TREATMENT GUIDELINE FOR BIPOLAR MOOD DISORDER (BMD)
LEVEL OF CARE MATRIX
  LEVEL 1
  LEVEL 2
GO TO ALGORITHM BMD MANAGEMENT LEVEL 3
  LEVEL 4
LEVEL 4                           4        
GO TO THE MANAGEMENT OF BMD AT THIS LEVEL POOR FUNCTIONING, POOR SUPPORT SYSTEMS   PSYCHIATRIST
CO-MORBID SERIOUS MEDICAL CONDITION, SERIOUS PSYCHIATRIC DISORDER   CLINICAL PSYCHOLOGIST
SERIOUS SUICIDAL IDEATION, SUICIDE ATTEMPT, DANGER TO SELF AND OTHERS     MENTAL HEALTH CARE TEAM
DANGER TO SELF AND OTHERS PROPERTY     HOSPITALISATION    
PSYCHOTIC FEATURES   MEDICATION AND PSYCHOTHERAPY, CONSIDER ECT HOSPITALISATION IN PSYCHIATRIC FACILITY OR STABILIZE IN GENERAL HOSPITAL BEFORE TRANSFER TO PSYCHIATRIC HOSPITAL
NO RESPONSE TO TREATMENT  
ADJUSTMENT OF MEDICATION   
ELECTROCONVULSIVE THERAPY  
           
LEVEL 3     3      
GO TO THE MANAGEMENT OF BMD AT THIS LEVEL MANIA, MODERATE OR SEVERE DEPRESSION   PSYCHIATRIST    
RAPID CYCLING CLINICAL PSYCHOLOGIST    
FIRST EPISODE MANIA OR HYPOMANIA   CONSIDER HOSPITALISATION MENTAL HEALTH CARE TEAM    
CO-MORBIDITY ON AXIS 1, 2 OR 3 MEDICATION AND PSYCHOTHERAPY    
POOR RESPONSE TO TREATMENT HOSPITALISATION IN PSYCHIATRIC FACILITY OR STABILIZE IN GENERAL HOSPITAL BEFORE TRANSFER TO PSYCHIATRIC HOSPITAL
     
     
             
                   
LEVEL 2     2        
GO TO THE MANAGEMENT OF BMD AT THIS LEVEL HYPOMANIA, MILD DEPRESSION  PSYCHIATRIST    
MILD ANXIETY - NOT FULL DISORDER   MENTAL HEALTH CARE TEAM    
      CLINICAL PSYCHOLOGIST    
    MEDICATION AND PSYCHOTHERAPY      
       
         
         
         
               
LEVEL 1    1    
GO TO THE MANAGEMENT OF BMD AT THIS LEVEL FOLLOW UP FOR PATIENTS IN REMISSION GP    
MENTAL HEALTH CARE TEAM    
  CLINICAL PSYCHOLOGIST    
  PSYCHIATRIST    
       
       
MEDICATION AND PSYCHOTHERAPY      
   
                             
BIPOLAR MOOD DISORDER EVALUATION OF LEVEL OF CARE
GO BACK TO TOP OF ALGORITHM BMD
DETERMINE LEVEL OF CARE ACCORDING TO LOC MATRIX
IF ANY OF THE FOLLOWING IS PRESENT, REVERT TO LEVEL SPECIFIED
DETERMINE CO-MORBIDITIES                   IF PRESENT: LEVEL 3 OR 4    
DETERMINE IF PSYCHOTIC     IF PSYCHOTIC             LEVEL 4    
DETERMINE SUICIDE RISK   IDEATION, INTENT AND PLANS   SERIOUS SUICIDAL IDEATION: LEVEL 4    
    MEANS AND LETHALITY OF MEANS   SUICIDAL IDEATION: LEVEL 3    
    PRESENCE OF PSYCHOSIS OR ANXIETY    
    SUBSTANCE ABUSE    
    PREVIOUS HISTORY OF ATTEMPTS    
    FAMILY HISTORY OF SUICIDE     
    RECENT EXPOSURE TO SUICIDE    
    MALE    
    AGE    
RECENT SUICIDE ATTEMPT                     LEVEL 4    
AXIS 2 OR 3 CO-MORBIDITY   LEVEL 3 OR 4    
POOR RESPONSE TO TREATMENT   LEVEL 3 OR 4    
POOR FUNCTIONING, POOR SUPPORT SYSTEMS                 LEVEL 4          
DANGER TO SELF AND OTHERS   LEVEL 4    
DANGER TO SELF AND OTHERS PROPERTY   LEVEL 4    
PSYCHOTIC FEATURES   LEVEL 4    
TREATMENT RESISTANCE   LEVEL 4    
ADJUSTMENT OF MEDICATION NEEDING HOSPITALISATION   LEVEL 4    
ELECTROCONVULSIVE THERAPY                   LEVEL 4            
ESTABLISH TREATMENT SETTING                                
DETERMINE PREVIOUS SUCCESSES OF TREATMENT