Youth Issues in Mental Health

Youth Issues in Mental Health PowerPoint PPT Presentation


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12/12/2011. 2. Important Facts About Mental Illness and Recovery:Mental illnesses are biochemical brain disorders that can interfere with a person's ability to think, feel, and interact with or relate to other people and the environment.

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Youth Issues in Mental Health

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1. Youth Issues in Mental Health Developed and Presented by: Joan Helbing Diagnostician [email protected]

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4. 12/12/2011 4 Studies Show MI Often Begin in Youth, Treatment Delays Worsen Issues One-half of all life-time cases of mental illness begin by age 14, and despite effective treatments for the disorders, there are long delays between the onset of symptoms and seeking treatment. These treatment delays- which can span decades- lead to more severe and difficult-to-treat illnesses and to co-existing disorders.

5. 12/12/2011 5 Once people do get treatment, few receive care that meets “minimally accepted standards” for mental health treatment. Anxiety disorders often begin in childhood, mood disorders in later adolescence and substance abuse in the early 20’s. Three-quarters of all lifetime cases begin by age 24!

6. 12/12/2011 6 Researchers say children are less likely to receive timely treatment because they rely on parents or other adults to recognize symptoms, but adults often miss the signs unless they are extreme. Nearly ˝ of those who have one mental disorder have one or more additional disorders. The more disorders a person has the more severe each may be.

7. 12/12/2011 7 Washington University research showed that mental illness is now the leading reason for hospitalization of people ages 5-19.

8. 12/12/2011 8 Many of these families of these children have inadequate health insurance, which does not provide coverage for the intensive counseling, therapy and medication that is often needed by these youth.

9. 12/12/2011 9 Causes Are Complicated Mental health disorders in children and adolescents are caused mostly by biology and environment. Biological Genetics Chemical imbalances Damage to central nervous system Head Injury Environmental Exposure to environmental toxins Exposure to violence Stress due to chronic poverty or other hardship Loss

10. 12/12/2011 10 What’s the Big Deal? 10% of children and adolescents in the United States suffer from serious emotional and mental disorders that cause significant functional impairment in their day-to-day lives at home, in school and with peers (Mental Health: A Report of the Surgeon General, 1999).

11. Extent of Mental Disorders in US ADHD = Attention Deficit Hyperactivity Disorder PDD = Pervasive developmental disorders Sources: Office of the Surgeon General and the national Institute of Mental Health 1999

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15. 12/12/2011 15 Top 3 Leading Causes of Death in Teens Accidents Suicide: depression is the leading cause of loss of functioning Homicide

16. 12/12/2011 16 Illness Development Gradual development over time. Child may start with another diagnosis, most often AD/HD or ODD. Sudden onset. Normally developing child develops significant difficulty within a short period of time.

17. 12/12/2011 17 Impact MI’s cause not only emotional but cognitive* problems. Problems with thinking clearly, paying attention and remembering are primary problems of Schizophrenia and affective disorders. *thinking skills

18. 12/12/2011 18 Data on Poor Outcomes for Children with Ineffective Treatment or no Treatment at All School drop out and failure (50% - highest rate of any disability group); Juvenile Justice Involvement (70% of youth in the JJ system have 1 or more psychiatric illnesses);

19. 12/12/2011 19 Youth Suicide (3rd leading cause of death in youth ages 15 to 24); it’s 2nd in Wisconsin! Loss of critical development years, with the failure to develop social skills, friendships and the opportunity to lead productive adult lives.

20. 12/12/2011 20 EBPs for Mental Illnesses in Children There are a number of evidence-based psychosocial interventions and medications for children and adolescents living with mental illnesses. There are also a number of home and community based service interventions that have proven to be effective for children with mental illnesses and their families.

21. 12/12/2011 21 Treatment Barriers Insurance parity Early identification Provider shortage: Four times more child and adolescent psychiatrists are needed to treat children with MI. Fragmented services, overly complex and bureaucratic systems Stigma

22. 12/12/2011 22 Treatment Options Educational Psychological Behavioral Medical

23. 12/12/2011 23 Educational Considerations predictability of routines structure opportunity for choice shorter work periods lower student-teacher ratio individualized instruction frequent teacher check-backs motivating and interesting curricula use of positive reinforcers

24. 12/12/2011 24 Psychological Support The child may need professional support to better understand his disorder and impact on his life. The family may need support to learn how to be supportive of this child who presents many challenges.

25. 12/12/2011 25 Behavioral Support Positive behavioral interventions can and do make a difference for many children with brain disorders. Special strategies may be utilized at school to help the child. These strategies may be help- ful at home as well.

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27. 12/12/2011 27 Why are EBPs Important? (Evidence-Based practice)

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29. 12/12/2011 29 Well…what is AD/HD? A Biological Disorder AD/HD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown.

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31. 12/12/2011 31 What do the Kids Say? “My head is just like a TV set-except it has no channel selector. I get all the programs on my screen at the same time.”

32. 12/12/2011 32 “when I sit in class, I keep having ‘mind shifts’. I never know when my mind is gonna shift away so I lose what’s happening.”

33. 12/12/2011 33 “I like to move around a lot. When I sit still, I get tired. I get bored. I need action.”

34. 12/12/2011 34 Coping with Common Challenges (A Baker’s Dozen) Disorganization Inattention Forgetfulness Impulsivity Impaired sense of time Sleep problems Messy handwriting

35. 12/12/2011 35 Coping with Common Challenges Work slowly or rush through things Slow processing speed vs “careless” errors Difficulty with written expression Difficulty remembering facts and formulas Procrastination; difficulty getting started Difficulty controlling emotions Restlessness/hyperactivity

36. 12/12/2011 36 Defining Depression Depression in children is characterized by a persistent sad mood; loss of interest or pleasure in activities that were once enjoyed; significant change in body weight or appetite; difficulty sleeping or oversleeping; physical slowing or agitation; loss of energy; feelings worthlessness or inappropriate guilt; difficulty thinking or concentrating; recurrent thoughts of death or suicide and, at times, suicidal tendencies. National Institute of Mental Health, 2005 Facilitator: “Here is a definition of Depression from the National Institute of Mental Health.” Facilitator: “Here is a definition of Depression from the National Institute of Mental Health.”

37. 12/12/2011 37 Depression: Mood Changes Signs and Symptoms Depressed mood Feelings of hopelessness Loss of interest/pleasure Irritable mood/anger Distractibility Excessive guilt/self-blame Negative thoughts Suicidal ideation Unrealistic negative self-worth-look for evidence of personal faults Increased worry or fear Facilitator: “These are some of the depressive symptoms that are expressed emotionally.” Facilitator: “These are some of the depressive symptoms that are expressed emotionally.”

38. 12/12/2011 38 Facilitator: “Be aware of the key points related to depression that are emphasized in this presentation.” Facilitator: “Be aware of the key points related to depression that are emphasized in this presentation.”

39. 12/12/2011 39 Defining Dysthymia Dysthymia is a less severe yet typically more chronic version of depression and is diagnosed in children and adolescents when a depressed mood persists for at least one year and is accompanied by at least two other depressive symptoms. National Institute of Mental Health, 2005 Facilitator: “Dysthymia, sometimes referred to as low-grade depression, is also defined by the National Institute of Mental Health.” Facilitator: “Dysthymia, sometimes referred to as low-grade depression, is also defined by the National Institute of Mental Health.”

40. 12/12/2011 40 Depression: Cognitive Changes Signs and Symptoms Difficulty concentrating Delayed mental reasoning Impaired ability to think Problems making decisions Slow movement, speech, and thinking Disinterest in normally pleasurable activities Forgetful Facilitator: “When a child is expressing behavioral symptoms, we may see these indicators.” Facilitator: “When a child is expressing behavioral symptoms, we may see these indicators.”

41. 41 12/12/2011 Facilitator: “These are some of the depression symptoms that occur when there are physical changes.” Facilitator: “These are some of the depression symptoms that occur when there are physical changes.”

42. 42 12/12/2011 School-wide Interventions Facilitator: “Here are several interventions that can be used to positively impact the school and home environment of the child.” Facilitator: “Here are several interventions that can be used to positively impact the school and home environment of the child.”

43. 43 12/12/2011 Classroom Interventions Facilitator: “Classroom teachers, licensed support personnel, and educational assistants can use these strategies.” Facilitator: “Classroom teachers, licensed support personnel, and educational assistants can use these strategies.”

44. 12/12/2011 44 Facilitator: “ Here is a definition of Bipolar from the National Institute of Mental Health. Please note that our recent review of symptoms and interventions related to depression applies to bipolar as well. In Bipolar Disorder, however, there are additional symptoms of mania that call for a few more interventions.” Facilitator: “ Here is a definition of Bipolar from the National Institute of Mental Health. Please note that our recent review of symptoms and interventions related to depression applies to bipolar as well. In Bipolar Disorder, however, there are additional symptoms of mania that call for a few more interventions.”

45. 12/12/2011 45 Bipolar Disorder Mood/Cognitive Symptoms of Mania Abnormally elevated mood/irritability Hallucinations Delusions Grandiose statements about self Racing thoughts Inflated self-esteem Facilitator: “Here are some common physical symptoms experienced by children experiencing the manic phase of Bipolar Disorder. Sometimes the delusional symptoms are misinterpreted as lying or an overactive imagination. ” Facilitator: “Here are some common physical symptoms experienced by children experiencing the manic phase of Bipolar Disorder. Sometimes the delusional symptoms are misinterpreted as lying or an overactive imagination. ”

46. 12/12/2011 46 Bipolar Disorder Physical/Behavioral Symptoms of Mania Increased talkativeness Uncontrollable temper tantrums Abnormally active/hyperactive Excessive energy Pressured speech Excessive risk-taking/daredevil behavior Hyper-sexuality Atypical speech patterns Active much of the night/decreased need for sleep Facilitator: “Children with Bipolar Disorder also have behavioral symptoms of mania. The pressured speech is a hallmark sign - it is as if the child’s verbalizations are driven by a motor that won’t turn off. Additionally, the hypersexuality may be interpreted as a sign of the child having experienced sexual abuse. Although this is a possibility, it is not necessarily the case. The aggressiveness and temper tantrums that sometimes accompany mania can be very frightening to the child, other children, and adults.” Facilitator: “Children with Bipolar Disorder also have behavioral symptoms of mania. The pressured speech is a hallmark sign - it is as if the child’s verbalizations are driven by a motor that won’t turn off. Additionally, the hypersexuality may be interpreted as a sign of the child having experienced sexual abuse. Although this is a possibility, it is not necessarily the case. The aggressiveness and temper tantrums that sometimes accompany mania can be very frightening to the child, other children, and adults.”

47. 47 12/12/2011 Facilitator: “ School-wide and other environmental interventions can be helpful.”Facilitator: “ School-wide and other environmental interventions can be helpful.”

48. 48 12/12/2011 Classroom Interventions Children with bipolar disorder can function relatively well in a classroom with a few simple accommodations or modifications implemented by the classroom teacher or support staff. With planning a team can provide a safe learning environment and guide the child to help when needed.Children with bipolar disorder can function relatively well in a classroom with a few simple accommodations or modifications implemented by the classroom teacher or support staff. With planning a team can provide a safe learning environment and guide the child to help when needed.

49. 49 12/12/2011 The Full Effect of Anxiety Facilitator: “In order to help us realize the full effect of fear, stress, and anxiety on a child, Dr. Reed Sulik, M.D. created this illustration to emphasize that there are mood, cognition, and physical changes that a child experiences.” Facilitator: “In order to help us realize the full effect of fear, stress, and anxiety on a child, Dr. Reed Sulik, M.D. created this illustration to emphasize that there are mood, cognition, and physical changes that a child experiences.”

50. 12/12/2011 50 Facilitator: “These are some of the anxiety symptoms that accompany a child’s mood changes.” Facilitator: “These are some of the anxiety symptoms that accompany a child’s mood changes.”

51. 12/12/2011 51 Anxiety: Cognitive Changes Signs and Symptoms Sluggish thinking/slow to participate Avoids or does not complete tasks Memory difficulty Difficulty concentrating Lack of confidence in skill and ability/gives up easily Automatic negative thinking Excessive worry about homework grades assignments tests Facilitator: “These are some of the symptoms that accompany a child’s changes in cognition.”Facilitator: “These are some of the symptoms that accompany a child’s changes in cognition.”

52. 12/12/2011 52 Anxiety: Physical Changes Signs and Symptoms Chest pain, increased heart rate, chills, trembling, profuse sweating Shortness of breath Abdominal distress Hypersensitivity to environmental stimuli (e.g. lights, sound, touch, smells) Flat affect/appears detached Cries frequently Avoids group functions/isolates self Frequent absences Fatigue Nightmares, sleep disruption Dry mouth, dizziness, nausea, diarrhea Aggressive actions Obsessions and compulsions Facilitator: “Physical changes may manifest themselves in these behavioral symptoms.” Facilitator: “Physical changes may manifest themselves in these behavioral symptoms.”

53. 53 12/12/2011 Facilitator: “Here are several interventions that can be used to positively impact the school and home environment of the child.” Facilitator: “Here are some additional school and home interventions.” Facilitator: “Here are several interventions that can be used to positively impact the school and home environment of the child.” Facilitator: “Here are some additional school and home interventions.”

54. 54 12/12/2011 Classroom Interventions Facilitator: “Classroom teachers, licensed support personnel, and educational assistants can all use these strategies. The goal is to foster a safe, encouraging classroom atmosphere where all student voices count and where there are multiple avenues for expression of ideas and demonstration of learning.” Facilitator: “Classroom teachers, licensed support personnel, and educational assistants can all use these strategies. The goal is to foster a safe, encouraging classroom atmosphere where all student voices count and where there are multiple avenues for expression of ideas and demonstration of learning.”

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57. 12/12/2011 57 Help! Individuals can help! Service organizations can help! Libraries, recreational programs, kind and sensitive neighbors, extended family members, small business owners-anyone who has contact with children.

58. 12/12/2011 58 How Can We Help At School? Knowledge of mental illness in children and its impact on school performance and social interactions Understanding and empathy Acceptance No bullying polices and enforcement Flexibility Adjustable and realistic expectations based on where the child is now Personal attention Positive feedback and encouragement Recognize efforts Utilize school student services as needed Cooperation with treatment recommendations Parent communication

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62. 12/12/2011 62 NO…but education will help!

63. 12/12/2011 63 Resources Books Videos/DVD’s Web sites Parent Support Groups (CHADD) www.chadd.org Wisconsin Family Ties www,wifamilyties.org NAMI (National Alliance on Mental Illness) www.nami.org

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