Stepped Care

Stepped Care ApproachStepped Care Approach

Stepped Care Approach

A stepped approach for the treatment of depression within primary care
Step One Early IdentificationStep One Early Identification

Step One Early Identification

Action: Screening and Assessment
Step Two Mild DistressStep Two Mild Distress

Step Two Mild Distress

Action: Active Monitoring
Step Three Moderate To Severe DistressStep Three Moderate To Severe Distress

Step Three Moderate To Severe Distress

Action: More Intensive Intervention and Close Monitoring
Step Four Recurrent, Atypical & High RiskStep Four Recurrent, Atypical & High Risk

Step Four Recurrent, Atypical & High Risk

Action: Risk Management, Complex Psychological Intervention

Screening

Routine screening for mental health is recommended as a support to clinical assessment and intervention. NZ Best Practice Guidelines suggest the use of the following simple screening questions to screen for depression, anxiety and substance abuse:

Questions for Depression:

  • During the past month, have you been bothered by feeling down, depressed or hopeless?
  • During the past month, have you been bothered by little interest or pleasure in doing things?

Question for Anxiety:

  • During the past month have you been worrying a lot about everyday problems?

Questions for Alcohol and Drug problems:

  • Have you used drugs or drunk more than you meant to in the last year?
  • Have you felt that you wanted to cut down on your drinking or drug use in the past year?

If yes to any of these questions, ask The Help question:

  • Is this something that you would like help with?

If yes, then move on to Assessment

Related Links:

Measure your stress and see how you compare to others.
Download the Case-Finding & Help Assessment Tool (CHAT)

Youth:

 Adult:

If you have serious concerns for your own or someone else’s mental health and addictions problems, the District Health Board have a phone-in service staffed by mental health professionals 24 hours per day. They are available for advice and assessments and will refer you onto the most appropriate service.

Te Haika 0800 745 477  

Kessler Distress Scale (K10)

The questionnaire below relates to how you have been feeling over the past month. It was developed by researchers and thousands of others with similar concerns. Click on the circle that most closely describes how you have been doing and when you are finished click on “Calculate my Results”. Once you get your score, you will be prompted to the next step, which will help you decide whether or not to seek help or to try some things on your own first.


In the past 4 weeks, about how often did you feel...

None of the time

A little of the time

Some of the time

Most of the time

All of the time

1. Tired out for no good reason?

2. Nervous?

3. So nervous that nothing could calm you down?

4. Hopeless?

5. Restless or fidgety?

6. So restless you could not sit still?

7. Depressed?

8. That everything was an effort?

9. So sad that nothing could cheer you up?

10. Worthless?


 





Published with permission from Professor Ronald Kessler, Harvard Medical School