A lot of confusing words and phrases are used within primary care mental health services and on this website and which you may not understand.
This is why we have created the following Glossary of Terms to help ease your understanding of mental health terminology.
However, it is not a directory of all terms associated with mental health, mental illness or primary care and if you would like us to add any words to it please contact our Project Manager Lesley Hills via email at lhills@rcgp.org.uk with your suggestions.
Anxiety
Anxiety disorders range from feelings of uneasiness to immobilizing bouts of terror. Most people experience anxiety at some point in their lives and some nervousness in anticipation of a real situation. However if a person cannot shake unwarranted worries, or if the feelings are jarring to the point of avoiding everyday activities, he or she most likely has an anxiety disorder. Anxiety can be associated with depression.
Assertive Community Treatment
A multi-disciplinary clinical team approach of providing 24-hour intensive community services in the individual's natural setting that help individuals with serious mental illness live in the community.
Behavioural Problems
Difficulties or problems caused by someone’s behaviour.
Behavioral Therapy
As the name implies, behavioural therapy focuses on behaviour- changing unwanted behaviours through rewards, reinforcements, and desensitization. Desensitization, or Exposure Therapy, is a process of confronting something that arouses anxiety, discomfort, or fear and overcoming the unwanted responses. Behavioural therapy often involves the cooperation of others, especially family and close friends, to reinforce a desired behaviour.
Bipolar Disorder
Extreme mood swings with recurrent episodes of depression and mania (being high or up) punctuated by periods of generally even-keeled behavior characterize this disorder. Bipolar disorder tends to run in families. This disorder typically begins in the mid-twenties and continues throughout life. Without treatment, people who have bipolar disorder often go through devastating life events such as marital breakups, job loss, substance abuse, and suicide.
Bursary Award
An award of money made by an institution to an individual or a group to assist the development of their education or research, intended to cover course related costs such as books, equipment, travel and study aids. WaMH in PC offer an annual bursary award which is supported by an educational grant from Wyeth Pharmaceuticals. There is a specific application process and all awards are judged by a panel of judges.
The Care Programme Approach (CPA)
The Care Programme Approach is a system of assessing and looking after people with mental health problems. People can either be offered standard or enhanced CPA, and being on CPA means a patient has a care plan which they should have a copy of, and have regular review with the mental health team looking after them. CPA has four main elements:
Chronic Disease
Is a long term condition that a patient has to live with, which may often fluctuate and for which there is usually no cure such as diabetes, asthma or many mental health problems.
Clinical Psychologist
A clinical psychologist is a professional with a doctoral degree in psychology who specializes in therapy.
Cognitive Therapy
Cognitive therapy aims to identify and correct distorted thinking patterns that can lead to feelings and behaviours that may be troublesome, self-defeating, or even self-destructive. The goal is to replace such thinking with a more balanced view that, in turn, leads to more fulfilling and productive behaviour.
Cognitive / Behavioural Therapy
A combination of cognitive and behavioural therapies, this approach helps people change negative thought patterns, beliefs, and behaviours so they can manage symptoms and enjoy more productive, less stressful lives.
Community Mental Health Team
This is a team of mental health workers who work together in a community setting. They often include Psychiatrists, Community Psychiatric Nurses, Occupational Therapists, Social Workers, Care workers, Psychologists.
Community Psychiatric Nurses (CPNs)
Consultant
In a hospital a consultant refers to a specially trained doctor who has finished his training and works in one area of medicine, usually with a team of doctors in training and other professionals working with them. In other areas of work, a consultant is someone who is consulted in order to get his opinion on something.
Counsellors
Crisis resolution and home treatment services
Short-term, round-the-clock help provided in a non hospital setting during a crisis. The purposes of this care are to avoid inpatient hospitalization, help stabilize the child, and determine the next appropriate step.
Declaration
A statement of intent. A communication or declaration in speech or writing, setting forth facts, particulars, etc.
Delusions
Delusions are bizarre thoughts that have no basis in reality.
Dementia
Significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning.
Dementia is a problem in the brain that makes it hard for a person to remember, learn and communicate; eventually is becomes difficult for a person to take care of himself or herself. This disorder can also affect a person's mood and personality.
Criteria for the diagnosis of dementia include impairment of attention, orientation, memory, judgment, language, motor and spatial skills, and function. By definition, dementia is not due to major depression or schizophrenia .
Dementia is reported in as many as 1% of adults 60 years of age. It has been estimated that the frequency of dementia doubles every five years after 60 years of age.
Depression
Depression is a mood disorder characterized by intense feelings of sadness that persist beyond a few weeks. It is associated with many physical symptoms such as disturbance of sleep, appetite, and concentration. Depressed people often feel tired, guilty and can find normal life extremely difficult. Depression can be associated with anxiety.
Doctors Consultation
This is where a doctor meets a patient, asks them questions about their problems, and maybe examines them and arranges investigations. The main objectives are to try and understand what the problems are and what is causing them, understand what the patient thinks and feels about them, and work out a plan of action that the doctor and patient can agree on.
Early intervention
A process used to recognize warning signs for mental health problems and to take early action against factors that put individuals at risk. Early intervention can help people get better in less time and can prevent problems from becoming worse.
Empowerment
Giving people the skills, knowledge attitudes and power to allow or enable them to be more responsible for their own lives, health and care.
Evidenced Based (Medicine)
Where actions, treatment or care are based on widely accepted evidence. This evidence can be from scientific trails, or based on the collective experience of senior professionals. The evidence must be published and accepted by a large proportion of professionals. Such evidence can be used to develop guidelines to help health care workers improve the care they provide, but the evidence is based on what is best in general for people/patients. Care for an individual may need to differ from what the guidelines says due to individual circumstance, patient wishes etc.
General Practitioners (GPs)
Doctors who are specially trained to work in a community setting, seeing any patients for any problems they have. They often work in a group, sharing resources. Access is usually available to any person who requests a consultation. Most health problems are dealt with solely by GPs and their staff, although they can refer on to specialist services.
Generalist
This refers to someone who will see, assess and treat any type of problem as opposed to a specialist who usually sees a limited type of problem (such as a Cardiologist). GPs, practice nurses, district nurses are all generalists.
Gold Standards Programme
A plan designed by WaMH in PC to improve standards of care for people in Wales with mental health problems by developing standards which demonstrate to service providers what they should be doing to improve the care of patients. It will cover aspects of how primary care teams work, as well as how other services can be used to prevent, diagnose, treat and support people with mental health problems.
Hallucinations
Hallucinations are experiences of sensations that have no source. Some examples of hallucinations include hearing nonexistent voices, seeing nonexistent things, and experiencing burning or pain sensations with no physical cause.
Local Government
Local councils and the services they run such as Social Services, Schools, Housing and Leisure departments.
Mania
A symptom of bipolar disorder characterized by exaggerated excitement, physical over activity, and profuse and rapidly changing ideas (scattered or tangential thoughts). A person in a manic state feels an emotional high and generally follows their impulses.
Managing Disease
This involves making a diagnosis, deciding on a plan of treatment which may involve medication, therapy, training etc and will include regular review and giving information to patients and their carers.
Mental Health
A state of emotional well-being in which an individual is able to use his or her thinking and feeling abilities, live with others, and meet the ordinary demands of everyday life.
Mental Illness / Ill health
A state where the persons mental health is disrupted so that their thinking, emotions or behaviour are affected to an extent that it has an effect on their daily life. It does not necessarily mean that they have a diagnosable psychiatric disorder or need any form or medical treatment.
Mental Well-being
A good or satisfactory condition of thinking, feeling and living; a state characterized by health, happiness, and prosperity. It is a broader term than mental health and includes the wider aspects of a persons life, not just how they feel.
Mortality
Death
Morbidity
Causing illness or disease, but not death
National Service Framework (NSF)
A policy document which sets out the plans for a certain area of care within one country. The NSF for mental health in Wales explains the principles which should govern how mental health services should be run, a series of standards relating to the services and a timetable for how services should be improved.
Obesity
Being significantly over weight. Having a body mass index of over 30.
Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder is a chronic, relapsing illness. People who have it suffer from recurrent and unwanted thoughts or rituals. The obsessions and the need to perform rituals can take over a person's life if left untreated. They feel they cannot control these thoughts or rituals.
Occupational Therapists (OTs)
An occupational therapist can have many different roles. They help people to adapt to their environment and to cope with their daily life.
OTs may work in hospitals or in the community. They supervise and assess a person's ability to look after themselves, eg self-care, cooking and housework. This may be done in purpose-built occupational therapy departments in hospitals or in the patient's own home.
OTs work with both individuals and groups. They can set goals for individuals with depression to encourage them to achieve more than they have been able to do while ill. They may get patients involved in specific job-related training schemes to improve their decision making and planning about the future. Group work is often aimed at increasing people's social interactions.
OTs may use many different types of therapy on an individual or group basis, including cognitive behavioural therapy and art and music therapy. They may also be involved in providing relaxation training to patients referred to them by the mental health team or GPs.
If patients have been in hospital for a long time, OTs become involved in rehabilitation work to help them reintegrate back into life outside hospital.
Panic Disorders
People with panic disorder experience heart-pounding terror that strikes suddenly and without warning. Since they cannot predict when a panic attack will seize them, many people live in persistent worry that another one could overcome them at any moment.
Paranoia and Paranoid Disorders
Symptoms of paranoia include feelings of persecution and an exaggerated sense of self-importance. The disorder is present in many mental health problems and it is rare as an isolated mental illness. A person with paranoia can usually work and function in everyday life since the delusions involve only one area. However, their lives can be isolated and limited.
Person Centred Care
Puts the patient at the heart of diagnosis and treatment. Patient centred care explores the main reason for the consultation, seeks an integrated vision of the patient’s world, finds common ground and creates a mutually agreed management plan, enhancing health promotion, and providing a solid basis for the long term doctor patient relationship. Patient centred care is therefore based on the patient’s problems, the patient’s needs, their feelings and beliefs and the skills and support they already have to combat their problems.
Phobias
Phobias are irrational fears that lead people to altogether avoid specific things or situations that trigger intense anxiety. Phobias occur in several forms, for example, agoraphobia is the fear of being in any situation that might trigger a panic attack and from which escape might be difficult; social phobia is a fear of being extremely embarrassed in front of other people.
Practitioner
A person who practices a profession or art, anyone licensed to provide healthcare services.
Primary Care
Community services which provide open access to patients. They include GP’s, Pharmacists, Dentists, District Nurses and Health Visitors and many others. Also called tier one services.
Psychiatrists
A consultant psychiatrist usually works in a community mental health team which is involved in looking after people living in a certain area. Team members include trainee psychiatrists, social workers, community psychiatric nurses, psychologists and others.
The consultant or the team will have patients referred to them by GPs and other professionals such as health visitors and social workers. Referrals are then allocated to various members in the team, depending on the nature of the individual's problems. The consultant has overall responsibility for the management of patients under the care of the team.
The consultant will also have responsibility for a certain number of patients in a hospital ward.
A consultant is approved under Section 12 of the Mental Health Act, enabling them to recommend the involuntary detention of a patient who is severely ill in hospital in the interests of their health, their safety or the safety of others. Involuntary detention in hospital only occurs if two doctors and an approved social worker all agree that this is an appropriate thing to happen.
The consultant often has a senior house officer or a specialist registrar under their supervision. The consultant closely supervises and monitors their work and progress.
A psychiatrist may use psychological treatments or medication to help a patient with depression.
Quality and Outcomes Framework (QOF)
This is part of the GP contract, and encourages Primary Care teams to work towards achieving standards of care in a wide range of conditions including mental health, diabetes, asthma and heart disease. Primary care teams keep computerized records of their performance and they are assessed on an annual basis to see how many points they have achieved. For mental health these targets include screening for depression in high risk groups, using questionnaires to assess depression, monitoring some of the medicines used, performing annual checks for those with a severe mental health problems and monitoring the care of patients with dementia and their carer’s needs.
Recovery
This may not mean cure, but does include not only a significant reduction in symptoms but also an improvement in the ability of the individual to lead a normal life including work, home life and leisure. Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
Schizophrenia
Schizophrenia is a mental disorder characterized by "positive" and "negative" symptoms. Psychotic, or positive, symptoms include delusions, hallucinations, and disordered thinking (apparent from a person's fragmented, disconnected and sometimes nonsensical speech). Negative symptoms include social withdrawal, extreme apathy, diminished motivation, and blunted emotional expression.
Secondary Care
Specialist health services which are usually hospital based and serve a wide area, such as a County or a large city. Apart from accident and emergency services, they are usually accessed through a referral from a primary care professional.
Self Management
Where a patient develops the knowledge and experience which enables them to be able to monitor their condition and modify their treatment with the full support of health care professional.
Service Provider
A person or an organization that provides a service to a member of the public. This can be an NHS body, a small local group or a national voluntary sector organization.
Severe and Enduring Mental Illness
This term is used to describe a group of illnesses which can cause more severe mental health problems. It includes schizophrenia, bipolar affective disorder (manic depression) and other psychotic illnesses.
Social Inclusion
Ensuring the marginalised and those living in poverty have greater participation in decision making which affects their lives, allowing them to improve their living standards and their overall well-being.
Social workers
Social workers are usually employed by social services rather than the health service. However, most mental health social workers are based in multidisciplinary community mental health teams.
Social workers may see patients referred to the team by GPs. They are likely to be involved if patients have social problems, such as housing, money and work. They may provide counselling and advice or more specific therapies.
Social workers may control access to some services such as day centres, respite care, residential care and other community support services, e.g. home helps.
The primary role of an approved social worker (ASW) is to act as the guardian of the patient's rights. If a psychiatrist believes that a patient should be detained in hospital against their will, they will request an ASW to see the patient, along with another doctor. If both doctors and the ASW agree that the patient is mentally ill and that it is in the interests of their health, safety or the safety of others, that they remain in hospital, then an order under the Mental Health Act will be applied to detain the patient. The ASW has responsibilities to contact the patient's next of kin and to help any appeals against the order that the patient wants to make.
Specialist
Someone who sees, assesses and treats a specific type of problem, usually having been asked to see a person by a generalist such as a GP. Examples would include Cardiologists (hearts), Paediatrician (children), Psychiatrist (mental health problems).
Statutory Sector
Organizations that are governed by law and set up to run certain parts of society, this may include local councils, national governments, the NHS etc.
Stigma
Stigma is discrimination, based upon societies fear and ignorance about an illness or a problem. It causes peoples to be marginalized and mistreated, and therefore leads to social isolation, health inequalities and many forms of discrimination. It is derived from the term used to describe the marks burnt onto Roman slaves.
Tertiary Care
Highly specialized services which may cover a very large area, or even the whole country. They usually provide care for rare or complicated problems requiring very specialized skills.
Voluntary Sector
Because of its diversity, it is not easy to define the voluntary sector. Voluntary sector organisations vary enormously in size, from small local groups staffed exclusively by volunteers, to large national charities that are household names with complex infrastructures and many hundreds of staff. Broadly speaking, however, the sector can be said to comprise organisations that are:
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