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Domain – Mental health (guiding topics)
- Communicate with patients presenting with mental health concerns in a sensitive and non-judgemental way that considers their life stage, education, previous experiences, belief systems and cultural context. Consider the specific concerns of:
- Aboriginal and Torres Strait Islander patients
- people from culturally and linguistically diverse backgrounds
- LGBTIQ+ people
- patients living in rural and remote areas
- people living with disability
- children and adolescents
- elderly patients.
- Use communication strategies to manage distress, de-escalate emotionally charged situations, manage acute stress and grief reactions and provide emotional support.
- Use language appropriate to the education and understanding of patients and carers to explain behavioural treatments for common mental health presentations. These may include:
- managing the sleep–wake cycle and sleep hygiene
- the benefits of physical activity, good nutrition and reducing alcohol and other drugs
- planning activities and scheduling pleasant events
- relaxation techniques and mindfulness meditation
- plans to prevent relapse.
- Recognise psychiatric emergencies, such as an acutely psychotic patient or a patient at high risk of suicide and be aware of local resources and services to manage the emergency safely.
- Undertake a risk assessment for patients presenting with mental health concerns that includes:
- risky behaviours (eg drug and alcohol use, dangerous driving, disordered eating)
- deliberate self-harm
- suicidality (suicidal ideation, intent, plans and means)
- potential harm from others (eg domestic violence)
- potential harm to others.
- Take a thorough biopsychosocial history, undertake a mental state examination and a general examination, and where appropriate, use screening and assessment tools to identify mental health conditions. Work with patients and carers to develop a management plan that aligns with the patient’s personal and cultural values, and that considers non-pharmacological and pharmacological strategies and referral to appropriate services and supports. Mental health conditions include:
- grief and complicated grief
- adjustment disorder
- anxiety disorders:
- generalised anxiety disorder
- panic disorder
- hyperventilation
- acute stress disorder
- post-traumatic stress disorder
- phobic disorders, including agoraphobia and social anxiety
- obsessive compulsive disorder
- mood disorders:
- major depression
- bipolar disorder
- antenatal/perinatal/post-natal depression
- complex mental health disorders, including:
- personality disorders
- complex post-traumatic stress disorder
- somatoform disorders
- medically unexplained illness
- psychotic disorders such as:
- drug-induced psychosis
- schizophrenia
- schizoaffective disorder
- eating disorders and related conditions, including:
- anorexia nervosa
- bulimia
- body dysmorphia.
- Through history and examination, identify mental health and behavioural disorders in children and work with the child and parents/caregivers to develop a management plan and referral to appropriate services, supports and resources. Disorders include:
- anxiety and mood disorders
- attention deficit/hyperactivity disorders
- autism spectrum disorder
- conduct disorders.
- Be familiar with e-mental health resources, identify patients who may benefit from using them and support them to use the programs.
- Develop a comprehensive mental health treatment plan for patients who meet Medicare criteria that facilitates a team approach to care and includes appropriate behavioural, psychological and pharmacological strategies as well as safety-netting and review-planning.
- Demonstrate awareness of the medico-legal issues of confidentiality and consent as they apply to patients with mental health disorders.
- Complete an assessment order/certification for an involuntary admission for a patient with a serious mental health disorder in accordance with the relevant state legislation, in appropriate circumstances.
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