Be careful about mental health labelling

Dr Bruce Arroll talks about the distressed patient and taking care when making a diagnosis. Bruce is a Professor in the Department of General Practice and Primary Care at the University of Auckland.

Topics

Addressing symptoms rather than applying a label in the first consultation
Often patients have applied a label to themselves. How do we avoid feeding into this ourselves?
Talk first, prescribe later!
Activity scheduling and behavioural activation
Scheduling sleep
Meditation and mindfulness
Exercising earlier in the day
Considering nutrition
Sunshine hours
Medications - is each new drug less effective?
Effects of early childhood trauma
Addressing inequity in mental health.

Take home messages

Avoid making mental health diagnosis at the first visit
Behavioural activation is the cornerstone of good management (sleep, exercise, diet, mindfulness)
Medications such as SSRI are not without issue
Inequity is problematic in this arena.

Resources

The Challenges of Improving Treatments for Depression JAMA (2018)

Patient Resources

Wellness Resources Health Navigator NZ

Presenter

Dr Bruce Arroll

General Practitioner

Professor, Department of General Practice and Primary Health Care

Bruce Arroll is a medical graduate from the University of Auckland and spent a year at McMaster University in Hamilton Ontario 1981-2 training in general practice. His current research interest is in rapid non-drug treatments of mental health conditions such as depression and anxiety.

He spends three half days per week in clinical practice working at Greenstone Family Clinic in Manurewa in South Auckland. The rest of his time is spent at the Department of General Practice and Primary Health Care at the School of Population Health at the University of Auckland.

He became the director of the Goodfellow Unit in 2014.