Mental Health for the Young & their Families in Victoria is a collaborative partnership between mental health & other health professionals, service users & the general public.
PO Box 206,
Parkville, Vic 3052
PROJECT EVIDENCE for Treatment of Mental Disorders. The project coordinator is Dr Allan Mawdsley. The version can be amended by consent. If you wish to contribute to the project, please email firstname.lastname@example.org
 Standard Treatment
a) Outpatient psychotherapies, medication and procedures
b) Inpatient psychotherapies, medication and procedures
c) Ancillary support services
[6 a ] Outpatient psychotherapies, medication and procedures
Specialist mental health services should offer a range of therapeutic programs for disabling mental health problems in the community. Service provision, clinical research and training are closely linked in the Tier Three facilities but the practice guidelines published by those services should be implemented at all levels of their service delivery facilities.
These are grouped under nine headings: (i) organic brain disorders, (ii) substance abuse disorders, (iii) psychotic disorders, (iv) mood disorders, (v) anxiety disorders, including stress-related, somatoform and obsessive-compulsive disorders, (vi) physiological disorders, including eating, sleeping and sexual, (vii) personality disorders, (viii) intellectual disability and developmental disorders including autism spectrum disorders, (ix) behavioural and relationship disorders of childhood.
All disorders in childhood require wholistic management involving caregivers. See PE4 for a general outline of case identification and assessment and PE2a(i) for infant mental health. See PE6a(ix) for a general outline of case management for young people.
PE6a (ii) Substance Abuse Disorders
Substance misuse is the harmful use of drugs or alcohol for non-medical purposes. Often associated with the use of illicit drugs, legal substances can also be misused, such as alcohol, prescription or over-the-counter medication, caffeine, nicotine and volatile substances (e.g. petrol, glue, paint). Most people with a substance use disorder are using alcohol.
Misuse is characterized by a preoccupation with or craving for the substance, a greater priority to substance use than other goals and/or a difficulty controlling consumption. Use of the substance may continue despite negative impacts on other activities, roles, relationships and physical and mental health.
Increased tolerance to the substance and withdrawal symptoms may also occur. Broad impacts on social and cognitive functioning and on physical and mental health emerge. Diffuse cognitive impairment may persist for up to 12 months post-detoxification in alcohol dependence. Psychological comorbidity is common, particularly mood and anxiety disorders. (Kavanagh and Connor, 2014 InPsych).
Addiction is a physical and/or psychological need to use a substance, often caused by regular continued use. Some substances are more highly addictive than others. Some people are more likely to become addicted to a substance depending on mental, physical and lifestyle factors.
People use drugs and alcohol for many reasons – to relax, have fun, socialise, cope with problems, escape life or dull emotional/physical pain. Using substances to cope doesn’t make problems go away and can make them worse or add new problems to the mix. Becoming dependent on drugs in order to cope, rather than getting help or finding positive solutions, can create longer term problems.
Substance abuse and addiction can have short-term and long-term impacts on physical, mental, social and financial health. Referral is indicated for:
Signs and Symptoms of Substance Abuse
It is difficult for substance abusers to accept that there is a problem and to ask for help. When concerned that a child is using substances it may be helpful to consult a clinician such as a psychologist to discuss how to broach the subject with the child. Whilst external limits have some role, the main solution to substance misuse depends on strengthening the internal locus of control through the person “owning” the need for change. For success it is necessary for the affected person to:
Evidence based psychological treatment guidance includes:
Online sources of information and treatment options are:
For a discussion of the prevention of mental disorders due to substance abuse, see PE3a(iii).
Last updated 10/1/2022
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