Section Name Description
Module 1: Lesson 1: URL The Optimal Mix of Services for Mental Health Care

Read the entire document. 

URL Human Resources for Mental Health Care: Current Situation and Strategies for Action (14 mins)

Read the entire article, focusing on the idea of task-shifting and primary health care involvement in mental health care. This training aims to train lay health workers in identifying patients with substance use disorders. It is essential that patients get correct information from lay health workers, and if indicated, the right level of intervention from other primary care practitioners.

URL Task-Sharing Approaches to Improve Mental Health Care in Ruraland Other Low-Resource Settings: A Systematic Review (28 mins)

Read the entire article, focusing on the idea of task-shifting and primary health care involvement in mental health care.

URL mhGAP Intervention Guide: for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings (15 mins)

This training is based on the mhGAP goals and recommendations for the implementation of mental health services in primary care. To familiarize yourself with the rationale for doing so and how the mhGAP Intervention Guide works, please read the Introduction, General Principles of Care, and the Master Chart (pp. 1-8 in the document; pp. 10-21 on the page navigator). In this training, we will mostly focus on alcohol and other substance use disorders, including tobacco use. Although tobacco use is not covered in the mhGAP, it will be covered in other resources in this course). The training will also review when to refer to primary care practitioners with additional training in mental health and substance use disorders, for example, in cases of immediate risk of self-harm or danger to others and severe intoxication. NextGenU’s Alcohol, Tobacco and Other Substance Use Disorders: Identification and Management in Primary Care can assist practitioners in addressing those conditions, as well as commonly co-occurring conditions like depression and psychosis. Please save this document so that you can access it later in this course, as well as in your practice as a quick reference guide. You are welcome to review the rest of the mhGAP Intervention Guide to familiarize yourself with the World Health Organization's suggestions for addressing other priority conditions in primary care.

URL Drugs, Brains and Behaviour: The Science of Addiction (45 mins)

Download the booklet.  Read the entire manual, as this will be your foundation for understanding the science behind addiction and health. The next module of this training will cover issues of stigma and human rights related to those with mental health conditions (including substance use issues), because stigma and violations of human rights are major barriers in the provision of care to these populations. Stigma and human rights violations can come from people in every part of society, including care providers, family, neighbors, employers, and government officials. This is why our first module starts by exploring these concepts and how they affect those who suffer from mental health or substance use disorders, and what you can do about it when you interact with them.

Module 2: Lesson 1: Policies and Legislation URL Mental health, human rights & legislation (8 mins)

Read the entire web page. This document will give you an overview of international considerations for mental health human rights, legislations, standards, and policies.   Feel free to click on any of the links to learn more about mental health, human rights and legislation.

URL Anti-Stigma Toolkit: A Guide to Reducing Addiction-Related Stigma (10 mins)

Read Chapter 1, from pp. 7 - 24.

URL Taking Action on Stigma and Social Inclusion in British Columbia (90 mins)

Read the entire report to learn more about the stigma and social isolation due to mental health and substance abuse along with stigma and discrimination Interventions.

URL Good Practices Guide - Privacy and Confidentiality: Overview and objectives (20 mins)

Click on the links titled "Circle of Care" and "Breaches" found under the heading "Privacy and Confidentiality" located on the left side of the web page.  Read each section. The section, called 'Breaches', will provide you with valuable information, such as examples of breaches of confidentiality or privacy. These breaches occur too often, usually inadvertently. The link titled 'Test yourself' located under the "Privacy and Confidentiality' tab can help you test your knowledge and understanding of the content of the module. The other sections are optional reading. Note:  If your browser asks you to select an item from the list, please select ‘public’ and then press submit.

URL Consent: A Guide for Canadian Physicians (40 mins)

Read the guide.

URL Global Mental Health: A Failure of Humanity (10 mins)

Read this article for an overview of the global situation in relation to the challenges of respecting international standards and human rights of those with mental health or substance use disorders.

URL Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (39 mins)

Read this document as it is an overview of international human rights standards on mental health.

URL Understanding and Responding to Youth Substance Use: The Contribution of a Health and Human Rights Framework (53 mins)

This resource provides a discussion of the current global situation in relation to the use of psychoactive substances, international policies, and the utility of a human rights framework.

URL Stigma (20 mins)

Go through the presentation. When you see an icon (such as 'Story' in red, or 'Myth Check' in beige) please click on it. Another pop-up window will appear, containing essential information for the module, which you should read. At the end of the presentation, you will have access to the last page, which offers a review. By clicking on the word 'Review' (in blue), it brings you to a quiz. This quiz is optional to complete, as it might not work well in your browser. However, if it works, we encourage you to take it to test your understanding.

URL Equality and Diversity (60 mins)

We suggest you read and complete the learning activities outlined in this document to help you reflect on issues of equality and diversity. Some of the listed resources are specific to the UK and their National Health System (NHS). You can discuss with your peer or mentor how to find locally relevant information, and use your own experience as a source of knowledge. There are many resources from the NHS Education for Scotland about conducting deep critical reflections that help practitioners gain self-awareness and communication skills, improve their clinical practice, and decrease burnout. This is one tool suggested by the NHS Effective Practitioner program, and other tools to record your learning can be found here as well. Although not mandatory for this training, we recommend that you build yourself a portfolio to document your professional learning. This can be a powerful tool to seek and obtain employment, and be successful in your occupation.

Module 3: Lesson 1: URL The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) (93 mins)

You will be using this document extensively throughout this training. Review the 'Table of Contents' and read Sections 1 to 6 (pp. 1-8) to familiarize yourself with the background of the ASSIST and the rationale for its administration in primary care.

  • Read sections 6-8 (pp. 8 - 18) to learn about general and health-related problems of various substances.
  • Read sections 9 -12 (pp.19 - 31), which explain how to use the ASSIST. Perform the self-testing question in Chapter 11 (p. 23), and note your answers. Then review the answers in Appendix F (p. 55).
  • Read section 13, 'Scoring of the ASSIST questionnaire' (pp. 32-33).
  • Read section 14, 'Interpretation of ASSIST scores' (p. 34) and section 15, 'Linking ASSIST scores with treatment' (pp. 34-36).
URL mhGAP Intervention Guide: for mental, neurological and substance use disorders in non-specialized health settings (30 mins)

Please review sections ALC1 - ALC3 and DRU1 - DRU 3 (pp. 58 - 72). The sections on 'Alcohol Use and Alcohol Disorders' and the section on 'Drug Use and Drug Use Disorders; starting with an 'Assessment and Management Guide for Emergency Cases,' followed by an Assessment and Management Guide, which covers an algorithm to look at alcohol consumption, and finally an 'Intervention Details' segment.This is a very basic overview of care for alcohol and substance use disorders. Many resources in the rest of this training will assist you in developing your skills for brief interventions and the management of alcohol use and other substance use disorders.

URL Screening for Drug Use in General Medical Settings: Quick Reference Guide (10 mins)

This Quick Reference Guide is a very simple and easy way to understand how to provide care to individuals who are using substances. This course focuses on screening with the ASSIST, but it may be useful to explore a different model of screening and intervention in your context.

URL Tools (30 mins)

Click on the tabs titled “Validated Screening Forms” and “Brief Intervention Tools” and read the content of each to learn about other evidence-based models of screening and brief intervention in primary care.

URL The Clinical Assessment of Substance Use Disorders (60 mins)

From the menu on the left-hand side, read the 'Key Concepts and Learning Goals', then read the 'Questions' section. Complete the 'Questions' and post them online by entering your name and clicking ‘Done'. Continue through the modules from the 'Introduction' section and complete 'Clinical Evaluation'. While watching the 'Initial Visit Video', take note of the blue icons and comments to the right of the video. At appropriate times during the video, these comments will be highlighted in yellow. At this time, you can click on the blue icon and another smaller video will pop up. This smaller video will share thoughts and comments running through the minds of the doctors and patients during the interview.

Module 4: Lesson 1: URL Quitting Tobacco (5 mins)

Read all the information in this table to learn about the effectiveness of certain smoking cessation interventions.

URL Behavioural Science Learning Modules: Encouraging People to Stop Smoking (30 mins)

This resource refers to brief advice for smoking cessation, however, brief interventions are done in a very similar fashion for all other psychoactive substances. Beginning at the section titled 'Address the topic of smoking and tobacco use' (on page 23 of the page navigator), read to the end of Part 1 (pp. 23 - 33). Pay special attention to the tips and flowcharts that are used in clinical practice, as seen in Tables 7 - 11 and Figure 2. Read Appendices 3 and 4 (pp. 46 - 57) to help you understand how to give cessation advice as per best practices. The rest of this manual is supplementary.

URL Health Effects of Cigarette Smoking (5 mins)

Read the entire article, which describes the personal health risks of tobacco use.

URL How To Handle Withdrawal Symptoms and Triggers When You Decide To Quit Smoking (10 mins)

Read the entire article, which provides further information on how to deal with tobacco withdrawal symptoms in language adapted for patient self-help.

URL Fact Sheets: Alcohol Use and Health (10 mins)

Read this factsheet to learn more about how alcohol use and abuse can affect health.

URL Alcohol Use and Safe Drinking (7 mins)

Read this resource to learn about the effects and risks of drinking alcohol for teens and adults.

URL Self-Help Strategies for Cutting Down or Stopping Substance Use: A Guide (15 mins)

In some settings, it might be considered part of the duties of a community health worker (or other types of health workers) to develop self-help strategies for those who use substances. This guide can be useful in assisting you to perform this task. You do not need to read everything in detail, but please familiarize yourself with this manual.

URL Primary Care Addiction Toolkit: Dealing with Alcohol Problems (60 mins)

Click on the tab titled "Screening".  Then, click on the link titled "Screening for Alcohol Use in Pregnancy" and read the content of that link.  Then, under the tab titled "Treatment", click on the link titled "Managing alcohol use in pregnancy" and read the content of that link.  Note:  It is possible that your setting has decided to prioritize screening pregnant women for only a few substances (such as alcohol or tobacco) rather than use the ASSIST. If that is the case, you will need to familiarize yourself with those other modalities of screening. 

URL Health Consequences of Drug Misuse (14 mins)

By clicking the links found on the left-hand side of the resource, read all the sections under 'Medical Consequences of Drug Abuse' (from 'HIV, Hepatitis, and Other Infectious Diseases' to 'Mortality').

URL Primary Care Addiction Toolkit: Dealing with Alcohol Problems (14 mins)

Click on the tab titled "Screening".  Then, click on the link titled "Screening for alcohol problems in older adults" and read the content of that link.  Then, under the tab titled "Assessment", click on the link titled "Assessing alcohol problems in older adults" and read the content of that link.  Then, under the tab titled "Treatment", click on the link titled "Treating alcohol problems in older adults" and read the content of that link. 

URL Smoking and Cancer (30 mins)

From the menu on the left-hand side, read each of the subsections that fall under Smoking and Tobacco (from 'What's in a cigarette?' to 'How do we know?').

URL Beyond Hangovers: Understanding Alcohol's Impact on your Health (30 mins)

This resource will give you a good understanding of the impact of alcohol on the body.

URL Substance Abuse Treatment: Addressing the Specific Needs of Women (120 mins)

If you would like further information on a particular topic, review the relevant chapter from this resource. It is quite detailed regarding providing health care to women who may abuse substances, and while it might take approximately one hour to review a chapter, it would take considerably longer to review the entire document.

URL Substance Abuse Among Older Adults

If you treat many seniors, this resource will be useful for you, as it gives detailed information about seniors' health and possible interactions, comorbidities, and co-occurrences. Review the chapter(s) most relevant to your situation and context. While it might take approximately one hour to read a chapter of this resource, it will take considerably longer to review the entire document. 

URL The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, U.S. Department of Health and Human Services: Secondhand Smoke what it means to you (19 mins)

Read the booklet to learn about the harm of secondhand smoke.

Module 5: Lesson 1: URL mhGAP Intervention Guide: For Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings (15 mins)

Read Module 10: 'Self-harm/Suicide' (pp. 74 -79 in the document, pp. 107 - 112 in the page navigator) to learn more about the importance of inquiring about self-harm.

URL Working with the Suicidal Patient: A Guide for Health Care Professionals (15 mins)

Read this entire resource, which describes a practical technique to assess and address sucidal risk in primary care.

URL DrugFacts: Comorbidity: Addiction and Other Mental Disorders (10 mins)

Read each of the following sections: 'What Is Co-morbidity?', 'Is Drug Addiction a Mental Illness?', 'How Common Are Comorbid Drug Addiction and Other Mental Illnesses?', and the first 3 paragraphs of 'Why Do These Disorders Often Co-occur?'.

URL Substance Abuse Treatments for Persons with HIV/AIDS: Chapter 3: Mental Health Treatment (15 mins)

Read this online version of Chapter 3 - Mental Health Treatment. The rest of the manual is supplementary.

URL Alcohol Use and Abuse Guideline (12 mins)

Read the entire section titled "Introduction".  Then, click on the links titled "Identifying Alcohol Abuse", "Effects of Alcohol Use", and "Provider Assistance, Counseling, and Brief Interventions".  Ensure you review the recommendations in bold.  The rest of the resource is optional reading.

URL Fetal Alcohol Spectrum Disorders: FASD The Course: Modules 2-5 (45 mins)

Review Module 2 ('Effects of Alcohol on the Fetus'), Module 3 ('Risk Factors for FASD'), Module 4 ('FASD Signs and Symptoms'), and Module 5 ('FASD Prevention'). The other modules are supplementary; review them if you are interested.

URL The Antidepressant Skills Workbook (30 mins)

This resource gives you the choice of either reviewing online or downloading the Antidepressant workbook as a PDF. It is a very practical guide that patients can use for mood self-management.

URL The Association Between HIV Infection and Alcohol Use: A Systematic Review and Meta-Analysis of African Studies (22 mins)

Read the 'Conclusions' section, and if you are interested, read the whole article.

URL CAMH and McMaster Addictions Curriculum Project: Alcohol and Major Depression (30 mins)

Go through the entire module titled 'Alcohol and Major Depression' to understand the link between alcohol and major depression. Once you click on the VIEW button, make sure you start from the begining of the module.

URL The use of psychotropic medication during pregnancy: how about the newborn? (45 mins)

Read the entire article to learn about the effects of psychotropic medication during pregnancy.

URL Sexual, Reproductive and Mental Health: Module 4: Safer Relationships & Safer Sex

This resource covers many aspects related to relationships and safety (for those with or without mental illness). In this training, you are not expected to become competent in providing advice in relation to sexual health, healthy relationships, or safety. However, if you are interested in these topics and their interactions with issues of mental illness, this is a good resource.

URL Substance Use, Sexual Risk, and Violence: HIV Prevention Intervention with Sex Workers in Pretoria

This supplementary resource provides an overview of issues faced by female sex workers in relation to violence, substance abuse, and HIV, as well as an intervention to prevent the transmission of HIV that seemed promising in Pretoria, South Africa.

URL HIV/AIDS and Substance Use Disorders
This case-based slide share discusses the connection between HIV and substance use disorders and the implications for patient care.
URL Black Dog Institute Model of Sub-typing Depression

You will want to read about the Black Dog Institute's model of depression. Create a free user account to access all of the materials. This resource includes a video as part of its learning module, therefore you will need high bandwidth internet access to use this resource.

Module 5: Lesson 2: Physical activities, diet, and healthy living in relation to substance use and mental health URL CBIS: Cognitive Behavioural Interpersonal Skills Manual (35 mins)

Healthy lifestyles and stress management are important aspects of well-being for those suffering from mental health or substance use disorders. This resource does a good job of teaching relaxation skills to address stress. First, navigate to the 'Relaxation Module' (pages 70-82). Perform all of the exercises, taking note of how you react to them so that you can teach those exercises when needed. Then try to offer them to someone you know (e.g., a friend, a family member, or a peer) and ask them how they feel after the exercise. Please also review the 'Lifestyle Module' (pages 101-106). The rest of the guide, which is optional reading, covers many skills that are useful in addressing depression and improving well-being. If your patient has access to the Internet, this might be a fantastic resource for them. If so, please guide them through the process of finding and reviewing the material. The 'Introduction' and the following section can help guide you in supporting your patient to use this resource.

URL How to look after your mental health using exercise (18 mins)

Read the entire web page about exercise and mental health, paying special attention to the benefits and possible tips that you can give to patients who may be suffering from mental health disorders, to increase their level of physical activity.

URL Diet and Mental Health (18 mins)

Read the entire web page to learn about diet and mental health.

URL Assessing Your Weight (15 mins)

Read through this resource to learn about healthy weights.

URL About BMI for Adults (10 mins)

Read this entire resource that provides a background on the usefulness and limitations of the BMI.

URL Calculate Your Body Mass Index (5 mins)

This is a direct link to an online BMI calculator (in metrics units). Please calculate your own BMI for practice.

URL Hints for Developing Exercise Plans With Depressed Patients (5 mins)

Read these tips on prescribing exercise, intended for GPs and other health professionals. Throughout this training, we have provided other links and info-sheets from the Black Dog Institute.

URL 3 Steps to Initiate Discussion About Weight Management with Your Patients (10 mins)

Read this entire document for some tips on how to discuss overweight and obesity issues with your patients who are identified as overweight.

URL The Psychological Toolkit (60 mins)

Review any info-sheets you feel are useful, and which you'd like to learn about in more depth. Each info-sheet should take about 10 minutes to review. 

URL Stress Symptom Test (10 mins)

This is another fantastic resource to help patients through the difficulties of living with a chronic health condition of any kind.  It addresses many skills that are highly relevant to general well-being, as well as supporting mental health and substance use disorder recovery. You can review this resource to help you advise your patients, or you can recommend it to patients who have access to the internet.

URL Canadian Guidelines for Body Weight Classification in Adults - Quick Reference Tool for Professionals (10 mins)

Read the entire guide.  This resource gives you access to a table (in metric units) to assess BMI risk levels, as well as BMI combined with waist circumference risk level. Of note, this resource explicitly states that a BMI below 18.5 is associated with a higher risk of undernutrition, malnutrition, osteoporosis, infertility and an impaired immune system.

URL Guidelines on Overweight and Obesity: Treatment Guidelines (30 mins)

This is the 'Guidelines on Overweight and Obesity: Electronic Textbook,' produced by the U.S. National Heart, Lung, and Blood Institute. You can click the links at the top or the 'Back' or 'Next' arrows at the bottom to review any sections about which you might want additional information.

URL Wellness Modules (30 mins)

This link provides several self-help wellness modules covering issues such as anger, sleep, and diet.

Module 6: Lesson 1: URL Patient-Physician Communication: Why and How (30 mins)

Read the entire article, with a focus on the section 'How to Communicate with Patients.'

URL Figure 7-3: Guidelines To Minimize Cultural Clashes (2 mins)

This figure reviews tips to avoid cultural clashes when communicating with people of other cultures.

URL When a parent drinks too much alcohol... What kids want to know (14 mins)

Read this entire resource, which covers how to talk to children of adults who drink too much. The way the questions are answered in the resource can be applied to other types of substance use as well (besides alcohol), providing that the relevant information for the substance is given instead. You should have become more familiar with the relevant information about the other substances as you have progressed through this NextGenU training. When treating someone with psychoactive substance use disorder, address the families’, caregivers’, and children's questions and concerns, and involve them in the care plan and support when the patient has provided their consent (as needed).

URL Parental Substance Misuse: Module 1: Understanding Substance Misuse (30 mins)

First, we recommend you click on text only button at the bottom of the webpage. Use the full audio-visual version only if you have a sufficient Internet connection, and then click on the various pictures to hear the participants speak rather than reading the transcripts.

Please review 'Section Five: Relationships with Family' by clicking on it (the blue tile). In the text only version, read all pages by clicking next on each one. On p. 2, click on the various links for the various transcripts. Please note that each parent's reaction is not right or wrong. This resource does not cover how you can support the families of those who care about someone with a substance use issue, it simply explains that they benefit from support.  It is very important that you do not judge how the family or others are reacting. The best conduct to adopt is that of empathy and a sharing of scientific information about substances. The sharing of personal information of patients outside the circle of professional care may be done only with the consent of the patient, as explained in prior modules. 

URL Talking to Patients About Sensitive Topics: Techniques for Increasing the Reliability of Patient Self-Report (30 mins)

Under the heading of Resource Materials, click to download the file named 'Powerpoint Slides (4.2MB)', which has lecture notes. Review slides 1-19, 23-39 and 44-58 and be sure to read the speaker notes as well. The rest of the slides are supplementary for this training.

URL Quitting Smoking and Beating Nicotine Addiction: Interventions (10 mins)

Read the 'Interventions' section (pp. 159 - 163 in the document; pp. 9 - 13 in the page navigator), which reviews various ways to communicate information in relation to smoking cessation. The section on women's issues in relation to smoking cessation (pp. 166-170) is supplementary.

URL Physician Communication Regarding Smoking and Adolescent Tobacco Use (10 mins)

Read the abstract on p. e1368 and the discussion section on pp. e1372 - e1374.

URL Tools and Resources

This resource provides links to other resources from CARMHA (the Centre for Applied Research in Mental Health and Addiction), including resources for workplace mental health and adolescent health, and many other practical tools.

URL Primary Care Addiction Toolkit: Motivation and Change (26 mins)

Click on the tab titled "Motivation & Change".  Then, click on the links titled "Influencing motivation to change", "Negotiating a change plan", "Setting goals and finding solutions", and "Preventing and managing relapse".  Read the content of those links for additional information about change and motivation and well as how to ask solution-focused questions to help assess and improve a patient's ability to change.