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OF mental health care and mentally ill

Referring to a mental health specialist

There are various types of mental health specialist:

?Psychiatrists are medical doctors who, after completing basic medical training, have specialisedin the treatment of mental disorders. In many countries, the majority of psychiatrists are almostentirely based in hospitals. These may be general hospitals with a psychiatric ward or a hospitalspecialising in mental health problems. Psychiatrists?main skills are in the diagnosis andtreatment of severe mental disorders. They mainly use medicines and ECT and a variable amountof talking treatments.

Psychologists are trained in treating mental health problems using theories based on howhuman beings learn about life, feel emotions and behave towards others. Psychologists use onlytalking treatments.

Psychiatric nurses are nurses who have specialised in psychiatry. They may work either inhospitals or in the community. Their main roles are in providing talking treatments and thetreatment and rehabilitation of people with severe mental disorders.

Psychiatric social workers tend to work either in hospitals or in the community and deal withsocial problems and life difficulties faced by people with a mental illness. Both social workersand nurses can provide talking treatments.

In most developing countries, there are few mental health professionals. Thus, the majority ofpeople with a mental illness will need to be treated by general health workers. Of course, themajority of them do not need to see a specialist mental health professional at all. Most mentalillnesses can be recognised and treated by general health workers. However, there are somesituations in which you may need to refer someone to a specialist. Specific situations arediscussed throughout this manual. As a general rule, refer to a mental health specialist in thefollowing circumstances:

people with abnormal behaviour and evidence of a physical illness such as head injury or highfever;

people who are so disturbed that they can no longer be managed at home;

any child whom you suspect is suffering from mental retardation or other brain problems;• people who are taking large amounts of alcohol or drugs, so that stopping suddenly may lead toa severe withdrawal reaction;• people whose illness is continuing to have a serious effect on their personal life or work, despiteyour efforts to provide treatment.

In addition, people who have made a serious suicide attempt must be referred to an emergency medical unit to make sure their life is not in danger. Once this is done, and if they still have suicidal feelings, refer to a mental health specialist.

People with a convulsion should, ideally, be assessed by a specialist doctor (a neurologist or psychiatrist) before they start to take regular anticonvulsant medication.

Remember that when you refer someone it can be very helpful if you write a short note explaining a little bit about the background to the problem and what treatments you have already tried. You can also ask the specialist to write to you, advising on how someone should be cared for in the community.

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