Common Mental Disorders Depression - New Zealand Doctor

Chapter 3 Recognition and assessment of common mental disorders in young people/rangatahi/tamariki
Figure 3.1
When to refer a young person/rangatahi/tamariki
to secondary care mental health services
Red Flag symptoms
refer immediately to secondary care
• Suicidal ideation or intent
• Psychotic symptoms
• Severe self-neglect
Symptoms to evaluate when determining
whether to refer to secondary care
Manage in
primary care
Refer to
secondary care
Symptoms for hours
Symptoms for months
Positive view of future
Profound hopelessness
No other mental health or
substance use disorders
Able to do daily activities
Multiple other serious
mental health or
substance use disorders
Unable to do
most daily activities
Moderating factors to consider when
determining whether to refer to secondary care
No past history
of depression
Past episodes
of depression
No family history
of mood disorders
Extensive available
network of caring
family relationships
High level of support
services available
Many family members
with mood disorders
Isolated and alone
No other support
services available
Identification of Common Mental Disorders and Management of Depression in Primary Care 41