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Mental Health Assessment

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What Are Mental Health Assessments?
A mental health assessment is when a professional like your family doctor, a psychologist, or a psychiatrist checks to see if you might have a mental problem and what type of treatment may help.

Everyone goes through tough times. But sometimes, the negative way someone feels inside depressed, anxious, wanting to avoid people, having trouble thinking may be more than the ups and downs most people feel now and then. If symptoms like these start to get in the way of your life, or that of a loved one, it's important to take action. Research shows that getting help early can prevent symptoms from getting worse and make a full recovery more likely.

The first step is to get a mental health assessment. It usually involves a couple of different things. You may answer questions verbally, get physical tests, and fill out a questionnaire.

What to Expect
Physical exam. Sometimes a physical illness can cause symptoms that mimic those of a mental illness. A physical exam can help find if something else, such as a thyroid disorder or a neurologic problem, may be at play. Tell your doctor about any physical or mental health conditions that you already know you have, any prescription or over-the-counter drugs you take, and any supplements you use.

Lab tests. Your doctor may order bloodwork, a urine test, a brain scan, or other tests to rule out a physical condition. You will probably also answer questions about drug and alcohol use.

Mental health history. Your doctor will ask questions about how long you've had your symptoms, your personal or family history of mental health issues, and any psychiatric treatment you've had.

Personal history. Your doctor may also ask questions about your lifestyle or personal history: Are you married? What sort of work do you do? Did you ever serve in the military? Have you ever been arrested? What was your upbringing like? Your doctor may ask you to list the biggest sources of stress in your life or any major traumas you've had.

Mental evaluation. You'll answer questions about your thoughts, feelings, and behaviors. You may be asked about your symptoms in more detail, such as how they affect your day-to-day life, what makes them better or worse, and whether and how you've tried to manage them on your own. Your doctor will also observe your appearance and behavior: Are you irritable, shy, or aggressive? Do you make eye contact? Are you talkative? How do you appear, compared with others your age?

Cognitive evaluation. During the assessment, your doctor will gauge your ability to think clearly, recall information, and use mental reasoning. You may take tests of basic tasks, like focusing your attention, remembering short lists, recognizing common shapes or objects, or solving simple math problems. You may answer questions about your ability to do daily responsibilities, like caring for yourself or going to work.

When a Child Needs an Assessment
Just like adults, children can get mental health assessments that involve a series of observations and tests by professionals.

Since it can be hard for very young children to explain what they're thinking and feeling, the particular screening measures often depend on the child's age. The doctor will also ask parents, teachers, or other caregivers about what they've noticed. A pediatrician can do these evaluations, or you may get referred to another professional who specializes in children's mental health.

Concerned About a Loved One?
If you think that a friend or family member is having symptoms, don't be afraid to start a conversation about mental health. Let them know you care, remind them that mental illness can be treated, and offer to help connect them with a professional who can help.

Although you may not be able to force a loved one to seek diagnosis or treatment, you can raise concerns about their mental health with their general physician. Because of privacy laws, don't expect any information in return. But if your family member is in the care of a mental health professional, the provider is allowed to share information with you if your loved one allows that.

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Prescribed exercise from a physiotherapist supports better mental health

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Worldwide, one in four people will experience a mental health condition at some point in their lives; one in six will have experienced a mental health condition in the past week alone. This year World Physiotherapy Day—Saturday 8 September—focused on the role physiotherapists play in supporting people with a range mental health conditions.

That physical activity is good for us is well known—it supports a healthy cardiovascular system, strengthens joints and bones and keeps weight in check. The relationship between physical activity and improved mental health outcomes in those suffering mental health conditions is less well known.

Depression and anxiety often co-exist with chronic health conditions such as osteoarthritis, stroke and diabetes. Left unchecked, people with severe mental illness (schizophrenia, bipolar disorder, major depressive disorder) can die up to 15 years earlier than those without severe mental illness, often as a result of co-existing cardiovascular illnesses related to sedentary behaviours1.

APA National President Phil Calvert said the evidence supporting regular exercise as a treatment option for mental illness is compelling. “For those Australians who struggle with mental illness, maintaining regular, prescribed physical activity can be the difference between merely functioning and enjoying a better quality of life.”

“Motivation to exercise is often lacking due to a combination of poor understanding of the benefits of exercise and the difficulties associated with the mental health condition itself. Physios are well placed to support these people as they can put together a tailored exercise plan based on the individual’s ability and interests, and keep them motivated by mixing it up as the individual progresses.”

Physical activity has a well-established antidepressant effect in people with mild to moderate depression. Health outcomes have been shown to be best when exercise is prescribed by a qualified health professional such as a physiotherapist, as they have a strong understanding of the physical, psychological and social factors affecting health and can adjust exercise programs to suit the individual’s needs.

The Brisbane-based paediatric specialist said that while she was passionate about the development of physiotherapy services and associations in emerging countries, she also understood the different needs of large Member Organisations (MOs). “I hope to be able to look at the needs of all MOs and work with the board to provide value on multiple fronts to our member organisations,” Melissa said.

In the lead up to World Physiotherapy Day, the APA encourages all Australians to view physical activity as a way of life, and value the positive difference it makes to our physical and mental health and wellbeing.

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The mental health benefits of exercise

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A good workout doesn’t just benefit your physical fitness. Exercise also has a positive effect on mental health, providing benefits that range from improving sleep to easing anxiety.

Research has shown that exercise is beneficial for everyone’s mental health, whether or not they have a mental illness. For those with conditions such as anxiety or mood disorders, studies have shown that exercise can improve outcomes.

“Exercise can be extraordinarily beneficial both as a way to prevent a mental illness from re-occurring, and as a way to treat a mental illness if you actually have symptoms right now,” says Dr. Valerie Taylor, chief of psychiatry at Women’s College Hospital.

Exercise can help address a range of mental health symptoms, but the strongest research supports its benefits for depression and anxiety. Evidence has shown that aerobic exercise – exercise that raises the heart rate, such as brisk walking, biking, running, or swimming – can be as effective as medication in treating mild to moderate depression, Dr. Taylor explains.

“Exercise actually increases serotonin, which is a neurotransmitter that’s often deficient in people who have depression or anxiety,” she says. “So it does exactly the same thing a medication does: it increases serotonin levels.”

People who have symptoms of seasonal affective disorder (SAD) struggle with mood symptoms related to the lack of sunlight in the fall and winter months. Combining exercise with natural light can be helpful.

“If you can force yourself to do some exercise that’s outside – walking, running, doing anything where you have sun exposure – that can be really effective for helping to control seasonal affective disorder,” Dr. Taylor says.

Challenges and support

The trouble with recommending exercise for people with depression is that the symptoms of the condition can make it very difficult to act on that advice.

“Some of the symptoms of depression are that you don’t have a lot of energy, and motivation can become a challenge. This seems counterintuitive to starting an exercise program,” Dr. Taylor says. That’s why self-care is important for people with a mental health diagnosis, even when there are no active symptoms. “If you can make exercise part of your life when you are feeling well, this can be a tool to help keep you well and to help minimize symptoms of depression.”

For those with current symptoms, a good place to start is to make an appointment with a healthcare professional.

“If you have active, significant depression, it’s going to be very hard to engage in anything, so make sure that you speak to a healthcare provider to ensure that those symptoms are being treated properly,” Dr. Taylor says. “If you need a medication, taking that medication may make it easier for you to engage in other activities like exercise that can help you get well faster and perhaps stop needing the medication.”

Including exercise in a mental health regimen is also an area where family and friends can offer significant support. Dr. Taylor notes that loved ones often asked what they can do to help someone who has a mental illness.

“This is an area where support from friends and family can really be essential,” she says. “They can help organize group activities, or activities with a buddy, that can really motivate you, get you out, get you active. So if there is something that you can do with friends, that can be really motivating.”

It can also help address the isolation experienced by many people with mental illnesses.

“Exercise that’s part of a group activity – a running program, yoga with friends, anything that’s an organized social activity – can really help minimize some of those symptoms and make a person feel less isolated and alone,” Dr. Taylor says.

Making mental health a priority

Maintaining good mental health is important for everyone, even if they don’t have a mental health condition. Some of the benefits of exercise include better sleep, improved memory and higher energy levels, which all influence how people feel day to day.

“I think exercise should be part of a wellness program for all of us. Certainly it’s a great stress management tool, it can help keep anxiety under control, and it really forces us to think about ourselves sometimes,” Dr. Taylor says. “Often – especially as women – we prioritize everyone else above ourselves. So if you make this ‘me time’ something that you do to prioritize your own health, that can only be good. If you make it a family activity or something you do with friends, all the better because then you are getting some companionship along with releasing endorphins and increasing serotonin.”

Although the research evidence supports doing exercise that gets your heart rate up and increases your breathing rate for mental health benefits, Dr. Taylor notes that there’s really no such thing as bad exercise as long as it’s done in moderation.

“As an overall effective strategy for managing physical health, stress management, and treating your mental health, we can’t overemphasize the benefits of exercise,” she says.


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Health Care For Patients With Serious Mental Illness - Role Of Family And Psychiatrist!

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Mental illness or disorders are not uncommon, and they continue to affect millions of people around the globe irrespective of their ages and sex. Such disorders often require thorough and prolonged treatment, which is extremely challenging and involves a lot of risks as well. If not treated appropriately, it can lead to further worsening of the condition of the affected individual.

To keep affected individuals grounded and on course for an effective treatment, it is essential for their family members to support them. Many people employ psychiatrists, whose expertise in handling mentally unstable individuals, can be the difference between the success and failure of treatments.

Role Of Family In Caring Affected individual-
No matter how distant you feel from your family, it is your one true support system. People with mental conditions are often misunderstood by their own families. But such people need family care, love, and affection the most. Many mentally disturbed people, both young and old, experience worsening symptoms, because no one seems to understand, or even empathize with them. Families can help affected individuals by listening to them without being biased - like taking care of their needs that they can't take care of on their own.

Benefits of Family Involvement
The benefits that the mentally ill individual gets from family involvement, have far-reaching positive consequences on the overall effectiveness of treatment. First and foremost, the chances of recovery are highly increased. The rates of hospitalization and chances of relapse decrease significantly. In addition to this, the adherence to the choices of treatment is readily enhanced. A lot of money is saved as well, as family support often leads to an improvement in conditions within a short space of time. Whereas, without family support, the treatment may be prolonged.


Support of the Psychiatrist
Apart from the complete support of the family members, the psychiatrist plays an important supporting role that can significantly increase the chances of successful treatment. Psychiatrists undergo the study of psychiatry, a branch of medicine that deals with diagnosis, study, prevention and treatment of disorders related to the mental health of human beings.
A psychiatrist conducts a detailed clinical assessment of the mentally ill individual and chalks out a treatment plan accordingly. The family can help as per the directions of the psychiatrist, and hence the support is quite vital. Psychiatrists regularly conduct counseling sessions to assess the condition of the affected individuals, so that they can recover soon.

Recovery may be difficult initially, but with support systems like families and psychiatrists, the problems are bound to be resolved eventually.

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Mental healthcare is non-existent for LGBTQI community in India

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The word depression in itself is terrifying. One of the deadliest mental health disorder, it has been on a rise, especially among the LGBTQI community. In order to create mental healthcare awareness, Keshav Suri, executive director, The Lalit Group, who himself is a strong advocate of LGBTQI rights, recently collaborated with Dr Prasad Raj Dandekar, founder of HPQI (Health Professionals for Queer Indians).

“I am happy to collaborate with HPQI for an important cause, such as this and glad that Dr Prasad has taken the initiative to educate us all on this crucial subject. Over the years, I have realised that mental healthcare is non-existent for LGBTQI people in this country. It is yet another of the initiatives from our #PureLoveCampaign and we want to tell people we are here to support them and spread the message of love”, said Suri in a statement.

Depression among LGBTQIA is a rising problem
Creating awareness is one of the solution to this problem, says Bhubhaneswar-based psychiatrist, Dr Amrit Pattojoshi. “Firstly, we have to see what causes depression. If I consider myself not normal, then how will the society perceive me?” It’s also a matter of one’s own perspective. So one has to change their own mindset.

Making everybody comfortable, whether a person is gay or lesbian is equally important. “When a parent knows about their child’s sexuality, they are sometimes unable to accept the truth. Many a time, they come to a psychiatrist, thinking they will cure their child of the problem. But we are trying to make everyone aware that it is a normal thing and is not a disease or problem”, says Dr Pattojoshi.

Depression is also related to how others perceive an individual who is coming out as gay, lesbian or transgender. “Coming out is a very personal experience and one needs to consider many factors like what is the mental health of the individual and who is he going to talk to. For example, if it’s his parents, are they amenable to receiving that information? If he comes from a very conservative family, the fear of his parent’s rejection may take a toll on his mental health”.

Hence, such individuals with the help of healthcare professionals, need to deal with it together and make a proper plan. LGBT community first needs the support of a medical professional or if they are in school or college, they need the support of an authority. Every school should have a counselor where students can come out and talk about their problems. And once an authority figure, who remains unbiased in such situations, stands behind a victim, then a lot is sorted.

When a parent says my son is gay, the reaction of a teacher or psychiatrist should be “so what” and not “what!”. That makes the difference. And if that individual is going through depression, it’s better to start treating it at an early stage.

After people become aware about the individual’s sexuality, they need to acknowledge it. “From the point of a healthcare professional, the way to deal with a depressed patient is to start talking to the patient. Once you diagnose that the person is going through depression there are two things we need to do — one is to treat the depression with pharmacotherapy or medication. There has to be a plan in action that how many months would you treat or temper those medications. That will help the individual immediately to reach a level where he/she will become a little comfortable”.

“When a person is severely depressed, no amount of counselling helps. They are not in the mental frame of mind to undergo counselling, to understand and follow. After few weeks of pharmacotherapy, the person will become amenable for therapy and then the counseling session should start. We, then, refer the patient to a trained counselor, who can help him through the problem and overcome it”.

Dr. Vijay Shirke
Dr. Vijay Shirke
MS/MD - Ayurveda, Ayurveda Family Physician, 17 yrs, Pune
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Dr. Prashant Innarkar
BHMS, Medical Cosmetologist Trichologist, 8 yrs, Pune
Dr. Amit Murkute
Dr. Amit Murkute
MBBS, Dermatologist Hair Transplant Surgeon, 6 yrs, Pune
Dr. Abhay Singh
Dr. Abhay Singh
MBBS, Family Physician, 2 yrs, South Delhi
Dr. Mandar Phutane
Dr. Mandar Phutane
BDS, Cosmetic and Aesthetic Dentist Dental Surgeon, 10 yrs, Pune
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