Transcript Mental health and drug use

Prison staff and harm reduction
Additional module:
Mental health and drug use
Training Criminal Justice Professionals
in Harm Reduction Services for Vulnerable Groups
funded by the
European Commission
Directorate General for Health and Consumers
Mental health and drug use
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Activity
What is mental health?
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Lecture
Mental health, mental diseases
and drug use
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What are mental health
problems?
 Complex interaction of biological, social and
psychological factors
 Neurotic or psychotic symptoms
 Organic or functional mental disorder
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What is mental illness?
 The term “mentally ill” is difficult since:
 There is no universally agreed cut-off point between normal
behaviour and behaviour associated with mental illness
 What is considered abnormal behaviour differs between cultures,
social groups etc.
 The term “mental illness” can misleadingly imply that
all mental health problems are solely caused by
medical or biological factors.
 Most mental health problems result from a complex interaction of
biological and social/psychological factors
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ICD-10 (International Classification
of Mental and Behavioural
Disorders)
 F00-F09 Organic, including symptomatic, mental disorders
 F10-F19 Mental and behavioural disorders due to psychoactive
substance use
 F20-F29 Schizophrenia, schizotypal and delusional disorders
 F30-F39 Mood (affective) disorders
 F40-F48 Neurotic, stress-related and somatoform disorders
 F50-F59 Behavioural syndromes associated with physiological
disturbances and physical factors
 F60-F69 Disorders of adult personality and behaviour
 F70-F79 Mental retardation
 F90-F98 Behavioural and emotional disorders with onset usually
occurring in childhood and adolescence
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Interactions between mental
health and drug use I.
 People with substance use disorders often suffer from other
mental health disorders at the same time
 Sometimes the mental problem occurs first
 This can lead people to use alcohol or drugs that make them feel
better temporarily
 Sometimes the substance use occurs first
 Over time, that can lead to emotional and mental problems
 Drug use can be a kind of “self-medication” by a person
with mental health problems not diagnosed/ treated
properly
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Interactions between mental
health and drug use II.
 Mental health problems/disorders can be:
 A direct result of the substance use of a person, in
which no psychiatric disorder was pre-existing
 Pre-existing to harmful substance use
 A result of substance use by a person in which the
symptoms of the mental disorder have pre-existed
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What kind of drugs can lead to
psychic/ physical dependence?
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Dual diagnosis and co-morbidity I.
 Substance use disorders and other mental health
disorders often co-occur (so-called dual diagnosis or
co-morbidity)
 Treatment of both conditions is crucial
 Acohol and drug problems tend to occur with
 Personality disorders
 Depression
 Anxiety disorders
 Schizophrenia
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Dual diagnosis and co-morbidity II.
 Personality disorders
 Long-term patterns of thoughts and behaviours
causing serious problems with relationships and work
 Difficulty dealing with everyday stresses and problems
 Stormy relationships with other people
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Dual diagnosis and co-morbidity III.
 Depression
 Serious medical illness that involves the brain
 Symptoms persist and interfere with everyday life
 Can run in families, and usually starts between the
ages of 15 and 30
 Much more common in women
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Dual diagnosis and co-morbidity IV.
 Symptoms of depression can include
 Sadness
 Loss of interest or pleasure in activities you used to enjoy
 Change in weight
 Difficulty sleeping or oversleeping
 Energy loss
 Feelings of worthlessness
 Thoughts of death or suicide
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Dual diagnosis and co-morbidity V.
 Anxiety disorders
 Persistent and worsening feeling of anxiety
 Types include
 Panic disorder
 Obsessive-compulsive disorder
 Post-traumatic stress disorder
 Phobias
 Generalized anxiety disorder
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Dual diagnosis and co-morbidity VI.
 Schizophrenia
 Severe, lifelong brain disorder
 In men, symptoms usually start in the late teens and early 20s,
for women in the mid-20s to early 30s
 They include hallucinations, or seeing things, and delusions such
as hearing voices. Other symptoms include:
 Unusual thoughts or perceptions
 Disorders of movement
 Difficulty speaking and expressing emotion
 Problems with attention, memory and organization
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Dual diagnosis and co-morbidity VII.
 Over 50% of those with a substance use disorder
(except for alcohol) are found to have a cooccurring mental health disorder, of these have
 26% an affective disorder like depression or manic
depression (4,7 times higher than normal)
 28% an anxiety disorders (2,5 times higher)
 17,8% an antisocial personality disorder (13,4 time higher)
 6,8% schizophrenia (6,2 times higher)
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Dual diagnosis and co-morbidity VIII.
 Co-morbidity is associated with higher rates of
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Relapse
Hospitalization
Violence
Incarceration
Homelessness
Infectious diseases (HIV/AIDS, Hepatitis B and C)
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Suicide and substance use I.
 Likelihood of suicides among persons with a
substance dependence is 6 to 10 times higher
than normal
 40-60% of the suicides in Europe and the USA
are alcohol- or drug-affected
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Suicide and substance use II.
Likelihood of suicide attempts
 Cocaine use: 62 times more likely
 Major depression: 41 times more likely
 Separation or divorce: 11 times more likely
 Alcohol use: 8 times more likely
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