Comprehensive assessment and management of common mental health problems

Suicidal patients and special observation

“…Nurses have been identified as being in an excellent position to make such assessments ( Duffy 1995, Libberton 1996). Common indicators of suicidal ideation or intent are well documented ( Hawton 1987, Griffin 1989, Reid & Long 1993, Morgan 1994, Hughes 1995, Weintraub et al 1996 , Rossau & Mortensen 1997) but the difficulties of establishing the degree of risk are also acknowledged ( Hawton 1987, Cheung 1992, Morgan 1994). A number of factors contribute to assessment complexity, for example, transference, patient diagnosis, intuition and level of staff experience ( Bydlon‐Brown & Billman 1988).…”

Science Update

“…A third form of depression can alternate with periods of mania and intervening periods of normal mood. This form of depression, bipolar disorder, is commonly treated pharmacologically and psychotherapeutically (8). The incidence of bipolar disorder is small compared to dysthymia, which is estimated to have a lifetime prevalence of about 8% in women (9).…”

“…When evaluating women for depression, care must be taken to tailor the diagnostic approach to each individual (8), taking into account age; stressors and work roles; reproductive events including premenstrual syndrome, postpartum mood changes, and menopause; and/or seasonal influences. In addition, all depressed clients should be assessed for suicide risk by asking them directly about any suicidal thoughts or plans.…”

“…Suicide risk is increased in women who have experienced the loss of a child, are facing the potential loss of their partner, have a desire for abortion, or are undergoing economic hardship or crisis (10). The wide array of appropriate treatment strategies for depression includes pharmacologic treatment, electroconvulsive therapy, psychotherapy, hospitalization, or a combination of methods (8). The key to success treatment is diagnosis of the problem.…”

Assessing and Managing Women With Depression: A Midwifery Perspective

“…The American College of Nurse Midwives (ACNM) published a position statement in 1992 (revised 1994 and 1997) that defined certified nurse‐midwives/certified midwives (CNMs/CMs) as primary care providers 7 . Weintraub et al stated, “that while the assessment of common emotional disorders and the coordination of referrals for acute, chronic, and life‐threatening mental health conditions in women are within the scope of the primary care role of nurse‐midwives, ordinarily, the management of such conditions is not,” in an article published in this journal in 1996 8 . However, by 2002, a position paper published by ACNM recommended integration of depression care for women by CNMs/CMs 9 .…”