CG123 Common mental health disorders - National Institute for ...

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Case identification and formal assessmentpregnancy and the postnatal period arising from the changing risk–benefitratio for psychotropic medication at this time 22 .5.4.1.11 When considering drug treatments for common mental health disorders inwomen who are pregnant, breastfeeding or planning a pregnancy, consultAntenatal and Postnatal Mental Health (NICE, 2007a) for advice onprescribing.5.4.2 Research recommendations5.4.2.1 For people with a suspected common mental health disorder, what is theclinical and cost effectiveness of using a comprehensive assessment(conducted by a mental health professional) versus a brief assessment(conducted by a paraprofessional)? (See Appendix 11 for further details.)5.4.2.2 What methodology should be used to allow ‘walking across’ from oneassessment instrument for common mental health disorders to another?(See Appendix 11 for further details.)22 Adapted from Antenatal and Postnatal Mental Health (NICE, 2007a).135
Further assessment of risk and need for treatment, and routine outcome monitoring6 FURTHER ASSESSMENT OF RISK ANDNEED FOR TREATMENT, AND ROUTINEOUTCOME MONITORING6.1 INTRODUCTIONThis chapter is focused on the further assessment and decision making that followson from an initial assessment, the primary purpose of which is to identify and characterisethe nature of the presenting problem, as discussed in Chapter 5. A further taskof this chapter is to advise on how the information gained from the assessment can beused to inform the choice of appropriate treatment. This will be informed by a numberof factors including patient characteristics, the patient’s previous experience of treatment,the presence of other mental and physical disorders, the nature of the treatmentand the setting in which it is delivered. The degree of risk that the patient faces canalso significantly affect both the nature of the treatment and the setting in which it isprovided, and this may, to a greater or lesser extent, be independent of the nature ofthe disorder.Finally, this chapter considers ROM and the role it has to play in the delivery ofeffective interventions for people with common mental health disorders.6.2 RISK ASSESSMENT6.2.1 IntroductionCommon mental health disorders are associated with an increased risk of suicide; thisis most marked in depression, which is the single greatest cause of death by suicide(Moscicki, 2001), but an increased risk of suicide is also found across the range ofanxiety disorders (Khan et al., 2002). Identifying those with common mental healthdisorders at risk of suicide is therefore of considerable importance. A number ofmethods have been developed to assess risk of suicide and all tend to focus on anumber of common issues, including suicidal ideation, intent and planning, pasthistory of suicide attempts and protective factors (for example, presence of supportivefamily or close friends), and risk factors (such as drug or alcohol misuse). Suicideprevention strategies tend to focus on the delivery of protocols to ensure that appropriateinformation is obtained and systems are in place for the effective managementand monitoring of identified risks (for example, National Patient Safety Agency,2009). However, these approaches tend to be focused on secondary care mental healthservices and inpatient services in particular. Primary care-focused initiatives tend tofocus more on staff training to improve identification and detection, for example136
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Further assessment of risk and need
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Systems for organising and developi
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendations●●a g
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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