Mental health and psychosocial support
Scope
The domain tests the biopsychosocial model, common mental disorders, psychological first aid, stepped care and legal frameworks for involuntary care.
Core rules
- Mental health is more than the absence of disorder. The biopsychosocial model integrates biological vulnerability, psychological factors and social circumstances; the stress–vulnerability model explains relapse under stress.
- Common presentations include depression, anxiety disorders, harmful substance use and psychosis. Screening tools support, but do not replace, clinical assessment.
- Suicide risk assessment asks directly about thoughts, plans, intent, means and protective factors; asking does not increase risk. Immediate safety planning and referral are required when risk is significant.
- Psychological first aid follows look, listen and link: check safety, listen without pressing for traumatic details, and connect people to basic needs and services. It is not psychotherapy and is not delivered to everyone regardless of need.
- The IASC MHPSS pyramid has four layers: basic services and security, community and family supports, focused non-specialist supports, and specialised services.
- Stepped care matches intensity to need, starting with low-intensity interventions and escalating. Mental health legislation permits involuntary assessment or admission only with mental disorder, risk to self or others, and proportionality.
Worked example
After an earthquake, a man is agitated and cannot find his family. A responder should ensure physical safety, offer water and shelter, ask what he needs, help him contact relatives, and give clear practical information. The reasoning: acute distress is normal, and the priority is safety, connection and information. Debriefing that forces trauma narration is not recommended; specialised referral is for persistent severe symptoms or danger.
Traps
Do not pathologise normal distress; do not equate psychological first aid with therapy; do not promise confidentiality when there is immediate risk; do not use involuntary admission for social or housing problems alone.