Assessment
Your patients' screening scores will likely determine your next steps; this downloadable algorithm is a helpful tool. below JPG to PDF)
Assessment Algorithm.JPG
RED/YELLOW! Warning box here for anyone who scored + on the self-harm question: Score on Self-Harm Question
- Do not allow woman/baby to leave office until plan/assessment is complete.
- Assess safety. Patient Safety Screener
- Call for psychiatric consultation, as needed.
- If acute safety concern, refer to emergency services for further evaluation of safety.
Otherwise, a reminder!
A screening tool score is not a diagnosis.
To assess for presence and severity of disease, ask the patient about:
– Recent stressors – Symptom frequency – Symptom duration – How symptoms impact daily functioning |
– Current treatment (meds/therapy) – Feelings of hopelessness, helplessness – Current suicidal ideation, plan, intent – Family history |
– Prior symptoms – Previous suicide attempt(s) – Past psychiatric treatment (meds/therapy) – Previous psychiatric hospitalization(s |
For mild, moderate, and severe illness:
- Start treatment - contact Ask Masi for support if needed
- Check for underlying medical conditions - order TSH, B12, folate, HgB, Hct
- Assess for substance use or medications which can cause or worsen mood/anxiety disorders
Treatment
Consider treatment options based on the highest level of illness severity:
If severity of symptoms overlap, clinical decisions should be based on your assessment, with strong consideration of higher level treatment options.
Therapy and Support Options
All women who screen positive, regardless of illness severity, should be referred to therapy or be advised to continue therapy.
Always discuss and encourage prevention and support options (e.g., peer and social supports and groups, sleep hygiene, self-care, and exercise).
Select resources on depression, anxiety, and sleep are provided here. These can be printed or emailed directly to your patient from this website.
Contact Ask Masi for more information about appropriate community programs or services, or consider a referral to AccessMHA, a centralized intake for therapy and counselling.
Pharmacological Options
Check out the Prescribing page!