MENTAL HEALTH & MENTAL DISORDERS California Common Core Curricula for Child Welfare Workers

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1 MENTAL HEALTH & MENTAL DISORDERS California Common Core Curricula for Child Welfare Workers Instructor: Kathleen Adams, LCSW Outcome Objectives WHAT YOU WILL LEARN TODAY: Competencies and Learning Objectives What s Your Learning Style? Auditory Learners: Hear Visual Learners: See Kinesthetic Learners: Touch Variety is the spice of life! 1

2 Agenda Introduction UPDATE KATIE A Facts and Stats Labeling and Stigma Culture & Mental Health Definitions Strength Based Perspective Overview of Common Diagnoses and Implications for Child Welfare Resources, Interventions, & Referrals Meet and Greet Exploratorium Museum 2

3 Lives Lost in the System Who Said It? The pressures of being a parent are equal to any pressure on earth. To be a conscious parent, and really look to that little being s mental and physical health, is a responsibility which most of us, including me, avoid most of the time because it s too hard. Landmark Decision: Katie A. vs. Bonta A WIN FOR KIDS! Community-based mental health services for foster children must be provided on the Medi-Cal menu of services. 3

4 Facts and Stats 23% of adults suffer from a diagnosable disorder One in four adults approximately 57.7 million Americans. Only 50% of those report daily impairment 3% have both mental and addictive disorders 5-7% have a serious mental illness (schizophrenia, major depression, bipolar) Facts and Stats Continued Adults with serious mental illness die 25 years younger Leading cause of disabilities for ages Less than 1/3 receive MH services in a year Delay of 10 years from the onset of symptoms until the first contact with treatment CA: 300,000 with serious mental illness do not have access to services Homeless Stats 20 to 25 percent of the homeless population in the United States suffers from some form of severe mental illness. Mental illness is the third largest cause of homelessness for single adults. Approximately 1.6 million children will experience homelessness over the course of a year. 4

5 Who Said It? Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat. Small Group Discussion Answer the following questions: 1. How did your family define crazy? 2. Was this how your larger culture defined it? 3. How did your culture handle parents who were mentally ill? 4. Did you know someone who fit this description growing up? Explain 5. Consider a cultural practice within your family s culture that could be mistaken as a sign of mental illness Labeling and Stigmas What are some of the labels we put on mental illness? What are the stigmas to be aware of with mental illness/disorders? How does this impact CW? 5

6 Bias at Work Early messages become our templates for biases in the future What happens if you add other layers of potential bias? What should your role be in helping with systemic bias? Bias Write down some biases that you have concerning mentally ill people/parents For your eyes only Implications for Practice Bias shapes our decision making Community and systemic bias can impact our families negatively Cultural practices can be misdiagnosed and misinterpreted CW has a role in preventing and advocating Ethical obligation to understand 6

7 Who Said It? Mental illness is nothing to be ashamed of, but stigma and bias shame us all. Advocacy is. Advocacy Advocacy In your small groups: Brainstorm a list of ways CW can act as advocate for the mentally ill client who is a parent Write down list Prepare to share with rest of class 7

8 Who Said It? Truth is on the side of the oppressed. Definition Card Sort In small groups: Sort the cards in the envelope to match the word/concept to the correct definition Link Acute vs. Chronic What are the implications for parenting when referring to a symptom, sign, or prognosis? 8

9 Strengths and Protective Influences Symptoms manifest differently for different individuals Same diagnoses are more debilitating for some individuals than others Mitigating Factors Factors that decrease severity Factors that can help risk be less severe Factors that can help symptoms be more bearable and increase functionality Strengths of the Mentally Ill Consider factors that can help mitigate symptoms Consider coping factors as strengths Make a list of mitigating factors and strengths commonly seen with mentally ill clients 9

10 Anxiety Disorders Includes disorders that share features of excessive fear and anxiety and related behavioral disturbances: Panic Disorder Generalized Anxiety Disorder Agoraphobia Anxiety Symptoms Pounding heart Sweating Trembling Shortness of breath Feeling of choking Chest pain or discomfort Nausea Dizziness Excessive anxiety and worry Keyed up or on edge Easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance Obsessive -Compulsive and Related Disorders Obsessive Compulsive Disorder 10

11 Trauma and Stressor Related Disorders Disorders where exposure to traumatic or stressful events are listed explicitly in criteria Post-Traumatic Stress Disorder Adjustment Disorder Reactive Attachment Trauma Symptoms Shock, denial, or disbelief Anger, irritability, mood swings Guilt, shame, self-blame Feeling sad or hopeless Anxiety and fear Withdrawing from others Feeling disconnected or numb Trauma Symptoms continues Insomnia or nightmares Being easily startled Racing heartbeat Aches and pains Fatigue Difficulty concentration Edginess and agitation Muscle tension 11

12 Who Said It? One out of every three Americans is suffering from some form of mental illness. Think of two of your best friends. If they are ok, then it must be you. Vignette One In small groups read vignette #1 Use the chart to consider the diagnosis, signs of escalation, risk factors Discuss case plan interventions Identify which aspects of the MH system of care will be utilized Answer the questions following the vignette Process Points Strengths of family Implications for parenting Chronic vs. acute Your role? 12

13 Who Said It? Through all the drama, I love my momma. Depressive Disorders Common features are sad, empty, irritable moods, accompanied by somatic & cognitive changes that impacts functioning Persistent Depressive Disorder (Dysthymia) Substance/Medication-Induced Depressive Disorder Depressive Disorder due to a medical condition Depressive Disorder Symptoms Sad or irritable mood Loss of interest in activities Significant change in appetite Sleep disturbance Psychomotor agitation or retardation Loss of energy Feelings of worthlessness or inappropriate guilt Difficulty concentrating Thoughts of death or suicide Elevated, expansive or irritable mood, Inflated self-esteem or grandiosity Excessive talking Flight of ideas Risk taking behavior 13

14 Movie Time! Watch DVD Small group discussion/questions Use the chart to consider the diagnosis, signs of escalation, and risk factors Process Points Who do you identify with most? Strengths of the family? Assess mother s mental health Implications for parenting What are other considerations? Short and long term goals? How might the eldest daughter handle outside intervention? Who Said It? A question that sometimes drives me hazy am I or are the others crazy? 14

15 Bipolar and Related Disorders Changes in mood and changes in activity or energy Bipolar 1 similar to classic manic/depressive model Bipolar II Schizophrenia and other Psychotic Disorders Defined by 1 or more: delusions, hallucinations, disorganized thinking, grossly disorganized or abnormal motor behavior and negative symptoms Schizophrenia Depressive Disorder with psychotic features Hallucinations and delusions Disorganized speech Loss of ego boundaries Grossly disorganized or catatonic behavior Negative symptoms: Flat affect Poverty of speech Poverty of content of speech Lack of energy or drive/apathy Signs/Symptoms Disorganization: in personal care in social and professional performance Profound disruption in cognition and emotions Perceptions of reality strikingly different from the reality seen and shared by others around them 15

16 View the video Beautiful Mind Pick out signs/symptoms of psychosis Small Group Discussion List signs/symptoms Relate to identified parental risks How does MSLC impact a case with a schizophrenic parent? Personality Disorders Enduring pattern of inner experience and behavior that: Deviates markedly from expectations of the individual s culture Is pervasive & inflexible Has an onset in adolescence Is stable over time Leads to distress or impairment. Personality Disorders Antisocial: Disregard for, and violation of, the rights of others Borderline: Instability in relationships, self-image, affects and marked impulsivity Narcissistic: Grandiosity, need for admiration & lack of empathy Dependent: submissive and clinging behavior related to an excessive need to be taken care of. 16

17 Fictitious Disorder Attention seeking Heroic or martyr Exaggeration or exacerbation Fabrication In small groups: Vignette Two Use the chart to consider the diagnosis, signs of escalation, risk factors Discuss case plan interventions Identify which aspects of the MH system of care will be utilized Answer questions following vignette Consider: Safety Risk Protective capacity MSLC 17

18 Who Said It? Be the change that you want to see in the world. Questions? Any questions about anything we discussed today? Any questions about anything that did not come up? Thank you! Kathleen Adams, LCSW 18

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