Module 1. Overview of Serious Mental Illness and Recovery. Statistics on Adults with Serious Mental Illness. Defining Serious Mental Illness

Size: px

Start display at page:

Download "Module 1. Overview of Serious Mental Illness and Recovery. Statistics on Adults with Serious Mental Illness. Defining Serious Mental Illness"

Henry Stanley
5 years ago
Views:

Module 1 Overview of Serious Mental Illness and Recovery 4

American adult s have a ment al illness.

( N IM H, 2 0 1 0 ) Leading cause of disabilit y is serious

Speciflc psychiat ric diagnosis: Schizophrenia Bipolar disorder

1 Module 1 Overview of Serious Mental Illness and Recovery 4 Statistics on Adults with Serious Mental Illness 26% of American adult s have a ment al illness. 6% of American adult s have a serious ment al illness. ( N IM H, ) Leading cause of disabilit y is serious ment al illness. 5 Defining Serious Mental Illness 1. Speciflc psychiat ric diagnosis: Schizophrenia Bipolar disorder Major depression ( D S M - 5 ) 2. Signiflcant funct ional impairment : Less t han 60 GAF score ( S A M H S A, 2002) 6

DSM-5 Criteria for Schizophrenia At least t wo of t he following sympt oms for at least 1 mont h: Posit

ive Sympt oms: Flat affect Social wit hdrawal Difflcult y init iat ing behavior Anhedonia ( A PA, 2 0 1 3

Problem-solving Reasoning Decision-making Working memory impairment s. Slower processing speed.

May not see or hear t hings t hat ot hers not ice. 3. May have difflcult y screening sensory st imuli. 4.

2 DSM-5 Criteria for Schizophrenia At least t wo of t he following sympt oms for at least 1 mont h: Posit ive Sympt oms: Delusions Hallucinat ions Disorganized speech Disorganized or cat at onic behavior Negat ive Sympt oms: Flat affect Social wit hdrawal Difflcult y init iat ing behavior Anhedonia ( A PA, ) 7 Common Cognitive Impairments in Schizophrenia Difflcult ies wit h execut ive funct ions: Problem-solving Reasoning Decision-making Working memory impairment s. Slower processing speed. 8 Common Sensory Processing Impairments in Schizophrenia 1. Tend t o miss and avoid sensory st imuli. 2. May not see or hear t hings t hat ot hers not ice. 3. May have difflcult y screening sensory st imuli. 4. Oft en overwhelmed by cert ain sounds, sight s, smells, or t ouch. 5. May lose t he opport unit y t o process necessary informat ion. 9

Heterogeneity of Schizophrenia No t wo individuals wit h schizophrenia are t he same: Some individuals may experience positive symptoms. Others may experience negative symptoms.

10 Relationship of Symptoms & Impairments to Occupational Performance (Mileu et al. 2005; Tandon et al.

3 Heterogeneity of Schizophrenia No t wo individuals wit h schizophrenia are t he same: Some individuals may experience positive symptoms. Others may experience negative symptoms. Some may experience signiflcant executive dysfunction. Others may have few issues with cognitive or sensory processing. Must appreciat e t he individual and identif y areas of need. 10 Relationship of Symptoms & Impairments to Occupational Performance (Mileu et al. 2005; Tandon et al. 2009) A particular impairment or symptom does not translate to difficulties in occupational performance. 11 Knowledge Check Susan works in a busy and noisy of flce. She has a diagnosis of schizophrenia. She was recent ly given a new and complicated assignment, but has yet to start. Her boss didn t spend much time giving her instructions. Although there may be several reasons why Susan has not started, what is the most likely explanation based on the existing research? Click Submit to check your answer. A. Auditory hallucinations are interfering with Susan s ability to initiate her work. B. Susan always flnds it challenging to initiate a new task in a busy and noisy environment. C. The complex assignment and hurried instruct ions are making it dif flcult f or Susan t o underst and how t o do t he work. Subm it 12

DSM-5 Criteria for Bipolar Disorder At least one manic episode charact erized by elevat ed, expansive, or irrit able

Decreased need for sleep. Pressured speech. Flight of ideas/ racing t hought s. Dist ract ibilit y.

Excessive involvement in pleasurable act ivit ies t hat have a high pot ent ial for painful consequences.

and mania. ( J a m is o n, 1993) Somet imes high levels of product ivit y.

Disrupt s daily rout ines, int erfering wit h work and social relat ionships.

4 DSM-5 Criteria for Bipolar Disorder At least one manic episode charact erized by elevat ed, expansive, or irrit able mood last ing at least 1 week and t hree or more of t he following: In at ed self est eem or grandiosit y. Decreased need for sleep. Pressured speech. Flight of ideas/ racing t hought s. Dist ract ibilit y. Increase in goal-direct ed act ivit y. Excessive involvement in pleasurable act ivit ies t hat have a high pot ent ial for painful consequences. ( A PA, ) 13 Relationship of Bipolar Disorder and Occupational Performance Associat ion bet ween creat ivit y and mania. ( J a m is o n, 1993) Somet imes high levels of product ivit y. Can be debilit at ing wit h a negat ive impact on one s life. Disrupt s daily rout ines, int erfering wit h work and social relat ionships. 14 DSM-5 Criteria for Major Depressive Disorder At least one major depressive episode charact erized by depressed mood or loss of int erest or pleasure and at least 4 of t he following sympt oms: Weight loss or weight gain. Insomnia or hypersomnia. Psychomot or agit at ion or ret ardat ion. Fat igue. Feelings or wort hlessness. Difflcult y concent rat ing. Suicidal ideat ions. ( A PA, ) 15

2 0 0 5 ; Fu r u k aw a e t al. 2 0 1 0 ) 16 Knowledge Check There is a great deal of similarit y in sympt omat ology and impairment among individuals wit h serious ment al illness.

5 Depression and Occupational Performance Fact ors associat ed wit h great er occupat ional dysfunct ion: Mult iple episodes. Lack of t reat ment. ( Pr a t t & Bro d y, ) Nat ure of occupat ional performance problems in depression: Impairment s in self efflcacy. Impairment s in volit ion. ( D u n lo p e t al ; Fu r u k aw a e t al ) 16 Knowledge Check There is a great deal of similarit y in sympt omat ology and impairment among individuals wit h serious ment al illness. Click Submit t o check your answer. A.True B.False Sub m it 17 A Change in Paradigms: Medical Model to Recovery Model Recovery Model emphasizes t he following principles: Hope Choice Empowerment Full part icipat ion President s New Freedom Commission st at ed: after a year of study, and after reviewing research and testimony, the Commission finds that recovery from mental illness is now a real possibility. The promise of the New Freedom Initiative a life in the community for everyone can be realized (p.1). Click here t o access t he report summary. 18

You can access more of her work at www.pat deegan.com.

6 21 The Recovery Movement Pat Deegan is a leader in t he recovery movement. She is an advocat e and innovator, developing technology and contributing signiflcantly to the adoption of recovery-oriented practices. Click here to view Showing Up for Recovery by Pat Deegan. You can access more of her work at deegan.com. 19 Fundamental Components of Recovery 20 Knowledge Check Explain how you would you alt er t hese common pract ices t o re ect a recovery orient ed perspective?à Click Submit to check your answer. Practice 1: The building has separate lunch rooms and bathroom for staff and clients. Practice 2: Topics related to spirituality are avoided in treatment. Practice 3: All services are provided by licensed professionals. Pract ice 4: The board f or t he mental healt h center consists primarily of prof essionals, f amily members, and community leaders. Learner s response: Subm it

7 Occupational Therapy and Recovery Ways that occupational therapy is consistent with recovery: Support ing individuals in t heir goal t o live lif e t o t he f ullest. Developing a sense of meaning and purpose. Providing services t hat contribute t o successf ul communit y living. Promot ing choice t hrough client-centered pract ices. Believing in t he pot ent ial of humans t o realize a more positive fut ure. Challenges for occupational therapists: Abdicating control of the decision-making process. Allowing individuals to make mistakes in life. Learn about recovery: The National Empowerment Center Mental Health Recovery Website Mental Healt h and Recovery: What Helps and What Hinders 22

Building Allies in Deafhood

Building Allies in Deafhood Chriz Dally, Deafhood Foundation N ational Counselors of the Deaf Association Conference A pr i l 20 14 - W ashington School for the Deaf Presentation Agenda Considering t he