Transcript Module 3: Mental health Awareness

Module 3: Mental health
Awareness
Objectives
• To be aware of the range of mental health
problems
• To be aware of the signs and symptoms of
mental health problems
• To be aware of the prevalence of mental
health problems
Dual Diagnosis Capabilities
• Education and Health Promotion: Be able
to offer basic but accurate and up to date
information and advice about effects of
substances on mental and physical health
and vice versa. Dual Diagnosis Capability
8 level
Mental Health Problems
• Mental health is in a constant state of flux and is
affected by a variety of things such as lifeevents, stress, environmental factors (like being
in prison), relationships, losses, financial
problems, and physical health problems.
• mental health problem: severe and prolonged
stress and an underlying vulnerability.
• Manifested in a number of ways: mood
problems, anxiety problems, or psychosis (loss
of reality).
• Affects almost 20% of the population.
Recovery Model of Mental Health
• Comes from the growing force of the service user
movement
• Changing from a negative view to a more positive view
which includes rebuilding, reclaiming and taking control.
• Recovery is not about a “cure” but more about achieving
an optimum quality of life, and learning something from
ones own experiences of mental illness.
• Focus on the individual and place them and their views
at the centre.
• Emphasize strengths rather than focus on problems,
educate the public to combat stigma.
• Foster collaboration between those who need support
and those who provide it rather than using coercion.
Types of Mental Disorders
Mental
disorders
Disorders of Mood
Depression
anxiety
Organic brain
Disease
Dementia
Head injury
Disorders related
to
Psychoactive
Substance use
Alcohol dependence
Developmental
Disorders
Autism
Schizophrenia
And delusional
disorders
Neurotic
Anxiety disorders
Personality
Disorders
Borderline
Anti-social
Depression
• Lowering of mood, and reduction in energy and activity
• Symptoms include:
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tearfulness
loss of appetite
loss of libido
feelings of guilt and worthlessness,
loss of interest in things
poor sleep (either too much or too little),
sleep disturbances including early morning waking
negative view on life both past and present
Social withdrawal.
• Treatment includes talking therapies, anti-depressant
medication, and rarely ECT.
Anxiety
• Symptoms:
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extreme restlessness and agitation
complaining of physical symptoms such as palpitations
sweating
breathlessness
shaking
diarrhoea and indigestion
problems sleeping
problems concentrating
constant worrying.
Panic attacks: extreme anxiety response with no
apparent cause. Sudden onset and difficult to predict.
– Feeling of terror, difficulties breathing (hyperventilation)
dizziness, heart pounding and a sense of doom.
OCD, Phobias, and PTSD
• Obsessive compulsive disorder
– Obsession: an unwanted or unpleasant idea that the
person can’t stop thinking about (e.g. thoughts of
harming a loved one);
– Compulsion is a behaviour that a person can’t stop
doing e.g. hand washing, counting etc.
• A phobia is an “unreasonable” fear and the
person copes by avoiding the trigger at all costs.
• Both OCD and phobias in their extreme form can
be very disabling as they prevent people from
doing their normal activities.
• OCDs and phobias are treated with cognitive
behavioural therapy, support and sometimes
medication such as anti-depressants
PTSD
• Post-traumatic stress disorder
• Occurs immediately or delayed reaction to a traumatic
experience above and beyond normal experiences e.g.
major disaster, military combat, childhood abuse
• Symptoms include:
– intrusive (often very intense and real) memories (also known as
“flashbacks”),
– dreams and nightmares about the traumatic experience,
– a sense of numbness and detachment from those around them,
– anhedonia (which means inability to experience pleasure)
– “hyperarousal” and “hypervigilance”
– Substance misuse
– Suicidal and aggressive behaviours
– Treated with anti-depressants, and specialist counselling
Schizophrenia
• Schizophrenia is a disorder of thinking and perception and affects
(feelings and emotions) that are inappropriate or blunted.
• Serious and enduring mental illness characterised by “psychosis”
(difficulty separating what is real from imaginary happenings).
• Positive symptoms (things that are present) include:
– Odd or unusual beliefs that they hold with very strong conviction
(or “delusions”).
– Strong convictions that some external force is controlling their
thoughts and behaviour (delusion of control, influence) and may
feel powerless over this.
– auditory hallucinations
– Thought insertion or withdrawal, thought broadcast, and thought
echo
• Negative symptoms (things that are absent) include:
– being socially withdrawn,
– lacking motivation to do things
– not experiencing pleasure from anything
• Treatment includes anti-psychotic medication, support, psychosocial
interventions such as CBT and family work
Bi-polar affective disorder
• This causes extreme mood swings, so people may have episodes of
extreme happiness or mania, and then plummet to despair and
depression.
• Some people will experience psychotic symptoms at either end of
the spectrum as well.
• Someone who is elated will have pressure of speech (talking fast
and incessantly), restless and agitated, flight of ideas (having lots of
ideas), little or no sleep, disinhibition (may take off clothes, or act
sexually), feel powerful or famous.
• When depressed they will exhibit symptoms as described in the
depression section. When people are stable they function very well.
• People are treated with mood stabilisers and psychosocial
interventions.
Personality Disorders
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Severe disturbances of personality and behavioural tendencies of
individuals
Usually manifest during childhood and adolescence and continue
through into adulthood.
They may develop as a result of traumatic experiences in early
childhood and are most common in people who have been abused
sexually or violently.
Many people with PD have co-morbid mental health and substance
use problems
Antisocial PD:
– Difficulty coping with boredom.
– Difficulties holding down a job or stay in a long-term relationship.
– Act impulsively and recklessly, often without considering the
consequences.
Borderline PD:
– Problems controlling their emotions.
– Extreme fear of abandonment by others.
– Over-dependent and demanding which in turn pushes others away.
– Impulsive acts of self-harm and suicide attempts.
– NO LONGER A DIAGNOSIS OF EXCLUSION- should get access to
help from mental health services.
Prevalence of Mental Disorders.
Psychiatric morbidity of adults in private households survey 2000 (ONS)
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Adults rates per 1000 population
General anxiety
44
Depression
26
Phobias
18
OCD
11
Panic
7
Any PD
44
ASPD
6
BPD
7
Psychotic disorders
5
More than one disorder
4
Alcohol dependence
Drug dependence:
– Cannabis
– Cocaine
– Heroin
– Cannabis only
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31
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25
Prevalence of Mental Disorders.
Psychiatric morbidity of adults in private households survey 2000 (ONS) One
year prevalence
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rates per 1000
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10
5
0
anxiety
depression
phobias
OCD
Panic
psychosis
ASPD
BPD
O-C PD
any PD