Asking specific questions can be helpful in screening for mental health disorders. A few of my favorites include asking about new difficulties with sleep, changes in appetite or weight, and how much alcohol patients are drinking.
May has been designated “Mental Health Awareness Month,” and much has been written in the press over the past year about the importance of supporting practices that promote positive mental health. But how might clinicians detect possible declines in mental health in their patients, friends, family, and colleagues?
There’s no simple way to detect mental health changes that could be concerning. Sometimes people will directly express that they’re struggling emotionally with feelings of depression or anxiety or stress. At times, concerned family members may reach out to clinicians directly to express their concerns about another family member’s mental health. During office visits, a number of routine questions can be especially helpful in identifying possible mental health changes that may need attention:
1. New difficulties falling or staying asleep
2. Change in appetite and weight
3. Feeling irritable or easily irritated
4. Isolating from friends and family
5. Difficulty concentrating
6. Difficulty motivating oneself
7. Drinking more alcohol than usual or than recommended
What can clinicians do if they’re concerned that a patient may be experiencing a decline in mental health or well-being? The first step is to appreciate that non-judgmental, empathic listening is of therapeutic value itself. Listening to patient’s candid concerns, with the goal to simply understand what they’re experiencing, is validating and supportive. Depending on the nature of the symptoms and how they’re impacting daily functioning, it may be appropriate to refer the individual for counseling or psychiatric evaluation. Certainly, whenever you’re worried that a patient may be in danger of self-harm, it’s vital to take immediate action. This may involve ensuring that the individual has an urgent psychiatric assessment, and this may require going to the nearest emergency room. It may also mean, with the patient’s permission, including a close family member, such as spouse or partner or adult child, in the conversation.
It’s always helpful to remind patients about the importance of self-care that supports mental and emotional well-being, such as getting seven to nine hours of sleep at night, ensuring good nutrition, engaging in regular exercise, limiting alcohol, and limiting time spent on social media or the news that can be disturbing. Using relaxation apps such as Headspace and Calm can also be beneficial. Sensitivity to mental health concerns are important year-round, and not just during Mental Health Awareness Month. In these stressful times, these are helpful measures that are valuable for all of us.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.