15
Minds Ohio Psychotropic Medication Quality Improvement Collaborative Maer Toolkit Minds Matter for You and Your Family This is the property of
MindsOhio Psychotropic Medication Quality Improvement Collaborative
Matter
Toolkit Minds Matter
for You and Your Family
This is the property of
About Minds MatterMinds Matter is a project to help teens, families, and caregivers work with doctors to care for certain types of mental health problems among kids and teens. Problems like poor attention, or being depressed or angry a lot. This toolkit was made to help you make good choices about mental health. It can help kids and teens have a voice in their care, and guide family members, caregivers, and foster parents to help their children. It also helps professionals like doctors and social workers support their patients and clients.
Minds Matter has resources for your family on its website: www.ohiomindsmatter.org
How to use this toolkitPersonal Decision Guide
■
Make good choices and share them with others.
■
■
Prepare for a doctor’s visit.
Think through your options.
¨
¨
Learn about mental health medications.
Discuss possible side effects and benefits of medications.
Medication Side Effects Watch List
■
■
Use this during and after your doctor visit to:
Use this before, during, and after your doctor visit to:
Your Decision Team: Makes the best choices together
Information for Foster Care
Social Service Agency
Makes informed decision about treatment
approval.
JudicialGathers information.
Makes legal decisions.
Youth and CaregiverShares needs, questions, and concerns. Follows through on
what they agree to do.
Health professionalShares information.Listens to patients’
needs.
SchoolHelps student learn.
Your Family Can:Challenges?
Your Decision Team: Makes the best decision together.
There is no system for foster youths/parents to:• Get a second opinion.• Request to lower the
dose of medication or not take medication.
Decide what to share and double check it will be kept private.
Keep a journal.
Ask questions and do your own research.
Speak up until you get the help you need.
Consent or refuse medication.
Ask about care for any trauma or stressful event that you have experienced.
Before Your Visit
Youth and Parent/CaregiverShare needs and concerns.
Follow through on what they agree to do.
SchoolSupports your learning.
Health ProfessionalListens to your needs and helps make a care plan.
Other Important Adults
Mentor/help you.
Other Family
MembersProvide support.
Personal Decision Guide
Your Family You or Your Child
■Any alcohol/drug use during the mother’s pregnancy.
A typical day.■Any blood relatives with mental health problems.■
Stressful or traumatic events.■
Sickness or disability.■
Things you have already tried or want to try. ■Anyone who is important in your life.■
What behaviors concern you or others the most?
Poor attention Hyper Depressed or sad Angry Acts out
Poor listening Moody Worried or stressed Other
What do you want to get out of your doctor’s visit?
Prepare for visit:Be ready to describe:
Information for Foster Care
Social Service Agency
Makes informed decision about treatment
approval.
JudicialGathers information.
Makes legal decisions.
Youth and CaregiverShares needs, questions, and concerns. Follows through on
what they agree to do.
Health professionalShares information.Listens to patients’
needs.
SchoolHelps student learn.
Your Family Can:Challenges?
Your Decision Team: Makes the best decision together.
There is no system for foster youths/parents to:• Get a second opinion.• Request to lower the
dose of medication or not take medication.
Decide what to share and double check it will be kept private.
Keep a journal.
Ask questions and do your own research.
Speak up until you get the help you need.
Consent or refuse medication.
Ask about care for any trauma or stressful event that you have experienced.
Before Your Visit
Personal Decision Guide
Who is on your decision team?
Describe your family You or your child
NOTES :
Personal Decision Guide
Is there a diagnosis? Yes No What is it?
Treatment Option 1
Treatment Option 2
TreatmentOption 3
Discuss Options
Is there a big benefit? Yes No Yes No Yes No
Are the side effects/risks small? Yes No Yes No Yes No
Is the cost ok? Yes No Yes No Yes No
Will it help meet your goals? Yes No Yes No Yes No
How much do you like this option? A lot Some
Not much
A lot Some
Not much
A lot Some
Not much
During Your Visit
Check if you and the doctor have the same understanding.
Other treatment options.
Issues with getting the option you like (travel, cost, time).
Will the medications interact with (or affect) each other?
Where can you get more information or help? i
Have you had a complete evaluation? Yes No Should you see a specialist? Yes No
Today’s appointment
Date
Time
Personal Decision Guide
During Your Visit
Evaluation/diagnosis:
Treatment Options:
NOTES :
Step 1: Think
Personal Decision Guide
Are you readyto make choices?
Use the next page to keep track of how the treatment is working out.
Take it to your next appointment.
Date
Time
YesDiscuss how to begin with the doctor.
NoThat’s ok.
Take some more time to think. Make a follow-up appointment today.
To ask questions or tell the doctor your choices over the phone, call:
Step 2: Choose
Step 3: Set GoalsTreatment
Treatment
Treatment
Step 4: Evaluate
During or After Your Visit
Make Choices
How will you know you are making progress?
How often will you have check-ups?
What should you do to get good results?
How long will it take to see results?
Personal Decision Guide
During or After Your Visit
Treatment:
Goals:
NOTES :
Personal Decision Guide
How is it going since your last visit? Any side effects?
Symptoms
Care Plan
Is there anything else you would like to talk about today?
How many doses were missed?
How are you doing?Describe
How many times did you go?
0–1 2–4
More than 4
Describe
Counseling
0–4 5–10
More than 10
Why?
Medication
Were you able to follow the plan?
Yes No
Somewhat
Describe
Other (like diet or exercise)
Follow-Up Appointments
How many days have you missed?
School 0–1 2–4
More than 4
Describe
Today’s appointment
Date
Time
Yes No
Describe
Personal Decision Guide
Follow-Up Appointments
What changes are you seeing?
Questions you have for the doctor:
Anything going on at home?
NOTES :
Personal Decision Guide
Who shares?You can complete this page and share it with others if you choose to.
Why share?Professionals can help you if they know basic information about treatment.
To get more support.
Who to share with?School, counselors, caseworkers, family members, doctors, and others.
How to share?1. Decide who to share with and what to share.2. Complete this checklist and make copies.3. The doctor or nurse can help fill it in.
Who to contact about this child
Parent/legal guardian/authorized caregiver
Relationship to child Best way/time to contact
Email Cell phone
NeedsHow my team can help me succeed:
School
Caseworker/care manager
Counselor
Home
Doctors
Others
Treatment
Goals:
Treatment
Goals:
Treatment
Goals:
Diagnosis
Current treatments (include frequency/dose of medications)
Child’s Information
Name Date of birth
Share Your Choices
Personal Decision Guide
Share Your Choices
Treatment:
Needs:
NOTES :
Any
med
icat
ions
may
cau
se c
omm
on, g
ener
al s
ide
effec
ts s
uch
as:
Med
icati
on S
ide
Effec
tsW
atch
List
Pers
onal
Dec
ision
Gui
de Sym
ptom
:A�
en�o
n-D
efici
t/Hy
pera
c�vi
ty D
isor
der (
ADHD
) an
d A�
en�o
n De
ficit
Diso
rder
(ADD
)
Bran
ds: R
italin
, Add
eral
lM
ethy
lphe
nida
te, A
mph
etam
ines
Medica�on: S�mulants*
Com
mon
and
Sev
ere
Side
Effec
ts
Loss
of
Appe
�te/
W
eigh
t Los
s
High
Bloo
dPr
essu
re
Diffi
culty
Falli
ngAs
leep
Irrita
bilit
yan
d/or
Moo
dine
ss
“Tic
s” o
rIn
volu
ntar
yM
ovem
ents
Man
ia
(Sup
er H
yper
/Irr
itabl
e)
Head
ache
Sym
ptom
:De
pres
sion
, Obs
essi
ve-C
ompu
lsiv
e D
isor
der
and
Anxi
ety
Diso
rder
s
Bran
ds: P
roza
c, L
exap
ro,
Zolo
�Fl
uoxe
�ne,
Ser
tral
ine,
Esci
talo
pram
Medica�on: An�depressants
Com
mon
and
Sev
ere
Side
Effec
ts
Thro
win
gU
p/Di
arrh
ea
Depr
essio
nW
orse
ns/
Suic
idal
Appe
�te
Chan
ges
Sexu
alPr
oble
ms
Ac�v
a�on
(R
epea
ted
Ac�o
ns)
Dizz
ines
s
Head
ache
Swea
�ng
Tire
dnes
s/Sl
eepi
ngPr
oble
ms
LEGE
ND
= C
omm
on S
ide
Effec
t =
Sev
ere
Side
Effe
ct
*Hig
h ab
use
pote
ntial
. **
Ther
e m
ay b
e ot
her u
ses f
or s
ome
of th
ese
med
icati
ons.
The
US
Food
and
Dru
g Ad
min
istr
ation
(FDA
) app
rove
s adv
ertis
ing
med
icati
ons t
o be
use
d fo
r cer
tain
con
ditio
ns w
hen
they
ar
e sa
tisfie
d th
ey w
ork
to tr
eat t
he c
ondi
tion
and
are
safe
whe
n us
ed a
s dire
cted
. You
r hea
lthca
re p
rovi
der m
ight
reco
mm
end
“off-
labe
l use
” w
hich
is u
sing
a m
edic
ation
to tr
eat a
con
ditio
n th
at is
diff
eren
t fr
om w
hat t
he F
DA h
as a
ppro
ved.
Off-
labe
l use
is le
gal a
nd s
ometi
mes
app
ropr
iate
.
Hea
dach
eSl
eepy
Chan
ges
in
appe
tite/
wei
ght
Stom
ach-
ache
Rash
esCh
ange
s in
bo
wel
ha
bits
Tips
abo
ut m
edic
atio
ns• M
edic
atio
ns tr
eat t
he sy
mpt
oms o
f men
tal c
ondi
tions
.
• The
y ca
nnot
cur
e th
e co
nditi
on, b
ut th
ey c
an h
elp
you
feel
an
d fu
nctio
n be
tter
.
• Med
icat
ions
wor
k di
ffere
ntly
for d
iffer
ent p
eopl
e.
• Use
cau
tion;
med
icat
ions
can
reac
t with
eac
h ot
her.
• The
re m
ay b
e ot
her u
ses f
or m
edic
atio
ns w
hich
is c
alle
d “o
ff-la
bel.”
• You
shou
ld h
ave
ther
apy
alon
g w
ith y
our m
edic
atio
n.
• Don
’t ta
ke st
reet
dru
gs o
r med
icin
es n
ot p
resc
ribed
to y
ou.
Abo
ut s
ide
effec
tsSo
me
side
effe
cts
go a
way
with
tim
e. If
they
ha
ppen
righ
t aft
er s
tart
ing
med
icat
ion,
they
m
ight
be
side
effe
cts.
Abo
ut th
is w
atch
list
Com
mon
sid
e eff
ects
are
list
ed, b
ut th
ere
may
be
oth
ers
you
wan
t to
disc
uss
with
you
r doc
tor.
Thro
win
g up
Med
icati
on S
ide
Effec
ts W
atch
List
Gene
ral S
ide
Effe
cts
Pote
ntia
l Con
ditio
nsM
edic
atio
nsCo
mm
on S
ide
Effec
tsRa
re S
ide
Effec
tsSy
mpt
oms
Loss
of a
ppet
ite
Diffi
culty
falli
ng a
slee
p
Att
entio
n D
efici
t H
yper
activ
ity D
isor
der
(AD
HD
) and
Att
entio
n D
efici
t Dis
orde
r (A
DD
)
Stim
ulan
ts1
such
as
met
hylp
heni
date
or
amph
etam
ines
Bra
nds:
Rita
lin, A
dder
all
Non
-Stim
ulan
t: A
tom
oxet
ine,
St
ratte
ra
Hyp
er
Poo
r at
tent
ion
Poo
r lis
teni
ng
Act
with
out t
hink
ing
Hig
h bl
ood
pres
sure
and
he
art r
ate
Stra
nge
feel
ings
on
skin
or s
eein
g/he
arin
g th
ings
that
are
n’t t
here
Man
ia (
supe
r hyp
er o
r moo
dy)
Diz
zine
ss
Swea
ting
Slee
ping
pro
blem
s
Dep
ress
ion,
Anx
iety
, P
TSD
, and
Obs
essi
ve-
Com
puls
ive
Dis
orde
r (O
CD
)
Dep
ress
ed o
r sa
d
Moo
dy
Wor
ries
a lo
t
Dep
ress
ion
wor
sens
or s
uici
dal
thou
ghts
Cha
nges
in h
eartb
eat,
body
te
mpe
ratu
re o
r mus
cle
tone
Act
ivat
ion
(repe
ated
phy
sica
l act
ions
)
Ant
idep
ress
ants
su
ch a
s fl
uoxe
tine,
ser
tral
ine
and
esci
talo
pram
Bra
nds:
Pro
zac,
Zol
oft,
Lexa
pro
Diz
zine
ss
Get
s an
noye
d ea
sily
Sei
zure
dis
orde
rs, c
erta
in
case
s of
sev
ere
anxi
ety
(like
pan
ic a
ttack
s)
Mem
ory
prob
lem
s
Seiz
ures
(mig
ht h
appe
n if
you
sudd
enly
sto
p ta
king
it)
Dep
ende
ncy
(bod
y be
com
es u
sed
to
med
icin
e)
Ben
zodi
azep
ines
1 *
such
as
alpr
azol
am o
r clo
naze
pam
Bra
nds:
Xan
ax,
Klo
nopi
n,
Ativ
an*N
ot u
sual
ly re
com
men
ded
for c
hild
ren
Cry
ing
Cra
nky
Com
plai
nts
abou
t hea
lth
with
out a
cle
ar c
ause
Med
icati
on S
ide
Effec
tsW
atch
List
Pers
onal
Dec
ision
Gui
de Sym
ptom
:A�
en�o
n-D
efici
t/Hy
pera
c�vi
ty D
isor
der (
ADHD
) an
d A�
en�o
n De
ficit
Diso
rder
(ADD
)
Bran
ds: R
italin
, Add
eral
lM
ethy
lphe
nida
te, A
mph
etam
ines
Medica�on: S�mulants*
Com
mon
and
Sev
ere
Side
Effec
ts
Loss
of
Appe
�te/
W
eigh
t Los
s
High
Bloo
dPr
essu
re
Diffi
culty
Falli
ngAs
leep
Irrita
bilit
yan
d/or
Moo
dine
ss
“Tic
s” o
rIn
volu
ntar
yM
ovem
ents
Man
ia
(Sup
er H
yper
/Irr
itabl
e)
Head
ache
Sym
ptom
:De
pres
sion
, Obs
essi
ve-C
ompu
lsiv
e D
isor
der
and
Anxi
ety
Diso
rder
s
Bran
ds: P
roza
c, L
exap
ro,
Zolo
�Fl
uoxe
�ne,
Ser
tral
ine,
Esci
talo
pram
Medica�on: An�depressants
Com
mon
and
Sev
ere
Side
Effec
ts
Thro
win
gU
p/Di
arrh
ea
Depr
essio
nW
orse
ns/
Suic
idal
Appe
�te
Chan
ges
Sexu
alPr
oble
ms
Ac�v
a�on
(R
epea
ted
Ac�o
ns)
Dizz
ines
s
Head
ache
Swea
�ng
Tire
dnes
s/Sl
eepi
ngPr
oble
ms
LEGE
ND
= C
omm
on S
ide
Effec
t =
Sev
ere
Side
Effe
ct
*Hig
h ab
use
pote
ntial
. **
Ther
e m
ay b
e ot
her u
ses f
or s
ome
of th
ese
med
icati
ons.
The
US
Food
and
Dru
g Ad
min
istr
ation
(FDA
) app
rove
s adv
ertis
ing
med
icati
ons t
o be
use
d fo
r cer
tain
con
ditio
ns w
hen
they
ar
e sa
tisfie
d th
ey w
ork
to tr
eat t
he c
ondi
tion
and
are
safe
whe
n us
ed a
s dire
cted
. You
r hea
lthca
re p
rovi
der m
ight
reco
mm
end
“off-
labe
l use
” w
hich
is u
sing
a m
edic
ation
to tr
eat a
con
ditio
n th
at is
diff
eren
t fr
om w
hat t
he F
DA h
as a
ppro
ved.
Off-
labe
l use
is le
gal a
nd s
ometi
mes
app
ropr
iate
.
1 H
igh
abus
e po
tent
ial
Med
icati
on S
ide
Effec
ts W
atch
List
Med
icat
ion-
Spec
ific
Si
de E
ffec
ts
Trem
ors
Thirs
tyU
rinat
e a
lot
Bip
olar
dis
orde
r
Trou
ble
with
kid
neys
an
d/or
thyr
oid
Moo
d St
abili
zers
* su
ch a
s lit
hium
Bra
nds:
Esk
alith
Extr
eme
moo
ds o
r be
havi
or c
hang
es
Rac
ing
thou
ghts
Cha
nges
in s
leep
hab
itsN
ause
aTr
emor
sW
eigh
t gai
n
Easy
to b
ruis
e/bl
eed
Trou
ble
with
live
r and
/or p
ancr
eas
Con
fusi
on
such
as
valp
roic
aci
dB
rand
s: D
epak
ote
*Reg
ular
blo
od w
ork
is n
eede
d
Alp
ha-a
goni
stsu
ch a
s cl
onid
ine,
gua
nfac
ine
Bra
nds:
Kap
vay,
Intu
niv
AD
HD
and
AD
D
Hyp
er
Poo
r at
tent
ion
Poo
r lis
teni
ng
Act
with
out t
hink
ing
Ligh
t-he
aded
Dry
mou
th/e
yes
Trou
ble
with
live
r or k
idne
ys
Cha
nges
in b
lood
pre
ssur
e
Med
icat
ion
Type
Pote
ntia
l Con
ditio
nsCo
mm
on S
ide
Effec
tsRa
re S
ide
Effec
ts
Wei
ght g
ain
Feel
ing
slee
py
Dry
mou
th
Con
stip
atio
n
Blu
rred
vis
ion
Res
tless
Ari
pipr
azol
e lik
e A
bilif
y®
Mus
cle
stiff
ness
Unu
sual
mov
emen
t lik
e je
rkin
g or
twitc
hing
Cha
nges
in b
lood
sug
ar a
nd c
hole
ster
ol
Del
ay o
r cha
nges
in y
our p
erio
d
Bre
ast e
nlar
gem
ent i
n bo
ys o
r girl
s
Sudd
en h
igh
feve
r with
con
fusi
on
Aty
pica
l Ant
ipsy
chot
ics
Ase
napi
ne li
ke S
aphr
is®
Clo
zapi
ne li
ke C
loza
ril®
Ilope
rido
ne li
ke F
anap
t®
Lura
sido
ne li
ke L
atud
a®
Ola
nzap
ine
like
Zypr
exa®
Que
tiapi
ne li
ke S
eroq
uel®
Ris
peri
done
like
Ris
perd
al®
Zipr
asid
one
like
Geo
don®
= Te
ll a
nurs
e or
doc
tor.
= Se
e a
nurs
e or
doc
tor r
ight
aw
ay
and
take
you
r med
icat
ion
with
you
.
Key
Med
icati
on S
ide
Effec
ts W
atch
List
Med
icat
ion-
Spec
ific
Si
de E
ffec
ts
✦ T
here
may
be
othe
r use
s fo
r med
icat
ions
whi
ch is
cal
led
“off-
labe
l.”
Sch
izop
hren
ia
Bip
olar
Irri
tabi
lity
with
aut
ism
Oth
er ✦ {
Med
icat
ion
Lege
ndbi
d=tw
ice
a da
y
tid
= th
ree
times
a d
ay
qid
= fo
ur ti
mes
a d
ay
i =on
e
ii =
two
iii =
thre
e
prn
= as
nee
ded
hs =
bed
time
po =
by
mou
th
