Lesson 1When to refer and collaborative care models: criteria for urgent psychiatric referral, outpatient therapy referral, collaborative care integration with school and community resourcesExplains criteria for urgent, routine, and specialty referrals, outlines collaborative care models linking primary care, psychiatry, school, and community services, and offers practical steps for shared care plans and communication in Uganda.
Red flags requiring urgent psychiatric referralIndications for routine therapy referralDesigning shared care plans with specialistsWorking with school-based mental health teamsPartnering with community and youth servicesLesson 2Follow-up, documentation, and safety planning: follow-up intervals, relapse prevention, documentation templates, crisis resource planningAddresses structuring follow-up visits, monitoring symptoms and functioning, documenting assessments and plans, building individualised safety plans, and providing crisis contacts and relapse prevention strategies for adolescents and families.
Setting follow-up intervals by risk levelTracking symptoms with brief rating scalesKey elements of clear clinical documentationDeveloping written safety plans with teensCrisis lines, apps, and local emergency optionsRelapse prevention and early warning signsLesson 3Focused psychosocial history: symptom onset, sleep, appetite, concentration, school functioning, relationships, substance use, family history of mental illness or suicideGuides a focused psychosocial and psychiatric history, including symptom onset, sleep, appetite, cognition, school performance, relationships, trauma, substance use, and family history of mental illness or suicide to inform diagnosis and risk.
Clarifying symptom onset, duration, and triggersAssessing sleep, appetite, and energy changesSchool performance, attendance, and bullyingPeer, family, and online relationship stressorsScreening for substance use and risky behavioursFamily history of mental illness and suicideLesson 4Epidemiology and how presentations differ by age and sex, common comorbidities (substance use, ADHD)Reviews prevalence of adolescent anxiety and depression, how symptoms differ by age and sex, and patterns of comorbidity with ADHD, substance use, and other conditions to guide targeted screening and early intervention in Ugandan practice.
Prevalence and global burden in adolescentsAge-specific symptom patterns 12–14 vs 15–18Sex differences in presentation and help-seekingOverlap with ADHD and learning disordersLinks with substance use and risk behavioursLesson 5Validated screening tools and administration: PHQ-A/PHQ-9 modified for adolescents, GAD-7, Columbia-Suicide Severity Rating Scale (C-SSRS), usage and scoringCovers selection and administration of PHQ-A, PHQ-9 modified for teens, GAD-7, and C-SSRS, including scoring, interpretation, cultural issues, and integrating results into clinical decisions and shared discussions with families in Uganda.
Choosing tools for anxiety versus depressionAdministering PHQ-A and teen PHQ-9Using and interpreting the GAD-7 in teensColumbia-Suicide Severity Rating Scale basicsScoring, cutoffs, and false positive handlingCommunicating results to adolescents and parentsLesson 6Pharmacologic strategies and monitoring: SSRIs with evidence in adolescents (fluoxetine, escitalopram), dosing principles, side effect monitoring, black-box concerns and informed consentReviews evidence-based SSRI use in adolescents, including indications, medication selection, dosing and titration, monitoring side effects and suicidality, black-box warning counselling, and shared decision-making with teens and caregivers.
When to start medication versus wait or referChoosing between fluoxetine and escitalopramStarting doses, titration, and trial durationMonitoring side effects and activationDiscussing black-box warnings and consentCombining SSRIs with psychotherapy effectivelyLesson 7Initial nonpharmacologic management: cognitive behavioural therapy fundamentals, brief behavioural interventions in primary care, parental involvement and school liaisonExplores first-line non-drug strategies, including CBT principles, brief interventions feasible in primary care, motivational techniques, psychoeducation, and structured collaboration with parents, schools, and community supports in Uganda.
Explaining diagnosis and normalising help-seekingCore CBT concepts for anxiety and depressionBrief behavioural strategies in short visitsEngaging parents as therapeutic partnersCoordinating with school counsellors and staffWhen to add structured psychotherapy referralLesson 8Safety assessment and suicide risk triage: direct questions about self-harm, plans, means, protective factors, when to enact emergency protocolsDetails structured suicide risk assessment, including direct questioning about ideation, intent, plans, and means, evaluating protective factors, determining risk level, and deciding when to activate emergency or higher level care pathways.
Creating a safe, private interview settingDirect questions on ideation, intent, and plansAssessing access to means and recent behavioursEvaluating protective and buffering factorsRisk stratification and triage decisionsIndications for emergency referral or hold
