Transcript The 2016 SERNRA and GRA Annual Training Conference

Understanding Mental Health
Diagnosis Barriers When Placing
Consumers with Disabilities
Dr. Randy Medeiros, Ed. D, LPC, CRC
Learning Objectives
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Schizophrenic symptomology that need to be
understood when effectively placing
consumers.
Understanding the difference between
positive and negative symptoms of
schizophrenia when placing consumers.
Understanding Bipolar disorder and factors to
consider when placing people with disabilities
Understanding delusions and hallucinations
that can affect placement with both Bipolar
and Schizophrenic consumers.
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Learning Objectives
Understanding personality disorders that
affect placement.
 Learning the differences in types of
personality disorders that can affect
placement of people with disabilities.
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Change in services
Our agency is seeing more consumers
with more severe diagnoses. It is difficult
to place consumers in job placements
without understanding the main
symptomology of their disorder.
Sometimes we have trouble charting using
the correct terminology that is causing the
consumer not to be placed.
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Schizophrenia
According to the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition, the
patient must have experienced at least 2 of the
following symptoms:
 Delusions
 Disorganized speech
 Disorganized or catatonic behavior
 Negative symptoms
 Hallucinations
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Schizophrenia Symptoms
Positive:
Delusions
Hallucinations
Negative:
Avolition
Alogia
Anhedonia
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Positive Symptoms
Positive symptoms have behavioral
increases.
Hallucinations- sensory experiences in the
absence of any relevant stimulation from
the environment.
Delusions-beliefs held in contrary to reality
and firmly held despite disconfirming
evidence.
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Negative symptoms
Negative symptoms have behavioral
decreases
Avolition-lack of energy, flat affect, lack of
interest.
Alogia-poverty of speech
Anhedonia-lack of interest and lack of
pleasure and joy
Make up and layered clothing example.
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Types of Delusions
Hand Out
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Not all schizophrenics can work. Why?
When schizophrenics are exposed to
stress hallucinations and delusions can
occur.
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Placement for Schizophrenics
Consumers with Hallucinations or delusions
should not be placed around large machinery.
(command hallucinations)
Environments that are calm. People exposure
limited.
People who have worked before their
schizophrenic illness began will find it easier to
find a job and will find it easier to cope with work
than those who have never worked.
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Possible Placement
Considerations
Consumers with an eye for detail and are
good at managing finances then you may
do well in a financial placement. I put one
to work doing night auditing at a hotel.
Another example, working for an
insurance company doing quotes. If the
person is physically fit and enjoy the
outdoors then a job looking after a park or
in farming
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First Step

Make two lists: what you are good at
and what you enjoy doing then look to
see if there are any overlapping areas
between your lists.
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For all the disorders
1. What sort of things do you enjoy doing?
2. What sort of things are you good at?
3. How will your illness limit your
ambitions?
4. What previous experience in work do
you have?
5. What qualifications do you have?
6. External factors such as travel to work
and family commitments?
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Bipolar Disorders
Bipolar Disorder is chronic and a lifelong illness.
The disorder exhibits episodes of mania and
depression. Many people sometimes continue to
have symptoms, even after getting treatment for
their bipolar disorder.
There are more than two types, however I will
focus on one of the main types as it is harder to
maintain employment. Let me first define the
main two types.
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Bipolar I
Symptoms of the disorder involves
periods of severe mood episodes from
mania to depression. Which can be
accompanied with symptoms such as
delusions.
Mania is excitement by mental and
physical hyperactivity, disorganization of
behavior, and elevation mood.
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Bipolar II
Bipolar II disorder is a milder form of
mood elevation, involving milder episodes
of hypomania with periods of severe
depression.
 Hypomania is a mild form of mania,
marked by elation and hyperactivity.
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Job Placement?
The following information comes from
Accommodation and Compliance
Series:
Employees with Mental Health
Impairments.
Handout
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Personality Disorders
Personality Disorder is a type of
mental disorder in which you have a rigid
and unhealthy pattern of thinking,
functioning and behaving. A person with
a personality disorder has trouble
perceiving and relating to situations and to
people.
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Clusters of Personality
Disorders

Cluster A: suspicious, odd
» Paranoid, Schizoid, Schizotypal
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Cluster B: dramatic
» Antisocial, borderline, histrionic, narcissistic
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Cluster C:anxious
» Avoidant, dependent, obsessivecompulsive
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Borderline Personality
Disorder
Borderline Personality Disorder is a
mental health disorder that impacts the
way you think and feel about yourself and
others, causing problems functioning in
everyday life. It includes a pattern of
unstable intense relationships, distorted
self-image, extreme emotions and
impulsiveness.
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Paranoid Personality Disorder
Paranoid Personality Disorder is
characterized by paranoia and a
pervasive, long-standing suspiciousness
and generalized mistrust of others.
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Antisocial Personality Disorder
This is the most dangerous of the
personality disorders.
Antisocial Personality Disorder is a
mental condition in which a person has a
long-term pattern of manipulating,
exploiting, or violating the rights of others.
This behavior is often criminal.
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Schizotypal Personality
Disorder
Schitzotypal Personality Disorder is a
psychiatric condition marked by disturbed
thoughts and behavior, unusual beliefs
and fears (such as of witches or aliens),
and an inability to form intimate
relationships.
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Histrionic Personality Disorder
Histrionic Personality Disorder is
characterized by a pattern of excessive
attention-seeking emotions, usually
beginning in early adulthood, including
inappropriately seductive behavior and an
excessive need for approval.
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Avoidant Personality Disorder
Avoidant Personality Disorder is a
psychiatric condition characterized by a
lifelong pattern of extreme shyness,
feelings of inadequacy, and sensitivity to
rejection.
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Narcissistic Personality
Disorder
Narcissistic Personality Disorder in which
people have an inflated sense of their own
importance, a deep need for admiration
and a lack of empathy for others. But
behind this mask of ultra confidence lies a
fragile self-esteem that is vulnerable to the
slightest criticism.
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Job Placement Considerations
Hand Out
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References
Americans With Disabilities Act: Applying Performance And Conduct Standards To Employees With
Disabilities. Retrieved September 02, 2016, from http://www.eeoc.gov/facts/performance-conduct.html
Cloninger, Susan, (2013). Theories of personality: understanding persons/6th ed.
https://phoenix.vitalsource.com/books/9781323293225/epubcfi/6/10[;vnd.vst.idref=d6e178]!/4/2[d6e178]/44/2@0
:0
Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, D.C.: American
Psychiatric Association.
DSM-5 classification. (n.d.).
EEOC Enforcement Guidance on the Americans with Disabilities Act and Psychiatric Disabilities.
Retrieved September 02, 2016, from http://www.eeoc.gov/policy/docs/psych.html
Kring, A. M., Davison, G. C., Neale, J. M., & J. (2007). Wiley Plus Stand-alone to accompany Abnormal
Psychology, 10th Edition. John Wiley & Sons.
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References
Lents, P. B. (n.d.). Psychology Today. Retrieved September 02, 2016, from
https://www.psychologytoday.com/
Merriam-Webster Medical Dictionary on MedlinePlus. (n.d.). Retrieved September 02, 2016, from
https://www.nlm.nih.gov/news/mplusdictionary03.html
National Alliance on Mental Illness. (2013). Mental illness: Facts and numbers. Retrieved
from http://www.nami.org
Personality disorders. (n.d.). Retrieved September 02, 2016, from
http://www.mayoclinic.org/diseases-conditions/personality-disorders/basics/definition/con20030111
Oxford Dictionaries - Dictionary, Thesaurus, & Grammar. Retrieved September 02, 2016, from
http://www.oxforddictionaries.com/us/
Team, J. W. (n.d.). Consultants' Corner Volume 05 Issue 04. Retrieved September 02, 2016, from
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http://AskJAN.org/corner/vol05iss04.htm