Curriculum for General Practice - The Royal New Zealand College ...

M Curriculum Mental Health for General Practice
Psychosis and Bipolar Affective Disorder
The GP will demonstrate the ability to:
• understand the spectrum of mood stability disorders,
their diagnosis and assessment of severity
• understand the principles of de-escalation and appropriate
oral sedation when dealing with a manic and/or psychotic
patient
• diagnose and offer initial management of an episode
of hypomania or mania
• competently describe the Mental Health Act, the role of the
duly authorised officer and local community mental health
team protocols for compulsory assessment
• prescribe the commonly used mood-stabilising
medications, and understand potential side effects,
follow-up and monitoring
• recognise and manage safety issues around assessment
of an acutely disturbed patient.
Other conditions
The GP will demonstrate the ability to:
• show some knowledge of more commonly encountered
personality problems
• safely restrain and use emergency sedation and transport
for compulsory assessment, complying with the Mental
Health Act
• manage self-harm, including risk assessment, in particular
when isolated from emergency department and acute
mental health services
• recognise somatisation (bodily stress syndrome) as a
common presentation in general practice
• discuss the interaction between mental illness
and substance misuse and how this may affect their
management plan and referral pathways
• make an early consideration of bodily stress syndrome as
a ‘positive’ diagnosis when presented with functional or
‘hard to explain’ symptoms
• sensitively assess early warning signs that a patient is
becoming distressed or agitated, and use strategies to
manage this
• introduce the possibility of bodily stress syndrome to the
patient in an acceptable and understandable manner
• use non-confrontational consultation skills to de-escalate
and prevent an acute crisis and suitable oral medication
choices for sedation
• institute some potential management options for
somatisation, including psychological therapy and
medication.
100
Curriculum for General Practice