Transcript Presentation

MENTAL HEALTH AND DOMESTC
ABUSE CONFERENCE- 15 TH OCTOBER 2015
RACHEL BELLENGER
CARE COORDINATOR
OXFORD HEALTH FOUNDATION
TRUST
DEFINITIONS OF MENTAL HEALTH
“A clinically recognisable set of symptoms or behaviours associated in
most cases with distress and with interference with personal functions”
ICD-10 (2011)
"A mental disorder is a syndrome characterized by clinically significant
disturbance in an individual's cognition, emotion regulation, or
behaviour that reflects a dysfunction in the psychological, biological, or
developmental processes underlying mental functioning. Mental
disorders are usually associated with significant distress in social,
occupational, or other important activities”
DSM-5 (2013)
MENTAL HEALTH DISORDERS
DEPRESSION
PERSONALITY
DISORDER
ANXIETY
PSYCHOSIS
BI-POLAR
AFFECTIVE
MENTAL HEALTH MYTHS
Myth: Mental health problems
are very rare.
Myth: Young people just go
through ups and downs as
part of puberty, it’s nothing.
Myth: People with mental
health illnesses are usually
violent and unpredictable
MENTAL HEALTH MYTHS
Fact: 1 in 4 people will
experience a mental
health problem in any
given year
Fact: 1 in 10 young people
will experience a mental
health problem
Fact: People with a mental
illness are more likely to
be a victim of violence
MENTAL HEALTH STATISTICS
Approximately a quarter of the population will experience some kind of mental health
problem in the course of a year, with mixed anxiety and depression the most common
mental disorder in Britain
Women are more likely to have been treated for a mental health problem than men
and about ten percent of children have a mental health problem at any one time
Male prisoners are 14 times more likely to have two or more disorders than men in
general, and female prisoners are 35 times more likely than women in general.
Only 1 in 10 prisoners has no form of mental disorder.
Social Exclusion Unit (2004)
PERSONALITY DISORDERS
In a study in 2011, The Ministry of Justice estimated that between 60-70% male
offenders have a personality disorder.
ICD 10 Personality Types- Paranoid
- Schizotypal
- Narcissistic
- Anti-Social
AETIOLOGY OF PERSONALITY
DISORDERS
-Genetics
-Neurotransmitters
-Neurobiology
-Environmental factors includingbeing a victim of emotional, physical or sexual abuse
being exposed to chronic fear or distress as a child
being neglected by one or both parents
growing up with another family member who had a serious
mental health condition or a drink or drug misuse problem
TREATMENT OF PERSONALITY
DISORDER
There is no medication currently licensed for the treatment of any
personality disorder. However, medications may be prescribed to treat
associated problems, such as depression, anxiety or psychotic
symptoms.
Long Term Psychological TherapiesPsychotherapy
CBT
DBT
Interpersonal Therapy
Therapeutic Community
RISK ASSESSMENT IN MENTAL
HEALTH
EXPLORATION OF HISTORICAL FACTORS AND CURRENT PRESENTATION-HARM TO SELF – including self neglect and vulnerability
-HARM TO OTHERS
-HARM FROM OTHERS- including history of abuse
-CRIMINAL OFFENDING and SUBSTANCE MISUSE
-PHYSICAL HEALTH
-FAMILY HISTORY and CHILDHOOD AND DEVELOPMENT
-ENVIRONMENTAL AND SOCIAL FACTORS
-EVIDENCE OF RECENT STRESSORS/CHANGES IN RISK FACTORS
-PROTECTIVE FACTORS
RISK MANAGEMENT PRINCIPLES
Risk assessment is linked to the practice of risk management, whereby a mutually
agreed plan, aimed at reducing identified risks, is negotiated with the individual
concerned. The plan incorporates specific therapeutic strategies and is a
collaborative, interactive and dynamic process
Risk cannot be eliminated, as there is no such thing as a completely risk-free
situation. Outcomes are not easily predicted. The goal is the minimisation of risk and
the prevention of harm or further harm.
Risk is a dynamic process, influenced by any number of variables within a given
situation. Risk fluctuates and is influenced by the experiences, perceptions and
interactions that the individual is subject to at any point in time.
Harrison A (2003)
RISK MANAGEMENT PRINCIPLES
“Positive risk-taking is weighing up the potential benefits and harms of
exercising one choice of action over another. This means identifying the
potential risks involved, and developing plans and actions that reflect the
positive potentials and stated priorities of the service user. It involves
using available resources and support to achieve desired outcomes, and
to minimise potential harmful outcomes” (Morgan, 2004)
ASSESSING CAPACITY
Mental State Screening-
-What were the persons beliefs at the time?
-Any suggestion of perceptual disturbance?
-History of mental disorder and treatment?
-Current diagnosis?
-Contact with specialist services?
MENTAL HEALTH ACT
The person is suffering from a recognised mental disorder of a nature
or degree that makes it appropriate to receive treatment in hospital
and that the appropriate treatment is available.
Detainment under the MHA does not assume a lack of capacity or
preclude being charged and tried for criminal behaviour.
MENTAL HEALTH AND DOMESTIC
ABUSE
-Abused women are at least three times more likely to experience depression or
anxiety disorders than other women.
-One-third of all female suicide attempts and half of those by Black and ethnic
minority women can be attributed to past or current experiences of domestic
violence.
-Women who use mental health services are much more likely to have experienced
domestic violence than women in the general population.
-70% of women psychiatric in-patients and 80% of those in secure settings have
histories of physical or sexual abuse.
MENTAL HEALTH AND DOMESTIC
ABUSE
-Children who live with domestic violence are at increased risk of behavioural problems and
emotional trauma, and mental health difficulties in adult life. (See also Children and
domestic violence.)
-An audit in Greenwich found that 60% of mental health service users had experienced
domestic violence. Another survey of women using mental health services in Leeds found
that half of them had experienced domestic violence and a further quarter had suffered
sexual abuse.
Womens Aid (2015)
-Individuals diagnosed with Borderline/Emotionally Unstable Personality Disorder are more
likely than the general population to be verbally, emotionally/psychologically and physically
abusive.
Mental Health Matters (2011)
TO ACCESS FURTHER
INFORMATION* Royal College of Psychiatry
* Rethink Mental Illness
* MIND
* Mental Health Foundation
* Sainsbury’s Centre for Mental Health
* Time to Change Campaign