Transcript Slide 1

Maze Advocacy
Project Staff Training
Day 1
An Intro to Mental Health and
Advocacy
Being Healthy
Mental Health and Emotional
Wellbeing
Exercise: Create a definition
of Mental Health and
Emotional Wellbeing
Health Definition 1
“Children's mental health is the strength and
capacity of children's minds to grow and develop
with confidence and enjoyment. It consists of the
capacity to learn from experience and to
overcome difficulty and adversity.
It's about physical and emotional well-being, the
ability to live a full and creative life and the
flexibility to give and take in friendships and
relationships. Children who are mentally healthy
are not saints or models of perfection but
ordinary children making the most of their
abilities and opportunities.”
Health Definition 2
• A capacity to enter into, and sustain, mutually
satisfying and sustaining personal relationships
• Continuing progression of psychological
development
• An ability to play and to learn so that attainments
are appropriate for age and intellectual level
• A developing moral sense of right and wrong
• A degree of psychological distress and
maladaptive behaviour within normal limits for the
child’s age and context
Health vs Illness
• These are important definitions, because they
emphasise the nature of health, rather than that of
illness. Problems may arise from a number or
combination of factors – congenital, constitutional,
environmental, family or illness. The task of
maintaining good mental health is significantly
affected by where and how people live, and each
individual’s own life events and experiences.
• Children and young people who experience mental
health problems usually find the experience very
distressing. Most learn to overcome their problems if
they receive the right kind of help from family, friends
or specialist support services.
History,
Models and
Concepts
The History of Mental Illness
• The English-speaking world has not always used medical
language to describe the behavior we now label as symptomatic
of mental illness or mental disorder. Descriptions were
sometimes framed in quite different terms, such as possession.
What we now call mental illness was not always treated as a
medical problem. The medical model is a product of the 18th
century, when people with mental health ‘conditions’ first
became seen as being sick, and therefore treatable by medical
professionals.
• Anthropological work in non-Western cultures suggests that
there are many cases of behaviour that psychiatry would
classify as symptomatic of mental disorder, which are not seen
within their own cultures as signs of mental illness. Indeed, other
cultures may not even have a concept of mental illness that
corresponds even approximately to the Western concept.
Models of
‘Mental Illness’
Medical Model
• Medical Model – People with mental health problems
are seen as sick and therefore not responsible for
their conditions. So they are put in the care of doctors
and nurses.
• Typified by the classification and identification of
different types of disorder, each of which has a
characteristic pattern of symptoms. Goals of this are:
a common set of terms with agreed-on meanings
• Creates an understanding of the origins of disorders
and thereby a common treatment plan (e.g.
medication)
Relativist/Cultural Model
• Some have argued for a relativist view,
that the reality of mental illness is not an
absolute transcultural fact. The relativist
view would have to be that statements
about the existence of mental illness
can be true in some cultures and false
in other cultures.
Deviancy Model
• Deviancy from the norm of behaviour
and/or mental and emotional experience
Extreme Model
• A more extreme view is that there is no such
thing as mental illness in any culture, and that
there could not be, because the very notion of
mental illness is based on a fundamental
mistake or set of mistakes. This sort of view is
most closely associated with the psychiatrist
Thomas Szasz.
Recovery Model
• "Recovery is about seeing people and people seeing
themselves as capable of recovery rather than as passive
recipients of professional treatments.
• It is about working out strategies and taking control of their
own lives.”
• It’s key elements are: An individual belief and commitment
that they can and will recover.
• A shared belief and commitment from people helping
them.
• A strategy for recovery; a recovery plan. Adequate and
appropriate resources which facilitate recovery.
• A willingness to share the journey of recovery with others.
Or…
• It could be simply seen as the
experience of disordered and
distressing thoughts.
Reality Bites…
The medical model is the dominant
paradigm of thought in approaching
mental ill-health and psychiatrists
are the one’s who make the
diagnoses and who traditionally
hold most power.
What does this all mean for
an advocate?
• An advocate is not anti-psychiatry, however
nor should he or she be limited by the
medical model of mental illness, or any
others.
• When working with children with mental
health issues an advocate needs to
understand both the medical model and
models of social welfare in order to work
within this area and advocate effectively for
History
Illness,
Disorder and
Problems
Terminology
Young people
with mental
or psychiatric
illness
Young people
with risk
factors but
no obvious
problems
Young people
with mental
health
problems
Young people
with mental
disorder
Definitions
• There is a great complexity around the
terminology used to describe ‘mental health
problems’ in relation to children and young
people. One reasonable definition could be:
“Abnormalities of emotions, behaviour or
social relationships sufficiently marked or
prolonged to cause suffering or risk to
optimal development in the child or
distress or disturbance in the community”
Exercise: Create a definition
of Mental and Emotional Illhealth
Definitions
• Mental Health Problems are relatively
common and consist of…a broad range
of emotional and behavioural difficulties
which may cause concern or distress
Mental Disorders are less
common…but are more severe and/or
persistent
How is mental illness
diagnosed…1?
At the moment, there are no tests for mental illnesses. A diagnosis
will usually be made by an experienced psychiatrist working with
other health professionals.
• Child psychiatry takes into consideration the influence on
children of a wide variety of modes of living, biological,
psychological, social, and developmental aspects and
interaction processes within the family and the
community
• At first the person will be observed for symptoms, and
the doctor will use pre-determined criteria to explore the
person's behaviour, then the person will be observed
over a period of time.
How is mental illness
diagnosed…2
• The psychiatrist's ongoing assessment will follow one
of the internationally agreed diagnostic schedules. It
will be important for the psychiatrist to check that the
symptoms are not part of some other medical
syndrome, for example:
– high fever, epilepsy, problems with thyroid gland or
diabetes,
– use of illicit drugs or alcohol,
– brain tumours, brain damage, following head injury
or surgery,
• This is because some symptoms found in mental
illnesses, such as hallucinations, can also appear in
other medical conditions.
How is mental illness
diagnosed…3
• Many different mental illnesses have overlapping
symptoms and it can be difficult to tell the conditions
apart. Reaching a diagnosis can be difficult and it
takes time to be sure that the individual's symptoms
truly indicate a particular mental illness.
• Family and friends can and should be involved, as
they will be aware of details of family intimacies,
cultural differences and religious beliefs. They may
well be able to confirm to the professional that a
desire for contact with a church, for example, is not a
sudden change brought on by illness, but a part of
the person's previous upbringing and normal
practice.
Types of problems
Brainstorm: Different kinds of problems
Types of problems
The most common forms of mental health problems in
children and young people are:
Emotional disorders
Anxiety, phobias and
depression
Conduct disorders
Stealing, defiance, firesetting, and aggression
Hyperkinetic disorders
Attention deficit
(hyperactivity) disorder
(ADHD).
Developmental disorders Delay in acquiring speech
or bladder control
Types of problems
Eating disorders
Anorexia nervosa or
bulimia nervosa
Habit disorders
Tics, sleeping problems,
soiling
Post-traumatic
syndromes, following
traumatic events
Psycho-somatic
disorders
Psychotic disorders
Chronic fatigue symptoms
Schizophrenia and manic
depression
Causes &
Treatment
Causes & Predisposing
Factors
Some children and young people are
more likely to develop mental health
problems.
Important causes include factors in:
• The child,
• The family
• The environment
Brainstorm: Causes/Predisposing Factors
Predisposing Factors…
• Genetic influences, such as a family history of mental
health problems
• Low IQ and learning disability
• Other health or development problems, such as physical
illness
• Communication difficulties
• Academic failure or low self esteem
• Overt parental conflict including divorce
• Death and loss, including loss of friendship
• Abuse, neglect or bullying
• Inconsistent or unclear discipline
• Poverty, unemployment or crime
• Children in contact with CAMHS correlate to children
whose experiences cover all of the main social deprivation
indexes.
Treatment
• In the treatment of mental health problems and disorders there
is an emphasis on building resilience in children, as well as
treating problems and disorders. Of particular importance is the
encouragement and teaching of emotional literacy and
intelligence - increasing the capacity of children and young
people to understand and manage feelings and thoughts about
themselves and others.
• Earlier a problem is diagnosed, the greater the chance of some
kind of recovery. Psychiatrists generally more cautious about
developing diagnoses and prescribing medication to children
and adolescents when it comes to severe mental illness. The
most common approach that a psychiatrist will recommend will
be a whole family approach, usually involving some kind of
therapy. The young person and their family are supported in
learning to deal with their problem or illness. Already a time of
great physiological (e.g hormones) and psychological change
and any diagnoses needs to take developmental factors in to
account.
Pyramid of
CAMHS
Provision
What Works?
Exercise: “A service should…”
Describe the way in which you feel a
mental health service should work to
better help young people…
What Works?
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Themes from the evidence (YoungMinds 2005), a service
should:
Be readily accessible
Be accepting of young people
Offer an assessment of young people’s needs
Work with the context in which the young person lives
Seek to engage children, young people and their
parents/carers
Change attitudes
Offer interventions tailored to suit individual needs
Offer advice, consultation and training
Work in close collaboration with relevant disciplines and
agencies
Have the capacity to keep in touch with young people over
the long term
The end