Mental health toolkit
The Mental Health Toolkit may be used by any primary care professional or general practice in the UK. It is designed to collate resources which inform and support delivery of high quality mental health care in the primary care setting. It is arranged by clinical topic, and there are also sections collating important national and international guidelines and key documents for those involved in service design and commissioning. Patients, carers, and GPs concerned about their own mental health, may also find the toolkit useful.
Medical and psychological treatments
Guidelines
British Association for Psychopharmacology - Evidence-based guidelines for treating depressive disorders with antidepressants -2015) - These guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing and management, next-step treatment, relapse prevention, treatment of relapse and stopping treatment. Pages 3-9 of the document are particularly pertinent to primary care.
British Association for Psychopharmacology -Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder -2014) - Each of the principal disorders – generalised anxiety disorder, panic disorder, specific phobia, social anxiety disorder, post-traumatic stress disorder, and obsessive-compulsive disorder – is considered in turn, following key steps in management -acute treatment; longer-term treatment; combination with psychological approaches; treatment resistance). Pages 4, 6-7 and 9-10 of the document are most relevant to primary care.
NICE Clinical Knowledge Summary: Antipsychotics -2021) - All the information required for the prescribing and monitoring of antipsychotics in primary care.
NICE Clinical Knowledge Summary: Lithium -2021) - All the information required to prescribe and monitor lithium, including spotting symptoms and signs of toxicity and the actions to take.
Useful resources
ACB Calculator - Many of the medications that we commonly prescribe have anticholinergic properties. In patients over 65 years of age these can cause adverse events, such as confusion, dizziness and falls. These have been shown to increase patient mortality. This calculator works out the anticholinergic burden for the patient. A score of 3+ is associated with an increased cognitive impairment and mortality.
British National Formulary - Treatment summaries on antidepressants, antipsychotics, hypnotics and anxiolytics and dementia are very helpful.
CredibleMeds - This website is a useful resource when considering medications and the risk of QTc prolongation. One-time registration is required, but it is free.
emc - The electronic medicines compendium is a repository of the summary of product characteristics -SPC) and patient information leaflets -PIL) for drugs prescribed in the UK. The SPCs include detailed information on usage, contraindications and side effects.
Living Life - The Living Life service offers support to people in Scotland through guided self-help and cognitive behavioural therapy. It is self-referral.
MDCalc - This benzodiazepine conversion calculator provides equivalent doses between different benzodiazepines.
National Centre for Mental Health - They offer a ‘Medication Handy Chart’ which can be used as a quick reference guide for clinicians when discussing mental health medication with patients. The chart contains information on hundreds of common mental health medications, including their use, effects and side effects. Information is impartial and has been written and checked by expert pharmacists. It can be ordered by emailing info@ncmh.info.
Specialist Pharmacy Service – Choosing an equivalent dose of benzodiazepine - This provides information and guidance on approximately equivalent doses of oral benzodiazepines to diazepam.
UK Drugs in Lactation Advisory Service -UKDILAS) - UKDILAS provides evidence based information on the use of drugs during the breastfeeding period.
UK Teratology Information Service -UKTIS) - This site and offers information on the use of medication in pregnancy and is linked to ToxBase -which has more detailed reviews)
Patient/Carer Information
Best Use of Medicines in Pregnancy -BUMPS) - This website provides reliable, evidence-based, and accurate information about use of medicines in pregnancy, in the form of freely available patient information leaflets, written by the UK Teratology Information Service.
Changing Minds - Relaxation tools and wellbeing resources in different languages which may be suggested to patients
Foundation for Positive Mental Health - A charity dedicated to promoting skills training for positive mental health, to enhance everyday wellbeing, increase resilience to, and recovery from, mental health difficulties. It offers skills training for positive mental health, derived from Olympic sports.
Mind: Psychiatric Medications - Explains what psychiatric drugs are, what to know before taking them, and information on side effects and coming off medication.
RCPsych: Antidepressants - This section of the website provides information on the use of antidepressants, including commonly asked questions. There is a further section on stopping antidepressants.
RCPsych: Cognitive Behavioural Therapy - Information for patients on what CBT is and how it can help.
RCPsych: Psychotherapies and psychological treatments - Details on the type of therapies, highlighting the fact that the Improving Access to Psychological Therapies -IAPT) service is available through primary care in England.
Further Information and Reading
Association for Cognitive Analytical Therapy -ACAT) - This includes info about CAT as a therapy & also as a consultation model.
British Association for Psychopharmacology – Benzodiazepines: Risks and benefits. A reconsideration. -2013) - This short, interesting document looks at the pros and cons of benzodiazepine prescribing, including information on stopping them.
RCGP eLearning module – Mental health in times of lockdown - This extended screencast looks at various factors during lockdown that may contribute to mental health problems for patients, including grief, domestic abuse and increased alcohol intake.
RCGP – Mindfulnes for GPs and Primary Care Teams - This explains what mindfulness is, how it helps and signposts to resources.
Responsibility without Blame - The Responsibility without Blame Project provides a free and accessible e-learning for anyone interested in thinking about our ideas of responsibility and blame, and finding ways to work and relate more effectively with people with personality disorder or complex needs.