understanding mental illness a review of the disorders l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Understanding Mental Illness A Review of the Disorders PowerPoint Presentation
Download Presentation
Understanding Mental Illness A Review of the Disorders

Loading in 2 Seconds...

play fullscreen
1 / 55

Understanding Mental Illness A Review of the Disorders - PowerPoint PPT Presentation


  • 139 Views
  • Uploaded on

Understanding Mental Illness A Review of the Disorders. Defining Mental Illness. Clinical definition : Clinically significant behavioral problems Associated with distress (painful symptoms) Causes disability (impairment in functioning) A biological illness that responds to treatment

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Understanding Mental Illness A Review of the Disorders' - jeslyn


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
defining mental illness
Defining Mental Illness

Clinical definition :

  • Clinically significant behavioral problems
  • Associated with distress (painful symptoms)
  • Causes disability (impairment in functioning)
  • A biological illness that responds to treatment
  • Not to be confused with weakness of character
facts about mental illness
Facts about Mental Illness

Has nothing to do with intelligence

Can happen to anyone

Chronic but not contagious

Difficult to diagnose and to treat

Treated but not cured

Mentally ill are not all dangerous

Should not be confused with terms psychopath or sociopath

general signs of mental illness
General Signs of Mental Illness

Observable

Confusion

Disoriented

Darting looks

Talking to self

Poverty of Speech

Pressured speech

Poor hygiene

Inappropriate attire

Behavior Changes

Flat Affect

Withdrawn

Sad or anxious mood

Panic

Psycho somatic complaints

schizophrenia
Schizophrenia

Symptoms

  • Brain disease
  • Includes psychosis
  • Impacts 1 out of every 100 people. Does not differentiate across SES
  • Onset is late teens, early adulthood.
  • Positive Symptoms include :
    • hallucinations
    • delusional thinking
  • Negative symptoms include
    • apathy
    • withdrawal.
schizophrenia6
Schizophrenia

Symptoms in Jail

  • May appear non compliant
  • Agitated by voices and delusions -may look and act dangerous
  • Command hallucinations may actually be dangerous
  • More likely to respond to clear directions, and reassurance in a kind tone of voice
  • Poor hygiene - Not aware of their surroundings enough to know that they are not clean
mood disorders major depression
Mood DisordersMajor Depression

Symptoms

  • Affects 5 percent of the general population
  • Sad mood that lasts 2 weeks
  • Loss of interest or pleasure in daily activities
  • Changes in sleep, appetite, decreased energy
  • Thought problems affect concentration, memory, decisions, feelings of guilt, worthlessness
  • Risk of suicide is high
  • Important to differentiate mental health from

physical problems

  • Responds well to treatment
mood disorders major depression8
Mood DisordersMajor Depression

Symptoms in Jail

  • Loss of interest in food and self care
  • May not care about legal situation
  • Suicide risk is real and must be monitored
  • Risk of suicide may increase after medication
mood disorders mania bipolar disorder
Mood DisordersMania/ Bipolar Disorder

Symptoms

  • Euphoric Mood (elevated, high or happy)
  • Irritable Mood (touchy)
  • Three Stages of Mania Hypomania, Acute Mania, Psychosis
  • Bipolar Disorder - mood swings from depression

to mania

  • Can be Rapid Cycling
mood disorders mania bipolar disorder10
Mood DisordersMania/ Bipolar Disorder

Symptoms in jail

  • Jail may be the consequence of the disorder
  • Mood can swing from entertaining to hostile
  • Talkativeness can be irritating
  • If depressed, often cry, feel hopeless, become suicidal
  • Can be restless, pacing, demanding and destructive
  • Often non-compliant
  • Can be professional and well-educated
anxiety disorders panic disorders
Anxiety DisordersPanic Disorders

Symptoms

  • Prevalence is 1 to 2 percent of the population; Women twice as high as men.
  • Panic attacks occur without warning
  • Symptoms include intense fear, heart palpitations,chest pain,

shortness of breath, dizziness

  • Person is concerned that the attacks will strike again

Symptoms in Jail

  • Jail environment and structure of holding can

induce symptoms

  • Referral is indicated
anxiety disorders obsessive compulsive disorder
Anxiety DisordersObsessive-Compulsive Disorder

Symptoms

  • Obsessions are recurrent thoughts, images, impulses that cause anxiety. They are illogical,at times repulsive and/or center on violence or harm.
  • Compulsions are behaviors that are repetitive - attempts at reducing the anxiety created by the obsessions.

Symptoms in Jail

  • Rarely seen in jail and do not pose high risk
post traumatic stress disorder
Post Traumatic Stress Disorder

Symptoms

  • Exposure to an extremely stressful event.
  • Painful memories, nightmares,, suspicion, anxiety, depression, feelings of guilt and sleep difficulties
  • Symptoms worsen with exposure to similar events
  • Substance abuse is a common method to cope

Symptoms in Jail

  • Jail environment can trigger symptoms
  • Jail inmates and personnel can trigger symptoms
  • Lack of privacy and loss of control are issues
personality disorders
PersonalityDisorders

Inflexible, maladaptive, ways of coping and relating

Difficulty in holding steady work and relationships

Difficult to change

Can co -exist with other mental illnesses

Behavior problems

precipitate jail

Antisocial

Narcissistic

Borderline

Avoidant

Paranoid

Dependent

Schizotypal

Schizoid

personality disorders15
Personality Disorders

Predominant disorders in jail are Antisocial and Borderline

Jail environment heightens symptoms

Effective management requires consistent limit-setting

Suicidal risk is real and must be monitored

Jail personnel must professionally manage housing unit, inmates and themselves

substance abuse
Substance Abuse

Symptoms

  • 85% of jail population have substance abuse problems
  • High correlation of substance abuse and other mental illnesses

Symptoms in Jail

  • Monitor risk of OD or withdrawal
  • Monitor abuse of prescription drugs
  • Can mimic other Mental illnesses
  • Long term abuse can cause dementia
co occurring disorders
Co-occurring Disorders
  • Presence of both a mental illness and substance abuse disorder
  • High prevalence rates
  • 60% of persons with a mood disorder also have a substance abuse disorder
  • 50% of persons with schizophrenia also have a substance abuse disorder

In Jail - More prone to violence, impulsivity, paranoia and anxiety

common factors of mental illness and substance abuse
Common Factors of Mental Illness and Substance Abuse
  • Brain disorders
  • Lack of Insight
  • Chronic
  • Impacts Family
  • Shame and guilt
  • Needs Treatment
dementia and other cognitive disorders
Dementia and other Cognitive Disorders

Symptoms

  • Memory problems
  • Confabulations
  • Impaired thinking
  • Impaired Judgement

Symptoms in Jail

  • Poor memory and may not follow directions
  • Treat individual as you would any with adisability
mental retardation
Mental Retardation

Symptoms

  • Poor adaptive functioning from birth
  • Related to intelligence, not thoughts, feelings and behaviors

Symptoms in Jail

  • Not to be confused with mental illness
  • Requires patience
keys to communication
Keys to Communication
  • Empathy
  • Warmth
  • Genuine
promoting communication
Promoting Communication

Listening:attend to both verbal and nonverbal cues, hear and observe, and avoid distractions

Clarification: Restate.Repeat, Clarify, Question

Dealing with Silence

Respond Effectively

Maintain Personal Space

Open ended questions

Non verbal Cues

basic communication guidelines
Basic Communication Guidelines
  • Short, clear direct sentences
  • Low stimulation level
  • Don’t take actions or reactions personally
  • Simple content
  • Don’t force communication
  • Be consistent
basic communication guidelines25
Basic Communication Guidelines
  • Be patient
  • Be pleasant and firm
  • Praise cooperative behavior
  • Practice reflective listening
  • Know your non verbal communication
  • Person may not “get” all the information
basic communication guidelines26
Basic Communication Guidelines

Short, clear direct sentences

Simple content

Low stimulation level

Don’t force communication if person is withdrawn

Be consistent

Don’t take actions or reactions personally

Person may not “get” all the information you provide

Be patient

Be pleasant and firm

Praise cooperative behavior

Practice reflective listening

Know your non verbal communication

types of non verbal communication
Types of Non-Verbal Communication
  • Body Posture
  • Facial Expression
  • Eye Contact
  • Gestures
crisis management29
Crisis Management
  • Crisis defined
  • What is crisis intervention
  • Recognizing a person in

crisis – behavioral

and verbal cues

violence
Violence

The incidence of violence is no greater in persons with mental illness than it is in the general population

Incidence increases 60% if the illness is untreated.

Substance use greatly increases violence

Greatest risk, males in late teens to early 20’s

Past behavior best predictor

warning signs
Warning Signs
  • Tremors
  • Hyperactivity
  • Rigid Posture
  • Clenched jaws and fists
  • Pulsing arteries
  • Verbal abuse/profanity
effective crisis intervention
Effective Crisis Intervention
  • Reduce Stress
  • Force as the last resort
  • Consider the symptoms of mental illness
  • Identify precipitating factors
  • Goal is to de-escalate
5 stages of successful interventions
5 Stages of Successful Interventions

Immediacy- Intervene as soon as possible. Goal is to reduce anxiety.

Assume Control - via providing the structure the person needs, not be overwhelming them

Assess the situation- let the person talk, watch for nonverbal cues, be a guide and avoid judgements and putdowns

Situation Management

Post crisis intervention

5 stages of successful interventions34
5 Stages of Successful Interventions

Immediacy- Intervene as soon as possible. Goal is to reduce anxiety.

Assume Control - via providing the structure the person needs, not be overwhelming them

Assess the situation- let the person talk, watch for nonverbal cues, be a guide and avoid judgements and putdowns

Situation Management

Post crisis intervention

slide36
Jail suicide is 9 times higher than general pop.

8 of 10 have given prior warnings

Ambivalent about death

Ambivalence is not the same as manipulation

Most jail suicides are not impulsive

Risk does not increase with discussion

Facts about Suicide

slide37
Understanding SI behavior increases prevention!

Facts about Suicide

  • Prior attempts increases risk by 33%
  • Mental illness increases the risks -
    • 61% have major depression
    • 48% have personality disorder
    • 40% Alcohol use
    • 10% Anxiety
    • 6% Schizophrenia
why jails are suicide prone settings
Why Jails are Suicide Prone Settings

Authoritarian environment

Loss of control over future

Isolation

Shame

Dehumanizing

aspects of

incarceration

Fears

Police and Jail staff immune to arrest and incarceration

Officers and jail staff overlook or misunderstand symptoms

terms related to suicide
Terms related to Suicide
  • Ambivalence
  • Ideation
  • Lethality
  • Attempt
  • Gesture
evaluation tool the sad persons scale
Evaluation ToolThe Sad Persons Scale

Sex

Age

Depression

Previous Attempts

Ethanol

Rational Thinking Loss

Social Support Losses

Organized Plan

No Spouse

Sickness

why do people die by suicide
Why Do People Die by Suicide?
  • Impulsive
  • Depressed
  • Escape from suffering
  • Communication
  • Loss of a loved one
understanding suicidal thinking
Understanding Suicidal Thinking
  • Suicide is a solution to a problem, what is the problem ?
  • Most suicides are acts to end intolerable feelings
  • Coping Patterns Fail
  • “Tunnel Vision” interferes with seeing alternatives
  • Person feels “unheard”
  • Ambivalence
recognizing suicidal risk in jail
Recognizing Suicidal Risk In Jail
  • Psychological Factors
  • Social Risk Factors
  • Behavioral Warning Signs
special features of jail suicide risk
Special Features of Jail Suicide Risk

Legal Status Factors

Time of the year

Long Term Factors

intervening
Intervening

Create a safe environment

Only one person communicate

Talk about plan

Emphasize positives

Evaluate potential

Refer for treatment

Do not lie

prevention
Prevention
  • Admission Screening
  • Utilize a formal screening worksheet
  • Develop tiered assessments - intake, supervisor, mental health professional referral
  • Observe for risk factors, even after intake
  • Assure treatment
shared goals
Shared Goals
  • Diversion of inmates from jail to appropriate community care
  • Assure adequate mental health care while incarcerated
  • Assure Continuity of Care for those inmates at the time of their release.
steps to meeting shared goals
Steps to Meeting Shared Goals

Screening and identification

EvaluationClassification

Diversion

Crisis Prevention

Provision of emergency mental health services

Assure care

Supervision

Suicide Prevention

Pre release planning

team approach options
Team Approach Options
  • Employ Mental Health Staff
  • Formal Contractual Agreements with Providers
  • Informal Agreements (MOA)
characteristics of a good working system
Characteristics of a good Working System
  • Shared Vision, mission and values
  • Involvement of all stakeholders
  • Established written documentation
  • Formal and informal verbal communications
  • Ongoing Commitment
formal agreements
Formal Agreements
  • Purpose
  • Range of Services
  • Time Frame
  • Remuneration, if applicable
  • Expectations of the jail re documentation, referrals, medication administration, etc
  • Confidentiality
  • Mechanism for review, evaluation and modification
comprehensive service array
Comprehensive Service Array
  • Diversion
  • Timely and effective treatment
  • Placement in programming
  • Linkage with support groups
  • Housing assistance
  • Educational Assistance
  • Entitlements
  • Other supports
systematic planning
Systematic Planning
  • Cooperation
  • Coordination
  • Collaboration
  • Integration
  • Key Issues Identification of problems, barriers and solutions
technical assistance resources
Technical Assistance Resources
  • National Institute for Corrections (Jail Center) 1-800-995-6429
  • The GAINS Center for People with Co-Occurring Disorders in the Justice System 1-800-311-GAIN