COURSE OUTLINE
Module 1: Detection, assessment and review of mental health issues
This module introduces skills and techniques to detect, assess and review patients with mental health issues including screening under the Mental Health Better Access Initiative. It includes guides and examples of conducting effective mental health interviews and developing General Practice Mental Health Treatment Plans. The first unit provides an overview of Australia’s mental health care system including the epidemiology and aetiology of mental health. The list of mental health illnesses/disorders eligible under the Better Access initiative are outlined. This unit includes strategies to detect and assess mental health illnesses including recognition of physical and differential factors, and management of associated complexities and comorbidities. The process of reassessment and regular review of patients is provided. The second unit introduces shared understanding of mental illness with patients and the development of a mental health care plan (MHTP). Using screening and treatment evaluation tools, this section then describes how to detect early warning signs and relapse prevention. Self-help including when to use pharmacotherapy, evidence based psychological therapies, and optimum patient care through shared care, multidisciplinary communication and teamwork are discussed. The final unit focuses on risk assessment, progress monitoring and coordination of care to patients. Available resources, frameworks, local services and referral pathways to assist patients are listed. Case studies are used throughout the module to reinforce learning.
Module 2: Depression
This module begins with an overview of the current statistics of depression in Australia along with the definition and causes of depression. The risk factors of depression and ‘at risk’ groups include carers, Aboriginal and Torres Strait Islanders, refugee, adolescents, elderly, perinatal depression and others are discussed in detail. The module then focuses on diagnosing depression through history taking, examination, investigations and using assessment tools such as Mental State Examination to confirm diagnosis. The final section outlines the different types of treatment of depression including lifestyle changes, psychological approaches, medication, other considerations and psychiatric referral. Several case studies conclude this module.
Module 3: Anxiety
This module commences with the definition and epidemiology of anxiety disorders. Considerations for assessment, secondary causes, investigations, diagnosis and treatment using non-pharmacological and pharmacological approaches to anxiety are discussed. The content then focuses on generalised anxiety disorder, social anxiety disorder and panic disorder. The DSM-V and ICD-10 diagnostic criteria of these disorders include epidemiology, differential diagnosis, treatment, pharmacotherapy and psychological interventions. Other anxiety disorders are discussed including agoraphobia, specific phobia, separation anxiety, selective mutism, substance/medication induced anxiety, and anxiety disorder due to other medical conditions. Case studies are used throughout the module to reinforce learning.
Module 4: Bipolar disorder
The module commences with the history, epidemiology and aetiology of bipolar disorder. Three main types of this disorder are outlined including further classification and severity of current and recent episodes. Clinical features of symptoms, mania and hypomania, depressive episode, mixed episode, cyclothymic disorders and psychotic symptoms are discussed in detail. The third section focuses on psychiatric history, mental state examination and findings, Young Mania Rating Scale (YMRS) and the Bipolar Depression Rating Scale (BDRS). The content includes differential diagnoses and the challenges in diagnosing bipolar disorder in children and adolescents including how to catch a mixed episode. The principles of managing bipolar disorder and the management of hypo/mania, bipolar depression and mixed state are discussed. Course learning is reinforced with case studies. Pharmacotherapy including lithium and valproate dosage, drug interactions, adverse effects and risk are mentioned. The module concludes with information on diet, supplements and bipolar disorder patient support.
Module 5: Anorexia nervosa and bulimia nervosa
This module focusses on eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding and eating disorders. The role of the medical practitioner is discussed including advocacy for changing societal norms and healthy lifestyle perspectives and targeting at risk individuals. High risk groups are noted. The module provides screening tools to be used in conjunction with behavioural, psychological and physical signs – a comprehensive list of signs for these categories are listed. Assessment information and guides are provided including when immediate referral is appropriate. Patient engagement may be challenging and the suggested approach by the clinician is included. Treatment goals and guidelines are given including suggested multidisciplinary team involvement, medical practitioner management, pharmacotherapy and eligibility criteria.
Module 6: Trauma and stressor related disorders
The first section of this module outlines the history and origins of post-traumatic stress disorder (PTSD). The different DSM-V diagnostic criteria of PTSD are included. Unit two discusses the keys to diagnosis of PTSD and describes treatment options including psychological treatments, medications and lifestyle measures. Self-help and managing other co-morbidities are included. A case study is presented to reinforce learning. The module concludes with discussion of how medicinal cannabis and classical psychedelics have the potential to assist with the treatment of PTSD.
This module is recognised by the GPMHSC as a clinical enhancement module of the modular Mental Health Skills Training.
Module 7: Domestic abuse
This module on domestic abuse reviews the definition and support mechanisms when patients present who are in a domestic abuse relationship. Statistics related to its prevalence and impact both worldwide and in Australia are listed. It discusses the role of general practitioners in responding, supporting and treating women who disclose experiences of domestic violence in a supportive, non-judgemental manner. Signs and symptoms to identify domestic violence including psychological and behavioural symptoms are outlined. Screening information and understanding the reasons why a woman does not find it easy to leave an abusive relationship are included. Techniques to provide a safe environment and how to respond to disclosures including follow up care and responsibilities are addressed. The module includes advice about the most effective response to patient disclosure both immediately and as part of a long-term plan for follow up, and continuing care, including information about available resources and support services.
Module 8: Depression in the elderly
This module begins with an overview of depression and the increasing higher levels of psychological distress for older people. The content includes information on understanding depression, depression categories and how the medical profession defines depression. It then moves to the causes of depression, risk factors for the elderly, and other causal factors including at-risk groups. The effects of depression and how they may be displayed are mentioned, then considers diagnostic information, screening and assessment tools. Assessing suicide risk, differential considerations and investigations are outlined. The GP Mental health Care Plan and treatment approach includes education, lifestyle changes, psychological and medication considerations. The module concludes with two clinical case studies.
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Upon successful completion of the exam, course participants will receive a Professional Certificate of Mental Health.
