Key Principles of Managing Mental Illness

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Principles of helping someone manage mental illness

There are many things to consider when supporting somebody with a mental health problem. Some of these include:

  1. Work with the patient
    • Create the management plan in collaboration with the patient.
    • Explore how important is treatment to the patient and are they ready to participate in their care.
    • Encourage the patient to monitor their symptoms and explain when they should seek help.
  2. Inform the patient
    • the expected duration of treatment
    • potential side-effects of any medication
    • alternative treatment options
    • the importance of adhering to the treatment plan
    • their likely prognosis – be honest and realistic
  3. Involve family and community
    • Encourage the patient’s family to become involved in their care.
    • Try to link the patient to community support (self-help groups, church, school).
    • Use the local community’s resources to contact people who have not returned for regular follow-up appointments.
  4. Provide appropriate and effective follow-up
    • Continually monitor for treatment outcomes, drug interactions (including with alcohol, over-the-counter medication and traditional medicines) and treatment side-effects.
    • During a follow-up appointment, reassess the patient’s expectations of the treatment, their clinical status, their understanding of the treatment and their adherence to the treatment and correct any misconceptions.
    • Provide more frequent follow-up visits for who may be vulnerable and isolated (e.g. older people).
  5. Seek help if required and available: facilitate referral to specialists (see box).
  1. Ensure that people are treated in a holistic manner
    • Meet the mental health needs of people with physical illnesses, as well as the physical health needs of people with mental illnesses.
  2. Take extra care when treating childbearing women
    • Request more frequent follow-up visits for pregnant women or women who are planning a pregnancy.
    • Assess the potential risk of medication on the foetus or baby when providing care to a pregnant or breastfeeding woman.
    • Ensure babies of women on medication who are breastfeeding are monitored for adverse effects.

Referrals

Refer the following people to hospital and/or specialist services:

  • People with mental illness and evidence of a physical illness such as head injury or high fever.
  • People who are so disturbed that they can no longer be managed at home.
  • People who are taking large amounts of alcohol or drugs, as stopping suddenly may lead to a severe withdrawal reaction.
  • People whose illness is continuing to have a serious effect on their personal life or work, despite your efforts to provide treatment.
  • People who have made a serious suicide attempt e.g. attempted hanging, poisoning. They must be referred for urgent medical review. Once this is done they must be assessed for ongoing suicide risk, ideally by mental health specialist.
  • People presenting with seizures should (if available) be managed by paediatrics or medicine. Ideally, they should be assessed by a specialist doctor (a physician or neurologist) before they start to take regular anticonvulsant medication.

Remember that when you refer someone always write a referral note explaining the background to the problem and what treatments you have already tried.