Transcript Building mental health in a family service setting

Mental Health and Illness
Sailing the Seas to Success
Prevention & Early
Intervention
Paula Westhead
drummond street services
Why is mental health and
illness an issue ?
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Who we are
Why the interest – the issue
How we might experience it
What causes it
What can helps
drummond street services
125 years old community not for
profit
Two core areas of work:
1. Provision of Services
(responding to community need)
2. Contributing to the knowledge
base (building evidence base)
What we do
at drummond street
Family Service Programs
• Family and Relationship Services
• Family Mental Health Support Service
• Specialist Trauma Services and Royal Commission Community
Based Service
Family Wellbeing Programs
• Community Awareness - Mental Health Literacy
• Parenting Seminars, Groups and Intensive Services
Community Building Programs
• the drum Youth Service
• the drum - African Family Service
• queerspace
Centre for Research and Evaluation (CFRE)
• Family Based Intervention Research
• Research, program development and evaluation
• Social Policy Research
• Dissemination and social commentary, advocacy
So what do we know about
mental health and illness
A snapshot of mental health issues in
Australia
Mental health refers to how
people feel about themselves emotionally,
socially and spiritually, and about their
ability to cope with everyday life and the
stressful events that may come up to reach
the goals they have set out for themselves
to go to work and work productively to be a
part of the community they live in
Mental health means much more than
whether a person suffers from a mental
illness. The World Health Organisation
includes mental health in their general
meaning of health, which is defined as a
state of total physical, mental and social
wellbeing.
• What are our BIG three?
• Have a chat to the person
next to you, which 3 mental
illnesses are most common
in our country?
FIRSTLY – HOW MUCH DO WE KNOW?
• In 2007, the Australian Bureau
of Statistics (ABS) conducted
the second National Survey of
Mental Health and Well-being.
The survey involved
approximately 8,800 people
aged over 16 years and living in
private dwellings in all states
and territories of Australia.
• That is the best and most
recent data we have
But in the last 20 years
• We learnt about
pathways to risk
• The complexities of
mental health as a family
and community issue
• Adolescence most
common time for onset
Transition to parenthood
• LSAC: 3 year olds showing
mental distress
HOW COMMON IS MENTAL ILLNESS?
• Almost one in five Australians surveyed had
experienced symptoms of a mental
disorder during the 12 month period before
the survey.
• Anxiety disorders were most common –
14.4%, followed by affective disorders - 6.2%
(of which depression is 4.1%), and substance
use disorders – 5.1% (of which 4.3% is
alcohol related).
A handy way of seeing mental illness...
WHO IS MOST WORRYING…
• The percentage of people meeting
the criteria for diagnosis of a
mental illness was highest in
younger people, with the
prevalence decreasing with age.
26% of 18-24 year olds had
experienced a mental disorder,
while only 5.9% of people aged 65
years and over had experienced a
mental disorder.
Total Persons aged 1685yrs (100%)
Experienced any
mental health disorder
in lifetime
(45%)
Has experienced in
past year or currently
has a mental health
disorder
(20%)
Has not experienced
any mental health
disorder in lifetime
(55%)
Had experienced
mental health disorder
at some point in life
but not in past year
(25%)
The National Mental
Health Survey 2007 ABS
DEPRESSION
• About 4% of people will experience a major
depressive episode in a 12-month period, with
5% of women and 3% of men affected.
• Easier way of seeing it is (according to
beyondblue) 1 in 5 women and 1 in 8 men in
their lifetime (but it may be temporary)
Depression symptoms
(beyondblue website)
Behaviour
Thoughts
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not going out anymore
not getting things done at work/school
withdrawing from close family and friends
relying on alcohol and sedatives
not doing usual enjoyable activities
unable to concentrate
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'I’m a failure.'
'It’s my fault.'
'Nothing good ever happens to me.'
'I’m worthless.'
'Life’s not worth living.'
'People would be better off without me.‘
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Feelings
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Physical
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overwhelmed
guilty
irritable
frustrated
lacking in confidence
unhappy
indecisive
disappointed
miserable
sad
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tired all the time
sick and run down
headaches and muscle pains
churning gut
sleep problems
loss or change of appetite
significant weight loss or gain
Anxiety disorder symptoms
Generalised anxiety disorder
For 6 months or more, on more days
than not, have you:
• felt very worried
• found it hard to stop worrying
• found that your anxiety made it
difficult for you to do everyday
activities (e.g. work, study, seeing
friends and family)?
• If you answered yes to all of these
questions, have you also
experienced 3 or more of the
following ..........felt restless or on
edge
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felt easily tired
had difficulty concentrating
felt irritable
had muscle pain (e.g. sore jaw or
back)
• had trouble sleeping (e.g.
difficulty falling or staying asleep
or restless sleep)?
ANXIETY
14 % of Australians will be
affected by an anxiety
disorder in any 12-month
period
 ABUSING SUBSTANCES TO THE POINT WHERE IT’S
DESTROYING MENTAL HEALTH
• About 5% of Australians will experience substance abuse
disorders in any 12-month period, with men more than twice
as likely as women to have substance abuse
• Often this is self medicating...a coping strategy gone to
extremes
THANKFULLY LESS COMMON – low prevalence
disorders
• About 3% of Australians are
affected by psychotic illness;
such as schizophrenia, where
there is a loss of contact with
reality during episodes of illness.
• Approximately 2% of Australians
will experience some type of
eating disorder in their life, with
women 9 times more likely than
men.
Negotiating Risk and Protective Factors
Protective
Factors
Individual Factors
Risk factors
Refer to handout.
Individual Factors
Family Factors
Family Factors
School Context
School Context
Life
Events/Situations
Life
Events/Situations
Community and
Cultural Factors
Community and
Cultural Factors
Risk
factors
Protective
Factors
looking at Mental Health and Wellbeing
throughout the Family Life Course
Birth to 10yrs
Adolescence and
early adulthood
Coming Together:
Coupling
• Develop view of the world. Begin School and learn
to manage new social expectations and behavioral
norms.
• Transition to secondary school and beyond- face
academic and social demands of new setting.
Learning when to conform and when to assert
while establishing yourself as an individual. ‘Finding
Yourself’
• Social norm to form couples- balancing social
expectations with the personal. Making
commitment or not. Beginning to create own family
unit
Parenthood
Empty Nests
and Child Free
Retirement
and Old Age
• Decision to parent. Potential fertility difficulties.
Parenthood brings big life change with changing
demands along stage of child. Managing relationship
with and behavior of child. Terrible Twos and Teens.
For many coinciding with care of parents or other
elderly relatives
• Letting go of children. For some a stage of new
beginnings in relationships too bringing stressful and
upsetting change as part of the process. For others,
if healthy, a time of contentment and potential for
more involvement in leisure / community activities.
• A time of change that can be positive or negative
depending on attachment to or financial reliance on
job. Potential involvement in parenting next
generation of family as grandparent in varying
capacities. Some find fulfilling social networks.
Dealing with deteriorating health.
Specific Populations
Aboriginal families
Refugee and Humanitarian
Entrants – African Families
Program
GLBTI (Queer Community)
Sole parents or parenting in
isolation and young parents
Limited research suggests that Aboriginal and Torres
Strait Islander people experience mental disorders
more often as other Australians – and poverty and
intergenerational trauma play a huge part – but
family connections and spirituality are protective
CALD
• The settlement experience is the key
• Experience of racism and
discrimination
• These families often deal with trauma
for years with no support – inter
generational
• Children and young people often live
in two distinct worlds and must find a
way to bridge them “school and
family engagement can be harnesses”
• Isolation and financial difficulty can
make getting ahead for these families
more difficult
GLBTI Client Data
Based on annual client snapshot at intake:
• Of total clients (1266 clinical clients year )
in one 17% lesbian, 10% gay, 3% bisexual
• GLBTI rate highest in our FMHSS program
with 33% present with depression and
anxiety
• 10% of GLBTI clients are SSAY many
presenting with gender and sexuality
identity issues
HOW IT IMPACTS
• Those with a mental disorder
averaged three days out of
role (i.e. unable to undertake
normal activity because of
health problems) over a four
week period.
• This compared with one day
out of role for people with no
physical or mental condition.
MENTAL ILLNESS HAS HUGE IMPACT ON WORKPLACES
• Stress related workers
compensation claims have doubled
to over $10 billion dollars annually
and Australian businesses are
losing over $6.5 billion each year by
failing to recognise symptoms and
provide early intervention for
employees with mental health
conditions
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Australian Human Rights Commission May 2010
We like to soldier on...we don’t get
help when we should
A national survey showed that
only 35% of people with a mental
disorder had used a health service
and 29% consulted a GP within
the 12 months before the survey.
We all have a role to play
1. Ensuring we all have mental health literacy :
• Know the signs and symptoms (and behaviours
• Know that it is a illness and that there are effective
treatments
• Know where to go for help
2. Reducing stigma through understanding the facts and
having empathy
3. Knowing how to respond and offering
containment
TALKING TO PEOPLE WHO ARE UNWELL
• Listen and acknowledge their feelings (everyone wants to be validatedthen they relax)
• Ask simple questions and be encouraging when they answer
• If they are distressed ask if this sort of thing has happened before
• Suggest they think of things that have helped in the past
• Gently ask if they have seen a GP or similar
• Encourage them to return to a health professional they know- rather than
suggesting a new one
• Try to help the make an action plan
• If you feel they are at risk try to speak to someone else they know
• If you are worried they may harm themselves confidentiality doesn]t applyits good to give them a choice of who you can tell if possible
DEALING WITH OTHER’S DISTRESS related to trauma
• Listen, listen and listen
• Acknowledge the humanity of it all, speak to the ideas,
avoid, simply describing emotion
• Do not collude
• Offer assistance with emphasis to “Maslow’s
Hierarchy ”- offer practicalities
• Reassure with authenticity
• Link them with supports
• Follow up
Safety is paramount
– of client
– of you and other staff
– of the building/equipment
Spectrum of Interventions Model
For further
information:
Paula Westhead
[email protected]
www.ds.org.au