Transcript mental illness and stigma

MENTAL HEALTH
AWARENESS
TRAINING
FOR PROBATION WORKERS’
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Trainer and Group Introductions
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Housekeeping
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Ground Rules:
Confidentiality
Take time out and seek further support if needed
Respect yourself and each other
Allow each other time to talk
Look after our own and each others wellbeing
Ice Breaker Exercise
CONTENTS
Course Structure
Defining mental health and coping
What is mental illness
The mental health continuum
Mental Illness and Stigma
Mental disorders
The Offender with Anxiety
The Offender with Depression
The Offender with Eating Distress
The Offender with Bi-Polar Disorder
The Offender with Schizophrenia
The Offender with a Personality disorder
Young Offenders and Mental Health
Mental health in Older Offenders
Self injury and Suicidal Behaviour
The Offender with Dual Diagnosis
Communication
Working with risk
Diversity and Equality
MENTAL HEALTH
Group activity
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How would you define good mental health?
• How would you define poor mental health?
MENTAL ILLNESS AND STIGMA
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25% of us may experience mental distress at some point in our lives.
We can all have positive and negative ‘life experiences’ which have
an impact on how we think, feel and engage with the world.
Certain circumstances increase the risk of mental illness.
The stigma surrounding mental illness adds to the
distress and isolation felt by offenders who experience
mental health problems
COPING MECHANISMS
Group activity
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What ‘coping mechanisms’ do you use to maintain or improve
your mental health?
• What resources might offenders use to help themselves cope?
HOW WOULD YOU DEFINE
MENTAL HEALTH?
“Mental health is the emotional and spiritual resilience which
enables us to enjoy life and to survive pain, disappointment
and sadness. It is a positive sense of well-being and an
underlying belief in our own, and others “dignity and worth.”
Mental Health Promotion 2006
MENTAL DISORDER
What are the causes of mental disorder?
WHAT FACTORS COULD
CAUSE MENTAL DISTRESS
Many theories, many factors, complex reasons
THE MENTAL HEALTH
CONTINUUM
Where are you on the continuum at the moment?
THE MAIN CATEGORIES OF
MENTAL DISORDERS
WHAT IS ANXIETY?
Anxiety is physiological sense of unease we experience in
response to environmental stressors.
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More prevalent amongst offenders.
Often associated with other mental illnesses, such as depression
and Post Traumatic Stress Disorder.
Considered a mental health problem when it is prolonged, severe
and interferes with everyday activities.
If left unmanaged may develop into other problems such as panic
attacks, phobias and obsessive compulsive disorders.
ANXIETY
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What are the physical and psychological effects of anxiety?
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How can we recognise it?
THE EFFECTS OF ANXIETY
PANIC ATTACKS
Anxiety may take the form of a panic attack..
Panic attacks are a rapid build-up of powerful sensations generally
associated with physical feelings
Pounding and sometimes irregular heartbeat
Chest pains, inability to breathe
Feeling faint and/or sick, sweating
Shaky limbs, legs turning to jelly
Feelings of losing control
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Offenders fear that they are going mad, blacking out or having
a heart attack.
It can be a terrifying experience.
WHAT IS DEPRESSION?
Symptoms of depression vary from offender to offender but may include:
Low mood & low energy – neglect of personal hygiene.
Disturbed sleep or appetite.
Withdrawing from social situations.
Loss of interest in usual activities.
Low self-worth
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Depression can be a long-term illness or may last for just one episode.
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The severity and effect it has on the offender varies significantly
DEPRESSION
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Make a list of some of the symptoms of depression
HOW DO YOU THINK AN OFFENDER
WITH DEPRESSION MIGHT BEHAVE?
EATING DISTRESS
Eating disorders are treatable medical conditions.
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Although eating disorders are experienced predominantly by
women men can be also be affected
Offenders with an eating disorder may also have other mental
health problems such as generalised anxiety or depression.
In severe cases eating disorders can lead onto physical health
problems including heart conditions and kidney failure.
EATING DISTRESS
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How would you define eating normally?
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Is it the same for everyone?
UNDERSTANDING OFFENDERS
WITH BIPOLAR DISORDER
Bipolar illness (manic depression) is a mood disorder which can
involve extreme swings of mood ranging from severe depression
to severe mania (‘lows’ to ‘highs’).
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There may be long periods of stability in between.
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Each individual will have a unique pattern of severity and duration.
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The most common types of Bipolar disorder are known as
Bipolar I and Bipolar II…
BIPOLAR I AND BIPOLAR II
HOW DOES MANIA
AFFECT INDIVIDUALS
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Incoherent, rapid or disjointed thought
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Paranoia
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Hallucinations affecting vision, hearing or perception
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Grandiose delusions or ideas
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Psychosis – losing touch with reality
HOW DOES HYPOMANIA
AFFECT INDIVIDUALS
Hypomania is a less severe form of mania.
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Self confident and euphoric but may also react with sudden anger,
impatience, or become irritable.
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More ideas than usual, very creative.
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More reckless, more talkative or more challenging.
THE DEPRESSIVE PHASE IN
BIPOLAR DISORDER IS SIMILAR
TO DEPRESSION…
Severe depression usually follows an episode of mania.
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Feelings of emptiness or worthlessness.
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Loss of energy and motivation for many or all day-to-day activities.
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Pessimism and negativity about most things (or everything).
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Thoughts of death and suicide can be common but may be hard
to discuss.
WHAT IS SCHIZOPHRENIA?
“Schizophrenia is a severe mental disorder, characterized by
profound disruptions in thinking, affecting language, perception,
and the sense of self. It often includes psychotic experiences, such
as hearing voices or delusions. It can impair functioning through
the loss of an acquired capability to earn a livelihood, or the
disruption of studies”.
(W.H.O. 2009).
STIGMA AND SCHIZOPHRENIA
It’s important to say that Schizophrenia is not:
• Split or Multiple Personalities
• Caused by parents or the way someone was brought up
• Untreatable
• A guarantee that a person will be in hospital for life.
• A guarantee that the offender will be dangerous.
People with Schizophrenia are more likely to:
• Harm themselves
• Be passive
• Withdraw
SCHIZOPHRENIA
Generally 1 in 100 people experience Schizophrenia
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The highest incidence is in the late teens and early twenties
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It affects men and women equally
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Onset of illness is earlier in men than women
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25-50% of sufferers make a full recovery
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25% may experience long lasting problems
HOW ARE INDIVIDUALS
AFFECTED BY SCHIZOPHRENIA?
• Hallucinations
• Delusions
• Agitation
• Disorganised thinking
• Slowness to move, think, speak, react
• Social withdrawal
• Apathy
These experiences may occur separately, together or alternately.
UNDERSTANDING
HALLUCINATIONS
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Hallucinations are when a person hears, sees, smells or feels
things that others do not.
The most common type are auditory hallucinations i.e. hearing voices.
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To the person experiencing them the voices are very real.
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These experiences can be very frightening.
DELUSIONS
Delusions happen when a person has a belief that seems very real
to them but others do not share.
Examples include:
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Having special powers - e.g. the ability to read other peoples minds.
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Believing that people are against them.
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Thinking that people may be trying to harm them.
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Their thoughts are being broadcast out loud.
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Everybody knows what they are thinking.
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It is important to bear in mind the cultural context – strange behaviour
in our culture may not be considered strange in other cultures.
PERSONALITY DISORDERS
An offender with a personality disorder may show some of the
following traits:
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Aggression and sudden outbursts of inappropriate anger.
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Signs of anxiety or depression.
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Deliberate acts of self harm.
Signs of eating distress.
Provocative and antagonistic behaviour.
Pre-occupation with routine.
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Lack of emotion and remorse and/or taking everything personally.
Constantly seeking approval.
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Dependence on others, deceitfulness, bullying and disregard for others.
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OLDER PROBATION SERVICE USERS
Group activity
• Why might older adults in the criminal justice system be more
vulnerable than younger adults?
• What particular problems do older adults face within the criminal
justice services?
SELF HARM AND SUICIDE
Group activity
• What are the causes of self harm?
DUAL DIAGNOSIS
• The term ‘dual diagnosis’ can be defined in a number of
ways but for the purpose of this publication it will be taken to
mean the co-existence of severe mental health and
substance misuse problems.
• It is generally accepted that individuals with dual diagnosis
suffer poorer health outcomes and present significant
challenges to both health and criminal justice services.
HOW ARE MENTAL
DISORDERS TREATED?
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Prescribed medication
Self and advocacy groups
Talking therapies
Advocacy
Complementary therapies
Some people find prescription medicine helpful, while others find that
talking treatments are better. For some people find that a combination
works best.
Everyone is different and what works for one offender may not
work for another.
REFERRING ON…
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When would you need to refer to Mental Health services?
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Where do you refer to?
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Is there a single entry to Mental Health services?
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Are you aware of local care pathways?
Group to discuss…