Mental Health First Aid Notes

Transcription

1 Mental Health First Aid Ntes Prgram Overview What is Mental Health First Aid (MHFA)? Mental Health Prblems in the United States Mental Health First Aid Actin Plan Understanding Depressin and Anxiety Mental Health First Aid Actin Plan fr Depressin and Anxiety Suicidal Thughts and Behavir Symptms f Depressin Nn-suicidal Self-Injury Mental Health First Aid Actin Plan fr Depressin and Anxiety Panic Attacks Traumatic Events Symptms f Anxiety Understanding Psychsis Mental Health First Aid Actin Plan Psychsis Disruptive r Aggressive Behavir Understanding Substance Use Disrders Mental Health First Aid Actin Plan Overdse Withdrawal Substance Use Disrders Using yur Mental Health First Aid Training Definitin: Mental Health First Aid is the help ffered t a persn develping a mental health prblem r experiencing a mental health crisis. The first aid is given until apprpriate treatment and supprt are received r until the crisis reslves.

2 A mental disrder r mental illness is a diagnsable illness that: Affects a persn s thinking, emtinal state, and behavir Disrupts the persn s ability t: Wrk Carry ut daily activities Engage in satisfying relatinships See page 3 fr U.S. Adults with a Mental Disrder in Any One Year Chart The Impact f Mental Illness Disability refers t the amunt f disruptin a health prblem causes t a persn s ability t: Wrk Carry ut daily activities Engage in satisfying relatinships Mental illnesses can be mre disabling than many chrnic physical illnesses. Fr example: The disability frm mderate depressin is similar t the impact frm relapsing multiple sclersis, severe asthma, r chrnic hepatitis B. The disability frm severe depressin is cmparable t the disability frm quadriplegia. Recvery frm Mental Illness Recvery is the prcess in which peple are able t live, wrk, learn, and participate fully in their cmmunities. Fr sme, this is the ability t live a fulfilling and prductive life despite a disability. Fr thers, recvery implies the reductin r cmplete remissin f symptms. President s New Freedm Cmmissin n Mental Health See page 5 fr Spectrum f Mental Health Interventins Chart Mental Health First Aid: The Actin Plan This is the plan that was presented as the prcess f addressing the mental illness categries

3 lked at in the curse during an emergency situatin: depressin, anxiety disrders, psychsis, substance use disrder, and eating disrders. The actin plan is ALGEE. Mental Health First Aid: The Actin Plan Assess fr risk f suicide r harm Listen nnjudgmentally Give reassurance and infrmatin Encurage apprpriate prfessinal help Encurage self-help and ther supprt strategies First tpic: Depressin & Anxiety Are the mst cmmn mental illnesses Have sme similar signs and symptms Frequently c-ccur Depressin Majr depressive disrder lasts fr at least 2 weeks and affects a persn s Emtins, thinking, behavir, and physical well-being Ability t wrk and have satisfying relatinships Ability t carry ut usual daily activities Types f Md Disrders Majr depressive disrder Biplar disrder Pstpartum depressin Seasnal depressin Depressin: Signs and Symptms Physical Fatigue Lack f energy Sleeping t much r t little Overeating r lss f appetite Cnstipatin Weight lss r gain Headaches

4 Irregular menstrual cycle Lss f sexual desire Unexplained aches and pains Behaviral Crying spells Withdrawal frm thers Neglect f respnsibilities Lss f interest in persnal appearance Lss f mtivatin Slw mvement Use f drugs and alchl Psychlgical Sadness Anxiety Guilt Anger Md swings Lack f emtinal respnsiveness Feelings f helplessness Hpelessness Irritability Frequent self-criticism Self-blame Pessimism Impaired memry and cncentratin Indecisiveness and cnfusin Tendency t believe thers see ne in a negative light Thughts f death and suicide Anxiety Anxiety disrder differs frm nrmal stress and anxiety The symptms f an anxiety disrder are mre severe and can cause impairment in daily life (i.e.. Wrk, relatinships) See page 41 f curse bk fr U.S. ADULTS WITH AN ANXIETY DISORDER IN ANY GIVEN YEAR Chart Anxiety: Signs and Symptms Physical Cardivascular: punding heart, chest pain, rapid heartbeat, blushing Respiratry: fast breathing, shrtness f breath Neurlgical: dizziness, headache, sweating, tingling, numbness Gastrintestinal: chking, dry muth, stmach pains, nausea, vmiting, diarrhea

5 Musculskeletal: muscle aches and pains (especially neck, shulders and back), restlessness, tremrs and shaking, inability t relax Anxiety: Signs and Symptms Behaviral Avidance f situatins, bsessive r cmpulsive behavir, distress in scial situatins, phbic behavir Psychlgical Unrealistic r excessive fear and wrry (abut past and future events), mind racing r ging blank, decreased cncentratin and memry, indecisiveness, irritability, impatience, anger, cnfusin, restlessness r feeling n edge r nervus, fatigue, sleep disturbance, vivid dreams Risk Factrs fr Depressin & Anxiety Distressing and uncntrllable event Stressful r traumatic events Difficult childhd; histry f childhd anxiety Onging stress and anxiety Anther mental illness Previus episde f depressin r anxiety Family histry Mre sensitive emtinal nature Illness that is life threatening, chrnic r assciated with pain Medical cnditins Side effects f medicatin Recent childbirth Premenstrual changes in hrmne levels Lack f expsure t bright light in winter Chemical (neurtransmitter) imbalance Substance misuse; intxicatin, withdrawal Apply the Mental Health First Aid Actin Plan What are the steps? Assess fr Risk f Suicide r Harm The mst cmmn crises t assess fr with depressive and anxiety symptms are: Suicidal thughts and behavirs Nn-suicidal self-injury Suicide Risk Assessment Gender

6 Age Chrnic physical illness Mental illness Use f alchl r ther substances Less scial supprt Previus attempt Organized plan Warning Signs f Suicide Threatening t hurt r kill neself Seeking access t means Talking, writing, r psting n scial media abut death, dying, r suicide Feeling hpeless Feeling wrthless r a lack f purpse Acting recklessly r engaging in risky activities Feeling trapped Increasing alchl r drug use Withdrawing frm family, friends, r sciety Demnstrating rage and anger r seeking revenge Appearing agitated Having a dramatic change in md Questins t Ask f a Suicidal Persn Ask directly whether the persn is suicidal: Are yu having thughts f suicide? Are yu thinking abut killing yurself? If yes t either abve, then Ask whether the persn has a plan: Have yu decided hw yu are ging t kill yurself? Have yu decided when yu wuld d it? Have yu cllected the things yu need t carry ut yur plan? Hw t Talk with a Persn Wh Is Suicidal Let the persn knw yu are cncerned and willing t help Discuss yur bservatins with the persn Ask the questin(s) withut dread D nt express a negative judgment Appear cnfident, as this can be reassuring Check Fr Tw Other Risks:

7 Has the persn been using alchl r ther drugs? Has he r she made a suicide attempt in the past? Keeping the Persn Safe Prvide a safety cntact number Help the persn identify past supprts Invlve them in decisin making Call law enfrcement immediately if the persn has a weapn r is behaving aggressively D Nt Leave an actively suicidal persn alne Use guilt and threats t try t prevent suicide Yu will g t hell Yu will ruin ther peple s lives if yu die by suicide Agree t keep their plan a secret Sme Reasns fr Self-Injury T escape unbearable anguish T change the behavir f thers T escape a situatin T shw desperatin t thers T get back at ther peple T gain relief frm tensin T seek help Hw t Help with a Persn Wh Self-Injures Recgnize that self-injury is usually a symptm f serius psychlgical distress Avid any negative reactins t the self-injury Discuss the situatin calmly Fcus n ways t stp the distress D Nt: Fcus n stpping self-injury Trivialize the feelings r situatins that have led t self-injury Punish the persn Threaten t withdraw care Medical Emergencies Seek emergency medical help when smene has: Taken an verdse f medicatin Cnsumed pisn Sustained a life-threatening injury

8 Is cnfused, disrientated r uncnsciusness Is actively bleeding (rapid r pulsing) Apply the Mental Health First Aid Actin Plan What are the steps? Listening Nnjudgmentally Key attitudes t make the persn feel respected, accepted, and understd: Acceptance Genuineness Empathy Key nnverbal skills t shw yu are actively listening: Attentiveness Cmfrtable eye cntact Open bdy psture Being seated Sitting next t the persn rather than directly ppsite D nt fidget Give Reassurance and Infrmatin Treat the persn with respect and dignity Understand that symptms are an expressin f distress r part f an illness Have realistic expectatins Offer cnsistent emtinal supprt and understanding Give the persn hpe fr recvery Prvide practical help Offer credible infrmatin What Isn t Supprtive D Nt: Tell the persn t snap ut f it Act hstile r sarcastic Blame persn fr symptms Adpt an verinvlved r verprtective attitude Nag the persn t d what he r she nrmally wuld d Trivialize the persn s experiences Belittle r dismiss the persn s feelings Speak with a patrnizing tne Try t cure the persn

9 Encurage Apprpriate Prfessinal Help Types f Prfessinals Dctrs (primary care physicians) Psychiatrists Scial wrkers, cunselrs, and ther mental health prfessinals Certified peer specialists Types f Prfessinal Help Talk therapies Medicatin Other prfessinal supprts Funny Cartn Picture f peple at a bus stp Encurage Self-Help and Other Supprt Strategies Exercise Relaxatin and Meditatin Peer supprt grups Self-help bks based n cgnitive behaviral therapy (CBT) Family, friends, faith, and ther scial netwrks Sessin 2 Mental Health First Aid Actin Plan fr Depressin and Anxiety Panic Attacks Traumatic Events Anxiety Symptms Understanding Psychsis Mental Health First Aid Actin Plan Acute Psychsis Disruptive r Aggressive Behavir Understanding Substance Use Disrders Mental Health First Aid Actin Plan Overdse Withdrawal Substance Use Disrders Using yur Mental Health First Aid Training

10 Assess fr Risk f Suicide r Harm The mst cmmn crisis t assess fr with anxiety symptms is an extreme level f anxiety: Panic attack Reactin t a traumatic event Symptms f a Panic Attack Palpitatins, punding heart, r rapid heart rate Sweating Trembling and shaking Shrtness f breath, sensatins f chking r smthering Chest pain r discmfrt Abdminal distress r nausea Dizziness, light-headedness, feeling faint, unsteady Feelings f being detached frm neself (unreality) Fear f lsing cntrl r ging crazy Fear f dying Numbness r tingling Chills r ht flashes Hw t Help: Express cncern and willingness t help Ask whether the persn knws what is r has happened If yu dn t knw it is a panic attack: Check fr a medical alert bracelet and fllw the instructins Seek immediate medical assistance If the persn believes it is a panic attack: Reassure the persn that it is a panic attack Ask the persn if yu can help Hw t Help: Remain calm Speak in a reassuring but firm manner Speak slwly and clearly Use shrt sentences when speaking Be patient with the persn Acknwledge that the terrr feels very real Remind the persn that while a panic attack is frightening, it is nt life threatening Reassure the persn that he r she is safe and that the symptms will pass

11 Avid expressing yur wn negative reactins Assess fr Risk f Suicide r Harm: The mst cmmn crisis t assess fr with anxiety symptms is an extreme level f anxiety: Panic attack Reactin t a traumatic event Hw t Help: Encurage the persn t: Tell thers what he r she needs Identify surces f supprt Use cping strategies that have helped befre Take care f himself r herself Spend time in a safe and cmfrtable place Discurage the persn frm using negative cping strategies Seek prfessinal help if needed Encurage seeking prfessinal help if, fr 4 weeks r mre after the trauma, the persn: Can t stp thinking abut the trauma Remains upset r fearful Is unable t escape intense, nging, distressing feelings Finds imprtant relatinships are suffering Feels jumpy Has nightmares related t trauma Is unable t enjy life as a result f the trauma Has symptms that are interfering with usual activities Apply the Mental Health First Aid Actin Plan What are the steps? Next Tpic: Psychsis A picture f mvie pster f Psychsis was shne What is Psychsis? Psychsis is a cnditin in which a persn has lst sme cntact with reality The persn may have severe disturbances in thinking, emtin, and behavir

12 Disrders in which psychsis can ccur are nt as cmmn as depressin and anxiety disrders Psychsis usually ccurs in episdes and is nt a cnstant r static cnditin Cmmn Symptms When Psychsis is Develping Changes in emtin and mtivatin: Depressin Anxiety Irritability Suspiciusness Blunted, flat, r inapprpriate emtin Change in appetite Reduced energy and mtivatin Changes in thinking and perceptin: Difficulties with cncentratin r attentin Sense f alteratin f self, thers, r the utside wrld (e.g., feeling that self r thers have changed r are acting different in sme way) Odd ideas Unusual perceptual experiences (e.g., a reductin in r greater intensity f smell, sund, r clr) Changes in behavir: Sleep disturbances Scial islatin r withdrawal Reduced ability t carry ut wrk and scial rles Types f Disrders in Which Psychsis May Occur Schizphrenia Biplar disrder Psychtic depressin Schizaffective disrder Drug-induced psychsis See page 57 fr mre infrmatin n the abve disrders Symptms f Schizphrenia Delusins

13 Hallucinatins Disrganized speech Disrganized behavir Lss f drive Blunted emtins Scial withdrawal Symptms f Manic Episde (Biplar) Feeling unusually high and ptimistic r extremely irritable Unrealistic, grandise beliefs abut ne s abilities, increase in gal directed behavir Increased energy and veractivity Decreased need fr sleep and still feeling energetic Racing thinking and rapid speech Distractibility Excessive pleasurable activities Impaired judgement, impulsiveness and lack f insight Withut Early Interventin Prer lng-term functining Increased risk f depressin and suicide Slwer psychlgical maturatin and delay in assuming adult respnsibilities Strain n relatinships and subsequent lss f scial supprts Disruptin f educatin and emplyment Increased use f alchl and drugs Lss f self-esteem and cnfidence Greater chance f prblems with the law Apply the Mental Health First Aid Actin Plan What are the steps? Assess fr Risk f Suicide r Harm The mst cmmn crises t assess fr in persns with symptms f psychsis are: Suicidal thughts and behavirs Disruptive r aggressive behavir Hw t Help: Apprach the persn in a caring nnjudgmental way Chse a private time and place, free frm distractins

14 Let the persn knw yu are cncerned and want t help; state the specific behavirs that cncern yu Be sensitive t the way the persn is behaving Let the persn set the pace and style f interactin D nt tuch the persn withut permissin Allw the persn t talk abut their experiences and beliefs if they want t, but d nt frce them Let the persn knw yu are available t talk in the future Respect the persn s privacy and cnfidentiality Remain calm Talk in a clear, cncise manner Use shrt, simple sentences Speak quietly in a nnthreatening tne Use a mderate pace when talking Answer questins calmly Cmply with reasnable requests Maintain yur safety and access t an exit D nt d anything t further agitate the persn Try t De-escalate the Situatin Speak slwly and cnfidently with a gentle, caring tne f vice D nt argue r challenge the persn D nt threaten D nt raise yur vice r talk t fast Use psitive wrds instead f negative wrds Stay calm and avid nervus behavir D nt restrict the persn s mvement Try t be aware f what may increase the persn s fear and aggressin Pause, if needed, during the cnversatin Listen nnjudgmentally: Try t: Understand the symptms fr what they are Empathize with hw the persn is feeling abut his r her beliefs and experiences Try nt t: Cnfrnt the persn Criticize r blame Take delusinal cmments persnally Use sarcasm

15 Use patrnizing statements State any judgments abut the cntent f the beliefs and experiences When Cmmunicatin is Difficult Respnd t disrganized speech by talking in an uncmplicated manner Speak slwly and use shrt sentences Repeat things if needed Be patient and allw plenty f time fr respnses Be aware that just because the persn may be shwing a limited range f emtins, it des nt mean that he r she is nt feeling anything D nt assume the persn cannt understand yu, even if the respnse is limited Give Reassurance and Infrmatin Treat the persn with respect and dignity Offer cnsistent emtinal supprt and understanding Give the persn hpe fr recvery Prvide practical help Offer infrmatin D nt make any prmises that yu cannt keep Encurage Apprpriate Prfessinal Help Types f Prfessinals: Dctrs (primary care physicians) Psychiatrists Scial wrkers, cunselrs, and ther mental health prfessinals Drug and Alchl Specialists Certified peer specialists Types f Prfessinal Help: Talk therapies Medicatin Psycheducatin Other prfessinal supprts Encurage Self-Help and Other Supprt Strategies Peer supprt grups Family, friends, and faith and ther scial netwrks Family supprt grups Discntinuatin f alchl and ther nn-prescribed drugs

16 What if the Persn Desn t Want Help? Encurage the persn t talk with smene he r she trusts Never threaten the persn (i.e. with hspitalizatin) Remain patient Remain friendly and pen The persn may want yur help in the future Next Tpic: What are Substance Use Disrders? Dependence Abuse that leads t prblems at hme r wrk Abuse that causes damage t health Understanding Substance Use Disrders 8.1% f the ppulatin ver 12 have a substance use disrder in any given year The use f alchl r drugs des nt mean a persn has a substance use disrder 75% f peple wh develp substance use disrders d s by age 27 Alchl use disrders are almst three times as cmmn as drug use disrders C-Occurrence: Substance use disrders can c-ccur with any mental illness Sme peple self-medicate with alchl and/r ther drugs Peple with md r anxiety disrders are tw t three times mre likely t have a substance use disrder Warning Signs: Increased substance use ver time Increased tlerance fr the substance Difficulty cntrlling use Symptms f withdrawal Preccupatin with the substance Giving up imprtant activities (wrk, scial, family, etc.) Cntinued use even after recgnizing prblem with substance use

17 The precentrs read the descriptin f the cmmn substances and participants needed t identify the right substances based upn the list belw. Cmmn Substances: Marijuana (and synthetic Marijuana) Herin (and ther piids) Sedatives and tranquilizers Ccaine Amphetamines Methamphetamines Ecstasy and ther hallucingens Bath Salts Inhalants Tbacc Alchl Others? Presenters shwed Substance Use Disrders in the United States, 2014 chart n page 74 in the curse bk. Risk Factrs fr Substance Use Disrders: Availability and tlerance f the substance in sciety Scial factrs Genetic predispsitin Sensitivity t the substance Learning/Expsure Other mental health prblems Apply the Mental Health First Aid Actin Plan What are the steps? Assess fr Risk f Suicide r Harm Talk when bth f yu are sber Talk when yu are in a calm frame f mind Talk with the persn abut his r her drinking penly and hnestly Talk with the persn in a quiet, private envirnment Keep in mind: The persn s wn perceptins f his r her drinking The persn s readiness t talk Use f I statements The persn s recall f events

18 Fur main crises are assciated with prblem drinking: 1. Intxicatin with alchl pisning r severe withdrawal 2. Aggressin 3. Suicidal thughts and behavirs 4. Nn-suicidal self-injury When t Call an Ambulance Call 911 immediately when the persn: Cannt be awakened r is uncnscius Has irregular, shallw, r slw breathing Has irregular, weak, r slw pulse Has cld, clammy, pale, r bluish skin Is cntinually vmiting Shws signs f a pssible head injury (e.g., talking incherently) Has seizures Has delirium tremens a state f cnfusin and visual hallucinatins Has cnvulsins Has blackuts May have cnsumed a spiked drink Listen nnjudgmentally Try t: Listen t the persn withut judging him r her as bad r immral Avid expressing judgments abut his r her drinking Shw yu are cncerned fr his r her well-being Try nt t: Be critical f the persn Label the persn r accuse him r her f being an addict r an alchlic Express yur frustratin at the persn fr having these prblems Give Reassurance and Infrmatin Changing drinking and drug habits is nt easy Willpwer and self-reslve are nt always enugh t stp the prblem Giving advice may nt help the persn change substance use habits Nt everyne wants abstinence as a gal reducing the quantity f use can be wrthwhile A persn may stp r try t stp substance use mre than nce befre being able t stp entirely Actins Nt t Take When Helping Smene with a Substance Use Disrder

19 Jin in drinking alchlic beverages with the persn Bribe, nag, r threaten Make excuses fr the persn s behavir Try Nt T: Take n the persn s respnsibilities Feel guilty r respnsible A diagram f The Stages f Change was shwn frm page 81. Encurage Apprpriate Prfessinal Help Types f Prfessinals: Dctrs (primary care physicians) Psychiatrists Scial wrkers, cunselrs, and ther mental health prfessinals Drug and Alchl Specialists Certified peer specialists Types f Prfessinal Help: Talk therapies Medicatin Psycheducatin Other prfessinal supprts Encurage Self-Help and Other Supprt Strategies Supprt grups Family, friends, and faith netwrks Avidance f friends and scial settings invlving alchl and ther drugs Self-help grups As f 2015, Alchlics Annymus (AA) had mre than 115,000 grups wrldwide and 60,000 grups and 1.2 millin members in the United States. As f 2015, Narctics Annymus (NA) had mre than 63,000 meetings weekly in 132 cuntries. This was an interesting stat: Treatment Gap: In 2014, an estimated 22.5 millin Americans aged 12 r lder needed treatment fr a prblem related t drugs r alchl, but nly abut 4.1 millin peple received treatment.