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Pathways to risk: What can we do?

Pathways to risk: What can we do?. Ian Webster. PATHWAYS TO RISK. Sven Silburn 2003. PATHWAYS TO RISK. Society & social. MHS . Educational development. Emotional development. Early development. Sven Silburn 2003. Opportunities for prevention - Anticipatory care. Addiction. Social.

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Pathways to risk: What can we do?

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  1. Pathways to risk:What can we do? Ian Webster

  2. PATHWAYS TO RISK Sven Silburn 2003

  3. PATHWAYS TO RISK Society & social MHS Educational development Emotional development Early development Sven Silburn 2003

  4. Opportunities for prevention - Anticipatory care Addiction Social disadvantage Loss of function performance Impairment of body & mind Disease Injury Misuse Mental health & suicide risk Use

  5. Alcohol and suicide (Sher, L 2006) • Suicides 33-69% alcohol positive • Alcohol intoxication – suicide risk 90 x increased • Alcohol – more lethal means eg firearms • Alcohol reduces serotonin in brain • Low serotonin – increased aggression and impulsiveness • Association – countries with high alcohol – high suicide rates (11/13 studies)

  6. Relationship between dependence and depression *definitions are changing; addiction is a problem of reward systems

  7. Motor Brain Sensing Brain Planning Brain Seeing Brain Smelling & Tasting Brain PAIN FEELING ANXIETY SOMATOSENSORY BRAIN Balancing & Coordinating Brain DRIVES MOTIVATION HUNGER APPETITES Messaging system HIGHER LEVEL – Context, Planning, Action LOWER LEVEL – Safety, Drives, Emotion

  8. The remarkable human being Alcohol and other drug misuse Mental distress You and me? Mental illness Addiction/dependence Physical illness and disabilities (The special case of chronic pain.)

  9. Chronic physical disorders and mental illness • 77% Australians - one or more medical conditions • 19 % physically disabled – 10% out of work • 80% of those with psychosis – out of work • NSMHWB in 2007 in Australia • 58% mental or physical disorder • 8.2% mental disorder only • 19.9% • 11.7% mental and physical

  10. Homeless - Sydney 1998 • 3 in 4 have a mental disorder • 1 in 2 have a chronic physical illness

  11. Keys to success • Engagement • Harm minimisation/anticipatory care/limit setting • Long haul & follow-up (‘chain of care’) • Patient’s autonomy • Practical focus - ‘material’ & ‘structural’ • Medication choice • Dependence treatment works

  12. Connections – “Chain of Care” Ensuring links in the chain to - Structured follow through Other health services Social welfare (‘fare well’) Housing, corrections, law enforcement, homeless agencies, Indigenous organisations

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