Psychiatry and Behavioral Health
What candidates must know
Mental health is a core family-practice competency: recognise, assess risk, treat mild–moderate illness, and refer appropriately. Understand the assessment of depression and anxiety (PHQ-9, GAD-7 as aids, not diagnoses), the stepped-care model, and the difference between grief, adjustment and major depression. Know the principles of suicide risk assessment - direct enquiry, intent, plan, means, protective factors - and when to escalate. Understand first-line treatment for common conditions (SSRIs, psychological therapy, sleep hygiene), the recognition of psychosis and bipolar disorder (refer), and the safe use of benzodiazepines (short-term only). Know substance misuse screening and the biopsychosocial formulation.
Traps in questions
- Asking about suicide does not increase risk - the correct answer is to ask directly.
- Antidepressants in bipolar disorder can precipitate mania; screen for a history of elevated mood before prescribing.
- Benzodiazepines are not long-term treatment for anxiety.
- Delirium vs dementia: acute onset, fluctuating, inattention - delirium is a medical emergency.
- Confidentiality limits: risk to self or others overrides it.
Rule of thumb
Assess risk before treatment. For any mental-health vignette, the first decision is whether the patient is safe (suicide, self-harm, psychosis, neglect); only then choose the therapeutic step.
Worked example
A 40-year-old with 6 weeks of low mood, anhedonia and poor sleep admits to thoughts of self-harm but no plan. The priority is a structured suicide risk assessment and safety planning, then shared decision about therapy/SSRI and close follow-up - not immediate admission unless risk is high.