A . T H A N G A M A N I R A M A L I N G A M P T, M S C ( P S Y ) , M I A P

Psychiatry for physiotherapists

Psychiatric history

Identity• marital status• education• occupation• cultural • spiritual identity

Present complaint

The date of onset and was the onset slow or sudden? Why and precisely how has the person presented at this time? What precipitated the problem? The severity and its course and effect on work and relationships physical effects on appetite, sleep and sexual drive. Previous episodes, including dates, treatments and outcomes of

similar episodes. The description of the problem - patient's insight into their

situation. Some patients may deny the existence of a problem and it may

be necessary to obtain a history of the illness from a family member or close friend.

Personal history Work history: Marital history relationship history with others (intimate or sexual relationships) Family history: close family, including names, ages and their past and present mental

and physical health. Illegal activities/violence: criminal record and any previous episodes of violence or

other acts of aggression. Present social situation Pre morbid personality

Character traits. Confidence. Religious and moral beliefs. Ambitions and aspirations. Social relationships with family, friends, workmates. Alcohol and illicit drug misuse (past and present). Full current drug history (prescribed medications, self-prescribed, or recreational).

Mental state assessmentMini Mental State Examination (MMSE)Cognitive Impairment Screening Screening Depression Appearance and behaviour: appearance, motor behaviour,

attitude to situation and examiner.Speech: rate, volume, quantity of information; disturbance

in language or meaning.Mood and affect: mood (eg depressed, euphoric,

suspicious); affect (eg restricted, flattened, inappropriate).

Content of thought: delusions, suicidal thoughts, amount of thought and rate of production, continuity of ideas.

Perception: hallucinations, other perceptual disturbances (derealisation; depersonalisation; heightened/dulled perception).

Cognition: level of consciousness, memory (immediate, recent, remote), orientation (time, place, person), concentration: serial 7s, abstract thinking.

Insight: extent of the individual's awareness of the problemAssessing suicidal attempts/intent

Physical examination and investigations

To exclude physical (organic) causes for current mental problems.

Investigationseg blood tests for anaemia B12 deficiency TFTs or syphilis serology, may be required depending on

the presentation.

Clinical assessment

Clinical cognitive assessment in those with suspected dementia should include examination of attention and concentration, orientation, short-term and long-term memory, praxis, language and executive function.

Formal neuropsychological testing should form part of the assessment in cases of mild or questionable dementia.

The General Practitioner Assessment of Cognition (GPCOG)

The GPCOG – It has been found to be reliable and superior to the

Abbreviated Mental Test (AMT) and to the Mini Mental State Examination (MMSE), in detecting dementia. The two-stage method of administering the GPCOG had a sensitivity of 0.85 and a specificity of 0.86.Patient interviews took less than four minutes to administer and informant interviews less than two minutes.

The Mini Mental State Examination

The MMSE was developed by psychiatrists and is highly regarded. The test takes only about 10 minutes, but is limited because it will not

detect subtle memory losses, particularly in well-educated patients.People from different cultural groups, or of low intelligence or

education, may score poorly .The MMSE provides measures of orientation, registration (immediate

memory), short-term memory (but not long-term memory) as well as language functioning.

Scores of 25-30 out of 30 are considered normal; NICE classify 21-24 as mild, 10-20 as moderate and <10 as severe impairment

The MMSE may not be an appropriate assessment if the patient has learning, linguistic/communication or other disabilities

The Six Item Cognitive Impairment Test (6CIT)

Developed in 1983, the 6CITbecause of recognition by The Royal College of General Practitioners together with new computerised versions, its usage is increasing.

The 6CIT is a much newer test than the AMT Appear to be culturally and linguistically translatable

with good probability statisticsmore complex scoring system.

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

When combined with cognitive tests, such as the MMSE, the IQCODE provides a useful overview and hence sensitivity and specificity as a screening test can be improved.

The questionnaire asks how the patient compares today with ten years ago in various activities, eg remembering birthdays and recalling conversations.

Abbreviated Mental Test

The AMTis a quick to use screening test that was first introduced in 1972 but is less widely used today.

Developed by geriatricians, Best known test in general hospital usage Lacks validation in primary care and screening populations.

Its disadvantages are the ability to be confounded by intelligence, age, social class, sensitivity of hearing and history of stroke.

A four point AMT has been developed which should be easier to administer than the original ten point version and may obviate some of these problems.

Test Your Memory (TYM) Test

This is a useful screening test, particularly where clinician time is limited. The test involves:

Orientation.Ability to copy a sentence.Semantic knowledge.Calculation.Verbal fluency.Similarities.Naming.Visuospatial abilities.Recall of a copied sentence.

Initial screening in patients who may have depression

During the last month have you been feeling down, depressed or hopeless?

During the last month have you often been bothered by having little interest or pleasure in doing things?

If patients with a chronic physical illness answers 'yes' to either question, the following three questions should be asked:During the last month, have you often been bothered by:

Feelings of worthlessness?Poor concentration?Thoughts of death

Assessing newly diagnosed patientsThree tools are recommended in the Quality and Outcomes

Framework (QOF) guidance. Patient Health Questionnaire (PHQ-9): this is a nine-item questionnaire which helps

both to diagnose depression and to assess severity. It is based directly on the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual - Fourth Edition (DSM-IV). It takes about three minutes to complete. Scores are categorised as minimal (1-4), mild (5-9) , moderate (10-14), moderately severe (15-19) and severe depression (20-27). It can be downloaded free from the internet.

Hospital Anxiety and Depression (HAD) Scale: despite its name, this has been validated for use in primary care. It is designed to assess both anxietyand depression. It takes about 5 minutes to complete. The anxiety and depression scales each have seven questions, and scores are categorised as normal (0-7), mild (8-10), moderate (11-14) and severe (15-21).

Beck Depression Inventory® - Second Edition (BDI-II): this also uses DSM-IV criteria. it takes about five minutes to complete. It is an assessment of the severity of depression and is graded as minimal (0-13), mild (14-19), moderate (20-28) and severe (29-36). It consists of 21 items to assess the intensity of depression in clinical and normal patients. Each item is a list of four statements arranged in increasing severity about a particular symptom of depression. It is also not free but can be purchased from the supplier's website.

SPECIFIC TOOLS for depressionChildren's Depression Inventory (CDI) and Reynolds' Child

Depression Scale (RCDS). Both of these can be used on children aged over 7.

The Center for Epidemiologic Studies Depression Scale (CES-D) and Reynolds' Adolescent Depression Scale (RADS) are more suitable for adolescents.

The Edinburgh Postnatal Depression Scale (EPDS) - a self-rating scale - is for puerperal depression.

The Geriatric Depression Scale (GDS) is suitable for older patients. Center for Epidemiologic Studies (CES), Beck and Zung depression assessment tools can also be used in the elderly.

The Cornell Scale for Depression in Dementia (CSDD) is suitable for patients with dementia.

The Modified Scale forSuicidal Ideation

The purpose of this scale is to assess the presence or absence of suicide ideation and the degree of severity of suicidal ideas.

The time frame is from the point of interview and the previous 48 hours.

SPIRITUALITY AND RESILIENCEASSESSMENT PACKET

A.     Measuring a Resilient Worldview: The IPPA                                                   1.  Control Dimension: Self Confidence During Stress                                       2.  Meaning Dimension: Life Purpose and Satisfaction                                       3.  Unifying Concept: Confidence in Life and Self

 B.    Measuring Internalized Spirituality: The

INSPIRIT                                             1.  Religion and Spirituality as Overlapping Concepts                                         2.  Characteristics of Internalized Spirituality                                

Perinatal and infants 0–2 years Examples of Parenting—Knowledge, Skills and Attitudes relevant measures The Parenting Scale (Arnold et al. 1993)Parenting Sense of Competence Scale (Gibauld-Wallston &Wandersmann 1978)Parent Behaviour Checklist (Fox 1990)Parenting Stress Index (Abidin 1990)Abuse and NeglectChild Abuse Potential Inventory (Milner 1986).Child DevelopmentNeonatal Behavioural Assessment Scale (Brazelton 1973)Denver Developmental Screening Test II (Frankenberg et al. 1990)Griffiths Mental Development Scales (Griffiths 1954)Bayley Scales of Infant Development (Bayley 1993)Depression (postnatal)Edinburgh Depression Scale (Cox, Holden & Sagovsky 1987)Family Functioning and Couple Relationship SatisfactionFamily Adaptability and Cohesion Scales III (Olson, Bell & Portner1985)Outcomes and indicators, measurement tools Dyadic Adjustment Scales (Spanier 1976) and abbreviated version(Sharpley & Rogers 1984)ENRICH Short Form (Fowers & Olson 1993) and databases 53Family APGAR (Smilkstein 1978)Structural Family Interaction Scale (Perosa, Hansen & Perosa 1981)McMaster Family Assessment Device (Epstein et al. 1983)Family Environment Scale (Moos & Moos 1981)

Toddlers and preschoolers 2–4 years Examples of Parenting—Knowledge, Skills and Attitudes relevant measures The Parenting Scale (Arnold et al. 1993) Parenting Sense of Competence Scale (Gibauld-Wallston & Wandersmann 1978) Parent Behaviour Checklist (Fox 1990) Parent–Child Relationship Inventory (Gerard 1994) Parenting Stress Index (Abidin 1990) Abuse and Neglect Child Abuse Potential Inventory (Milner 1986) Child Development Screening Measures Denver Developmental Screening Test-II (Frankenberg et al. 1990) The Language Development Survey (Rescorla 1989) Griffiths Mental Development Scales: Scale 2 (Griffiths 1954) Family Functioning and Couple Relationship Satisfaction Family Adaptability and Cohesion Scales III (Olson, Bell & Portner 1985) Family APGAR (Smilkstein 1978) Structural Family Interaction Scale (Perosa, Hansen & Perosa 1981) McMaster Family Assessment Device (Epstein et al. 1983) Family Environment Scale (Moos & Moos 1981) Dyadic Adjustment Scales (Spanier 1976) and abbreviated version (Sharpley & Rogers 1984) ENRICH Short Form (Fowers & Olson 1993) Child Behaviour Problems and Disorders The Preschool Behaviour Questionnaire (Behar 1977). Preschool Behaviour Checklist (McGuire & Richman 1986) Child Behaviour Checklist (Achenbach 1992)

Examples of Parenting Skills, Knowledge and Attitudes

relevant measures Parenting Sense of Competence Scale (Gibauld-Wallston &

Wandersmann 1978)Parent–Child Relationship Inventory (Gerard 1994)Parenting Stress Index (Abidin 1990)Parenting Skills Inventory (Nash & Morrison 1984)The Parenting Scale (Arnold et al. 1993)Alabama Parenting Questionnaire (Shelton, Frick & Wooton 1996)Abuse and NeglectChild Abuse Potential Inventory (Milner 1986)Family Functioning and Couple Relationship SatisfactionFamily Adaptability and Cohesion Scales III (Olson, Bell & Portner1985)Family APGAR (Smilkstein 1978)Structural Family Interaction Scale (Perosa, Hansen & Perosa

1981)McMaster Family Assessment Device (Epstein et al. 1983)Family Environment Scale (Moos & Moos 1981)Dyadic Adjustment Scales (Spanier 1976) and abbreviated version(Sharpley & Rogers 1984)ENRICH (Fowers & Olson 1993)Child Mental Health/Behaviour Problems and DisordersChild Behaviour Checklist (Achenbach 1991) Parent and TeacherReport

Conners Rating Scales—Revised (Conners 1997)Diagnostic Interview Schedule for Children (DISC-IV;

Shaffer 1996)Schedule for Affective Disorders and Schizophrenia for

School-AgeChildren (K-SADS-IV-R; Ambrosini & Dixon, and K-

SADS-E,Orvaschel, 1995)Anxiety Interview Schedule for Children–Parent/Child

(ADIS-C;Albano & Silverman 1996)Ohio Youth Problems, Functioning and Satisfaction

Scales (Ogles,Davis & Lunnen 1998)Strengths and Difficulties Questionnaire (Goodman

1997)Health of the Nation Outcome Scales for Children and

Adolescents(HoNOSCA; Gowers et al. 1999a,b)Children’s Global Assessment Scale (CGAS; Shaffer et

al. 1983)Positive and Negative Syndrome Scale for Children

(Kiddie-PANSS;Fields et al. 1994)

Children 5–11 years

Disorder Specific MeasuresDepression

Children’s Depression Inventory (Kovacs 1992)Reynolds Child Depression Scale (Reynolds 1989)Outcomes and indicators, measurement tools and databases

59AnxietyRevised Children’s Manifest Anxiety Scale (Reynolds &

Richmond1978; 1985)Spence Children’s Anxiety Scale (Spence 1998)State-Trait Anxiety Inventory for Children (Spielberger 1973)Self-esteemCulture-Free Self-Esteem Inventories (Battle 1992)Coopersmith Self-Esteem Inventories (Coopersmith 1982)Piers-Harris Children’s Self-Concept Scale (Piers 1984)Optimistic/Pessimistic Thinking StylesChildren’s Attributional Style Questionnaire (Seligman et al.

1994)Sense of connectedness to school and community[available measures were not examined]Mental health literacy[available measures were not examined]

Acceptance and valuing of cultural diversity[available measures were not examined]Children’s Social Skills and Social Competence [not

examined inaudit]Social Skills Questionnaires (Parent, Child, Teacher

Versions;Spence 1995)Social Skills Rating System (Gresham & Elliot 1990)Social Support and Social NetworksSurvey of Children’s Social Support (Dubow & Ullman

1989)Teacher behaviour, skills and attitudes re: mental

health and resilienceskill building[available measures were not examined]Social facilities and resources[available measures were not examined]Type and number of school and community activities

appropriate tochildren and families[available measures were not examined]Level of bullying in schools[available measures were not examined

Young people 12–17 yearsYouth Mental Health and Emotional/Behaviour Problems Child Behaviour Checklist (Achenbach 1991)Youth, Parent andTeacher ReportOhio Youth Functioning and Satisfaction Scales (Ogles, Davis &Lunnen 1998)Diagnostic Interview Schedule for Children (DISC-IV; Shaffer, 1996)Schedule for Affective Disorders and Schizophrenia for School-AgeChildren (K-SADS-IV-R; Ambrosini & Dixon, and K-SADS-E,Orvaschel, 1995)Anxiety Interview Schedule for Children-Parent/Child(Albano & Silverman 1996)Composite International Diagnostic Interview (CIDI; Robins et al. 1988)Strengths and Difficulties Questionnaire (Goodman 1997)Health of the Nation Outcome Scales for Children and Adolescents(HoNOSCA; Gowers et al. 1999 a,b)Children’s Global Assessment Scale (CGAS; Shaffer et al. 1983)

Disorder Specific MeasuresDepressionChildren’s Depression Inventory (Kovacs 1992)Reynold’s Adolescent Depression Scale (Reynolds 1987)Beck Depression Inventory (BDI; Beck 1961) and BDI-2 (Beck et al.1996)Centre for Epidemiological Studies Depression Scale (Radloff 1977)Outcomes and indicators, measurement tools and databases 63AnxietyRevised Children’s Manifest Anxiety Scale (Reynolds & Richmond1978; 1985)State-Trait Anxiety Inventory for Children (Spielberger 1973)Spence Children’s Anxiety Scale (Spence 1998)Eating DisordersChildren’s Eating Attitudes Test (Maloney et al. 1988)Eating Attitudes Test -26 (EAT-26; Garner et al. 1982)Eating Disorder Inventory (EDI)Garner, Olmsted & Polivy 1983)and EDI-2, Garner 1991)Body Esteem Scale (Franzoi & Shields 1984)Drug and alcohol abusePersonal Experiences Screening Questionnaire (Winters 1992)Westminster Substance Use Questionnaire (Adelekan, Gowers &Singh 1994)PsychosisBrief Psychiatric Rating Scale (BPRS; Overall & Gorham 1962)Early Signs Scale (ESS; Birchwood et al. 1989)Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein &Opler 1987)Positive and Negative Syndrome Scale for Children (Kiddie-PANSS;Fields et al. 1994)Hopelessness, Suicidal IdeationHopelessness Scale for Children (Kazdin et al. 1983)Beck Scale for Suicide Ideation (Beck, Kovaks & Weismann 1979)Modified Scale for Suicidal Ideation (Miller et al. 1986)Suicide Probability Scale (Cull & Gill 1989)The Beck Hopelessness Scale (Beck et al. 1974)Youth Quality of LifeComprehensive Quality of Life Scale-Student (Cummins et al. 1994)Perceived Life Satisfaction Scale (Smith et al. 1987)Student Life Satisfaction Scale (Huebner 1991)Coping and Problem SolvingAdolescent Coping Scale (Frydenberg & Lewis 1993)Coping Strategies Inventory (Tobin, Holroyd & Reynolds 1989)Problem Solving Inventory (D’Zurilla, Nezu & Maydeu-Olivares1997)A

Self-Esteem and Self-imageCoopersmith Self-Esteem Inventories (Coopersmith 1982)Self Perception Profile (Harter 1988)64 National Action Plan for Promotion, Prevention and Early

Intervention for Mental Health 2000Children’s Social Skills and Social Competence [not examined inaudit]Social Skills Questionnaires (Parent, Child, Teacher Versions;Spence 1995)Social Skills Rating System (Gresham & Elliot 1990)Optimistic/Pessimistic Thinking StylesChildren’s Attributional Style Questionnaire (Seligman et al. 1994)Sense of Connectedness to School and CommunitySocial Connectedness Scale (Lee & Robbins 1995)Mental Health Literacy[available measures were not examined]Acceptance and Valuing of Cultural DiversityCultural Tolerance Scale (Gasser & Tan 1999)Quick Discrimination Index (Ponterotto et al. 1995)Motivation to Control Prejudice Scale (Dunton & Fazio 1997)Social Support and Social NetworksSurvey of Children’s Social Support (Dubow & Ullman 1989)Inventory of Socially Supportive Behaviours (Barrera 1981)Social Facilities and Resources[available measures were not examined]Audit of type and number of school and community activitiesappropriate to young peopleParenting skills and parenting stress among parents of

adolescentsParenting Stress Index (Abidin 1990)Parenting Skills Inventory (Nash & Morrison 1984)

AdultsMental Health and Wellbeingrelevant measures General Health Questionnaire (GHQ 60; 30; 28; 12; Goldberg1972, 1978)Mental Health Inventory (MHI; Viet & Ware 1983)Short Form-36 Health Survey Questionnaire (SF-36; Ware et al.1993)Brief Symptom Inventory (BSI; Derogatis & Spencer 1982)Outcomes and indicators, measurement tools and databases 71Composite International Diagnostic Interview (CIDI; Robins et al.1988)Diagnostic Interview Schedule (DIS; Robins et al. 1981)Symptom Checklist-90 Revised (SCL-90; Derogatis, Lipman & Covi1973)Life Skills Profile (LSP; Rosen, Hadzi-Pavlovic & Parker 1989)Health of the Nation Outcome Scales (HoNOS; Wing, Curtis &Beevor 1996)Global Assessment Scale (GAS; Endicott, Spitzer & Fleiss 1976)Global Assessment of Functioning Scale (GAFS; American PsychiatricAssociation 1994)

Disorder Specific MeasuresDepressionBeck Depression Inventory (BDI; Beck 1961) and BDI-2 (Beck et al.1996)Depression Anxiety Stress Scale (Lovibond & Lovibond 1995)Centre for Epidemiological Studies Depression Scale (Radloff 1977)Zung Self Rating Depression Scale (Zung 1965)AnxietyState-Trait Anxiety Inventory (Spielberger 1983)Beck Anxiety Inventory (Beck & Steer 1988)Eating DisordersEating Attitudes Test -26 (EAT-26; Garner et al. 1982)Eating Disorder Inventory (EDI) Garner, Olmsted & Polivy 1983)and EDI-2 (Garner 1991)Eating Disorder Examination-Self Report Questionnaire (Fairburn &Beglin 1994)Drug and Alcohol AbuseAlcohol Use Disorders Identification Test (Saunders et al. 1993)Alcohol Dependence Scale (Skinner & Allen 1982)The Short Michigan Alcoholism Screening Test (SMAST; Selzer,Vinokur & van-Rooijen 1975).PsychosisBrief Psychiatric Rating Scale (BPRS; Overall & Gorham 1962)Early Signs Scale (ESS; Birchwood et al. 1989)Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein &Opler 1987)Hopelessness, Suicidal IdeationBeck Scale for Suicide Ideation (Beck, Kovaks & Weismann 1979)Modified Scale for Suicidal Ideation-MMSI (Miller et al. 1986)Suicide Probability Scale (Cull & Gill 1989)The Beck Hopelessness Scale (Beck et al. 1974

Quality of LifeQuality of Life Questionnaire (Greenley, Greenberg & Brown 1997)WHOBREF/WHOQOL-100 (The WHOQOL Group 1996,1998a,b)Comprehensive Quality of Life Scale—Adult (Cummins 1993)Quality of Life Index (Spitzer et al. 1981)Quality of Couple RelationshipDyadic Adjustment Scales (Spanier 1976) and abbreviated version(Sharpley & Rogers 1984)ENRICH Short Form (Fowers & Olson 1993)Mental Health Literacy[available measures were not examined]Coping and Problem-solving SkillsProblem Solving Inventory (D’Zurilla, Nezu & Maydeu-Olivares1997)Ways of Coping (Folkman & Lazarus 1980)Multidimensional Coping Inventory (Endler & Parker 1990)Coping Scale for Adults (Frydenberg & Lewis 1997)Social Support and Social NetworksInventory of Socially Supportive Behaviours (Barrera 1981)Interview Schedule for Social Interaction (Hendlerson et al. 1980)Social Support Questionnaire (Sarason et al. 1983)Sense of Connectedness to Community (social connectedness)Social Connectedness Scale (Lee & Robbins 1995)Acceptance and Valuing Of Cultural DiversityCultural Tolerance Scale (Gasser & Tan 1999)Quick Discrimination Index (Ponterotto et al. 1995)Motivation to Control Prejudice Scale (Dunton & Fazio 1997)Modern Racism Scale (McConahay 1983)Intercultural Tolerance Scale (Mendleson et al. 1997)Occupational Stress and Burnout Measures [not reviewed]Maslach Burnout Inventory (Maslach, Jackson & Leiter 1996)Occupational Stress Indicator (Cooper, Sloan & Williams 1988)

Older adults

Quality of Life, Wellbeing and Life Satisfactionrelevant measures Quality of Life Index (Spitzer et

al. 1981)The Life Satisfaction Index A and Index B (Neugarten,

Havinghurst& Tobin 1961)The Life Satisfaction Index Z-13 item Version (Wood,

Wylie &Sheafor 1969)Lancashire Quality of Life scale (Lancashire Quality of

Life Scale,Oliver 1992)Mental Health and WellbeingShort Form-36 Health Survey Questionnaire (SF-36;

Ware et al.1993)General Health Questionnaire (GHQ 60; 30; 28; 12;

Goldberg1972, 1978)Mental Health Inventory (MHI; Viet & Ware 1983)Outcomes and indicators, measurement tools and

databases 75

Brief Symptom Inventory (BSI; Derogatis & Spencer 1982)

Composite International Diagnostic Interview (CIDI; Robins et al.

1988)Diagnostic Interview Schedule (DIS; Robins et al.

1981)Symptom Checklist—90 Revised (SCL-90; Derogatis,

Lipman &Covi 1973)Life Skills Profile (LSP; Rosen, Hadzi-Pavlovic &

Parker 1989)Health of the Nation Outcome Scales (HoNOS; Wing,

Curtis &Beevor 1996)Global Assessment Scale (GAS; Endicott, Spitzer &

Fleiss 1976)Global Assessment of Functioning Scale (GAFS;

American PsychiatricAssociation 1994)

Disorder Specific MeasuresDepressionBeck Depression Inventory (BDI; Beck 1961) and BDI-2 (Beck et al.1996)Depression Anxiety Stress Scale (Lovibond & Lovibond 1995)Centre for Epidemiological Studies Depression Scale (Radloff 1977)Zung Self Rating Depression Scale (Zung 1965)Geriatric Depression Scale (Yesavage et al. 1983)AnxietyState-Trait Anxiety Inventory (Spielberger 1983)Beck Anxiety Inventory (Beck et al. 1988)Eating DisordersEating Attitudes Test -26 (EAT-26; Garner et al. 1982)Eating Disorder Inventory (EDI)Garner, Olmsted & Polivy 1983)and EDI-2 (Garner 1991)Eating Disorder Examination—Self Report Questionnaire (Fairburn &Beglin 1994)Drug and Alcohol AbuseAlcohol Use Disorders Identification Test (Saunders et al. 1993)Alcohol Dependence Scale (Skinner & Allen 1982)PsychosisBrief Psychiatric Rating Scale (BPRS; Overall & Gorham 1962)Early Signs Scale (ESS; Birchwood et al. 1989)Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein &Opler 1987)Hopelessness, Suicidal Ideation

Beck Scale for Suicide Ideation (Beck, Kovaks & Weismann 1979)

Modified Scale for Suicidal Ideation—MMSI (Miller et al. 1986)Suicide Probability Scale (Cull & Gill 1989)The Beck Hopelessness Scale (Beck et al. 1974)

Screening Measures for Cognitive Impairment in Community Settings

[not reviewed in Appendix A]Mini Mental Status Examination (Folstein, Folstein &

McHugh1975)Minnesota Cognitive Acuity Screen (Knopman et al.

2000)Measures of Stress Among Carers [not reviewed in

Appendix A]Caregiver Strain Index (Robinson 1983)Sense of Connectedness to Community (social

connectedness)Social Connectedness Scale (Lee & Robbins 1995)

Outcomes and indicators,measurement tools and databases

• National Action Plan for Promotion, Prevention and EarlyIntervention for Mental Health 2000• NationalAction Plan for SuicidePrevention-Evaluation

Design Consultancy• School of Psychology and Centre for Primary Health

Care,University of Queensland