Mental Health

When counting sheep fails as first line therapy, what measures can you recommend to help your patient get some sleep?

In Part 2 of this podcast series, Dr Smith continues his discussion of the practice of nonsuicidal self-injury in adolescents.

In this podcast, Dr Smith discusses the practice of nonsuicidal self-injury in adolescents—cutting, burning, self-hitting or banging, scratching, interfering with wound healing—may be increasing.

After listening to the previous 3 podcasts, you may be wondering how to begin a therapeutically valuable conversation with your patient, which will provide the critical details that you need in the short time that you have. In his final podcast, Dr Lieberman offers a list of questions that you can use to break the ice and kick start a dialog with a patient whom you suspect has a mental health disorder.

At one time or another, every primary care physician will probably see a patient who is a hypochondriac, a chronic complainer, or a substance abuser. Rather than seeing these patients as difficult and avoiding them as much as possible, the physician can reframe the problem as an opportunity for growth and development. Dr Lieberman suggests that keeping the sessions brief but allowing more frequent visits and addressing medical and psychosocial concerns will make your relationship with your patient more positive. Managing hypochondriacal patients, chronic complainers, and substance abusers will be much easier after listening to Dr Lieberman’s suggestions.

Primary care physicians are often the first to see patients with mental health problems and they provide 70% of mental health care to patients. They also write a majority of the prescriptions for antidepressant and antianxiety medications in the United States. This is understandable in light of the fact that physical and mental ailments are often comorbid. But, there may be more to treating a patient who presents with depression than prescribing a pill.