“I am alone therefore no one wants to be with me. If no one wants to be with me, they are not willing to help me. If they are not willing to help me I will reject them too”
Social Isolation & Mental Illness blog <ul><li>15th May 2006 by Elise Stobbe (pen name for Carley ) </li></ul><ul><li>Think about what it would be like to spend most of your time alone because being around other people is just too difficult. You feel that others are judging you for your mental illness, and so you are scared to face the world. You withdraw to avoid this stigmatization. This social withdrawal is emotionally very costly. But this is a two-way street — the mentally ill withdraw from society–society withdraws from them. </li></ul>
IF BEINGS FROM ANOTHER PLANET LANDED ON THE PLANET EARTH 50,000 YEARS AGO AND CAME BACK TODAY WHAT WILL NOT HAVE CHANGED?
The Important Role Social Relationships Play In People’s Lives <ul><li>Friendship is a lot like food. We need it to survive. What is more, we seem to have a basic drive for it. Psychologists find that human beings have fundamental need for inclusion in group life and for close relationships. We are truly social animals. </li></ul>
WHAT IS IT? <ul><li>Social isolation can be defined as the absence of social interactions, contacts, and relationships with family and friends, with neighbors on an individual level, and with ''society at large" on a broader level. </li></ul><ul><li>Social isolation is defined and then measured by the strength of the person's existing social network and the characteristics of the individuals and institutions providing support to him or her through this network. The absence or weakness of the social support network forms the basis for identifying individuals who are socially isolated. </li></ul>
PREVALENCE <ul><li>General Social Survey funded by the National Science Foundation in 2004 </li></ul><ul><li>25% of Americans say they have no one with whom they can discuss personal troubles. 2 X the # from 1985. </li></ul><ul><li>Half as many Americans 8% can confide in a neighbor </li></ul><ul><li>Studies show that between 10 to 25% of people without a mental illness report feeling lonely while 60% of people with mental illness report feeling lonely or isolated. </li></ul>
WHERE DOES IT BEGIN? SOCIAL ISOLATION MENTAL ILLNESS SOCIAL ANXIETY/SHYNESS POOR SOCIAL SKILLS/PERCEIVED REJECTION ENVIRONMENTAL FACTORS MASS MEDIA HEALTH PROBLEMS STIGMA
What we see in the isolated person <ul><li>Constricted thoughts </li></ul><ul><li>Range of thought limited </li></ul><ul><li>Problem solving skills limited </li></ul><ul><li>Concrete thinking </li></ul><ul><li>Hopeless and helpless </li></ul><ul><li>Here and now and distorted thinking </li></ul><ul><li>Self control and self regulation limited </li></ul><ul><li>Anger, resentment, betrayal </li></ul><ul><li>Stress, Fear </li></ul><ul><li>Self critical </li></ul><ul><li>Self preoccupied </li></ul><ul><li>Lethargic </li></ul><ul><li>Persistent fear of having to survive alone in a dangerous and unfriendly world . </li></ul>
SOME CRITICAL RESULTS OF SOCIAL ISOLATION REHOSPITALIZATION DEPRESSION PREMATURE MORBIDITY HEALTH PROBLEMS PREDICTOR OF VIOLENCE DELAYED CARE SEEKING Social Isolation
Study on Loneliness Psychologist John Cacioppo of the University of Chicago has been tracking the effects of loneliness. He performed a series of novel studies and reported that loneliness works in some surprising ways to compromise health. Perhaps most astonishing, in a survey he conducted, doctors themselves confided that they provide better or more complete medical care to patients who have supportive families and are not socially isolated. Living alone increases the risk of suicide for young and old alike. Lonely individuals report higher levels of perceived stress even when exposed to the same stressors as non-lonely people, and even when they are relaxing. The social interaction lonely people do have are not as positive as those of other people, hence the relationships they have do not buffer them from stress as relationships normally do. Loneliness raises levels of circulating stress hormones and levels of blood pressure. It undermines regulation of the circulatory system so that the heart muscle works harder and the blood vessels are subject to damage by blood flow turbulence. Loneliness destroys the quality and efficiency of sleep, so that it is less restorative, both physically and psychologically. They wake up more at night and spend less time in bed actually sleeping than do the nonlonely
NEED FOR SOCIAL RELATIONSHIPS <ul><li>In fact, evidence has been growing that when our need for social relationships is not met, we fall apart mentally and even physically. There are effects on the brain and on the body. Some effects work subtly, through the exposure of multiple body systems to excess amounts of stress hormones. Yet the effects are distinct enough to be measured over time, so that unmet social needs take a serious toll on health, eroding our arteries, creating high blood pressure, and even undermining learning and memory. </li></ul>
Continued <ul><li>A lack of close friends and a dearth of broader social contact generally bring the emotional discomfort or distress known as loneliness. It begins with an awareness of a deficiency of relationships. This cognitive awareness plays through our brain with an emotional soundtrack. It makes us sad. We might feel an emptiness. We may be filled with a longing for contact. We feel isolated, distanced from others, deprived. These feelings tear away at our emotional well-being. </li></ul>
Social Isolation Kills, But How and Why? <ul><li>First recognized in epidemiologic research of the late 1970s and 1980s and replicated and extended for more than a decade since then social isolation has been shown repeatedly to prospectively predict mortality and serious morbidity both in general population samples and in individuals with established morbidity, especially coronary heart disease. The magnitude of risk associated with social isolation is comparable with that of cigarette smoking and other major biomedical and psychosocial risk factors. </li></ul><ul><li>Brumett et al </li></ul>
RESEARCH <ul><li>Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored. </li></ul>
“ Social Support May Extend Life Of People With Schizophrenia” <ul><li>"We found that the quantity of support significantly predicted the longevity of the patients," Christensen said. "The frequency of daily interactions with support providers or confidants seemed to make a difference in these people's lives." </li></ul><ul><li>People with Schizophrenia who had frequent social interaction lived on average 25% longer than those who had little or no social interaction. </li></ul><ul><li>Christenson, Psychosomatic medicine March 1999 </li></ul>
Make It An Issue <ul><li>Loneliness can be a very painful place to be. We all experience it from time to time, but some people live it day after day for years on end. It is emotionally depleting, interpersonally inhibiting, and psychologically regressing. When we are lonely, we feel empty and very much alone. Intimacy needs are not met and, if they are, they somehow remain fundamentally unsatisfying. When we are lonely, our thinking can become distorted so that we may over-react to life events that we might otherwise take in stride. For these reasons, it is important that mental health professionals become acquainted with the condition of loneliness. If we can learn to identify loneliness in ourselves, our students, and our clients, we may be able to increase the potential for greater life satisfaction and potentiation. </li></ul>
MOVING FROM ISOLATION TO INTERACTION WITH PSYCH REHAB Instill Hope Individualized Services Choice and Responsibility Community Integration Skill Development Drug Free Living Recovery Journey
Hope - People who have psychiatric disabilities can lead productive, satisfying lives. This belief instills hope and is directly communicated through the words and actions of staff. Services will be offered that incorporate environments that support recovery, person-first language, cultural and spiritual acceptance, and practices that promote recovery.
Individualized Services - Each person is unique with his/her own needs, skills, culture, and aspirations. Services are stage-based, incorporate best practice, and focus on relationship building . Each person is encouraged and empowered to establish recovery goals , assess skills and abilities, identify resources and develop and implement plans relevant to his/her desires, needs and preferences .
Choice and Responsibility - Each person is empowered to see that they have choices and to take responsibility for directing their own recovery. Staff respects the autonomy of each person and works in a collaborative effort assisting him/her to identify choices and to evaluate all possible outcomes of their decisions . People receiving services are encouraged and expected to move forward and take calculated risks toward their journey of recovery.
Community Integration - The local community comprised of family, friends, businesses and citizens at large, is an important element of support for rehabilitation and recovery. People receiving services are encouraged to become part of the larger community to the fullest extent possible by taking on roles such as worker, friend, neighbor, and student. Strengthening relationships within the person’s own family is encouraged to the greatest extent possible.
Skill Development - People receiving services are offered education and skills relevant to meeting their recovery goals. Bridgeway supports people in skill development and provides opportunities for practice, giving feedback and encouragement. As people begin to learn and work in the larger community, reliance on mental health services gradually decreases.
Drug Free Living - We acknowledge that many people have substance abuse issues. With the acceptance of this fact, a holistic program of recovery is offered to help each person achieve a lifestyle free of drug and alcohol dependence. This approach allows for the individualization of services, since it meets each person at his/her stage of recovery. An assertive engagement approach is used if the person is not yet ready to confront his/her substance abuse issues. People who are in precontemplation are assisted to develop healthy living skills, lengthen the time between relapses, and build intrinsic motivation to work on recovery goals.
Recovery Journey - Recovery is an individuals way of living a satisfying, hopeful, and independent life. Bridgeway staff will model , support and follow each person’s recovery journey toward wellness encompassing the emotional, physical and spiritual facets of life.
How Psych Rehab Helps <ul><li>Listen and engage…peel away the layers to get to feelings and emotions…We instill HOPE </li></ul><ul><li>Establish a trusting relationship </li></ul><ul><li>Motivate…one thing you want to change? </li></ul><ul><li>Be a friend…expand community options </li></ul><ul><li>Connect to valued roles </li></ul><ul><li>Get in touch with interests </li></ul><ul><li>Talk about nutrition, smoking , sleeping, meds </li></ul><ul><li>Illness Management & Recovery and Wellness Recovery Action Planning…involve others, RPP, soc. skills </li></ul><ul><li>Plan </li></ul><ul><li>Reframe </li></ul><ul><li>Use peers/self help </li></ul><ul><li>Affirm and legitimize experience </li></ul><ul><li>Teach coping skills </li></ul>
Wellness can include <ul><li>Exercise </li></ul><ul><li>Close contact with friends </li></ul><ul><li>Diet </li></ul><ul><li>Significant relationships </li></ul><ul><li>Getting adequate rest </li></ul><ul><li>Meditation/ stress reduction activities </li></ul><ul><li>Working </li></ul><ul><li>Keeping a routine/ schedule </li></ul><ul><li>Maintaining treatment </li></ul>