Psychiatric history

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Enquire as to whether the client has any current mental health symptoms (such as depression, anxiety, psychosis), whether he/she has experienced these in the past, whether he/she has ever been diagnosed with a mental health disorder, and whether he/she has ever received any treatment. If the client has experienced mental health symptoms or has been diagnosed with a mental health disorder, ask about the timing and context of these symptoms:

  • When did the symptoms start (did they start prior to AOD use)?
  • Do they only occur when the person is intoxicated or withdrawing?
  • Have the symptoms continued even after a period of abstinence (approximately one month)?
  • Do the symptoms change when the client stops using substances (i.e., do they get better or worse, or stay the same)?
  • Is there a family history of the particular mental health condition?
  • What kind of treatment did the person have? Did it work well?

If symptoms arise only in the context of intoxication or withdrawal, it is likely that they are substance induced [289], and will resolve with a period of abstinence without the need for any direct intervention [35, 119, 290]. It is nonetheless important for these symptoms to be managed to prevent the client from relapsing in the early stages (see Chapter B5). The duration of abstinence may vary depending on substances used; however, most should start to see considerable improvement over a period of one month [270, 291].

If the mental health symptoms started prior to the onset of AOD use, symptoms persist even during periods of abstinence, or there is a family history of the particular mental health condition, the client may have a mental health condition that is independent of his/her AOD use.