Section: Module 5: Lesson 1: Mental Health Comorbidities | Substance Use Disorders in Primary Care | NextGenU.org
-
Learning Objectives:
Upon completion of the first lesson of Module 5, students should be able to:
- Distinguish the link between various mental health conditions and substance use disorders.
- Recognize evidence of SEVERE self-injury such as signs of poisoning or intoxication or signs/symptoms requiring urgent medical treatment such as bleeding from a self-inflicted wound, loss of consciousness, or extreme lethargy.
- Understand how to maintain regular contact and follow-up with patients as needed.
- Explain how to identify and manage depression in all who have a tobacco, alcohol or other substance use disorder.
- Explain how and when to ask patients for self-harm or suicidal thoughts and how to offer psychosocial support.
-
Read "Comorbidity of Mental Disorders and Substance Use" Chapter 4 (from 4.1.1 to 4.1.3, inclusive) to learn more about mental health comorbidities with tobacco use. Also read all of Chapter 5, which covers depression as a comorbidity with various psychoactive substances, and Chapter 7, which covers psychosis comorbidity with psychoactive substances. All the other chapters are supplementary and you may refer to them as needed (for example, if you wish to learn more about personality disorders or other mental health comorbidities).
-
Read the "mhGAP Intervention Guide" sections on "Depression" (pp. 10 - 17 in the document; pp. 25 - 32 in the page navigator) and "Psychosis" (pp. 18 - 23 in the document; pp. 35 - 40 in the page navigator). Please also read Module 10 on "Self-Harm/Suicide" (pp. 74 - 79 in the document; pp. 107 - 112 in the page navigator). After this, you should understand the importance of inquiring about self-harm.
-
This WHO manual titled "Pharmacological Treatment of Mental Disorders in Primary Health Care" covers the essential medicines for mental health conditions. Within each disorder/chapter, the sections 6, 7, 8, and 9 cover adverse reactions, overdoses, special patient populations, and potentially relevant interactions, respectively. You should review: the treatment of psychosis (pp. 11 - 16); the entire chapter 4 on depression (pp. 19 - 28); relevant medications for bipolar disorders (pp. 31 - 35); relevant medications for anxiety disorders (pp. 38 - 42); and adverse reactions, overdoses, special patient populations, and potentially relevant interactions for alcohol and opioids (p. 51 - 59). The rest of the manual is supplementary. Pay particular attention to the medications that are readily available in your setting.
-
Read this entire document titled "Working with the Suicidal Patient" which provides a practical technique to assess and address sucidal risk in primary care.
-
To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
-
In the "Family Physician Guide" under the section titled "Overview of Disorders," read from segment 1.14 to 1.19. In the "Diagnostic Issues" section, read the segments on "Diagnosing Early Psychosis" (2.11 - 2.12) and "Diagnosing Major Depressive Disorders" (2.4 - 2.7 and 2.22). In the "Management Issues" section, under the subsection "Psychotherapies and Other Non-Pharmacological Interventions," read the segments pertaining to "Electroconvulsive Therapy ECT" (3.23 to 3.25) and "Major Depressive Disorder" (3.5 - 3.7). In the "Pharmacological Intervention" subsection, read the segments pertaining to "Major Depressive Disorder" (3.29 to 3.33) and "Early Psychosis" (3.35 to 3.38). There is also valuable information found in "Appendix 2: Women's Mental Health Issues." Review the "Screening Tool" for postpartum depression and "Pharmacotherapy in the Perinatal Period" (7.12 and 7.13). The rest of the manual is excellent, and you can use it as a reference. A few other sections of this guide are used in other parts of this training.
-
This resource offers videos related to alcohol use and mental illness. Click on the 'Videos' link to 'Kick Start Recovery', 'Getting Real', 'Ask the Questions', 'Ben and the Antidepressant Skills Workbook', 'Bounce Back', 'CBIS Skills', and 'Problem and Resource Lists'.
-
This link brings you to an overview of the Black Dog Institute's model of depression. You can read this overview and decide if you want to gain further experience in diagnosing and treating patients based on this approach.
-
If you treat many seniors, this resource titled "Substance Abuse Among Older Adults" will be useful for you. It provides detailed instructions on seniors' health and possible interactions, comorbidities, and co-occurrences.
-
This webpage titled "Tools and Resources" provides links to other resources from CARMHA, including resources for workplace mental health, adolescent health, and many other practical tools.