TOOL 8.2: Management of Prolonged Mental Health Disorders Algorithm

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TOOL 8.2: Management of Prolonged Mental Health Disorders Algorithm

If mild/moderate

Consider management by local health care professional

If severe

Consider combination of pharmacological and non-pharmacological therapy Refer to a psychiatrist, psychologist, or neuropsychologist

Non-pharmacological Treatment

Non-pharmacological Treatment

Pharmacological Treatment*

General Measures 

Support and psychoeducation: 

  • proper sleep hygiene, good diet, regular social and physical activity Psychosocial Interventions Evidence-based Psychotherapy:
  • Cognitive-behavioural therapy (CBT) Other Psychotherapy Interventions:
  • Depending on availability

Psychosocial Interventions

Evidence-based Psychotherapy:

  • Cognitive-behavioural therapy (CBT) 
Other Psychotherapy Interventions: 
  • Depending on availability

Was the treatment successful?

(minimum 8-10 sessions,  symptoms not worsening)

General Measures 

Support and psychoeducation: 

  • proper sleep hygiene, good diet, regular social and physical activity Psychosocial Interventions Evidence-based Psychotherapy:
  • Cognitive-behavioural therapy (CBT) Other Psychotherapy Interventions:
  • Depending on availability

Psychosocial Interventions

Evidence-based Psychotherapy:

  • Cognitive-behavioural therapy (CBT) 
Other Psychotherapy Interventions: 
  • Depending on availability

Anxiety/Mood Disorders

  • •SSRI, mirtazepine, TCA

PTSD

  •  •SSRI

PTSD & Sleep Disorder

  •  Trazadone, mirtazapine, prazosin 

*These medications are used “off-label”

 

Adapted from Guideline for Concussion/Mild Traumatic Brain Injury and Persistent Symptoms, Third Edition Acronyms: Post-traumatic stress disorder (PTSD); Selective serotonin reuptake inhibitors (SSRI); Tricyclic antidepressants (TCA)