Mental Health v Mental Health Issue v Mental Illness Recognising a - PowerPoint PPT Presentation

 Mental Health v Mental Health Issue v Mental Illness  Recognising a mental illness  Considerations in supporting mentally ill people  Trauma Informed Principles  Referral Pathways

Discussion about mental health may raise personal issues for some people and has the potential to identify mentally ill people in the community. Privacy and confidentiality  Respect for each other 

What is Mental Health? Mental health is a state of well-being in which every individual : realises his or her own potential  can cope with the normal stresses of life  can work productively and fruitfully  is able to make a contribution to her or his community  World Health Organisation 2011

What is a Mental Health Problem? A mental health problem is where cognitive, emotional or social abilities are diminished, but not to the extent that the criteria for mental illness are met as per DSM 5.

What is Mental Illness? A mental illness is an illness that significantly interferes with someone’s ability to function by affecting the way they think, feel or behave. The person will meet illness criteria as per the Diagnostic and Statistical Manual (DSM V) or the International Classification of Diseases (ICD).

Who is a mentally ill person under the Act? (s14) A mentally ill person is someone who has a mental illness and, because of that illness, there are reasonable grounds for believing that care, treatment or control of the person is necessary a) for the person's own protection from serious harm, or b) for the protection of others from serious harm. Under the Act a person who is mentally ill may be involuntarily detained

Mental Illnesses include:  Affective disorders  Anxiety disorders  Psychotic disorders  Eating Disorders

What are the statistics? 20 15 10 % Males 5 Females 0 All One in five

What is Depression? Depressed mood + other associated symptoms  Interferes with ability to function – work,  relationships, socially, spiritually and culturally.

Major Depressive Episode Depressed mood  Loss of enjoyment and interest  Poor concentration  Fatigue  5 or more symptoms Agitation  for more than 2 weeks Guilt  Negative thinking  Thoughts of death / suicide  Sleep  Weight 

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Who may be at risk of Depression? Personal or family history of depression  Being a more sensitive, emotional or anxious person  TRAUMA  Adverse experience in childhood (eg. neglect or abuse)  Significant changes in life – separation, having a baby,  financial strain Lack of close confiding relationship  Social isolation  Substance misuse  Long term or serious mental illness, chronic pain 

Bipolar Affective Disorder Increased energy and overactivity  Elated mood  Need less sleep than usual  Irritability  Rapid thinking and speech  Lack of inhibitions  Grandiose delusions  Awareness 

Anxiety Disorders Anxiety is a normal human emotion and can help us function at a higher level, avoid danger and solve problems.

Anxiety Disorders But in some people anxiety can: be uncomfortably intense  last too long, or get worse  interfere with their ability to function  They might then meet the criteria for  an anxiety disorder per DSM V

Symptoms of Anxiety Disorders Emotions Unrealistic fear  Feeling nervous or ‘on edge’  Impatience  Thoughts Irritability, anger  Excessive worry  Mind racing or going blank  Poor concentration and memory  Behaviour Difficulty making decisions  Avoidance  Distress in social situations  Obsessions or compulsions  Hoarding  Use of alcohol or drugs 

Symptoms of Anxiety Disorders Physical Palpitations  Chest pain  Shortness of breath  Nausea  Dizziness  Muscle aches and pains 

Psychosis Psychosis involves a loss of contact with, or distortion of, reality. This can include hallucinations  delusions  disorganisation of thought 

Delusions Sniper hiding CIA agents Has knife, wants to hurt me Can hear my thoughts

What to look out for Emerging psychosis can involve: Changes in emotion & motivation  Changes in thinking & perception  Behaviour change  Social withdrawal  Self neglect  This is sometime referred to as a PRODROME

Risk Issues - Suicide

Signs that a person may be suicidal Threatening to hurt or kill themselves  Talking or writing about death  Hopelessness  Rage, anger, seeking revenge  Reckless behaviour  Increased alcohol or drug use  Withdrawal from family and friends  Anxiety / agitation / sleep disturbance  Dramatic changes in mood  No future plans  Giving away valued possessions 

Suicide stats – by sex 40 35 male 30 female 25 20 15 10 5 0 1921 1926 1931 1936 1941 1946 1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2006

Suicide stats – by age 40 35 30 25 20 male 15 female 10 5 0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

Why blokes? The median age at divorce for males was 44.8 years 2013 ABS stats

Why blokes?

Rate per 100,000 NNSW and State 25 20 15 10 5 0 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 NNSW Rate (per 100,000) NSW Rate

Trauma Informed care We need to be asking … Not what is WRONG with you, but rather, what has HAPPENED to you?

The Brain in Action (Watchtower – Cortex observes & predicts – working memory Emotional regulation) Slower Hippocampus (Relates new input to past Slower experience) Thalamus Cook/fil (Sensory – Amygdala Very the Cook - (Smoke Filter) fast Detector) Stimulus Response

Adverse Childhood Experiences Study

ACE Study Findings ACE Scores Linked to Physical & Mental Health Problems Compared with people with no ACEs, those with four or more ACEs were:  Twice as likely to smoke  Seven times as likely to be dependent on alcohol  Six times as likely to have had sex before age 15  Twice as likely to have cancer or heart disease  Twelve times more likely to have attempted suicide  Men with six or more ACEs were 46 times more likely to have injected drugs than men with no history of adverse childhood experiences Source: Adverse Childhood Experiences (ACE) Study. Information available at http://www.cdc.gov/ace/index.htm

Considerations in supporting people with a mental illness Listening skills  Body language  Calm, quiet but clear voice  Ask about worries and concerns  Don’t pressure someone to talk – be comfortable with silence  Comfort, Care and Compassion. 

Body language for de-escalation

Body language for de-escalation Do not copy aggressive behaviour  Give the person more personal space  Avoid folding your arms  Limit eye contact – don’t stare  Open and balanced – palms facing the person . 

Do Try to find a quiet place to talk  Respect privacy and confidentiality  Be respectful of age, gender and culture  Listen actively  Be patient and calm  Acknowledge how they are feeling. “I can appreciate this is  incredibly distressing for you”. Allow for silence 

Suggestions “You may not have control over your circumstances, but you do have a say in how you cope with them”. “Most people who come through this door are incredibly stressed, let’s look at how you can find support for that”. “I believe it’s in your best interests that you seek some support during this process. Here are some options”.

Don’t Pressure someone to tell their story  Interrupt or rush them  Judge what they have or haven’t done  Tell them all about your own problems  Make things up you don’t know  Try to solve all of their problems for them 

What happens when I call the NSW Mental Health Line?

Other services Non-clinical support

Stigma  In our society  In ourselves  In our office

Thank you