Generalist mental health skills 1

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Unit 614

August 2024

Generalist mental health skills 1

The purpose of this activity is to provide you with an understanding of generalist whole-person assessment, a sophisticated skill built on a commitment to look beyond symptoms in order to establish a safe relationship, understand the complexity of the people we care for, facilitate hope for recovery and growth, develop joint treatment goals that empower the patient, and care for physical and psychological safety.

General practitioners are among the most experienced mental health clinicians in the country due to the high prevalence of mental distress in the large numbers of people they care for in their daily practice. They have a strong understanding of the impact of life experience (including trauma and neglect) on physical, psychological, social, cultural and spiritual health. 

Often these everyday skills of assessing and caring for people in distress are not valued – even by the practitioners themselves. General practitioners care for people over their lifespan and across their families. This care includes offering prevention and early intervention in undifferentiated distress. 

Generalist whole-person assessment is not simplified psychiatry; it is a sophisticated skill built on a commitment to look beyond symptoms in order to establish a safe relationship, understand the complexity of the people we care for, facilitate hope for recovery and growth, develop joint treatment goals that empower the patient, and care for physical and psychological safety – the interwoven biology and biography of each person.

Here we present five cases that help us to recognise the breadth, depth and length of whole-person care that is the integrative work of the general practitioner.

Learning outcomes

At the end of this activity, participants will be able to:

  • list the seven whole-person domains that can cause threat or be sources of strength
  • apply the principles of trauma-informed care to initiate a difficult conversation
  • outline the limitations and benefits of different frameworks to guide an assessment
  • discuss the potential for cognitive bias within a consultation
  • outline a management plan for an eating disorder.

Case studies

Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

Paul, aged 46 years, a mechanic who you have not seen for years, presents for a medical certificate for a recent flare of back pain, which is already under the care of an orthopaedic surgeon. He is quiet and fidgety and tersely relates feeling trapped in a trade with a boss he describes as being ‘on a power trip’. He attends with his wife, Priya, who sits very still next to him. Your receptionist mentioned to you a few weeks ago that he got very angry when she could not offer him an appointment straight away. However, you note that he seems to be concerned and kind in his interactions with his wife.

Lena, aged 15 years, is brought to see you by her mother, Priya, as her school is concerned about her and wants her to have a check-up. You know her well, having previously arranged early assessments regarding the school’s concerns about her reading and mathematics abilities, but have not had any follow-up from her usual paediatrician or the community health centre since she started at the local state high school four years ago. You notice that she looks pale and sullen, is wearing dark clothes with long sleeves even though it is warm and that she really does not want to be here.

Priya, aged 40 years, presents to you frequently with concerns about physical symptoms and comes armed with a number of articles from the internet. On this occasion she presents alone and describes fatigue and loss of appetite.

Ana, aged 10 years, has always been a diligent student who has been quietly but happily attending school in the past. This morning Ana attends with her mother, Priya, prompted by her teacher’s request at parent–teacher interviews last night. Ana’s teacher, Miss Mary, has noticed in Ana some unusual behaviours and an increasing reluctance to join in with the social aspects of the classroom. At lunchtime Ana eats her lunch sitting quietly on the periphery of a small group of girls, but she tends to play alone.

Jai, aged four years, is in his first year at preschool. His parents, Priya and Paul, attend together for flu vaccinations on a Saturday morning surgery. Jai is sitting cuddled on Priya’s lap and screams and wriggles when you try to give him his flu shot. Paul complains loudly that the child stays up too late and hates going to bed, and that he has been missing preschool as he is having frequent ‘belly aching’. You know Jai was a ‘surprise’ as Priya had come in to discuss relationship difficulties and was shocked to discover she was pregnant. You also remember that Priya had brought Jai with her to her last appointment as she had not been able to drop him at preschool due to his crying. 

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ Educational Activities and five hours’ Reviewing Performance.
 
Educational
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

To enroll in this check unit online: 

  1. Log into myCPD home page
  2. Select 'Browse' and search for 877924
  3. Select the course and register

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TOPICS

Mental health

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