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YEAR 2 Mental Health > Intervention and services in the global and UK context > Flashcards

Intervention and services in the global and UK context Flashcards

1
Q

Mental disorders are the _____ leading cause of ‘years lost to disability’

a. 5th
b. 7th
c. 10th
d. 3rd

A

b. 7th

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2
Q

Mental disorders are the 7th leading cause of …?

A

‘Years lost to disability’

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3
Q

7th leading cause of ‘years lost to disability’

A

Mental disorders

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4
Q

What are the 2 types of mental disorders with most years lost to disability globally?

A
  1. Depression
  2. Anxiety disorders
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5
Q

Depression followed by anxiety disorders are the mental disorders with …?

A

The most years lost to disability globally

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6
Q

_____ live with a mental health condition

a. 1/3
b. 1/4
c. 1/6
d. 1/8

A

d. 1/8

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7
Q

What is the global prevalence of mental health conditions?

A

13%

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8
Q

True or False?

Anyone can have mental health conditions; however, some groups are more vulnerable

A

True

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9
Q

Anyone can have mental health conditions; however, some groups are more vulnerable

Give at least 5 examples

A
  • Children at socioeconomic disadvantage / poverty
  • Ethnic minorities
  • Learning/physical disabilities
  • LGBTQ+ people
  • Prison population
  • Carers
  • Refugees
  • Individuals from war/conflict zone
  • Looked-after children
  • Survivors of sexual abuse / violence
  • Isolated older people
  • Older people in care homes
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10
Q

While effective interventions exist to treat mental disorders, the gap between need for treatment and its provision is wide in all countries

This is known as…?

A

Treatment gap

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11
Q

What is a treatment gap?

A

While effective interventions exist to treat mental disorders, the gap between need for treatment and its provision is wide in all countries

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12
Q

Proportion of people who received any treatment in the UK were:

____ % of moderately severe cases of mental disorder

a. 35%
b. 45%
c. 50%
d. 20%

A

a. 35%

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13
Q

Proportion of people who received any treatment in the UK were:

35% of ________ cases of mental disorder

a. moderately severe
b. extremely severe
c. mild
d. no

A

a. moderately severe

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14
Q

Proportion of people who received any treatment in the UK were:

_____% of severe cases of mental disorder

a. 70%
b. 80%
c. 55%
d. 65%

A

d. 65%

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15
Q

Proportion of people who received any treatment in the UK were:

65% of ______ cases of mental disorder

a. moderately severe
b. (extremely) severe
c. mild
d. no

A

b. (extremely) severe

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16
Q

Proportion who received any treatment in the previous 12 months:

11% of severe cases in ___

a. China
b. Nigeria
c. UK
d. USA

A

a. China

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17
Q

Proportion who received any treatment in the previous 12 months:

___% of severe cases in China

a. 15%
b. 22%
c. 11%
d. 7%

A

c. 11%

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18
Q

Proportion who received any treatment in the previous 12 months:

____% of severe cases in Nigeria

a. 44%
b. 21%
c. 18%
d. 9%

A

b. 21%

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19
Q

Proportion who received any treatment in the previous 12 months:

21% of severe cases in ____

a. China
b. Nigeria
c. UK
d. USA

A

b. Nigeria

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20
Q

Proportion who received any treatment in the previous 12 months:

59% of severe cases in ____

a. China
b. Nigeria
c. UK
d. USA

A

d. USA

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21
Q

Proportion who received any treatment in the previous 12 months:

____% of severe cases in USA

a. 25%
b. 92%
c. 72%
d. 59%

A

d. 59%

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22
Q

More than ____% of the world’s population live in low- and middle-income countries (LMICs)

A

85%

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23
Q

More than 85% of the world’s population live in _______ countries (LMICs)

A

Low- and Middle-income

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24
Q

Depression, schizophrenia, bipolar disorder, and alcohol use disorders are
in the top 10 causes of health-related disability in …?

A

Low- and middle-income countries (LMICs)

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25
Q

What are the 4 causes that are in the top 10 causes of health related disability in low- and middle-income countries (LMICs)?

A
  1. Depression
  2. Schizophrenia
  3. Bipolar disorder
  4. Alcohol use disorders
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26
Q

What are the 4 barriers to access to mental health care in low- & middle-income countries (LMIC)?

A
  1. Substantial lack of services and shortage of resources – mostly limited to large psychiatric hospitals
  2. Shortage of well-trained workforce and tools for detection of mental disorders
  3. Financial cost to families (direct and indirect)
  4. Perceived barriers to professional helpseeking; e.g. No perceived need for care,
    mental health stigma
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27
Q
  1. Substantial lack of services and shortage of resources – mostly limited to large psychiatric hospitals
  2. Shortage of well-trained workforce and tools for detection of mental disorders
  3. Financial cost to families (direct and indirect)
  4. Perceived barriers to professional helpseeking; e.g. No perceived need for care, mental health stigma

These are the 4 barriers to access to mental health care for…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

b. Low- & middle-income countries (LMIC)

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28
Q

What are the 3 barriers to access to mental health care in high-income countries (HIC)?

A
  1. Increased uptake of treatment for mental
    disorders since 1990 – For example, 1 in 3 with common mental health problems now
    receive some kind of treatment in the UK
  2. Treatment still “not reaching adequate standards”
  3. Not reaching those in the population who need it the most; e.g. ethnic minorities,
    young people – due to perceived barriers to
    professional help-seeking and likely ‘real’ structural barriers too
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29
Q
  1. Increased uptake of treatment for mental
    disorders since 1990 – For example, 1 in 3 with common mental health problems now
    receive some kind of treatment in the UK
  2. Treatment still “not reaching adequate standards”
  3. Not reaching those in the population who need it the most; e.g. ethnic minorities,
    young people – due to perceived barriers to
    professional help-seeking and likely ‘real’ structural barriers too

These are the 3 barriers to access to mental health care for…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

a. High-income countries (HIC)

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30
Q

Increased uptake of treatment for mental
disorders since 1990 – For example, 1 in 3 with common mental health problems now
receive some kind of treatment in the UK

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

a. High-income countries (HIC)

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31
Q

Substantial lack of services and shortage of resources – mostly limited to large psychiatric hospitals

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

b. Low- & middle-income countries (LMIC)

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32
Q

Shortage of well-trained workforce and tools for detection of mental disorders

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

b. Low- & middle-income countries (LMIC)

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33
Q

Treatment still “not reaching adequate standards”

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

a. High-income countries (HIC)

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34
Q

Not reaching those in the population who need it the most; e.g. ethnic minorities,
young people – due to perceived barriers to
professional help-seeking and likely ‘real’ structural barriers too

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

a. High-income countries (HIC)

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35
Q

Financial cost to families (direct and indirect)

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

b. Low- & middle-income countries (LMIC)

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36
Q

Perceived barriers to professional helpseeking; e.g. No perceived need for care, mental health stigma

This applies to…?

a. High-income countries (HIC)

b. Low- & middle-income countries (LMIC)

A

b. Low- & middle-income countries (LMIC)

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37
Q

What are the 3 types of stigma?

A
  1. Structural stigma
  2. Public (social interpersonal) stigma
  3. Internalised or self-stigma
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38
Q

What is a stigma?

A

When someone views the individual affected by mental health difficulties in a negative way because of it

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39
Q

When someone views the individual affected by mental health difficulties in a negative way because of it

a. Discrimination
b. Stigma

A

b. Stigma

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40
Q

What is discrimination?

A

When someone treats the individual in a negative way because of it

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41
Q

When someone treats the individual in a negative way because of it

a. Discrimination
b. Stigma

A

a. Discrimination

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42
Q

Mental health stigma is a ‘double jeopardy’ for individuals affected by …?

A

Mental disorders

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43
Q

Mental health stigma is a ‘double jeopardy’ for individuals affected by mental disorders

What does this mean?

A

It leads to reluctance to seek help from services

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44
Q

Ignorance/prejudice by family, friends and community lead to additional burdens, including discrimination, exclusion,
economic burden and hardships in accessing adequate care

What type is stigma is this?

a. Structural stigma

b. Public (social interpersonal) stigma

c. Internalised or self-stigma

A

b. Public (social interpersonal) stigma

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45
Q

Involves emotionally/cognitively absorbing the negative beliefs about the self, largely based on shame, accepting stereotypes, and alienating oneself from others

What type is stigma is this?

a. Structural stigma

b. Public (social interpersonal) stigma

c. Internalised or self-stigma

A

c. Internalised or self-stigma

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46
Q

Laws, policies, and practices result in the unfair treatment of people with lived and [living] experience of mental health difficulties.

Professionals contribute to stigmatisation through conscious or unconscious biases

What type is stigma is this?

a. Structural stigma

b. Public (social interpersonal) stigma

c. Internalised or self-stigma

A

a. Structural stigma

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47
Q

How do professionals contribute to stigmatisation?

A

Through conscious or unconscious biases

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48
Q

What is structural stigma?

A

Laws, policies, and practices result in the unfair treatment of people with lived and [living] experience of mental health difficulties

Professionals contribute to stigmatisation through conscious or unconscious biases

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49
Q

What is public (social interpersonal) stigma?

A

Ignorance/prejudice by family, friends and community lead to additional burdens, including discrimination, exclusion,
economic burden and hardships in accessing adequate care

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50
Q

What is internalised or self-stigma?

A

Self-stigma involves emotionally/cognitively absorbing the negative beliefs about the self, largely based on shame, accepting stereotypes, and alienating oneself from others

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51
Q

Mental health beliefs often affect (reduce) help-seeking (i.e. contacting to seek support from mental health services)

What are the 3 factors that influence this?

A
  1. Spirituality/religion
  2. Shame
  3. Emotional expression
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52
Q

How can spirituality/religion affect (reduce) help-seeking?

(i.e. contacting to seek support from mental health services)

A

Attributing to spiritual cause and therefore seeking guidance via spirituality etc.

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53
Q

How can shame affect (reduce) help-seeking?

(i.e. contacting to seek support from mental health services)

A

Perceiving that mental health difficulties as a ‘weakness’ of character or personality flaw that reflects and impacts on the family due to the significant role of family in one’s life

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54
Q

How can emotional expression affect (reduce) help-seeking?

(i.e. contacting to seek support from mental health services)

A

Perceiving that lack of emotional balance leads to mental health difficulties which may get aggravated by talking about the issues

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55
Q

Attributing to spiritual cause and therefore seeking guidance via spirituality etc

a. Spirituality/religion
b. Shame
c. Emotional expression

A

a. Spirituality/religion

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56
Q

Perceiving that mental health difficulties as a ‘weakness’ of character or personality flaw that reflects and impacts on the family due to the significant role of family in one’s life

a. Spirituality/religion
b. Shame
c. Emotional expression

A

b. Shame

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57
Q

Perceiving that lack of emotional balance leads to mental health difficulties which may get aggravated by talking about the issues

a. Spirituality/religion
b. Shame
c. Emotional expression

A

c. Emotional expression

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58
Q

Mental health interventions are methods of…?

List 2 points

A
  1. Providing treatment and support to individuals (or
    groups) experiencing mental health difficulties
  2. Reducing risk of mental health difficulties, building
    resilience and establish supportive environments
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59
Q
  1. Providing treatment and support to individuals (or
    groups) experiencing mental health difficulties
  2. Reducing risk of mental health difficulties, building
    resilience and establish supportive environments

These are methods of…?

A

Mental health interventions

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60
Q

What are the 3 types of pre-emptive mental health interventions?

A
  1. Universal – for all in a given society
  2. ‘At-risk group’ / selective – focused on groups known to be at risk
  3. At-risk / indicated: Sub-clinical, prodromal, ‘at risk state’
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61
Q

What are ‘pre-emptive’ interventions?

A

Interventions prior to usual treatment

62
Q

Interventions prior to usual treatment

This is known as…?

A

‘Pre-emptive’ interventions

63
Q

What are universal interventions?

A

Interventions for all in a given society

64
Q

What are ‘at-risk group’ / selective interventions?

A

Interventions focused on groups known to be at risk

65
Q

What are at-risk / indicated interventions?

A

Interventions that are sub-clinical, prodromal, ‘at risk state’

66
Q

Interventions focused on groups known to be at risk

a. Universal
b. ‘At-risk group’ / selective
c. At-risk / indicated

A

b. ‘At-risk group’ / selective

67
Q

Interventions that are sub-clinical, prodromal, ‘at risk state’

a. Universal
b. ‘At-risk group’ / selective
c. At-risk / indicated

A

c. At-risk / indicated

68
Q

Interventions for all in a given society

a. Universal
b. ‘At-risk group’ / selective
c. At-risk / indicated

A

a. Universal

69
Q

What are the 3 types of intervention that aim to prevent mental health issues?

A
  1. Universal
  2. ‘At-risk group’ / selective
  3. At-risk / indicated
70
Q

What are the 2 types of early intervention for mental health?

A
  1. At-risk / indicated
  2. Case identification
71
Q

What are the 3 types of intervention for treatment of mental health?

A
  1. Case identification
  2. Early treatment
  3. Standard treatment
72
Q

What are the 2 types of intervention for continuing care of mental health?

A
  1. Engagement with longer term treatment (including relapse retention)
  2. Long term care
73
Q
  1. Engagement with longer term treatment (including relapse retention)
  2. Long term care

What intervention does this apply to?

a. Prevention
b. Early intervention
c. Treatment
d. Continuing care

A

d. Continuing care

74
Q
  1. Case identification
  2. Early treatment
  3. Standard treatment

What intervention does this apply to?

a. Prevention
b. Early intervention
c. Treatment
d. Continuing care

A

c. Treatment

75
Q
  1. At-risk / indicated
  2. Case identification

What intervention does this apply to?

a. Prevention
b. Early intervention
c. Treatment
d. Continuing care

A

b. Early intervention

76
Q
  1. Universal
  2. ‘At-risk group’ / selective
  3. At-risk / indicated

What intervention does this apply to?

a. Prevention
b. Early intervention
c. Treatment
d. Continuing care

A

a. Prevention

77
Q

What is the best intervention for resilience?

A

School-based psychological
resilience training

78
Q

What is the best intervention for individuals with symptoms of psychosis?

A

Family-focused
psychotherapy for an individual with subclinical symptoms of psychosis

79
Q

A social-ecological model is another way to think about mental health intervention

What are the 5 stages in the social-ecological model?

A
  1. Policy
  2. Community
  3. Institutional
  4. Interpersonal
  5. Intrapersonal
80
Q

Interventions based on attitudes, beliefs, knowledge and behaviours

a. Policy
b. Community
c. Institutional
d. Interpersonal
e. Intrapersonal

A

e. Intrapersonal

81
Q

Interventions based on schools, health care administration, businesses, faith based organisations, institutions, etc.

a. Policy
b. Community
c. Institutional
d. Interpersonal
e. Intrapersonal

A

c. Institutional

82
Q

Interventions based on famililies, friends, social networks

a. Policy
b. Community
c. Institutional
d. Interpersonal
e. Intrapersonal

A

d. Interpersonal

83
Q

Interventions based national, provincial/territorial, local laws and policy

a. Policy
b. Community
c. Institutional
d. Interpersonal
e. Intrapersonal

A

a. Policy

84
Q

Interventions based on relationships and communications between organisations and institutions

a. Policy
b. Community
c. Institutional
d. Interpersonal
e. Intrapersonal

A

b. Community

85
Q

A social-ecological model is another way to think about mental health intervention

How? (List 3 points)

A
  1. Interventions can be implemented at different and multiple levels
  2. Interventions implemented at a higher level can influence outcomes at the
    lower/smaller levels
  3. Psychologists can be involved at all levels (policy to interpersonal) – provides a ‘big picture’ approach to thinking about
    mental health
86
Q

True or False?

Interventions cannot be implemented at different and multiple levels

A

False

Interventions can be implemented at different and multiple levels

87
Q

True or False?

Interventions implemented at a lower level can influence outcomes at the
lower/smaller levels

A

False

Interventions implemented at a higher level can influence outcomes at the
lower/smaller levels

88
Q

True or False?

Psychologists can only be involved at certain levels

A

False

Psychologists can be involved at all levels

89
Q

What is policy to interpersonal intervention?

A

Intervention that provides a ‘big picture’ approach to thinking about mental health

90
Q

Intervention that provides a ‘big picture’ approach to thinking about mental health

This is known as…?

A

Policy to interpersonal intervention

91
Q

_____ and other techniques that have been shown to be
effective in well controlled scientific research

A

Psychotherapeutic modalities

92
Q

Psychotherapeutic modalities and other techniques that have been shown to be
effective in ______ research

A

Well controlled scientific research

93
Q

Evidence-based interventions are primarily…?

A

Randomised controlled trials (RCTs)

94
Q

Evidence-based interventions are systematic reviews and meta-analyses of …?

A

RCTs (analyses of many RCTs together)

95
Q

Evidence based interventions relates to a specific mental disorder, often degree of _____ and sometimes to specific population groups

A

Severity/chronicity

96
Q

The evidence base relates to a specific mental disorder, often degree of
severity/chronicity and sometimes to _____

A

Specific population groups

97
Q

What are the 3 features of evidence-based interventions?

A
  1. Primarily randomised controlled trials (RCTs)
  2. Systematic reviews and meta-analyses of RCTs (analyses of many RCTs together)
  3. The evidence base relates to a specific mental disorder, often degree of
    severity/chronicity and sometimes to specific population groups
98
Q
  1. Primarily randomised controlled trials (RCTs)
  2. Systematic reviews and meta-analyses of RCTs (analyses of many RCTs together)
  3. The evidence base relates to a specific mental disorder, often degree of
    severity/chronicity and sometimes to specific population groups

These are 3 features of…?

A

Evidence-based interventions

99
Q

What are the 2 pros of evidence-based interventions?

A
  1. Maintains a standard and professional shared understanding in technique/vocabulary
  2. Critical part of professional standards and accountability
100
Q

What is the con of evidence-based interventions?

A

Practice in the real-world is often not carefully based on evidence

101
Q

What have governments and health insurance companies done to enhance evidence-based interventions?

A

They developed clinical guidelines, considering both evidence AND cost

e.g. the UK’s National Institute for Clinical Health and Excellence

102
Q

Governments and health insurance companies have developed clinical guidelines, considering both evidence AND cost

Give an example

A

e.g. the UK’s National Institute for Clinical Health and Excellence

103
Q

What must evidence-based
practice (EBP) consider?

List 4 points

A
  1. Clinical characteristics (e.g.
    severity)
  2. Past experience with treatment
  3. Client preferences
  4. Availability
104
Q

What is a major barrier of evidence-based practice (EBP)?

A

The empirical/evidence base remains under-developed, especially with regard to co-occurring disorders and in underserved populations

105
Q

A major barrier of evidence-based practice (EBP) is that the empirical/evidence base _______, especially with regard to co-occurring disorders and in underserved populations

A

Remains under-developed

106
Q

Mental health teams in the UK are structured around 3 types of care in the National Health Service (NHS)

What are they?

A
  1. Primary
  2. Secondary
  3. Tertiary
106
Q

Ethnoracial/ethnocultural minorities are not well represented in RCTs

What does this tell us about the validity?

A

The validity of ‘evidence based interventions’ for particular understudied/underserved groups is unclear

106
Q

A major barrier is that the
empirical/evidence base remains under-developed, especially with regard to _________ and in _________

A
  1. Co-occurring disorders
  2. Underserved populations
107
Q

What is the Improving Access to Psychological Therapies (IAPT)?

A

A programme of service delivery launched in the UK in 2008 to provide
widespread access to treatments for common mental disorders

107
Q

A programme of service delivery launched in the UK in 2008 to provide
widespread access to treatments for common mental disorders

This is known as…?

A

Improving Access to Psychological Therapies (IAPT)

108
Q

What uses a stepped-care model to improve access to treatment for common mental disorders via primary care or self-referral?

A

Improving Access to Psychological Therapies (IAPT)

109
Q

What type of model does Improving Access to Psychological Therapies (IAPT) use to provide mental health services?

A

A stepped-care model to improve access to treatment for common mental
disorders via primary care or self-referral

110
Q

What intervention does Improving Access to Psychological Therapies (IAPT) provide?

A

Provides evidence-based psychological intervention / treatment, defined by level of
need and therapist input

111
Q

Provides evidence-based psychological intervention / treatment, defined by level of need and therapist input

This is known as…?

A

Improving Access to Psychological Therapies (IAPT)

112
Q

Improving Access to Psychological Therapies (IAPT) provides evidence-based psychological intervention / treatment, defined by …?

A

Level of need and therapist input

113
Q

Why do Improving Access to Psychological Therapies (IAPT) provide evidence-based psychological intervention / treatment, defined by level of need and therapist input?

A

Because therapies largely pays for itself (~£650 per person per course) by reducing other public costs (e.g. welfare benefits, medical) and increasing tax revenue by a return to work

114
Q

What are the 4 steps to the UK’s IAPT stepped-care model of service delivery?

A
  1. Primary care / GP
  2. Low intensity service
  3. High intensity service
  4. Chronic / complex
115
Q
  1. Primary care / GP
  2. Low intensity service
  3. High intensity service
  4. Chronic / complex

These are the 4 steps to…?

A

UK’s IAPT stepped-care model of service delivery

116
Q

What is the step 1 of the UK’s IAPT stepped-care model of service delivery?

A

Primary care / GP giving simple advice

117
Q

What is the step 2 of the UK’s IAPT stepped-care model of service delivery?

A
  • Low intensity service
  • Psychological wellbeing practitioners
  • Mainly offers guided self help, computerised CBT and group-physical activity programmes
  • Mild to moderate (sub-threshold) depression / anxiety disorders, sleep problems, social anxiety etc.
118
Q

What is the step 3 of the UK’s IAPT stepped-care model of service delivery?

A
  • High intensity service
  • CBT / high intensity
    therapists
  • Usually weekly face-to-face, one-to one sessions with a trained therapist. including CBT, eye movement desensitization and reprocessing [EMDR], counselling & interpersonal psychotherapy [IPT] interventions
  • Moderate to severe
    depression & anxiety, OCD,
    social anxiety, phobias, PTSD
    etc.
119
Q

What is the step 4 of the UK’s IAPT stepped-care model of service delivery?

A
  • Chronic/ complex
  • Senior CBT therapists & other highly qualified specialists
  • Severe and recurrent disorders, complex
    trauma, personality disorders, and if other
    treatment unsuccessful
120
Q
  • Senior CBT therapists & other highly qualified specialists
  • Severe and recurrent disorders, complex
    trauma, personality disorders, and if other
    treatment unsuccessful

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

d. S4: Chronic / complex

121
Q
  • CBT / high intensity
    therapists
  • Usually weekly face-to-face, one-to one sessions with a trained therapist. including CBT, eye movement desensitization and reprocessing [EMDR], counselling & interpersonal psychotherapy [IPT] interventions
  • Moderate to severe
    depression & anxiety, OCD,
    social anxiety, phobias, PTSD
    etc.

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

c. S3: High intensity service

122
Q
  • Psychological wellbeing practitioners
  • Mainly offers guided self help, computerised CBT and group-physical activity programmes
  • Mild to moderate (sub-threshold) depression / anxiety disorders, sleep problems, social anxiety etc.

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

b. S2: Low intensity service

123
Q

Giving simple advice

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

a. S1: Primary care / GP

124
Q

Constant monitoring of improvement

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

c. S3: High intensity service

125
Q

Mainly offers guided self help, computerised CBT and group-physical activity programmes.

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

b. S2: Low intensity service

126
Q

Usually weekly face-to-face, one-to one sessions with a trained therapist. including CBT, eye movement desensitization and reprocessing [EMDR], counselling & interpersonal psychotherapy [IPT] interventions

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

c. S3: High intensity service

127
Q

Mild to moderate (sub-threshold) depression / anxiety disorders, sleep
problems, social anxiety etc.

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

b. S2: Low intensity service

128
Q

High intensity services involve weekly face-to-face, one-to one sessions with a trained therapist

This includes…? (List 4)

A
  1. CBT
  2. Eye movement desensitizationand Reprocessing [EMDR]
  3. Counselling
  4. Interpersonal psychotherapy [IPT] interventions
129
Q

Severe and recurrent disorders, complex
trauma, personality disorders, and if other
treatment unsuccessful

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

d. S4: Chronic / complex

130
Q

Moderate to severe depression & anxiety, OCD, social anxiety, phobias, PTSD etc.

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

c. S3: High intensity service

131
Q

Psychological wellbeing practitioners

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

b. S2: Low intensity service

132
Q

CBT / high intensity therapists

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

c. S3: High intensity service

133
Q

Senior CBT therapists & other highly qualified specialists

Which step of the UK’s IAPT stepped-care model of service delivery does this apply to?

a. S1: Primary care / GP
b. S2: Low intensity service
c. S3: High intensity service
d. S4: Chronic / complex

A

d. S4: Chronic / complex

134
Q

What are the 3 benefits of IAPT?

A
  1. Decreased waiting times
  2. Client’s condition improved
    (58% to 67%)
  3. Recovery improved (43% ->
    51%)
135
Q

What are the 3 criticisms of IAPT?

A
  1. Only half of referred patients go onto treatment
  2. Unclear if its interventions tailored enough to meet the actual complexity of its clientele
  3. Unclear if IAPT prevents need for onward referral to secondary care (as originally envisaged)
136
Q

Describe Amos et al.’s (2018) study on experiences of low intensity interventions in IAPT

List 2 points

A
  1. Qualitative experiences of 8 participants who had received low intensity intervention (3-6 sessions of a brief transdiagnostic group or low-intensity CBT)
  2. Participant’s anxiety
    and depression varied
    from mild to severe
137
Q

What were the findings of Amos et al.’s (2018) study on experiences of low intensity interventions in IAPT

List 3 points

A
  1. 4 Ps reported experiencing
    psychological change
  2. More severe participants were stepped up to more
    intensive treatment
  3. Time to talk, talking, normalization and personal approach were beneficial – therapists who adapted to client’s individual needs were perceived as more effective than those who did not
138
Q

True or False?

Therapists who generalise client’s individual needs were perceived as more effective than those who adapted

A

False

Therapists who adapted to client’s individual needs were perceived as more effective than those who did not

139
Q

What were the 4 interventions Amons et al. (2018) found to be beneficial for people with anxiety and depression?

A
  1. Time to talk
  2. Talking
  3. Normalization
  4. Personal approach
140
Q

What did Amos et al.’s (2018) conclude in their study on experiences of low intensity interventions in IAPT?

List 2 points

A
  1. Lack of time to talk, and lack of personal approach were non beneficial aspects
  2. Individual’s own goals, expectations and sense of stigma were factors outside of the therapy that impacted psychological change
141
Q

What are the factors outside of the therapy that impact psychological change?

List 3

A

Individual’s own:

  1. Goals
  2. Expectations
  3. Sense of stigma
142
Q

Individual’s own:

  1. Goals
  2. Expectations
  3. Sense of stigma

These are…?

A

Factors outside of the therapy that impacted psychological change

143
Q

What intervention approaches are considered non beneficial?

List 2 points

A
  1. Lack of time to talk
  2. Lack of personal approach
144
Q

True or False?

Mental health difficulties are of global concern due to their massive impact on people, yet there is still a wide gap between need and provision/access worldwide

A

True

145
Q

True or False?

Help-seeking and treatment/intervention is only affected by availability

A

False

Help-seeking and treatment/intervention is not only affected by availability but also by accessibility (e.g. cost) and beliefs and stigma – all of these are barriers to help-seeking

146
Q

Help-seeking and treatment/intervention affected by 3 things

What are they?

A
  1. Availability
  2. Accessibility (e.g. cost)
  3. Beliefs and stigma
147
Q

What are the 3 barriers to help-seeking?

A
  1. Availability
  2. Accessibility (e.g. cost)
  3. Beliefs and stigma
148
Q

What do mental health intervention approaches consider?

List 2 points

A
  1. When is best to ‘intervene’ on the spectrum from prevention through to treatment
  2. The level at which to intervene from public policy through to guided self-help

YEAR 2 Mental Health (11 decks)

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