Monash University

Leader(s): Associate Professor Carol Harvey

Offered

Clayton Second semester 2009 (Day)

Synopsis

This selective will examine the theory and practice of the provision of mental health services to the population in primary care and community settings. Seminar 1 and 2 will address issues related to the primary care setting. The first seminar will address the scope of mental health issues and service delivery in primary care. The topics will inlcude

1. primary care in the international and Australian context - with the opportunities and challenges presented by the Australian Primary Health Care system,
2. classification and diagnostic issues in primary mental health care,
3. epidemiology of common disorders treated in general practice settings,
4. models of service delivery by public and private psychiatrists and other mental health professionals in primary care. The 2nd seminar will focus on biological, psychological and social treatments for common psychiatric discorders in a primary care with particular emphasis on psychosocial treatment interventions. Illustrative examples will include the management of recurrent and relapsing depression and somatisation in general practice. Specific details about psychosocial treatment strategies relevant to primary care will be provided. Consideration will be given to the evidence base about the delivery of high quality mental health care in general practice.

The remaining seminars will focus on the mental health issues and service delivery in community settings. Seminar 3 will address the historical, socio-economic, cultural and political issues of relevance to the provision of community mental health care. Topics will include:

1. deinstitutionalisation,
2. public health issues including community attitudes and responses to mental illness and the impact of stigma,
3. the scope of community mental health (both internationally and in Australia) giving examples of service models in community psychiatry. Seminar 4 will cover rehabilitation and recovery in serious mental illness. Topics will include: the importance of functioning and definitions of disability; the traditional rehabilitation approach and current functioning and definitions of disability; the traditional rehabilitation approach and current understandings of the recovery process; consumer and carer perspectives with respect to rehabilitation and recovery; rehabilitation outcomes such as employment and social relationships as well as subjective experiences such as self-esteem and quality of life. The final two seminars in community mental health will review selected psychosocial treatment strategies, with an emphasis on enhancing students' skills. Strategies will include: ways to optimise the treatment alliance; goal setting; relapse management and identification of early warning signs; CBT for delusions and hallucinations; working with 'chronicity'; and family intervention techniques for lowering expressed emotion and improving problem solving.

Objectives

On completion of this unit, students will be able:

1. To describe the incidence, prevalence, distinct and common presentations of psychiatric disorders in primary care and in general practice.
2. To describe the factors which affect treatment outcome and the influences of lifestyle, social, cultural and environmental factors in promoting health and preventing disease.
3. To apply the various biological, psychological, social and cultural models to the understanding and treatment of psychiatric disorders in primary care and the community. This will include acknowledgement and respect of the role and contribution of significant others (relatives, general practitioners, other professionals) to the assessment, treatment and recovery of people with mental illness in the community. Students should be able to develop and implement a clear plan of care that integrates biological, psychological and social interventions according to the needs of each individual patient and takes account of the context in which the person is treated.
4. To describe and apply the principles and practice of providing effective mental health treatments including modern rehabilitation techniques in diverse settings ranging from primary care and the community, hospital and outpatient clinics to long-term care, rehabilitation and recovery for those people with well-established psychiatric disorders living in the community.
5. To appraise the various ethical, cultural, socio-economic, practical and political factors which influence the health care and social welfare systems when providing services for the individual. This includes sensitivity to the impact of illness on patients, families or carers and the wider community, and to strive to balance the needs of the patients with those of the family or carers and the community.
6. To demonstrate the confidence to interpret and disseminate relevant scientific information in relation to public debate on psychosocial and public health issues relevant to mental health and mental illness.

Assessment

Presentation 40%, Written review 1500 words 60%.

Contact hours

3.5 hours per week attending seminars x 6 weeks

Prerequisites

MPM Year 1 units