PMH1011 Lecture 2: W2 - BIOPSYCHOSOCIAL CONTRIBUTIONS TO MH ISSUES
29 May 2018
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W2 - BIOPSYCHOSOCIAL CONTRIBUTIONS TO MH ISSUES
Learning Outcomes:
❖ Understanding what MH Ax is, the purpose, and the types that exist.
❖ Appreciate importance of understanding the lived experience of consumers.
❖ Outline type of information gathered for purposes of a MH Ax, how this is gathered, and
who may involve.
❖ Explain components of biopsychosocial model.
❖ Outline some biological, psychological, and social factors that impact on MH and how to
address these.
❖ Understand what is involved in formulation.
❖ Discuss some of the pros and cons of diagnosis.
Biopsychosocial Formulation
➢ Defied as the reatie sthesis of liial ase, draig o eleets fro the leels
of iolog, psholog ad soiolog ad epressed hroologiall.
➢ Ioles seletig the highlights of a persos life: the important people or events that
shaped the person into a unique individual.
➢ A formulation is developed after doing a clinical assessment. It is based on the
assessment, and it springs forth from the assessment.
➢ A good formulation would be extremely valuable for someone who did not know the
patient and wanted to learn the maximal information about the patient in the minimal
time.
Mental Illnesses
Are of different types and degrees of severity.
Some of the major types are depression, anxiety, schizophrenia, bipolar mood disorder,
personality disorders and eating disorders.
The most common MIs are anxiety and depressive (mood) disorders.
Diagnosed by a suitably trained professional conducting a MH assessment.
Mental Health Assessment
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2
✓ Ax. = assessment
✓ First stage of a treatment process.
✓ Purpose:
o To determine what is going on for the individual
▪ Why here? Why now?
▪ What are their needs?
o To formulate a plan of action to assist that individual to manage/recover
from their MI
▪ What can we do?
Explanation
Intake Assessment
• Is the individual appropriate to be treated by a
particular service (e.g eating disorder clinic)?
Triage Assessment
• Who will be prioritized (i.e how great are the
needs of the individual)?
Psychiatric/diagnostic Ax
• Does the individual’s current state of mind?
Mental state Ax.
• What is the individual’s current state of mind?
Risk Ax
• Is the individual at risk of hurting themselves
or others?
Psychometric Ax
• Use of psychological tests to answer
questions such as:
• Does the individual have an intellectual
disability?
• What is their IQ?
Lived Experience of Consumers
❖ A mental health Ax. Always begins by seeking to understand the unique lived experience
and perspective of the consumer ie. Their story.
o This understanding is key in helping the individual
❖ Each person brings their own:
o Experience
o Perspective
o Expertise
❖ Consumers are seen as the experts within their own lives.
Understanding Lived Experience
➢ Rapport needs to be established FIRST
o Rapport: A close and harmonious relationship in which the people or groups
oered uderstad eah others feeligs or ideas ad ouiate ell.
➢ Use empathy to step into their use
➢ Use a non-judgement attitude/sensitivity
➢ Revere jumping to conclusions
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3
➢ Careful approach to interpreting information
➢ Check in with consumer to determine the accuracy of later understanding
➢ UNDERSTAND FIRST; INTERPRET LATER
➢ Why is it difficult to build rapport?
o Trust issues
o Cultural differences
o Personality types
o Their illness might impede that process
o Multiple professionals giving referrals – loss of faith in the system.
Gathering Information: What?
Depending on the purpose of Ax., type of information may include:
Reason for referral
Current situation/functioning across domains (e.g employment / education;
family ; social )
Presenting problems
History (Hx.) of presenting problems (onset , duration, course, severity)
Family Hx. (relationships ; medical / psychiatric Hx)
Personal Hx. (life story)
o Developmental Hx.
o Schooling/education Hx.
o Occupational Hx.
o Marital Hx.
o Sexual Hx.
o Forensic/legal Hx.
o Psychiatric Hx.
o Medical Hx.
o Medications
o Drug and alcohol Hx (substance use)
Risk Ax (danger to self and/or others?)
Mental status examination (MSE)
o Current state of mind
Previous Ax./Interventions
Goals for treatment
Gathering information: What?
➢ Interview
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find more resources at oneclass.com
Document Summary
Understanding what mh ax is, the purpose, and the types that exist. Appreciate importance of understanding the lived experience of consumers. Outline type of information gathered for purposes of a mh ax, how this is gathered, and who may involve. Outline some biological, psychological, and social factors that impact on mh and how to address these. Discuss some of the pros and cons of diagnosis. Defi(cid:374)ed as (cid:858)the (cid:272)reati(cid:448)e s(cid:455)(cid:374)thesis of (cid:272)li(cid:374)i(cid:272)al (cid:272)ase, dra(cid:449)i(cid:374)g o(cid:374) ele(cid:373)e(cid:374)ts fro(cid:373) the le(cid:448)els of (cid:271)iolog(cid:455), ps(cid:455)(cid:272)holog(cid:455) a(cid:374)d so(cid:272)iolog(cid:455) a(cid:374)d e(cid:454)pressed (cid:272)hro(cid:374)ologi(cid:272)all(cid:455). (cid:859) I(cid:374)(cid:448)ol(cid:448)es sele(cid:272)ti(cid:374)g the highlights of a perso(cid:374)(cid:859)s life: the important people or events that shaped the person into a unique individual. A formulation is developed after doing a clinical assessment. It is based on the assessment, and it springs forth from the assessment. A good formulation would be extremely valuable for someone who did not know the patient and wanted to learn the maximal information about the patient in the minimal time.
