This disorder which I have discussed about previously in general terms is actually quite common, especially in places which have a high occurrence of violence like Port Moresby.
Many individuals in Port Moresby, are quite stoic (mentally tough) and tend to soldier on with their public lives despite having some very stressful and agonising issues that they’re dealing with in their personal lives. They may feel, that what they are going through is normal, “everyone has these problems” and that they may think they are weak if they cannot hold themselves together and soldier on.
Many times it is difficult to find someone that one can trust and whom has time to sit down with you and to simply listen. Everyone seems busy with their work, family and their own problems. There are a few places available where people can go to for psychological support either for professional counseling or simply to talk to someone and feel that they’re being listened to without being judged.
The GP at the Primary Healthcare level offers a rare opportunity for people with mental illness depression, generalized anxiety disorders, social phobias, post-traumatic stress disorder, stress etc., to find the help they so desperately need and hopefully to receive it from their GP.
It is very important for GPs to be aware that these disorders are real and not “Just psychological”. They are recognized, diagnosable and treatable disorders listed in the DSM IV disease classification.
Primary Healthcare providers, GPs, need to think about mental illnesses and keep our ears and eyes out for them in our patients. Beware and recognized mental illness in stoic patients, they may present with a mental illness masquerading as another illness with other symptoms, having an open mind, listening and looking out for mental illness will make a GP more likely to pick it up…. Be non-judgmental and empathic.
- Know the diagnostic criteria for common mental illness and their management – major depression, generalized anxiety, social phobias, post-traumatic stress disorders, schizophrenia..
- Establish a good working relationship with a psychiatrist and work out a system for referring patients where appropriate.
- Always arrange follow up, after seeing patients, make them feel that you there for them, this is important to build rapport, following up on specific treatment/drugs, side effects, and simply provides an avenue for patients to talk about their problems. Provide an environment for CATHARSIS to take place which in itself can be therapeutic.
Always make sure there is a box of tissues in the consultation room!