Transcript Youth and Co-Occurring Disorders

Youth and Co-Occurring
Disorders
Disorders First Diagnosed in Infancy,
Childhood or Adolescence
Attention Deficit/Hyperactivity Disorder
 Conduct Disorder
 Oppositional/Defiant Disorder
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Other frequently diagnosed disorders
 Depressive disorders
 Anxiety disorders
 Posttraumatic Stress Disorder
 Bipolar Disorder
Co-Occurring Prevalence Rates
From the reading assignment
Among inpatient substance abuse cx 75-80% cod
Risk of substance dependence-youth 4X greater
with mental disorder
than general
population
Of incarcerated youth with sud
2/3 have
another d/o
Among substance abusing offenders 50% have
ADHD
Signs of depression in youth
(NIMH report)
Frequent vague physical complaints
 Frequent absence or poor performance at
school
 Talk of or efforts to run away from home
 Outburst of shouting, complaining, crying,
irritability
 Boredom
 Lack of interest in playing with friends
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Signs of depression, cont.
Substance abuse
 Social isolation
 Poor communication
 Fear of death
 Extreme sensitivity to rejection or failure
 Increased irritability, hostility or anger
 Reckless behavior
 Difficulty with relationships
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Assessment
What observations can you make related
to the MSE?
 What symptoms are apparent?
 Assess:
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 Dangerousness
 Therapy-interfering-behavior
 Quality-of-life-interfering
behavior
 Skill training opportunities
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What skills is Miller using?
Values and Principles-Page 1
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Early identification and intervention
Access to comprehensive services
Least restrictive environment
Full family involvement and linkage between
service systems
Care coordination
Smooth transition to adult services when needed
Children’s rights protected and advocacy
No discrimination
Discussion questions: Mental Health
Treatment for Youth
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Identify and discuss the four services
included in the Service Continuum.
List one or two key points for each
service.
Identify the Promising Practices. Choose
one to discuss in detail. What questions
about it do you have?
What approaches are ineffective with
youth?
Service Continuum-Justice systeminvolved youth
Prevention
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Universal
Selective
Indicated
Diversion Policies and Programs and
Community-Based Alternatives to Incarceration
Mental Health Screening, Assessment, Referral
and Treatment
Aftercare Services
What works?
Multisystemic Therapy
 Functional Family Therapy
 Wraparound
 Cognitive-Behavioral Therapy
 Multidimensional Treatment Foster Care
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What doesn’t work?
Suicide attempt rates
Overall Rate
3%
Kids with major
depression
Kids with sud
22%
“Runaways”
3X the risk
25%
Aggressive bx in
2X the risk
boys
Panic attacks in girls 3X the risk
Prevalence Rates
Mental Disorders-general youth
population
Mental Disorders-Juvenile Justice
population
PTSD in incarcerated girls
22%
Anxiety or mood disorders
1/4 - 1/3
Incarcerated and suicidal
19%
60%
50%
DVD-Youth Assessment
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Engagement
Screening-http://www.chestnut.org/li/gain/
Quadrant
Diagnosis
Cultural and linguistic supports and needs
Problem domains
Treatment plan
***What are the most important points re:
assessment of youth?
Important points
Youth have less autonomy than adults,
affecting engagement
 Level of severity is evaluated differently.
 Diagnosis is less important than behavior.
 Culture is first, a source of support.
 Multisystemic approach is needed.
 Rolling with resistance.
 S/I-follow up with risk assessment.
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Characteristics of effective treatment
for youth with COD
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Integrated
Comprehensive
Intensive
Long term
Aftercare
Bipolar Disorder in Kids:
The Conversation on KUOW, 94.9
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http://www.kuow.org/program.php?id=13
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Review symptomotology
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In your group you will be assigned a
disorder.
Develop the scenario according to the
instructions.
Trade scenarios with another group.
Identify sx and signs of disorders.
Identify the most likely diagnosis.