Useful links

Stepped care model

  • Identification
  • Assessment
  • Psychoeducation;
  • Active monitoring by primary health care professionals
  • Depression, GAD, Insomnia (where it is a symptom of Depression/GAD), OCD, Health Anxiety, Social Anxiety, Panic Disorder, Agoraphobia, Specific Phobia.
  • Mild to moderate symptoms and/or where no previous CBT based treatment has been tried.
  • PTSD, Depression, GAD, OCD, Health Anxiety, Social Anxiety, Panic Disorder, Agoraphobia, Specific Phobia.
  • Those that have not responded to step 2 interventions, and/or severe presentations with marked functional impairment.

Step 4 Psychological Services

  • Complexity; several or frequent recurrences; multiple traumas; childhood abuse.
  • Poor response to other treatment, has had a treatment of CBT in the past (if appropriate).
  • Significant and sustained impact on daily functioning or relationships with others.
  • History or continuing risk of moderate to severe harm to self or others.
  • Several mental health diagnoses or several different areas of difficulty.
  • Duration is greater than 12 months.
  • No current drug use or alcohol dependency

Adult Mental Healthcare Team AMHT

If a client is presenting with a high level of risk and/or requires a psychiatric assessment:

  • EMERGENCY- to be seen within 4 hours
  • URGENT – to be seen within 7 days (inclusive of weekends)
  • ROUTINE – to be seen within 28 days, for mental health assessment, psychiatric diagnoses or medication review.

Talking Therapy questionnaires

Depression symptoms (PHQ-9)

To measure depression symptoms, score ranges:

0 – 4: normal

5 – 9: mild

10 – 14: moderate

15 – 19: moderately severe

20 – 27: severe

A score of 9 or above would be determined as in caseness for depressive symptoms.

Generalised anxiety symptoms (GAD-7)

To measure generalised anxiety symptoms, score ranges:

0 – 4: normal

5 – 9: mild

10 – 14: moderate

15 – 21: severe

A score of 7 or above would be determined as in caseness for anxiety symptoms.

An additional measure can also be used to assess for GAD, the Penn State Worry questionnaire (short version) a score of 45 or above would indicate caseness.

Phobia

Talking Therapies phobia scale for assessing avoidance due to fear of outlined situations (panic attacks, social situations, or specific situations such as driving, flying, heights, confined spaces, vomit, blood, animals, etc.)

0 – would not avoid

2 – slightly avoid

4 – definitely avoid

6 – markedly avoid

8 – always avoid

Work and social adjustment scale (WSAS)

Work and social adjustment scale, assessing the impact on different areas of day-to-day activities due to experienced difficulties. This includes work, home management, social leisure activities, private leisure activities, family and relationships.

0 – would not avoid

2 – slightly avoid

4 – definitely avoid

6 – markedly avoid

8 – always avoid

Obsessive compulsive inventory (OCI)

Obsessive Compulsive Inventory, to measure symptoms of OCD, using the distress scale:

0 – not at all

1 – a little

2 – moderately

3 – a lot

4 – extremely

A score of 40 or above would indicate symptoms of OCD.

Health Anxiety Inventory (HAI)

Health Anxiety Inventory (short version), to measure symptoms of health anxiety. Each question consists of 4 statements, with the patient choosing which statement best fits with their feelings over the last week.

A score of 18 or above would indicate symptoms of health anxiety.

Social phobia inventory (SPIN)

Social Phobia Inventory, to measure symptoms of social anxiety, using the following scale:

0 – not at all bothered

1 – a little bothered

2 – moderately bothered

3 – bothered a lot

4 – extremely bothered

A score of 19 or above would indicate symptoms of social anxiety.

Mobility inventory (MI)

Mobility Inventory, to measure symptoms of agoraphobia, using the following scale:

1 – never avoid

2 – rarely avoid

3 – avoid about half of the time

4 – avoid most of the time

5 – avoid always

A score of 60 or above would indicate symptoms of agoraphobia.

Panic disorder severity scale (PDSS)

Panic Disorder Severity Scale, to measure symptoms of panic disorder, using the following scale:

0 – none

1 – mild

2 – moderate

3 – severe

4 – extreme

A score of 8 or above would indicate symptoms of panic disorder.

Post traumatic check list (PCL-5)

Posttraumatic Check List (PCL-5), to measure for symptoms of PTSD, using the following scale:

0 – not at all bothered / distressed

1 – a little

2 – moderately

3 – quite a bit

4 – extremely bothered / distressed

A score of 32 or above would indicate symptoms of PTSD.

Page last reviewed: 14 April, 2023

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