- use words that stigmatise
“Red flags”
- Unexplained chronic pain or fatigue
- Recurrentpresentations
- Changes in eating or sleeping patterns
- 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
Relevant questions for any mental health problem
- Identifyifatrigger
- Duration of symptoms, recurrent or isolated episode • Consider own/family history
- Dependents
- Level of social support/isolation
- Drugs, alcohol, cigarettes
mental health screening exam
mental status exam (MSE)
• Advise and inform re:
– Self help groups
– Support groups
– Other local and national resources
– Consider support for family/dependents/carers
Screening for depression
- 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?
Generalised Anxiety Disorder (GAD) key symptoms
– excessive anxiety and worry about a number of events or activities
– difficulty controlling the worrying
– occurs on a majority of days for at least 6 months
– not in keeping with another anxiety disorder
Associated symptoms of GAD
- restlessness
- being easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- disturbed sleep
Management of GAD - step 1 in the stepped care model
Identification and assessment; education about GAD and treatment options; active monitoring
Management of GAD - step 2 in the stepped care model
Low-intensity psychological interventions; individual non-facilitated self-help; individual guided self-help and psychoeducational groups
Management of GAD - step 3 in the stepped care model
Choice of a high-intensity psychological intervention (CBT/applied relaxation) or a drug treatment
Management of GAD - step 4 in the stepped care model
Highly specialist treatment, such as complex drug and/or psychological treatment regimens; input from multi-agency teams, crisis services, day hospitals or inpatient care
Drug treatments of GAD
- SSRI e.g. sertraline
- 2nd line alternative SSRI or SNRI
- 3rd line consider offering pregabalin
Psychosis
- Occurs in a number of serious mental illnesses e.g. schizophrenia, depression, bipolar, puerperal psychosis, some neurological conditions, alcohol and drugs
- Interferes with ability to function – can be very disabling
- Symptoms include delusions and hallucinations
- Often present through concerns of others
