Read the entire document. 

Read the entire article, focusing on the idea of task-shifting and primary health care involvement in mental health care. This training aims to train lay health workers in identifying patients with substance use disorders. It is essential that patients get correct information from lay health workers, and if indicated, the right level of intervention from other primary care practitioners.

Read the entire article, focusing on the idea of task-shifting and primary health care involvement in mental health care.

This training is based on the mhGAP goals and recommendations for the implementation of mental health services in primary care. To familiarize yourself with the rationale for doing so and how the mhGAP Intervention Guide works, please read the Introduction, General Principles of Care, and the Master Chart (pp. 1-8 in the document; pp. 10-21 on the page navigator). In this training, we will mostly focus on alcohol and other substance use disorders, including tobacco use. Although tobacco use is not covered in the mhGAP, it will be covered in other resources in this course). The training will also review when to refer to primary care practitioners with additional training in mental health and substance use disorders, for example, in cases of immediate risk of self-harm or danger to others and severe intoxication. NextGenU’s Alcohol, Tobacco and Other Substance Use Disorders: Identification and Management in Primary Care can assist practitioners in addressing those conditions, as well as commonly co-occurring conditions like depression and psychosis. Please save this document so that you can access it later in this course, as well as in your practice as a quick reference guide. You are welcome to review the rest of the mhGAP Intervention Guide to familiarize yourself with the World Health Organization's suggestions for addressing other priority conditions in primary care.

Download the booklet.  Read the entire manual, as this will be your foundation for understanding the science behind addiction and health. The next module of this training will cover issues of stigma and human rights related to those with mental health conditions (including substance use issues), because stigma and violations of human rights are major barriers in the provision of care to these populations. Stigma and human rights violations can come from people in every part of society, including care providers, family, neighbors, employers, and government officials. This is why our first module starts by exploring these concepts and how they affect those who suffer from mental health or substance use disorders, and what you can do about it when you interact with them.

Read the entire web page. This document will give you an overview of international considerations for mental health human rights, legislations, standards, and policies.   Feel free to click on any of the links to learn more about mental health, human rights and legislation.

Read Chapter 1, from pp. 7 - 24.

Read the entire report to learn more about the stigma and social isolation due to mental health and substance abuse along with stigma and discrimination Interventions.

Click on the links titled "Circle of Care" and "Breaches" found under the heading "Privacy and Confidentiality" located on the left side of the web page.  Read each section. The section, called 'Breaches', will provide you with valuable information, such as examples of breaches of confidentiality or privacy. These breaches occur too often, usually inadvertently. The link titled 'Test yourself' located under the "Privacy and Confidentiality' tab can help you test your knowledge and understanding of the content of the module. The other sections are optional reading. Note:  If your browser asks you to select an item from the list, please select ‘public’ and then press submit.

Read the guide.

Read this article for an overview of the global situation in relation to the challenges of respecting international standards and human rights of those with mental health or substance use disorders.

Read this document as it is an overview of international human rights standards on mental health.

This resource provides a discussion of the current global situation in relation to the use of psychoactive substances, international policies, and the utility of a human rights framework.

Go through the presentation. When you see an icon (such as 'Story' in red, or 'Myth Check' in beige) please click on it. Another pop-up window will appear, containing essential information for the module, which you should read. At the end of the presentation, you will have access to the last page, which offers a review. By clicking on the word 'Review' (in blue), it brings you to a quiz. This quiz is optional to complete, as it might not work well in your browser. However, if it works, we encourage you to take it to test your understanding.

We suggest you read and complete the learning activities outlined in this document to help you reflect on issues of equality and diversity. Some of the listed resources are specific to the UK and their National Health System (NHS). You can discuss with your peer or mentor how to find locally relevant information, and use your own experience as a source of knowledge. There are many resources from the NHS Education for Scotland about conducting deep critical reflections that help practitioners gain self-awareness and communication skills, improve their clinical practice, and decrease burnout. This is one tool suggested by the NHS Effective Practitioner program, and other tools to record your learning can be found here as well. Although not mandatory for this training, we recommend that you build yourself a portfolio to document your professional learning. This can be a powerful tool to seek and obtain employment, and be successful in your occupation.

You will be using this document extensively throughout this training. Review the 'Table of Contents' and read Sections 1 to 6 (pp. 1-8) to familiarize yourself with the background of the ASSIST and the rationale for its administration in primary care.

• Read sections 6-8 (pp. 8 - 18) to learn about general and health-related problems of various substances.
• Read sections 9 -12 (pp.19 - 31), which explain how to use the ASSIST. Perform the self-testing question in Chapter 11 (p. 23), and note your answers. Then review the answers in Appendix F (p. 55).
• Read section 13, 'Scoring of the ASSIST questionnaire' (pp. 32-33).
• Read section 14, 'Interpretation of ASSIST scores' (p. 34) and section 15, 'Linking ASSIST scores with treatment' (pp. 34-36).

Please review sections ALC1 - ALC3 and DRU1 - DRU 3 (pp. 58 - 72). The sections on 'Alcohol Use and Alcohol Disorders' and the section on 'Drug Use and Drug Use Disorders; starting with an 'Assessment and Management Guide for Emergency Cases,' followed by an Assessment and Management Guide, which covers an algorithm to look at alcohol consumption, and finally an 'Intervention Details' segment.This is a very basic overview of care for alcohol and substance use disorders. Many resources in the rest of this training will assist you in developing your skills for brief interventions and the management of alcohol use and other substance use disorders.

This Quick Reference Guide is a very simple and easy way to understand how to provide care to individuals who are using substances. This course focuses on screening with the ASSIST, but it may be useful to explore a different model of screening and intervention in your context.

Click on the tabs titled “Validated Screening Forms” and “Brief Intervention Tools” and read the content of each to learn about other evidence-based models of screening and brief intervention in primary care.

From the menu on the left-hand side, read the 'Key Concepts and Learning Goals', then read the 'Questions' section. Complete the 'Questions' and post them online by entering your name and clicking ‘Done'. Continue through the modules from the 'Introduction' section and complete 'Clinical Evaluation'. While watching the 'Initial Visit Video', take note of the blue icons and comments to the right of the video. At appropriate times during the video, these comments will be highlighted in yellow. At this time, you can click on the blue icon and another smaller video will pop up. This smaller video will share thoughts and comments running through the minds of the doctors and patients during the interview.

Read all the information in this table to learn about the effectiveness of certain smoking cessation interventions.

This resource refers to brief advice for smoking cessation, however, brief interventions are done in a very similar fashion for all other psychoactive substances. Beginning at the section titled 'Address the topic of smoking and tobacco use' (on page 23 of the page navigator), read to the end of Part 1 (pp. 23 - 33). Pay special attention to the tips and flowcharts that are used in clinical practice, as seen in Tables 7 - 11 and Figure 2. Read Appendices 3 and 4 (pp. 46 - 57) to help you understand how to give cessation advice as per best practices. The rest of this manual is supplementary.

Read the entire article, which describes the personal health risks of tobacco use.

Read the entire article, which provides further information on how to deal with tobacco withdrawal symptoms in language adapted for patient self-help.

Read this factsheet to learn more about how alcohol use and abuse can affect health.

Read this resource to learn about the effects and risks of drinking alcohol for teens and adults.

In some settings, it might be considered part of the duties of a community health worker (or other types of health workers) to develop self-help strategies for those who use substances. This guide can be useful in assisting you to perform this task. You do not need to read everything in detail, but please familiarize yourself with this manual.

Click on the tab titled "Screening".  Then, click on the link titled "Screening for Alcohol Use in Pregnancy" and read the content of that link.  Then, under the tab titled "Treatment", click on the link titled "Managing alcohol use in pregnancy" and read the content of that link.  Note:  It is possible that your setting has decided to prioritize screening pregnant women for only a few substances (such as alcohol or tobacco) rather than use the ASSIST. If that is the case, you will need to familiarize yourself with those other modalities of screening. 

By clicking the links found on the left-hand side of the resource, read all the sections under 'Medical Consequences of Drug Abuse' (from 'HIV, Hepatitis, and Other Infectious Diseases' to 'Mortality').

Click on the tab titled "Screening".  Then, click on the link titled "Screening for alcohol problems in older adults" and read the content of that link.  Then, under the tab titled "Assessment", click on the link titled "Assessing alcohol problems in older adults" and read the content of that link.  Then, under the tab titled "Treatment", click on the link titled "Treating alcohol problems in older adults" and read the content of that link. 

From the menu on the left-hand side, read each of the subsections that fall under Smoking and Tobacco (from 'What's in a cigarette?' to 'How do we know?').

This resource will give you a good understanding of the impact of alcohol on the body.

If you would like further information on a particular topic, review the relevant chapter from this resource. It is quite detailed regarding providing health care to women who may abuse substances, and while it might take approximately one hour to review a chapter, it would take considerably longer to review the entire document.

If you treat many seniors, this resource will be useful for you, as it gives detailed information about seniors' health and possible interactions, comorbidities, and co-occurrences. Review the chapter(s) most relevant to your situation and context. While it might take approximately one hour to read a chapter of this resource, it will take considerably longer to review the entire document. 

Read the booklet to learn about the harm of secondhand smoke.

Read Module 10: 'Self-harm/Suicide' (pp. 74 -79 in the document, pp. 107 - 112 in the page navigator) to learn more about the importance of inquiring about self-harm.

Read this entire resource, which describes a practical technique to assess and address sucidal risk in primary care.

Read each of the following sections: 'What Is Co-morbidity?', 'Is Drug Addiction a Mental Illness?', 'How Common Are Comorbid Drug Addiction and Other Mental Illnesses?', and the first 3 paragraphs of 'Why Do These Disorders Often Co-occur?'.

Read this online version of Chapter 3 - Mental Health Treatment. The rest of the manual is supplementary.

Read the entire section titled "Introduction".  Then, click on the links titled "Identifying Alcohol Abuse", "Effects of Alcohol Use", and "Provider Assistance, Counseling, and Brief Interventions".  Ensure you review the recommendations in bold.  The rest of the resource is optional reading.

Review Module 2 ('Effects of Alcohol on the Fetus'), Module 3 ('Risk Factors for FASD'), Module 4 ('FASD Signs and Symptoms'), and Module 5 ('FASD Prevention'). The other modules are supplementary; review them if you are interested.

This resource gives you the choice of either reviewing online or downloading the Antidepressant workbook as a PDF. It is a very practical guide that patients can use for mood self-management.

Read the 'Conclusions' section, and if you are interested, read the whole article.

Go through the entire module titled 'Alcohol and Major Depression' to understand the link between alcohol and major depression. Once you click on the VIEW button, make sure you start from the begining of the module.

Read the entire article to learn about the effects of psychotropic medication during pregnancy.

This resource covers many aspects related to relationships and safety (for those with or without mental illness). In this training, you are not expected to become competent in providing advice in relation to sexual health, healthy relationships, or safety. However, if you are interested in these topics and their interactions with issues of mental illness, this is a good resource.

This supplementary resource provides an overview of issues faced by female sex workers in relation to violence, substance abuse, and HIV, as well as an intervention to prevent the transmission of HIV that seemed promising in Pretoria, South Africa.

You will want to read about the Black Dog Institute's model of depression. Create a free user account to access all of the materials. This resource includes a video as part of its learning module, therefore you will need high bandwidth internet access to use this resource.

Healthy lifestyles and stress management are important aspects of well-being for those suffering from mental health or substance use disorders. This resource does a good job of teaching relaxation skills to address stress. First, navigate to the 'Relaxation Module' (pages 70-82). Perform all of the exercises, taking note of how you react to them so that you can teach those exercises when needed. Then try to offer them to someone you know (e.g., a friend, a family member, or a peer) and ask them how they feel after the exercise. Please also review the 'Lifestyle Module' (pages 101-106). The rest of the guide, which is optional reading, covers many skills that are useful in addressing depression and improving well-being. If your patient has access to the Internet, this might be a fantastic resource for them. If so, please guide them through the process of finding and reviewing the material. The 'Introduction' and the following section can help guide you in supporting your patient to use this resource.

Read the entire web page about exercise and mental health, paying special attention to the benefits and possible tips that you can give to patients who may be suffering from mental health disorders, to increase their level of physical activity.

Read the entire web page to learn about diet and mental health.

Read through this resource to learn about healthy weights.

Read this entire resource that provides a background on the usefulness and limitations of the BMI.

This is a direct link to an online BMI calculator (in metrics units). Please calculate your own BMI for practice.

Read these tips on prescribing exercise, intended for GPs and other health professionals. Throughout this training, we have provided other links and info-sheets from the Black Dog Institute.

Read this entire document for some tips on how to discuss overweight and obesity issues with your patients who are identified as overweight.

Review any info-sheets you feel are useful, and which you'd like to learn about in more depth. Each info-sheet should take about 10 minutes to review. 

This is another fantastic resource to help patients through the difficulties of living with a chronic health condition of any kind.  It addresses many skills that are highly relevant to general well-being, as well as supporting mental health and substance use disorder recovery. You can review this resource to help you advise your patients, or you can recommend it to patients who have access to the internet.

Read the entire guide.  This resource gives you access to a table (in metric units) to assess BMI risk levels, as well as BMI combined with waist circumference risk level. Of note, this resource explicitly states that a BMI below 18.5 is associated with a higher risk of undernutrition, malnutrition, osteoporosis, infertility and an impaired immune system.

This is the 'Guidelines on Overweight and Obesity: Electronic Textbook,' produced by the U.S. National Heart, Lung, and Blood Institute. You can click the links at the top or the 'Back' or 'Next' arrows at the bottom to review any sections about which you might want additional information.

This link provides several self-help wellness modules covering issues such as anger, sleep, and diet.

Read the entire article, with a focus on the section 'How to Communicate with Patients.'

This figure reviews tips to avoid cultural clashes when communicating with people of other cultures.

Read this entire resource, which covers how to talk to children of adults who drink too much. The way the questions are answered in the resource can be applied to other types of substance use as well (besides alcohol), providing that the relevant information for the substance is given instead. You should have become more familiar with the relevant information about the other substances as you have progressed through this NextGenU training. When treating someone with psychoactive substance use disorder, address the families’, caregivers’, and children's questions and concerns, and involve them in the care plan and support when the patient has provided their consent (as needed).

First, we recommend you click on text only button at the bottom of the webpage. Use the full audio-visual version only if you have a sufficient Internet connection, and then click on the various pictures to hear the participants speak rather than reading the transcripts.

Please review 'Section Five: Relationships with Family' by clicking on it (the blue tile). In the text only version, read all pages by clicking next on each one. On p. 2, click on the various links for the various transcripts. Please note that each parent's reaction is not right or wrong. This resource does not cover how you can support the families of those who care about someone with a substance use issue, it simply explains that they benefit from support.  It is very important that you do not judge how the family or others are reacting. The best conduct to adopt is that of empathy and a sharing of scientific information about substances. The sharing of personal information of patients outside the circle of professional care may be done only with the consent of the patient, as explained in prior modules. 

Under the heading of Resource Materials, click to download the file named 'Powerpoint Slides (4.2MB)', which has lecture notes. Review slides 1-19, 23-39 and 44-58 and be sure to read the speaker notes as well. The rest of the slides are supplementary for this training.

Read the 'Interventions' section (pp. 159 - 163 in the document; pp. 9 - 13 in the page navigator), which reviews various ways to communicate information in relation to smoking cessation. The section on women's issues in relation to smoking cessation (pp. 166-170) is supplementary.

Read the abstract on p. e1368 and the discussion section on pp. e1372 - e1374.

This resource provides links to other resources from CARMHA (the Centre for Applied Research in Mental Health and Addiction), including resources for workplace mental health and adolescent health, and many other practical tools.

Click on the tab titled "Motivation & Change".  Then, click on the links titled "Influencing motivation to change", "Negotiating a change plan", "Setting goals and finding solutions", and "Preventing and managing relapse".  Read the content of those links for additional information about change and motivation and well as how to ask solution-focused questions to help assess and improve a patient's ability to change.