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Mental Health Presentation

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Ashley Yambot

on 19 March 2013

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Transcript of Mental Health Presentation

Suji Kim, Ashley Yambot, Annabel Lee, Nan Thu, Eun Kyong Oh, Fely Embesan Psychosis in Adolescents and Young Adults Contents Conclusion 1. Definition of Psychosis and the causes
2. Epidemiology
3. Signs/Symptoms and Treatments
4. Barriers in seeking help
5. Contributions of members of the multidisciplinary team and the role of nurses
6. Organisations that offer support and other ways of seeking help
7. Conclusion
8. References Signs/Symptoms
& Treatments Psychosis is common in adolescents and young adults
Early recognition and treatment is important to prevent detrimental effects and therefore, better chance of recovery
There are many barriers in seeking help, most commonly stigma between peers
Contributions of multidisciplinary teams, nurses and different organisations can provide care for adolescents and young adults suffering from psychosis “Around two in one hundred young people will have a psychotic episode.”

- ReachOut.com, 2013 EPIDEMIOLOGY Very broad

Including anything from relatively normal unusual experiences through to the complex

A wide variety of central nervous system diseases from both external substances and internal physiologic illness

Not specific enough as a diagnostic term

Generally given to noticeable loss of normal behavior (negative signs) Psychosis Abnormal condition of the mind

Loss of contact with reality

People suffering from psychosis are described as psychotic

Psychosis is given to the more severe forms of psychiatric disorder.
Definition Genetic factor

Drug use or social changes

Health problems: physical injures, diseases, brain injury

Stress

Depression: feelings of worthlessness, failure Causes of psychosis in young people (Kelleher, et al 2012) The median prevalence of psychotic symptoms among:
Children (aged 9 – 12) = 17%
Adolescents (aged 13 – 18) = 7.5% Prevalence of psychotic symptoms: (Morgan, et al 2011) Two thirds of people experience their first psychotic episode before the age of 25 years. Onset of mental disorders: (Morgan, et al 2011) - The age of onset tends to be slightly older in females than males. Onset of mental disorders: (cont.) Negative symptoms Delusional thinking
Hallucinations
Severe thought process disturbance Positive symptoms Loss or reduction in functioning
Limited speech
Lack of energy and motivation (anergia)
Social withdrawal
Loss of living skills
Loss of drive (avolition)
Blunted affect
Loss of experience of pleasure (anhedonia) Delusions: false beliefs, strongly believing something is real, when it is not

Hallucinations: perceptions involving six senses without external stimuli. Auditory hallucination is most common Positive symptoms Disorganised behaviors: behaviors preventing effective functioning including difficulties engaging in goal directed actions, incoherent speech and agitation

Changes in behaviour, problems with memory and concentration, deterioration in work or study, difficulty communication, sleep or appetite disturbances Negative symptoms Negative symptoms tend to have stronger effect on cognitive and other areas of functioning

Could effect children and adolescence in their development and functioning in social and academic areas Positive vs negative http://www.youtube.com/watch?v=1jNtT4c86Ek Life with Psychosis Medications

Educational and community programs

Psychotherapy

Family involvement

Cognitive Behavioural Therapy Treatments Early recognition is necessary as early treatment is more effective for psychotic symptoms in youth.

Early treatment has been associated with better prognosis of the illness

Prevents and minimizes disability and reduces the personal, social and economic strains

Best chance for normal progress in school, work, and in the development of social skills Importance of early treatment Aims to reduce psychotic symptoms and improve general functioning

Regular monitoring is essential as side effects may happen

Practitioners need to use the lowest possible doses to control symptoms and use adjunctive medications to address side effects

After symptoms have been stabilized with medication, it is easier for youth to benefit from counseling and therapy Medications Risperidone
Olanzapine
Quetiapine
Haloperidol
Chlorpromazine or CPZ Commonly used anti-psychotics Should include information; accommodation; help with finding suitable work; training and education; psychosocial rehabilitation and mutual support groups.

Understanding and acceptance by the community is very important Educational and community programs Treatment of emotional, behavioral, personality, and psychiatric disorders based primarily on verbal or nonverbal communication and interventions with the client, in contrast to treatments using chemical and physical measures.

Aims to facilitate the healthy maturation of the adolescent, to help them to develop a concept of an independence, which modifies, selects, controls and coordinates instinctual impulses and excludes or modifies those that are in conflict with the external reality.

Helps clients and their relatives to understand their illness Psychotherapy (talking treatment) Non psycho pharmacological treatment

Individual psychological approaches

Produce significant improvements in psychotic symptomatology and in distress associated with psychotic symptoms
- Helpful in later stages of the illness
- Compliance enhancement or in developing better control of residual symptoms Cognitive Behavioural Therapy Involvement of the family in assessment, treatment, discharge and follow up

Important to consider family therapy when working with young adults and families

Focuses the identified problems with the child and how family has dealt with these issues, including family based assessments and treatments and attentions to the whole family Family involvement and support Should include working with both the parents and the child.

Targeted at improving family functioning, problem solving, communication skills, and relapse prevention have been shown to decrease relapse rate in adults. Psychosocial interventions - Confidentiality and Trust

- Stigma and embarrassment

- Self-reliance to solve problems

- Poor mental help literacy

- Knowledge about mental health services

- Negative attitudes toward mental health services

- Suicidal thoughts

- Lack of emotional competence

- Prefer other sources of help(e.g. family or friends) BARRIERS TO SEEKING HELP - Limited availability of professional services (Rural & Remote Communities)

- Lack of accessibility (Time, transport or cost)

- Lack of anonymity (Residents’ lives are clearly visible to the community) Multidisciplinary teams (MDTs) have become the norm in most forms of service delivery in metal health.

Provide a structure for most effectively meeting the needs of individuals with mental illness and their family and carers.

Support function for staff who face the challenge of meeting the varied needs of consumers and families while grappling with the complexities of serious mental illness.

Multidisciplinary mental health team
- Psychiatrist
- Nurse
- Social worker
- Psychologist
- Occupational therapist
(Mental Health Professional Online Development 2011) Contribution of the members of the multidisciplinary team Responsible for the biological aspects of treatment for diagnosing mental disorders and prescribing medication.

Usually the team leader

Responsible for the admission and discharge of patients, and for authorising special leave or close observation. (Elder 2009) Psychiatrist Bring skills in psychometric and neuro-psychological testing and diagnosis, and knowledge of developmental psychology and learning theories, as well as expertise with cognitive behavioural therapy. (Elder 2009) Psychologist Bring skills in psychosocial assessments and inter-agency liaison, with a knowledge of the law, social policy and how social systems affect young adults and adolescents within families. (Psychiatric Services Branch, Victorian Government Department of Health and Community Services 1996 )

Provide support for families, provide talking therapies, advise in relation to housing, finances, and supports. (Elder 2009) Social worker Help adolescents and young adults in developing the independent living skills they require, alongside school staffs, social worker and youth worker.

Help to organise leisure or work activities and the development of social and sexual relationships.

Provide group therapy in order to facilitate peer group experience alongside individual cognitive behavioural therapy and family work
(Creek & Lougher 2008) Occupational therapist Assessment and management of young consumers using nursing knowledge and skills

Forms a relationship with young people through engagement and fostering a sense of purpose with the treatment plan for adolescents
- Engagement between nurses, young people and their families is fundamental in developing a relationship based on trust. A relationship founded on trust will foster a willingness to work together towards changes.
(Groome,Henderson&Masters 2009) Contributions of mental health nurses Provide treatment such as group therapy and individual goal planning

Provide psycho-education in regards to a young consumer’s mental health status and their treatment.

Provide family support and therapy

Direct referrals of young consumers to other health care professionals

Provide medication therapy and monitoring of medication compliance and of the associated negative side effects
(Groome,Henderson&Masters 2009) Contributions of mental health nurses (cont.) ORGANISATIONS  Beyondblue’s work is aimed at achieving an Australian community that understands depression and anxiety, empowering all Australians, at any life-stage, to seek help.  beyondblue raises awareness, reduces stigma and ensures people have access to the information they need to ensure recovery, management and resilience.    Kids Helpline is Australia’s confidential and private counselling service specifically for children and young people aged 5 to 25 years.
Young Australians contact Kids Helpline via the phone, web and email about a wide range of issues; from everyday topics such as family, friends and school to more serious issues of child abuse, mental health concerns, homelessness and suicide.  Lifeline delivers immediate one off short term crisis support and suicide prevention services across Australia. Lifeline provides its services through a national telephone crisis support line, 13 11 14,  operating 24/7  and through its online crisis support chat service which operates every evening from 8am until midnight. Plays a vital role in the development of mental health initiatives which result in increased community awareness and knowledge of mental health issues. SANE Australia works for a better life for all people affected by mental illness through educating the community, applied research, and campaigning for improved services and attitudes. headspace provides mental and health wellbeing support, information and services to young people aged 12 to 25 years and their families. headspace has centres around Australia which have a range of youth friendly health professionals who can help with general health; mental health and counselling; education, employment and other services; and alcohol and other drug services. Visit www.headspace.org.au for information, to find your nearest centre and to access online and telephone support. ReachOut.com is Australia’s leading online youth mental health service. It’s the perfect place to start if you’re not sure where to look. It’s got information on everything from finding your motivation, through to getting through really tough times. With a mobile-friendly site and forums, you can access help, info and support no matter where you are. Anxiety Online is an initiative of the National eTherapy Centre based at Swinburne University of Technology. Anxiety Online provides information, assessment, referral and treatment for Panic Disorder, Social Anxiety Disorder, Generalised Anxiety Disorder, Obsessive Compulsive Disorder and Post Traumatic Stress Disorder. The MindSpot Clinic is a free telephone and online service for Australians with stress, worry, anxiety, low mood or depression. Parents

School

General Practice

Specialised services

Youth services

Self-help and complementary treatments

Youth participation . Reaching out!!! Birmaher, B. 2003, ‘Treatment of Psychosis in Children and Adolescents’, psychiatric annals, vol. 33, no. 4, pp. 257-264.
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Elder, R., Evans, K. & Nizette, D. (eds) 2009, Psychiatric and Mental Health Nursing, Elsevier, Chatswood, NSW
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Heretohelp 2010, Learn about psychosis, viewed 9 March 2013, <www.heretohelp.bc.ca>.
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