Recognising mental health problems

Emotional distress can be shown in various ways – all health professionals should have an awareness of what the signs are and try to alleviate distress where possible.

How would you know if someone you were working with was struggling emotionally?

• There may be clues in the persons behaviour e.g. stopping taking their medication or they may tell you that they are not sleeping well.
• Their self care and appearance may change. Weight gain, weight loss or lack of interest or care of their appearance or hygiene.
• The person may have started making excuses not to go out of the house or attend their regular activities.
• Physical symptoms of some respiratory conditions e.g. fatigue can make diagnosis difficult.
• If unsure it can be helpful to talk to other family members who may be more aware of changes in the persons mood. They can also tell you how the person has coped in the past or if they have a history of depression.
• They may tell you that they are not feeling themselves or that they feel hopeless about the future.

Some staff say that they worry about asking questions about mood and anxiety, they are scared of ‘opening a can of worms’ and not knowing how to deal with it. Asking the questions does not make a person depressed or anxious and can be a first step in recognising any problems and providing appropriate support or directing the person to where they can get help.

Mental Health Screening Measures can be a useful way of finding out more about the patients mood. These are usually short questionnaires which can help in opening up a discussion about how the patient is feeling and whether further help is needed.

• Patient Health Questionnaire (PHQ) Screeners
  • The PHQ9 asks about symptoms of depression including whether the patient has any suicidal thoughts.
  • The GAD7 asks about anxiety symptoms.
  • The PHQ4 is a shorter, quicker measure which consists of the first 2 questions from both the PHQ9 and the GAD7. 
• Vancouver Coastal Health: ReAct: Geriatric Depression Scale [.pdf]

Additional information

NICE: Depression in Adults with Chronic Physical Health Problems: Treatment and Management. National Clinical Practice Guideline 91 NHS Education for Scotland: Emotion Matters: this resource is for all health and care professional working with adults with long term physical health issues. It’s aim is to increase understanding and awareness of the psychosocial implications of living with a long term condition as well as provide some skills that will enable holistic, collaborative and person centred care. My Condition, My Terms, My life: Professional Resources: Framework for supporting self management