A Guide To Mental Health Terminology This guide aims to provide a quick reference for anybody seeking to understand terms

commonly used by mental health services. Acquired Brain Injury (ABI) A permanent brain injury that results in impairment to an individual's physical, cognitive (ability to think and reason), behavioural or emotional functioning. The injury may be caused by accident, infection, disease, overuse of alcohol, stroke, brain tumour or other medical illnesses. Acquired brain injury is not a mental illness and requires very different specialist skills from those offered by mental health services. However, people with acquired brain injury can also suffer from a mental illness. Acute Mental Illness Acute mental illness is characterised by significant and distressing symptoms of a mental illness requiring immediate treatment. This may be the person's first experience of mental illness, a repeat episode or the worsening of symptoms of an often continuing mental illness. The onset is sudden or rapid and the symptoms usually respond to treatment. Acute Treatment The intensive treatment provided to the person who is experiencing acute mental illness. Depending on the person's needs, acute treatment can be offered in the person's own environment or in a psychiatric inpatient service. Depending on the severity of symptoms, the distress involved for the person and the risk of harm to self or others, acute treatment may be provided in the community by a Crisis Assessment and Treatment (CAT) service, by a community mental health centre or in a psychiatric inpatient service. Adolescent Mental Health Services See Child and Adolescent Mental Health Services. Adult Mental Health Services The network of public mental health services providing assessment, treatment and support for people with severe mental illness or other severely disabling psychiatric disorders, aged 16-65 years of age. Services include community mental health centres, crisis assessment and treatment services, mobile support and treatment services, psychiatric inpatient services and non-government psychiatric disability support services. Affective Disorder See bi-polar affective/mood disorder. Aged Persons' Mental Health Services Specialist public mental health services for people with severe mental illness who are 65 years of age and over. Services include psychogeriatric assessment and treatment services and psychiatric inpatient services. Agitation/Agitated

Restless, repeated activity arising from a person's anxiety or frustration. For example the person may be unable to stand or sit still and may be noticeably upset. It is important to note that a side effect of antipsychotic medication is physical restlessness, usually first noticed as shaking in the arms and legs, which can mimic agitated behaviour. Alzheimer's Disease A form of dementia characterised by the gradual deterioration of brain tissues and brain function. The effects progress from mild forgetfulness and confusion to a permanent inability to perform routine life tasks, for example making a cup of coffee or putting on one's clothes. Antidepressant Medication Main form of medication used for the treatment of depression. Antipsychotic Medication Main form of medication for the treatment of psychoses such as schizophrenia. These drugs tend to reduce delusions and hallucinations and have a calming effect. Anxiety Disorder A mental disorder characterised by feelings of unease, tension and distress with an exaggerated fear of possible danger or misfortune and often associated with significant disruption to a person's life, such as inability to hold down a job or use public transport. Examples of such disorders may include phobias, panic attacks and obsessive compulsive disorder. Area Mental Health Service The network of public mental health services managed by a general health service that operates within a defined, geographical area providing clinical services. Assessment See psychiatric assessment. Authorised Psychiatrist The authorised psychiatrist has specific powers and duties under the Mental Health Act 1986. Consultant psychiatrists in the area mental health service may carry out the responsibilities of the authorised psychiatrist under delegation. Medical officers, in limited circumstances, can perform this role, but only with the approval of the Chief Psychiatrist, and delegation by the Director of Psychiatric Services. Bi-Polar Affective/Mood Disorder A mental illness in which the significant symptoms involve fluctuating states of mood characterised by marked depressive and/or manic episodes. Borderline Personality Disorder A specific type of personality disorder which is characterised by a lifelong pattern of behaviour which may include unclear and disturbed selfimage, brief psychotic episodes, involvement in intense unstable relationships, repeated

emotional crises, fear of abandonment and a series of suicidal threats or acts of selfharm without apparent cause. See also personality disorder. Carer A person who has a caring role with the client and whose life is affected by the client's welfare. Case Management Case management is a process which aims to ensure the client receives the best possible treatment and support through the identification of needs, planning individual goals and strategies and linking to appropriate services to meet these needs. See individual service plan, case manager, continuity of care. Case Manager A mental health professional employed by a mental health service who has the primary responsibility for case management of a particular client. The client's case manager may be a social worker, psychiatric nurse, consultant psychiatrist, occupational therapist, medical officer or psychologist. CAT Service See crisis assessment and treatment (CAT) service. Chief Psychiatrist The Chief Psychiatrist is a psychiatrist appointed by the Secretary, Department of Human Services with overall responsibility for the medical care and welfare of persons receiving treatment for a mental illness within the state of Victoria. Powers are prescribed via the creation of a statutory office of the Chief Psychiatrist under the Mental Health Act 1986. Child and Adolescent Mental Health Services Specialist public mental health assessment end treatment services provided for children and adolescents up to 18 years of age. They are provided by community-based, multi-disciplinary services and psychiatric inpatient services. Client A person who is currently using public mental health services. Community Mental Health Centre (CMHC) The first point of contact during business hours for access to area mental health services. Mental health professionals employed by the CMHC provide initial screening, and consultancy for people requesting public mental health services to guide the person to the appropriate service. They also provide assessment, treatment, continuing care and support for clients with severe mental illness. Community mental health centres employ a range of mental health professionals to provide clinical services, including social workers, psychiatric nurses, consultant psychiatrists, occupational therapists, medical officers and psychologists. Community Treatment Order (CTO)

Community treatment orders can be issued under the Mental Health Act 1986. They enable involuntary patients to receive treatment for their mental illness in the community. CTOs are made by an authorised psychiatrist and offer a less restrictive treatment option than psychiatric inpatient services. Comprehensive Mental Health Service People with a severe mental illness often have complex medical, psychological and social needs. A comprehensive mental health service is one which provides a range of services that meets the client's treatment needs, including community based services and inpatient care. See continuity of care, individual service plan. Consultant Psychiatrist A medical practitioner who has undertaken specialised training and registration that qualifies them to diagnose and treat mental illnesses. Some have further specialist training in areas such as child and adolescent psychiatry, the psychiatry of old age or forensic psychiatry. Psychiatrists work in psychiatric inpatient services, community mental health services or in private practice. Consumer A person who uses public mental health services. Continuity of Care Provision of mental health services to a client in a way that ensures care is continued when there is a change of service or case manager. An example is when a person leaves a psychiatric inpatient service and his/her care is transferred to the community mental health centre or where the client moves to a new area. Crisis See psychiatric crisis. Crisis Assessment and Treatment Services (CATS) These services provide urgent assessment and short term intensive treatment throughout the community to people in crisis due to a mental illness. This includes assessing the most effective and least restrictive client service options and screening all inpatient bed admissions.CATS provide treatment and support for people whose acute mental illness can be managed in the community with intensive outreach support as as alternative to hospitalisation. They also respond to people presenting at immediate risk of suicide. CATS operate 24 hours, 7 days a week. Deinstitutionalisation Describes the change from an institutional model of care in isolated stand alone psychiatric hospitals to psychiatric treatment being provided by area mental health services including community mental health services in the community and psychiatric inpatient units of general hospitals. This process has occurred gradually over the last 30 years. Delusions Delusions are psychotic symptoms of particular types of mental illness, such as schizophrenia. They are firmly held beliefs which are not held by other members of the person's social group. Persons who experience delusions may

offer bizarre explanations for experiences or circumstances. For example, they may believe they are being spied upon, followed, poisoned or that they possess great unrecognised talent. Dementia A group of brain disorders that most commonly occur in old age, although sometimes could develop earlier. They are the result of brain tissue deterioration. Common features include decline in the ability to recall recent and past events, decline in mental functioning (for example, may not be able to make simple calculations or organise a routine task) and the person behaving in ways considered out of character for him/her. Department of Human Services The Victorian Government department with responsibility for funding the following services health and hospital services, aged persons' services, youth and community services, housing, hostels and home care, intellectual, physical and sensory disability services, maternal and child health centres, child protection and placement support, juvenile justice, mental health services and Aboriginal affairs. Human Services directly manages some of the services, such as child protection, and funds others provided by non-government or private agencies. Depression A lowering of mood which includes feelings of sadness, despair and discouragement, which range from mild to severe and is sustained over a period of time. Mild depression is an emotional state that many people experience during their life. Severe depression is a severe mental illness producing symptoms such as slowness of movement, loss of interest or pleasure in most activities, sleep and appetite changes, and agitation. People experiencing severe depression will have intense feelings of worthlessness and may experience delusions; for example, a person may believe they are the cause of the world's problems. Severe depression can lead to suicidal ideas and actual suicidal actions. Disability See psychiatric disability. Diagnosis A medical term meaning the identification of symptoms which are consistent with a particular illness or disorder. Specific tests and a medical examination can sometimes prove that physical illness is present. Diagnosis of a mental illness, however, is based on interviewing the client and others who know them and on clinical observations. Disorientation A symptom of some illnesses which affects the person's ability to know where he/she is, have some idea of time of day, date and year, and remember familiar people. Drug Induced Psychosis A mental illness involving distorted or imaginary sensations caused by the one off or repeated use of a drug (such as marijuana or amphetamines) or the use of a drug over a long period of time. The symptoms of a drug induced psychosis will usually appear quickly and can last for up to four weeks until the effects of the drug wear off. Duty Worker

A mental health professional at a community mental health centre who is the first contact for a client requesting mental health services. The duty worker undertakes an initial screening and may then arrange an intake assessment of the client's current problem(s) and guide the client to the appropriate public mental health service or other community service. Epilepsy A disorder of the brain characterised by periodic and temporary loss of consciousness with or without fitting (seizures). Epilepsy is not a mental illness and requires very different specialist skills from those offered by mental health services. However, people with epilepsy can also suffer from a mental illness. Hallucination A psychotic symptom characterised by distorted or imaginary sensations of sight, hearing, smell, taste or touch that are experienced by the person as if real. For example, a person may see something that is not there or hear the voice of somebody who is not present. Hospital Security Order An order made under section 93A of the Sentencing Act 1991 or section 16A of the Mental Health Act 1986 requiring a person found guilty of an offence by a court to be detained and treated in an approved mental health service for the time specified in the order. Individual Service Plan (ISP) A plan, based on a comprehensive assessment, outlining the client's goals and strategies for the client's recovery, including the mental health services and general community services the client needs. The ISP is developed and regularly reviewed by the case manager, the client and, with the client's permission, their family or carer and other workers involved. Informed Consent In the context of mental health, this means that the client provides permission for a specific treatment to occur based on their understanding of the nature of the procedure, the risks involved, the consequences of withholding permission and their knowledge of available alternative treatments. Inpatient Admission See psychiatric inpatient admission. Inpatient Service See psychiatric inpatient service. Insight Refers to the level of understanding which a person suffering from a mental illness has into the nature of their illness, its causation and the possible treatments that are available. Intake Assessment

The process which occurs when a person first becomes a client of a mental health service. The person will have an initial psychiatric assessment in order to determine the nature of their psychiatric problem, their treatment needs and the most appropriate service required. Integration of Services Coordination and linkage between services to ensure client's receive continuity of care. Intellectual Disability People with intellectual disabilities have learning difficulties and develop at a slower rate than normal. The condition is usually identified at birth or in early childhood. Intellectual disability is not a mental illness and requires very different specialist skills from those offered by mental health services. However, people with intellectual disabilities can also suffer from a mental illness. Intervention A planned action taken by a mental health worker which occurs in the context of treatment. Examples are counselling, intensive support, referral or prescribing medication. Involuntary Admission Admission, without the person's consent, to a psychiatric inpatient service for the treatment of a severe mental illness. For an involuntary admission to a psychiatric inpatient service, a person must meet all of the specific criteria set out in the Mental Health Act 1986 (section 8) and be admitted under the procedures set out in the act. Least Restrictive Environment/Setting The principle of treating a client in the least restrictive environment/setting possible recognises that all clients of public mental health services should be treated in an environment and manner that respects each client's individual worth, dignity, privacy and enhances their personal autonomy. The Mental Health Act 1986 requires that restrictions on the liberty of persons with a mental illness must be the minimum necessary to enable effective treatment to occur, and to ensure protection of members of the public. Mainstreaming Management of public mental health services by the general health system, for example, by public hospitals. Major Psychiatric Illness See severe mental illness. Major Tranquilisers See anti-psychotic drugs. Manic Depressive Psychosis See bi-polar affective/mood disorder.

Manic Episode A state of elevated mood which is out of keeping with a person's normal behaviour and may vary from cheerfulness to almost uncontrollable excitement or irritation. It typically results in over activity, rapid speech, decreased need for sleep, being easily distracted and a loss of social inhibitions. A person may embark on extravagant schemes, spend money recklessly, become aggressive or flirtatious, or believe they possess extraordinary powers. Medical Sedation The prescribing and administration of medication that has a tranquilising, calming effect. Mental Health Describes the capacity of an individual to interact with other people and with the person's environment in ways that promote the person's sense of well being, enhance their personal development and allow the person to achieve their life goals. Mental Health Act 1986 Legislation concerning the treatment and protection of people with a mental illness in Victoria. Mental Health Professional Staff of mental health services with professional training and qualifications, and experience in working with clients who have a mental illness. Mental health professionals include social workers, psychiatric nurses, psychiatrist medical officers, occupational therapists and psychologists. Mental Health Services See public mental health services. Mental Health Review Board The Mental Health Review Board is an independent tribunal established the Mental Health Act 1986. Its purpose is to hear appeals and regularly review all involuntary admissions, and clients on community treatment orders and restricted community treatment orders. Mental Illness A person is described as having a mental illness when their thoughts, feelings and behaviour cause them or others distress, and are not in keeping with their cultural background. Examples are schizophrenia, depression and anxiety disorders. Mental State Examination (MSE) An interview using a standardised set of questions with the primary purpose of identifying a person's current mental state. See psychiatric assessment. Mobile Support and Treatment Service (MSTS)

A multidisciplinary, community based mental health service which supports and treats clients who have experienced many psychiatric crises, have associated psychiatric disability and are at risk of readmission to hospital without this support. Multidisciplinary Team Mental health professionals employed by a public mental health service who work together to provide treatment and care for people with mental illness. They include social workers, psychiatric nurses, psychiatrists, medical officers, occupational therapists and psychologists. Nervous Breakdown A lay term commonly used to describe an emotional disturbance or mental illness. This term is not used by mental health professionals. Neuroleptics This term is frequently used to refer to antipsychotic medication. Neuroses/Neurotic Disorders Mental disorders commonly associated with distressing symptoms of anxiety and depression. Neurotic disorders are different from psychotic disorders in that the person does not experience a loss of reality. Neuroses/Neurotic disorders has been largely replaced by more specific terms such as anxiety disorders and affective disorders. See depression. Non-Government Psychiatric Disability Support Services Psychosocial rehabilitation and support services provided by non-government community agencies to people with psychiatric disability. Such services include housing support, day programs, prevocational training, residential services and respite care. Obsessive Compulsive Disorder A disorder in which the person may experience strong impulses to perform certain acts over and over again, even though they realise this is illogical. They are the result of recurrent and persistent thoughts and urges. The urges can not be easily controlled or ignored. This can cause great distress to the individual and interfere with their ability to perform life activities. For example, a person may continually wash their hands or check to see if the door is locked. Occupational Therapists (OTB) Health professionals who work in community mental health services and psychiatric inpatient services. They are part of the multidisciplinary team and their role is to help people to develop confidence and skills in daily living, using a variety of techniques, such as creative therapies and training in practical tasks. Paranoia/Paranoid State In common use, this term means suspicion or mistrust of others. Mental health professionals use the term paranoia to describe persecutory ideas held by a person which are not quite as intense as delusions. For example, a person may believe someone close to them is poisoning their food.

Personality Disorder A group of disorders characterised by patterns of disruptive and dysfunctional behaviour well established by early adulthood, and continuing through out a person's life. The person with a personality disorder typically has marked problems and frequent crises in personal and social relationships including threatened or actual selfinjury. People with this disorder often have a history of inadequate or abusive parenting. See also borderline personality disorder; severe personality disorder. PGAT See psychogeriatric assessment and treatment services. Phobia A persistent and unreasonable fear of specific places, events or objects which leads to avoidance of that situation and significantly impacts upon a person's life. For example, fear of crowds, public places, public speaking, insects or blood. Primary mental health and early intervention teams (PMHEI) These teams support and enhance the capacity of primary care providers, especially general practitioners and community health services, to recognise and respond to mental disorders more effectively. They provide consultation, liaison, education and training services to primary care providers for both low and high prevalence disorders. The teams have a particular focus on disorders such as depression and anxiety, and also provide some short-term direct care treatment and assessment for these high prevalence disorders. Prognosis The predicted course of a person's mental illness or their interpersonal, emotional or social functioning, based on specialised psychiatric knowledge, assessment of the client's current mental state and an understanding of his her personal circumstances and environment. Psychiatric Assessment A thorough assessment of a client by a mental health professional which includes identifying a person's current mental state, personal and social history, social situation and any relevant past psychiatric history. The psychiatric assessment enables selection of the most appropriate form of treatment for the client. See also mental state examination, intake assessment. Psychiatric Crisis Psychiatric crisis describes the situation where a person with a mental illness or severe mental disorder experiences thoughts, feelings or behaviours which cause severe distress to him/her and those around him/her requiring immediate psychiatric treatment to assess and manage risk and alleviate distress. The acute stage of a mental illness is characterised by infrequent yet severely distressing symptoms that require immediate treatment. This may be the persons first experience of mental illness, a repeat episode or the worsening of symptoms of an often continuing mental illness. Psychiatric Disability

The effects of mental illness that severely impair functioning in different aspects of a person's life such as the ability to live independently, maintain friendships or maintain employment. Psychiatric Disorder See mental illness, severe mental illness. Psychiatric Inpatient Admission A voluntary or involuntary hospital admission for the treatment end management of a person who has a severe mental illness. Psychiatric Inpatient Service Publicly funded psychiatric hospitals and psychiatric units of general hospitals able to admit involuntary and security patients as well as voluntary patients. Psychiatric Nurses Registered nurses who specialise in the nursing care and treatment of people with mental illness. Psychiatric nurses work in community mental health services and psychiatric inpatient services. Their role includes administration of medication, counselling and long term support, and may include psychological therapies. Psychiatric Services Division The section of the Department of Human Services which develops and establishes the policy and program framework for the delivery of client focused mental health services. Psychiatrically Disturbed See severe mental illness. Psychiatrists See consultant psychiatrists. Psychogeriatric Assessment and Treatment Services Specialist community mental health services that provide assessment, treatment and support for people aged sixtyfive and over, who have a mental illness Psychologists Clinical psychologists have specialist training in the assessment of behaviour and mental functioning, and in a range of interventions aimed at changing how people think, feel and act towards themselves and others. Psychosocial Assessment An assessment procedure that is used to identify a person's abilities and difficulties in his/her personal, domestic and social functioning, and that assists in the development of his/her individual service plan.

Psychosocial Rehabilitation A range of interventions aimed at improving a client's personal, domestic and social functioning, so that they can live independently in the community. Psychotic A term used to describe a condition in which a person is unable to tell what is real from what is imagined, as occurs with the experience of hallucinations or delusions. The condition may also include features of thought disorder, disorientation or confusion. Public Mental Health Services The range of mental health services providing local and statewide specialist treatment and support for people with mental illness and associated psychiatric disability. These services are provided free of charge by the Government. They include child and adolescent mental health services, adult mental health services and aged persons' mental health services and specialist statewide services. Recommended Person A person with a severe mental illness who has been recommended under the Mental Health Act 1986 for involuntary admission to a psychiatric inpatient service. See request and recommendation forms. Request and Recommendation Forms Forms used to recommend a person for involuntary admission. The request form can be filled out by any person over 18 years of age who believes a person may be suffering from a mental illness and require treatment for that illness. The recommendation form must then be completed by a medical practitioner (who did not fill out the request form) following examination of the person's mental state. Restraint The physical restriction of a client's ability to move when, due to a deterioration in mental state, the client may harm him or herself or others. Section 9 of the Mental Health Act 1986and the Regulations contain the requirements for the use of restraint and its recording and reporting when transporting recommended patients. Restricted Hospital Transfer Order / section 16 An order made under section 16(3)(b) of the Mental Health Act 1986 requiring a person to be transferred from prison and be admitted and detained in an approved mental health service as a security patient. Restricted Community Treatment Order (RCTO) Similar to a community treatment order, but applies to a person who is on a restricted involuntary treatment order. It offers a less restrictive option than treatment in a psychiatric inpatient service. A restricted community treatment order can only be made by an authorised psychiatrist or the chief psychiatrist. Schedule 1 and Schedule 11 See request and recommendation forms.

Restricted Involuntary Treatment Order (RITO) Restricted involuntary treatment orders are made by a court under the Sentencing Act 1991. If a person with a mental illness is found guilty of an offence (other than a serious offence), the court may make a RITO instead of giving the person a sentence. The person is then taken to a mental health service and must be given treatment for their mental illness. Schizophrenia/Schizophrenic Disorder A group of mental illnesses where the essential and most obvious features are the presence of psychotic symptoms during the active phase of the illness. There may also be a loss in the person's ability to perform some life tasks, such as relating to others, maintaining employment and domestic duties. Screening A process that enables a duty worker to obtain enough information from the person requesting service so that the duty worker can guide them to an appropriate service within or outside public mental health services. The duty worker will take responsibility for referring a person to an outside agency or arrange an intake assessment with the appropriate local mental health service. Section 12 The section of the Mental Health Act 1986 that specifies the criteria for involuntary admission of a person for the treatment of their mental illness. Security Patient Patients detained and treated in an approved mental health service under a hospital security order or patients who are transferred from prison under a restricted hospital transfer order for treatment in an approved mental health service. Sedation See medical sedation. Severe Mental Illness A mental illness in which a person's ability to think, communicate and behave appropriately is so impaired that it interferes with the person's ability to deal with ordinary demands of life. Without effective treatment end support, the outcome for the person may be significant impairment, disability and/or disadvantage. Severe Personality Disorder A term frequently used to describe a serious form of personality disorder. See borderline personality disorder. Social Workers Health professionals who have a qualification in social work and have special ised in mental health. They form part of the multidisciplinary team and typical functions include counselling, advocacy, family work, and social and community development.

Substance Related Disorders Changes to a person's physical health and behaviour associated with the overuse of alcohol or drugs. For example, there may be an inability to perform their job or household duties, problems in personal and social relationships, and faulty memory. There may also be frequent legal problems such as drink driving or disorderly conduct. Substance related disorder is not a mental illness and requires very different specialist skills from those offered by mental health services. However, people with a substance related disorder can also suffer from a mental illness and others with long standing substance abuse can develop symptoms of a mental illness. Suicidal A person is regarded as suicidal when they have given strong indications or have intentions of taking their own life. Symptom Changes in a person's mind or body that indicate they may be suffering from a particular illness. Thought Disorder A symptom most often seen in schizophrenia and other psychoses. It describes a disturbance in a person's thought patterns and is usually shown in abnormal speech. For example, a person may jump from topic to topic in conversation, their answers may be quite unrelated to a question or they may use strikingly unusual words or phrases. Treatment The use of professional knowledge and skill to bring about an improvement in a person's mental illness or to lessen the ill effects of a mental illness, and the distress end suffering that may accompany it. Treatment Resistant Mental Illness A severe mental illness experienced by an individual where the symptoms have not responded satisfactorily to current forms of treatment. Voluntary Admission A voluntary patient who consents to treatment from a psychiatric inpatient service and is accepted for treatment with the approval of the authorised psychiatrist.