Process - Physician - Fraser Health Authority

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MAJOR DEPRESSIVE DISORDERNot all medications listed are eligible for coverage under the No-Charge Psychiatric Medication Program (Plan G).Coverage information is provided on the BC PharmaCare website at www.health.gov.bc.ca/pharme/outgoing/plangtable.html.FAMILY PHYSICIAN GUIDE | PHARMACOLOGICAL INTERVENTION87 3.31
APPENDIX 2: WOMEN’S MENTAL HEALTH ISSUESDetailed information on the specific application of these treatment modalities in theperinatal period is in the (1) Best Practices Guidelines relating to ReproductiveMental Health, and (2) Self-Care Program for Women with postpartum depression &anxiety (see Resources). See also the section on non-pharmacological therapies inthe Guide.Pharmacotherapy in the Perinatal PeriodPractice Issues: Antidepressants in Pregnancy and Postpartum■ Sustaining maternal mental health throughout pregnancy is the key to ensuringan optimum outcome for the baby.■ As yet, there is little evidence for the efficacy of psychotherapy in the treatmentof moderate to severe depression in pregnant, depressed women.■ Resolution of symptoms for women in this category is best achieved, at present,with antidepressant medications.■ Women with severe depression and with a prior history of depression can betreated with a combination of antidepressant medication and psychotherapy.■ To date, existing evidence suggests that the most commonly used antidepressantmedications, such as SSRIs (e.g., Prozac, Paxil, Zoloft, Luvox and Celexa) andSNRIs (e.g., Effexor), have not been associated with major birth defects.■ There is increasing concern regarding transient neonatal adaptation symptomsfollowing prenatal exposure.■ This has led the Health Canada (see Health Canada Advisory below) and the USFood and Drug Administration (FDA) to issue warnings regarding third-trimesterSSRI and SNRI use for treating depression during pregnancy.■ The recent concern over the warnings by Health Canada and the US FDAregarding infants exposed to antidepressants in the third trimester, has lead to aclinical dilemma for treating physicians. The evidence for these warnings is:– based on case reports and retrospective data.– the number of cases studied tends to be small, particularly with neweranti-depressants■ In addition, the presence/absence of symptoms observed in neonates aregoverned by a complex set of factors including:– prematurity– maternal mental and physical health– use of concomitant substances (e.g., alcohol, cigarettes)– polypharmacy■ Characteristics of this Neonatal Poor Adaptation Syndrome include:– transient course in the infant– resolution within the first few days of life– no evidence of long-term consequences in the children.– the use of multiple psychotropic medications during pregnancy with anSSRI appears to increase the risk of these symptomsNeonatal Management Issues■ An infant can be identified as being at risk for transient Neonatal PoorAdaptation Syndrome if the mother is:– taking a high dose of any antidepressant medication– on more than one medication– if the woman is mentally ill and/or under-treatedFAMILY PHYSICIAN GUIDE | APPENDIX 2: WOMEN’S MENTAL HEALTH ISSUES88 7.13
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SteppedCareLevel 1PSP Mental Health
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Fold back this page before administ
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CBISCOGNITIVE BEHAVIOURAL INTERPERS
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Table of ContentsINTRODUCTION. . .
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IntroductionThe following modules h
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TipsTeachingSelling Strategies• E
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Flow ChartsThis module contains flo
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Patient NeedsTryThe Circle of Depre
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AnxiousSymptomsTryOverwhelmedChaoti
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Assessment ModuleThe Assessment Mod
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5 Energy levela. How would you rate
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15 Phobiasa. Any unrealistic or exc
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21 CAGEHow many drinks might you ha
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DIAGNOSTIC SCREENING WORKSHEET (CON
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Problem List Action PlanACTIVATIONR
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Self-Assessment QuestionnaireName:
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Self-Assessment ProfilePleaser: Hig
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Self-Assessment ProfileOver-Thinker
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Understanding Depression- Frequentl
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Depression: System-Wide CrashDepres
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Activation ModuleThe Activation Mod
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Depression’s Energy BudgetEvery d
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Small GoalsThe concentration, fatig
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Problem SolvingDepression can make
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Chunk the DayStrategies that give p
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Appreciation Exercise“Good for Me
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The Circle of DepressionCognitive-b
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Common Thinking ErrorsThe situation
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THOUGHT CHANGE PROCESS (CONTINUED)T
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Thought StoppingDepression often ma
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Good Guilt / Bad GuiltA world witho
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Setting LimitsMost of us like to be
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Is Anger a Problem for You?Tom arri
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Stress ResponseIntroduction to Rela
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Variation - Box BreathingABDOMINAL
Page 71 and 72: Body ScanPurpose• Body scan is a
Page 73 and 74: Stress BustersPurpose• Shorter te
Page 75 and 76: MindfulnessPurpose• Mindfulness i
Page 77 and 78: BreathMINDFULNESS MEDITATION (CONTI
Page 79 and 80: Healthy Habits for SleepingDepressi
Page 81 and 82: IT’S TRUE: YOU ARE WHAT YOU EAT!
Page 83 and 84: The Wellness WheelPHYSICALGROWTHSEL
Page 85 and 86: CBISCognitive Behavioural Interpers
Page 87 and 88: FLOW CHARTS……………………
Page 89 and 90: PANIC DISORDER• Anxiety “System
Page 91 and 92: The Many Faces of AnxietyPanic Diso
Page 93 and 94: Medical ConsiderationsMost Common M
Page 95 and 96: Anxiety“System-Wide Explosion”A
Page 97 and 98: Resources for Self-HelpOnline Resou
Page 99 and 100: GAD: Self-Assessment QuestionnaireN
Page 101 and 102: GAD: Self-Assessment ProfileHard Dr
Page 103 and 104: How Anxiety WorksTHOUGHTSBODYFEELIN
Page 105 and 106: Panic CircleEvent (public speaking)
Page 107 and 108: Your Emotional Thermometer• Imagi
Page 109 and 110: Anxiety EquationAnxiety arises out
Page 111 and 112: 2. When something bad happens, I wo
Page 113 and 114: Coping CardsAnxious people often ma
Page 115 and 116: Problem SolvingAnxiety is strengthe
Page 117 and 118: Example: Kelly begins by making a l
Page 119 and 120: D.E.S.C. ScriptAssertiveness doesn
Page 121: Application forPsychiatric Medicati
Page 125 and 126: Pharmacotherapy in the Perinatal Pe
Page 131: FAMILY PHYSICIAN GUIDE | ADDRESSING
Page 134 and 135: Olanzapine (Zyprexa)Tablets, wafers
Page 136 and 137: Consortium forOrganizationalMentalH
Page 138 and 139: 3. Gather details on current andpre
Page 140 and 141: Task Two: ADVISE1. Provide meaning
Page 142 and 143: SUPPORTED SELF‐MANAGEMENT FOR DEP
Page 144 and 145: TABLE OF CONTENTSIntroduction 1What
Page 146 and 147: INTRODUCTIONTake a moment now to as
Page 148 and 149: WHAT IS DEPRESSION?The two most com
Page 150 and 151: WHAT CAUSES DEPRESSION?People becom
Page 152 and 153: WHAT CAUSES DEPRESSION?ThoughtsEach
Page 154 and 155: WHAT CAUSES DEPRESSION?EmotionDepre
Page 156 and 157: WHAT CAUSES DEPRESSION?ActionDepres
Page 158 and 159: WHAT CAN YOU DO ABOUT DEPRESSION?MI
Page 160 and 161: MORE ABOUT MEDICATIONMedication is
Page 162 and 163: ANTIDEPRESSANT SKILLSIn this sectio
Page 164 and 165: REACTIVATING YOUR LIFEStep 1: Ident
Page 166 and 167: REACTIVATING YOUR LIFESmall DutiesE
Page 168 and 169: REACTIVATING YOUR LIFEStep 2: Choos
Page 170 and 171: REACTIVATING YOUR LIFEStep 3: Set r
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REACTIVATING YOUR LIFEStep 4: Carry
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THINKING REALISTICALLYNegatively di
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THINKING REALISTICALLYStep 1: Learn
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THINKING REALISTICALLYStep 4: Pract
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SOLVING PROBLEMS EFFECTIVELYStep 1:
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REDUCING THE RISK OF RELAPSEPlan ah
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Congratulations! You have now made
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SUGGESTED READINGON DEPRESSION AND
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DIETThe Canada Food GuideGuidelines
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SLEEPStress, anxiety, and depressio
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CAFFEINECaffeine stimulates the sym
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CHALLENGING DEPRESSIVE THOUGHTSSitu
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PROBLEM SOLVINGACTION ADVANTAGES DI
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AnxietyDementiaDementiaBipolar155
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Practice Support ProgramGeneralized
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Montreal Cognitive Assessment(MoCA)
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Serial 7s: Administration: The exam
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Appendix CNAME OF PATIENTStandardiz
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Item 11Scoring WORLD backwards (ins
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Appendix CStandardized Mini Mental
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SCORING THE MOOD DISORDERQUESTIONNA
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FORM 4MENTAL HEALTH ACT[ Sections 2
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CommunityMHSU ReferralFormBounceBac
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REFERRAL FORMMental Health and Subs
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MENTAL HEALTH AFTER HOURSPLEASE LEA
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DOCUMENTATION REQUIRED UPON REFERRA
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Adult Eating Disorders ProgramRefer
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Medical History:Medical causes of l
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Who Are We?This is a specialized pr
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Fraser South Eating Disorders Progr
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Fraser South Eating Disorders Progr
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Fraser East:This program is part of
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Fact SheetPanic Disorder GroupDoes
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Fact SheetGeneralized Anxiety Group
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4 th Floor Sherbrooke Centre Tel (6
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Early Psychosis Intervention Progra
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*Additional Resources*For Informati
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Mental Healthand Addiction… suppo
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Fraser Health Mental Healthand Addi
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ADDICTION SERVICESAddiction Service
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ADDICTION SERVICESYouth Addictions
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ADDICTION SERVICES6. Long-term Resi
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MENTAL HEALTH SERVICESMental Health
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MENTAL HEALTH SERVICESDelta Mental
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MENTAL HEALTH SERVICES4. Community
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MENTAL HEALTH SERVICESMinistry of E
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MENTAL HEALTH SERVICES7. Residentia
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Mental Health & AddictionsHEALTHY L
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Client name: ______________________
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Client name: ______________________
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Taking Wellness to Heart! Metabolic
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Mental Health and Substance Use Rev
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Collaborative Care Process Map-Epis
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Fax the Special Authority Request t
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o o o o o o o • • • o o o o o
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Process - Physician - Fraser Health Authority

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