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Mental Health Awareness

South Lakeland Minds overview of an introduction to Mental Health
by

Christopher Frampton

on 10 December 2015

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Transcript of Mental Health Awareness

Mental Health Awareness
A Brief Introduction
National Mind

Mind is the leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress by:


•campaigning for people’s rights

•challenging poor practice in mental health

•informing and supporting thousands of people on a daily basis

•providing over a thousand services across England and Wales through our network of local Mind associations.
Who are we?
Mind’s Mission and Values

Informed
People with experience of mental distress drive all we do.

Determined
We will never give up challenging discrimination and campaigning for better mental health.

Diversity
We respect everyone's experience and ensure inclusion is at the heart of our work.

Integrity
Our independence ensures our integrity - we are never compromised.

Partnership
We are committed to working with our networks and allwho will help us achieve our mission.
South Lakeland Mind
Objectives
• To assist in relieving and rehabilitating people suffering from mental disorders
or conditions of emotional and mental distress.
• To work to develop prevention activity that reduces the scale and impact of
mental ill health.
• To promote the preservation of mental health and wellbeing.
• To challenge stigma and raise public awareness of mental health problems.


Mission Statement
South Lakeland Mind exists to enhance the quality of life for people experiencing
mental and emotional distress and to work generally towards the promotion of better
mental health and a greater sense of wellbeing for people in South Lakeland. We
achieve this through the provision of a range of services including information and
support, drop-in centres, one-to-one support, counselling, advocacy, befriending,
outdoor and other activities and complementary therapies. We aim to improve public
understanding of mental health issues, challenge discrimination and seek better local
and national services.


Values
We believe...
Everyone experiencing mental or emotional distress has the right to live a full life and
play their full part in society, and to be treated fairly, positively and with respect.
Everyone experiencing mental or emotional distress has the right to information,
choices and to be involved with their own care and recovery.
The experiences, needs, views and opinions of people experiencing mental or
emotional distress are valid and frame all we do at South Lakeland Mind.
In respecting and valuing the contribution made by staff and volunteers to the work we
do through their varied experience and skills we will provide a supportive environment
for them to work in.
Who are you ?
Introductions: Name, Get out of today, what gets you out of bed in morning?
Aims
To raise awareness and understanding of concepts of mental health and distress and to understand and recognise the causes, signs and symptoms, treatment and support options for the range of common and severe mental health conditions.
Mental Health
vs.
Mental Distress
Group Discussion - What is Mental Health?
Mental Health
World Health Organisation
Mental Distress


•Covers a range of experience that can effect an individuals ability to cope with day to day living or certain situations e.g. Social situations

•Mental distress is not constant, people can manage well for significant periods of time but stress and life events can have an impact just as we all vary in our ability to cope day to day.

•Mental distress is not always visible

•Common, 1 in 4 people will experience some form of mental health issue during their lifetime
Mental Health is a state of well-being in which an individual realizes their abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to their community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community.
Quiz or / and
There are 3 main ways of viewing Mental Health, called models.
Biological

Social

Psychological
Biological
• Psychiatry originally an offshoot of neurology e.g. Charcot, Freud

Biological health care focuses on the following:

•quest to conquer and cure disease;

•focused on disease more than on the whole person;

•concerned with what is normal and what is pathological and making judgements about the boundary between them;

•a rational activity based on scientific knowledge that is secured through lengthy formal training.

N.B The biomedical model has been the dominant model in mental health services because the dominant profession in these services has been psychiatry. Psychiatrists are medically trained and therefore tend to see the main purpose behind their work as the diagnosis and treatment of illness or disorder
Social Models
•Emphasises the interaction of social factors e.g. Deprivation

•It addresses the inner and the outer worlds of individuals, groups and communities e.g. family make up, culture etc.

•It places equal value on the expertise of service users, carers and the general public but will challenge attitudes and practices that are oppressive, judgemental and destructive.

•Social model of mental health places much greater emphasis on the role of networks and communities in maintaining the mental health of individuals.

•Social isolation is a common problem for people experiencing mental distress.

Duggan, Cooper and Foster,(2002)
Psychological Models
Psychological theories broadly attempt to understand the role of mental function, individual and social behaviors while also exploring physiological and neurological processes that underlie certain cognitive functions and behaviors. Psychological approaches are often separated in cognitive, behavior, person centred and other humanistic theories. Incorporate how psychological, emotional and spiritual processes impact individuals:

•Psychological formulations
•Attachment styles
•Thinking styles
•Learned helplessness
•Memory
•Attention
etc
Holistic: biological and environmental factors, together with a person's personal experiences, lead to mental disorder through their conjoint effects on these psychological processes.
Bio-Psycho-Social Model
by Chris Frampton
Adapted from National Mind training pack with additional modifications.
"If someone tells me that Banana therapy works for them, then I'd pass them the bananas."
Comment left by Mind reader on “Is the medical model so evil “ blog http://www.mind.org.uk/blog/2943_is_the_medical_model_really_so_evil
What other factors have an impact on mental distress?
Gender
•Gender is a critical determinant of mental health and mental distress.

•Gender determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status and treatment in society and their susceptibility and exposure to specific mental health risks.

•Depression is twice as common in women and may be more persistent in women than men.
•Alcohol dependence is more than twice as high in men than women. Approximately 1 in 5 men and 1 in 12 women. Men are also more than three times more likely to be diagnosed with antisocial personality disorder than women.
Culture and Race
• Both past and recent research suggests that some groups – notably Black Caribbean, Black African and other Black groups are over-represented in psychiatric hospitals and be admitted under sections of the mental health
• Are more likely to be diagnosed with a severe mental health problem e.g. Psychosis

Why

• Evidence suggests that the way people explain their distress may be mis-interpretated

•Evidence also suggests that the groups mentioned are more likely to have been in contact with the police or other forensic services prior to admission. They are also more likely to have been referred to treatment by a stranger rather than by a relative or a neighbour
Culture and Race cont.

• Perceptions of mental distress and health in general also differ across the world both in terms of diagnosis and stigma

•Some people may believe that spirits or supernatural factors cause mental distress.


Overall BME (Black, minority and ethnic) populations:

•are less likely to have access to available mental health services;

•are less likely to receive necessary mental health care;

•often receive a poorer quality of treatment; and

•are significantly underrepresented in mental health research.
Refreshment Break
Vs.
Common Mental Health Problems
•May affect up to 15% of the population at any one time.
•Cover diagnosis that are largely managed through primary care
•A significant proportion of common mental health problems go undiagnosed.

Common Mental Health Problems
• Depression
• Anxiety

-Generalised Anxiety Disorder
-Social Anxiety
-Panic Disorder
-Phobias
-Obsessive Compulsive Disorder
Mental Health Awareness
What does depression and anxiety mean to me?
Depression
"I felt detached from the world around me. All emotions – love, affection, anger – were gone.

Actually, I can't say I had no emotions, I did, but they all seemed desperately negative. Most involved fear.

Fear that I would never escape the condition."
Depression
•More than feeling down

•1 in 10 people will experience depression in a year

•Not just psychological or emotional symptoms

•A diagnosis of depression may be made when the person experiences the symptoms for 2 weeks or more (This may be longer if associated with a life event e.g. Bereavement)
•Persistent sadness or low mood and/or
•Loss of interest or pleasures
•Fatigue or low energy

At least one of these most days, most of the time for a least 2 weeks
Associated symptoms:
•Disturbed sleep
•Poor concentration or indecisiveness
•Low self confidence
•Poor or increased appetite
•Suicidal thoughts or acts
•Agitation or slowing of movement
•Guilt or self blame
Causes
At least one person in every six becomes depressed in the course of their lives. One in 20 is clinically depressed.
•Predisposition: the way we are made or family background:
•Triggered by life events: can start a downward spiral

•Unfinished mourning: not dealing with the emotions of a loss or change

•Underactive thyroid: can result in lethargy

•Food and mood: individual basis
Support Options

•Exercise

•Activity scheduling

•Food and mood

•Guided Self help

•Medication

•Talking therapies: Person Centred, Psychodynamic, Cognitive Behaviour, and many others.
Anxiety
Anxiety
•We all feel tense at some point, in fact it can be useful or even desirable e.g. interviews or theme parks

•Anxiety becomes a problem when it starts affecting day to day life such as avoiding situations

•Often based on worry or fear

•Physical response
Anxiety Disorders
• Generalised anxiety disorder:
-most common anxiety disorder
-centres on worry -worry about worry

•Panic disorder: -panic attacks
-catastrophic thoughts e.g. having a heart attack -physical response

•Social anxiety disorder:
-fear of evaluation by others
-avoidance of social situations
Anxiety Disorder
• Social anxiety disorder:
-fear of evaluation by others
-avoidance of social situation

Specific phobias
-Only a phobia if disrupt functioning
-Avoidance
OCD
Obsessive Compulsive Disorder

obsession: intrusive, persistent & uncontrollable ego-dystonic thoughts

compulsion: mental or physical ritualistic behaviours to ease anxiety


Obsession = Fear of writing something offensive

Compulsion= Repeatedly checking letters
"I'm a bit OCD"
"I don’t blame people for finding OCD an amusing label to stick on any quirk or obsession – before I was diagnosed and learnt more about the disorder I would probably have done the same. All I ask of them is to please stop belittling the suffering that hides behind this witty acronym. The mother who cannot hold her baby out of fear of contaminating her with an illness she doesn’t even have; the father who is so tormented by horrific thoughts that he can't even look at his children; the fourteen year old boy whose hands are raw and bleeding from being scrubbed with bleach, the child who believes that his rituals are the only thing stopping his mother from being killed”
Causes
Estimates vary per diagnosis: GAD just under 5% of the population
•Fight/flight response and biology
•Past experiences: distressing events
•Everyday life and habits: diet and exercise
•Fear of losing control: worry
•Hyper vigilant to internal bodily sensations
•Dysfunctional beliefs and interpretations: over estimate danger and under estimate ability to cope
Support Options

•Understanding the anxiety response

•Relaxation/ Breathing techniques

•Testing safety seeking behaviours

•Graded exposure

•Guided Self help

•Medication

•Talking therapies: Person Centred, Cognitive Behaviour, Psychodynamic, and others.
Severe Mental Health Problems
Increased effect on functioning
more enduring
more stigma
each diagnosis can vary
mental health is on a continuum
"Evidence shows exercise is more effective than antidepressants for mild depression"
'I stopped giving dinner parties, because I just couldn't bear the anxiety about getting everything ready in time. It sometimes got so bad that I'd start worrying days before the event.'
'I can never look forward to a holiday in the sun, as it involves flying. It just doesn't suit me. I get clammy hands, my heart races, I feel claustrophobic, and sometimes I just panic and want to escape.'
What types of anxiety have you heard of?
Brain Break
Why is understanding this topic important to you?
W
What do they look like?
Psychosis
"When we dream, all sorts of strange things can happen to us, but we still believe that they're really happening to us. Hearing voices can be like that - a waking dream-but something that is experienced as real"
Psychosis
Generally thought of as when an individual is unable to distinguish their own thoughts, ideas and perceptions from reality.
Characterised by:
'Positive Symptoms' and 'Negative Symptoms'

Strange thoughts, Hallucinations, Delusions.

Emotional Flatness or apathy, Unable to concentrate, Avoidance of people.

Can include paranoia
Associated with violence
Schizophrenia and Violence
Schizo?
Someone with mental health issues is more likely to be a victim of violence
1 in 4 people with mental health problems are a victim of a crime in a year
Not always negative experience many people live with voices and function-its reaction to them -
"don't shoot the messenger"
Reaction to traumatic experience -
70%
Causes
Most studies show a lifetime prevalence for schizophrenia of just under 1 per cent.

Trauma: up to 70% of people who hear voices have experienced trauma
Life events: common trigger e.g. Social isolation
Dopamine: medication targets the dopamine system
Drug abuse: cause/aggravate symptoms
Inheritance: more vulnerable
Support Options
Medication
Talking treatments: Person Centred, CBT, Family therapy
Community care
Crisis Services
Creative activities
Support groups e.g. Hearing Voices Groups
Awareness of triggers and warning signs
Simple coping strategies (increasing control)
Self Help
Common coping strategies for hearing voices etc.

Using mobile
Headphones
Changing what you are doing
Avoiding the news
Diary appointments
Visualisation
Relaxation / mindfulness
Challenge the voices
Trial log
Bipolar Disorder
"When I'm in a manic phase, I feel as though I am capable of anything and everything. This be an amazing feeling, but i sometimes get frustrated and angry with people, ideas flow constantly and quickly, as if my brain is on fast-forward. Everything happening in the world has significance in my life. But when I'm depressed, it's as if I'm completely crushed and living in slow motion. I feel capable of nothing."
Bipolar Disorder
Also known as manic depression
We all have variation in mood: a bipolar diagnosis is made when these changes are sustained and where ability to function is effected. Different bipolar disorders reflect the degrees of the change and duration in mood.
Mania
feeling exceptionally confident
feeling a need for less sleep
being more talkative
feeling full of ideas with racing thoughts
being easily distracted, darting between activities
increased goal-directed activity
involvement in pleasurable activities with high potential for painful consequences (e.g spending sprees or regretted sexual encounters)
Causes
About 1-2% of the population is diagnosed with Bipolar disorder

Stressful life events: many people link the start of their bipolar disorder to events such as child birth, losing a job or a relationship breakdown.
Family background: emotional damage caused by traumatic early life events
Life problems: reaction to overwhelming problems in everyday life. Mania could be seen as a way of escaping overwhelming depression.
(sleep problems including long term flights!)
Support Options
Medication
Talking therapies e.g Person Centred, CBT
Hospital admission
Self management
look at coping strategies for depression and mania
awareness of all moods (fear of swing can triger)
Low - stable - High
Triggers and early warning signs: Crisis planning
Monitoring
Refreshment break
Personality Disorders
Personality Disorder
Can you name any of the 10 personality disorders?
Causes
Support Options
"The problem is not so much the voices, as the inability to cope with them"
"I was convinced white vans where following me"
Mania

Racing thoughts
Restlessness
Exited
Overactive
Grandiosity
Impulsiveness
Depression

Fatigue
Worthlessness
loss of interest
Sleep changes
Diet changes
Hopelessness
"I always felt different from others and had no sense of belonging anywhere. My life was always chaotic as were my feelings - never consistent or stable, but changeable and unpredictable. I felt an outcast of society, undeserving of anything and secretly yearned for better way of life, but not knowing how to achieve it and lacking confidence that I could change"
One of the most controversial diagnosis
We all have personalities with different ways of thinking, feeling and behaving. Typically people with a personality disorder have patterns of thinking, feeling and behaving which are more stubborn, and have a more limited range of emotions, attitudes and behaviors with which to cope with everyday life. This can make life difficult to deal with.
Suggested about 10% of the general population have a personality disorder

Genetics and inheritance
: OCPD (obsessive compulsive) and ASPD (antisocial)
Trauma
: early and severe along with the subsequent support and care
Family Circumstances:
lack of warm and consistent care-giveing (attachment styles)
Traditionaly seen as hard to treat due to deep rooted behaviours
New guidance since 2003 to improve services
Group ad individual therapy
Psycho-education
Arts therapies
Talking therapies e.g person centred, DBT, Psychodynamic, CBT and others.
Medication
Therapeutic relationships of immence importance: non-judgemental, empathy, genuiness, warmth, neutrality... others?
Diagnosis
What other mental health conditions have you come across or heard about?
What do you think is the most difficult part of dealing with a mental health problem?
Prejudice and discrimination
9/10 people with mental health problems report the negative impact of stigma and discrimination on their lives (Time to change)
Time to change
Mind are partners in Time to Change.
Englands most ambitious program to end discrimination faced by people who experience mental health issues.
How does mental health discrimination and stigma effect people?
How does discrimination affect people?
Isolation
Excludes from day to day activities
Prevents employment -
"70% of people with mental health problems are put off from applying for jobs due to fear of discrimination."
Prevents seeking help
Negative impact on physical health -
"The physical health needs of people with mental health problems are often dismissed, causing higher rates of death from heart attacks and diabetes."
Impairs recovery
Useful Organisations
one thing you have taken away from today?
Questions?
Feedback and Thank you
Your comments are highly valued and inform our future training
Contact details
Chris Frampton MBACP
Counsellor and Psychotherapist
www.kendaltherapy.com
07969 323 898
and
Project Development Manager
www.southlakelandmind.org
01539 740591
07969 323 898

"Ad Montes Oculos Levavi"
("I shall lift up mine eyes unto the hills")
Chris Frampton MBACP
Counsellor and Psychotherapist
www.kendaltherapy.com
07969 323 898

and

Project Development Manager
www.southlakelandmind.org
01539 740591
07969 323 898

"Ad Montes Oculos Levavi"
("I shall lift up mine eyes unto the hills")

"It's so common, it could be anyone. The trouble is, nobody wants to talk about it. And that makes everything worse."

"Once the understanding is there, we can all stand up and not be ashamed of ourselves, then it makes the rest of the population realise that we are just like them but with something extra."

"I was frightened to tell people about it, because I thought they might treat me differently or think i couldn't cope."

"some people don't want to know you anymore, they delete you, rub you out."
Mental health awarness in PCT
Main Learning Outcomes
All students will be able to:

Define the key concepts of mental health and distress
Recognise causes, signs and symptoms, treatment and support options for the range of common and severe mental health conditions.
Summarise the effect of stigma on people experiencing mental and emotional distress.

Some learners will:
Discover how to confidently apply support options to people experiencing mental and emotional distress within their own roles.
Full transcript