Mental Health First Aid

1. Mental Health First Aid

2. What are Mental Health Problems? • There are a number of terms used to describe Mental Health problems: • mental disorder • mental ill-health • mental illness • nervous exhaustion • mental breakdown • nervous breakdown • Burnout • cracked up • stressed out • psycho

3. What is a Mental Disorder? • A Mental Disorder is a diagnosable illness which causes major changes in a person’s thinking, emotional state and behaviour.It also disrupts the person’s ability to study or work and carry out their usual personal relationships.

4. How common are Mental Health problems? • In any one year, one in five Australian adults have enough symptoms to be diagnosable with a mental disorder The following table shows the percentage of Australians who suffer from a common mental disorder in any one year

5. How common are Mental Health problems? • The common mental disorders often occur in combination • For example, it is not unusual for a person with an anxiety disorder to also develop depression, or for a person who is depressed to misuse alcohol or other drugs

6. Reasons for not seeking Professional help for Mental Illness • 38% would prefer to manage the problem themselves • 18% don’t believe anything could help • 17% didn’t know where to get help • 14% were worried what others would think of them

7. Leading causes of disease burden in Australians aged 15-24 years

8. ALGEE When working with people with any type of mental illness, the following procedure should be followed: • Assess risk of suicide or harm • Listen non-judgementally • Give reassurance and information • Encourage the young person to get appropriate professional help • Encourage self-help strategies

9. Depression

10. Depression • Depression (more commonly referred to as Clinical Depression) usually lasts for at least two weeks and affects the person’s ability to carry out their work or to have satisfying personal relationships • Clinical depression is a common but serious illness that is often recurrent • Clinical depression affects around 5% of Australian adolescents aged 13-17 years • 1 in 4 young people will have had clinical depression by the end of adolescence

11. What causes Depression? • Depression has no single cause and often involves the interaction of many diverse biological, psychological and social factors

12. Depression • People may develop depression as a result of significant trauma or distress • These may include:

13. Who is most likely to develop Depression? • Some people will develop depression in a distressing situation, whereas others in the same situation may not • Those most prone to developing depression are: • Adolescent girls and women • Those with low self esteem • Those who have a parent who has suffered from depression • Those who are unpopular with their peers and have poor social skills • Those who tend to enterpret things that happen in a pessimistic way • Those who have had a difficult childhood (eg. Physical abuse, sexual abuse, neglect, over-strictness)

14. The Depression Checklist • If a person is clinically depressed they would have, for at least two weeks, five or more of the following symptoms, including at least on of the first two • An unusually sad or irritable mood that does not go away • Loss of enjoyment and interest in activities that used to be enjoyable • Lack of energy and tiredness • Feeling worthless or feeling guilty when they are not really at fault • Thinking about death a lot or wishing they were dead • Difficulty concentrating or making decisions • Moving more slowly or, sometimes, becoming agitated and unable to settle • Having sleeping difficulties or, sometimes, sleeping too much • Loss of interest in food or, sometimes, eating too much; changes in eating habits may lead to either weight loss or weight gain

15. Depression Action Plan(ALGEE) • Early intervention for depression is very important • Once a person has had an episode of depression they become more prone to subsequent episodes • The following steps should be followed when dealing with someone with depression • Assess risk of suicide or harm • Listen non-judgementally • Give reassurance and information • Encourage the young person to get appropriate professional help • Encourage self-help strategies

16. Anxiety Disorders

17. Anxiety Disorders • Anxiety is something that everyone experiences. It can be quite useful in helping a person to avoid a dangerous situation or to help motivate them to solve every day problems. • An Anxiety Disorder will impair an individual rather than assist them • Anxiety Disorders differ from normal anxiety in the following ways: • It is longer lasting than normal anxiety • It is more extreme • It interferes with the person’s work or relationships

18. Types of Anxiety Disorders • There are a number of different types of Anxiety Disorders. These include: • Generalised Anxiety Disorder (GAD) • Panic Disorder • Phobic Disorders (Agoraphobia and Social Phobia) • Separation Anxiety Disorder • Acute Stress Disorder and Post Traumatic Stress Disorder (PTSD) • Obsessive Compulsive Disorder (OCD)

19. Generalised Anxiety Disorder • People with GAD worry excessively about school, money, health, appearance, sports and other regular activities, even when there are no signs of trouble • Physical Symptoms include fast or pounding heart, headaches, stomach pains, tremors, muscle tension, dizziness, sweating and dry mouth • Psychological Symptoms include excessive worry, irritability, restlessness, feeling on edge and difficulty concentrating

20. Panic Disorder • A person with a panic disorder suffers from panic attacks and is afraid that a panic attack might occur • A panic attack is a sudden onset of intense apprehension, fear or terror • These attacks can begin suddenly and develop rapidly • This intense fear is inappropriate for the circumstances in which it is occurring Symptoms of a panic attack include: • Increased heartbeat • Sweating • Trembling or shaking • Feeling of choking, shortness or breath or smothering • Chest pain or discomfort • Nausea or abdominal distress • Feeling dizzy, unsteady, light headed or faint • Numbness, tingling or pins and needles • Chills or hot flushes

21. Phobic Disorders • A young person with a phobia avoids or restricts activities because of fear • This fear appears persistent, excessive and unreasonable • They may have an unreasonably strong fear of specific places or events and often avoid them completely • Agoraphobia involves avoidance of situations because of fear of a panic attack occurring. They may avoid leaving home or certain situations • Social Phobia is the fear of any situation where public scrutiny may be possible, usually with the fear of behaving in a way that is embarrassing or humiliating • Specific Phobias involve a fear of something specific such as spiders or snakes.

22. Separation Anxiety Disorder • A person with separation anxiety disorder shows excessive anxiety about being separated from home or from a parent or caregiver • The person will worry about losing the loved one or about harm happening to them

23. Acute Stress Disorder and Post Traumatic Stress Disorder • Acute stress disorder and post traumatic stress disorder occur after a distressing or catastrophic event • This event may involve actual or threatened death, or serious injury • Alternatively, it may involve witnessing such an event or learning about such an experience of a family member or close friend • In Acute Stress Disorder the person gets over the event within a month • In Post Traumatic Stress Disorder the distress lasts longer

24. Obsessive Compulsive Disorder(OCD) • This form of Anxiety disorder is the least common but is a very disabling condition • Obsessive thoughts and behaviours accompany the feelings of anxiety • Obsessive thoughts are usually about fear of contamination or harm • Common compulsions include the need to wash, check things over and over and counting

25. What causes anxiety disorders? • People more at risk of developing Anxiety Disorders include: • Those who had a very anxious parent • Those with amore sensitive emotional nature who tend to see the world as threatening • Girls and women • Other causes include: • People who had a difficult childhood (ie. abuse) • Family is poor and lacks job skills • Alcohol problems in the parents • Certain prescription drugs • Other non prescription drugs such as caffeine, cocaine, ecstasy and speed

26. Action plan for Anxiety Disorders • Assess risk of suicide or harm People with Anxiety Disorders have a higher risk of suicide, especially if depression is present also. • Listen non-judgementally • Give reassurance and information • Encourage the young person to get appropriate professional help • Encourage self-help strategies

27. Psychosis

28. Psychosis • Psychosis is a general term used to describe a mental health problem in which a person has lost some contact with reality • There are severe disturbances in thinking, emotion and behaviour • Psychosis severely disrupts a person’s life • Relationships, work and self-care are difficult to initiate and/or maintain

29. Psychosis • The main types of Psychotic illnesses include: • Schizophrenia • Bipolar Disorder • Psychotic Depression • Schizoaffective Disorder • Drug-induced Psychosis

30. Schizophrenia • The term Schizophrenia means ‘fractured mind’ and refers to changes in mental function where thoughts and perceptions become disordered • The major symptoms of Schizophrenia include: • Delusions: These are false beliefs of persecution, guilt, special mission or being under outside control • Hallucinations: These are false perceptions that often involve hearing voices but can also involve seeing, feeling, tasting or smelling things • Thinking Difficulties • Loss of Drive • Blunted emotions • Social withdrawl

31. Bipolar Disorder • People suffering from Bipolar Disorder (manic depressive illness) have extreme mood swings, fluctuating between periods of depression, mania and normal mood Common symptoms of mania include: • Increased energy or overactivity • Elated mood • Needing less sleep than normal • Irritability • Rapid thinking and speech • Lack of inhibitions • Grandiose Delusions (very inflated self esteem, belief they are superhuman, especially talented, etc) • Lack of insight

32. Psychotic Depression • Sometimes depression can be so intense it causes psychotic symptoms • For example, the person may have delusions involving guilt, severe physical illness or hopelessness

33. Schizoaffective Disorder • This is where the person displays symptoms associated with both Schizophrenia and Bipolar Disorder

34. Drug-induced Psychosis • This is a psychosis brought on by the use of drugs • The symptoms usually appear quickly and last a short time (from a few hours to days) until the effects of the drug wears off • The most common symptoms are visual hallucinations, disorientation and memory problems • Drugs that cause psychosis are Cannais, Cocaine, Ecstasy, Amphetamines (speed) and Magic Mushrooms

35. What causes Psychosis? • It is believed psychosis is caused by a combination of factors including genetics, biochemistry, stress and unknown factors

36. Importance of early intervention for Psychosis • Unfortunately, diagnosis of Psychosis is often difficult and takes a long time • The consequences of delayed treatment include: • Slower and less complete recovery • Poorer long term functioning • Increased risk of depression and suicide • Slower maturing psychologically • Strain on relationships with friends and family and subsequent loss of social support • Disruption of study and employment • Increased use of alcohol and drugs • Loss of self esteem and confidence • Greater change of problems with the law

37. Action plan for Psychosis • Assess risk of suicide or harm • Listen non-judgementally • Give reassurance and information • Encourage the young person to get appropriate professional help • Encourage self-help strategies

38. Substance Use Disorder

39. Substance use Disorder • Using Alcohol or Drugs does not in itself qualify a person for a substance use disorder • Substance use disorders include any of the following: • Dependence on alcohol or a drug • Use of alcohol or a drug which leads to problems at work, school or home or to legal problems • Use of alcohol or a drug at a level which is causing damage to health

40. Symptoms of Substance use Disorder • Symptoms include: • Tolerance for the substance (person needs increased amounts over time or gets less effect with repeated use) • Problems in withdrawal (person experiences withdrawal symptoms or uses the substance to relieve withdrawal symptoms) • Use of larger amounts or over longer periods than intended • Problems in cutting down or controlling use • A lot of tie is spent getting the substance, using it or recovering from its effects • The person gives up or reduces social, occupational or recreational activities because of substance use • The person continues using the substance despite suffering from its ill effects

41. Substance use Disorder Statistics Percentage of Australian adults who suffer from a substance use disorder in any year

42. What causes substance use disorders? • Different substances affect the brain in different ways • People use substances because of these effects, which include increasing feelings of pleasure or decreasing feelings of distress • Substance use typically starts in adolescence or young adulthood • If a person has not started using a substance by age 30, then it is unlikely that they will develop a substance use disorder

43. Causes of alcohol use disorders • There is no single cause for alcohol use disorders rather, there are many factors that contribute to a person’s chance of developing alcohol use disorders • These include: • Availability and tolerance of alcohol in society • Social factors (work environments/occupation, friendship group) • Genetic predisposition (those with a biological parent who has an alcohol use disorder are more predisposed) • Alcohol sensitivity (some people do not feel the effects of alcohol as much so consume larger amounts)

44. Action plan for substance use disorder • Assess risk of suicide or harm • Listen non-judgementally • Give reassurance and information • Encourage the young person to get appropriate professional help • Encourage self-help strategies

45. Eating Disorders

46. Eating Disorders • Eating disorders involve a disturbance of eating habits or weight control behaviour which results in impairments to physical health or which affect the person’s psychological and social functioning • Eating disorders occur in people who over evaluate their body shape and weight • The three main types of eating disorders are Anorexia Nervosa, Bulimia Nervosa and Atypical eating disorders

47. Anorexia Nervosa • Anorexia Nervosa is characterised by extreme dieting and weight control to the point of starvation • Although extremely underweight, people with Anorexia Nervosa perceive themselves to be overweight or not thin enough • They see the extreme weight loss as success not as a problem so they are not motivated to change their behaviour • About 90% of people who suffer from Anorexia Nervosa are female • Anorexia is not common, affecting less than 1% of teenage girls

48. Characteristics of Anorexia Nervosa • Over evaluation of body shape or weight, so that self worth is largely judged in these terms • Maintaining a very low body weight (ie. BMI ≤ 17.5) • Loss of menstrual periods in females who have reached puberty • Obsessive concern about body weight, shape or dieting • Unrealistic beliefs about being fat or extreme fear of gaining weight • Cutting out foods that were once enjoyed • Excessively exercising • Inducing vomiting or using laxatives • Avoiding meal times with others • Excessively analysing food labels, or counting kilojoules from food and exercise

49. Bulimia Nervosa • Bulimia Nervosa is characterised by periods of extreme dieting and weight control followed by periods of uncontrolled overeating or binge eating • Bulimia Nervosa mostly affects females • It is more common than Anorexia Nervosa, affecting 1-2% of young women

50. Characteristics of Bulimia Nervosa • Over-evaluation of body shape or weight • Repeated episodes of uncontrolled over eating • Extreme weight control behaviour, e.g. extreme dieting, frequent use of vomiting or laxatives to control weight or excessive use of exercise • Do not meet the characteristics of Anorexia