Understanding & Managing Mental Health


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This presenation by Jodie Butler from St Vincents Hospital discusses the spectrum of mental health issues and how to recognise problems and support and refer people. This presentation was given at the AFAO Positive Services Forum in June 2009.

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  • Most/all disorders require a YES to these statements
  • traumatic event: experienced, witnessed or confronted with actual or threatened death or serious injury
  • UTI’s make delusional if not treated
  • No more likely than general public to harm you.
  • Understanding & Managing Mental Health

    1. 1. Understanding & Managing Mental Health Jodie Butler St Vincents Hospital HIV, Hep C and Mental Health (H2M)
    2. 2. All things are on a Spectrum <ul><li>“ Normal” --------------------------- “Clinical” </li></ul>
    3. 3. What is Clinical? <ul><li>Significant distress or impairment in functioning: </li></ul><ul><ul><li>social </li></ul></ul><ul><ul><li>occupational </li></ul></ul><ul><ul><li>or other important areas </li></ul></ul><ul><li>Rule out other mental health condition, medical condition, drug or medication effects. </li></ul>
    4. 4. CHANGE CHANGE CHANGE <ul><li>Past Present Future </li></ul><ul><li>Depression Anxiety </li></ul>
    5. 5. <ul><li>Depression and Dysthymia </li></ul><ul><ul><li>Physical </li></ul></ul><ul><ul><li>Behavioural </li></ul></ul><ul><ul><li>Emotional </li></ul></ul>
    6. 6. Physical <ul><li>Change in sleep pattern </li></ul><ul><li>Change in eating pattern </li></ul><ul><li>Fatigue </li></ul><ul><li>Loss of energy </li></ul><ul><li>Body aches and pains (somatic) </li></ul>
    7. 7. Behavioural <ul><li>Loss of interest in pastimes/pleasure* </li></ul><ul><li>Difficulty concentrating </li></ul><ul><li>Difficulty making decisions </li></ul><ul><li>Neglecting responsibilities </li></ul><ul><li>Neglecting looking after yourself </li></ul><ul><li>Slowed movements </li></ul>
    8. 8. Emotional <ul><li>Inappropriate guilt </li></ul><ul><li>Crying </li></ul><ul><li>Feeling down, apathetic, irritable, pessimistic, negative, “black” </li></ul><ul><li>Thinking negatively about yourself </li></ul><ul><li>Feeling hopeless/helpless/worthless </li></ul><ul><li>Feeling suicidal or recurrent thoughts of death </li></ul>
    9. 9. Remember, everyone has down days.
    10. 10. What you can do <ul><li>Encourage Encourage Encourage </li></ul><ul><ul><li>exercise </li></ul></ul><ul><ul><li>decrease in alcohol, substances </li></ul></ul><ul><ul><li>balanced diet </li></ul></ul><ul><ul><li>time in the sun if appropriate </li></ul></ul><ul><ul><li>decrease in caffeine </li></ul></ul><ul><ul><li>access to support networks </li></ul></ul><ul><li>Label emotions </li></ul>
    11. 11. <ul><li>Listen </li></ul><ul><li>Use problem solving skills </li></ul><ul><li>Do relaxation exercises </li></ul><ul><li>Set boundaries, routine & structure </li></ul><ul><li>Any activity is helpful </li></ul><ul><li>Adherence to medications </li></ul><ul><li>Refocus on valued areas of life </li></ul><ul><li>GP or specialist referral </li></ul>
    12. 12. Anxiety <ul><li>Social and Specific Phobias </li></ul><ul><ul><li>persistent and excessive fear </li></ul></ul><ul><ul><li>exposure to feared object/situation provokes immediate response </li></ul></ul><ul><ul><li>avoidance </li></ul></ul>
    13. 13. <ul><li>Panic </li></ul><ul><ul><li>physical sensations related to adrenaline </li></ul></ul><ul><ul><ul><li>Breathing increases </li></ul></ul></ul><ul><ul><ul><li>Heart rate increases </li></ul></ul></ul><ul><ul><ul><li>Dizzy, tingling sensations </li></ul></ul></ul><ul><ul><ul><li>Nausea, sweaty or clammy </li></ul></ul></ul><ul><ul><li>fear of losing control/dying </li></ul></ul>
    14. 14. <ul><li>Generalised Anxiety </li></ul><ul><ul><li>excessive worry about a variety of topics </li></ul></ul><ul><ul><li>difficult to control worry </li></ul></ul><ul><ul><li>physical symptoms </li></ul></ul><ul><ul><ul><li>Restless </li></ul></ul></ul><ul><ul><ul><li>Irritable </li></ul></ul></ul><ul><ul><ul><li>Tense </li></ul></ul></ul><ul><ul><ul><li>Sleep disturbed, tired </li></ul></ul></ul><ul><ul><ul><li>Poor concentration </li></ul></ul></ul>
    15. 15. <ul><li>Obsessive Compulsive Disorder </li></ul><ul><ul><li>disturbing, intrusive, inappropriate thoughts, images, impulses and: </li></ul></ul><ul><ul><ul><li>attempts to ignore, neutralise or suppress </li></ul></ul></ul><ul><ul><li>repetitive behaviours or mental rituals to neutralise obsessions </li></ul></ul>
    16. 16. <ul><li>Acute and Post Traumatic Stress </li></ul><ul><ul><li>traumatic event </li></ul></ul><ul><ul><li>response involved fear, helplessness, horror </li></ul></ul><ul><ul><li>event is re-experienced by recollection, dreams, reliving, flashbacks </li></ul></ul><ul><ul><li>avoidance of things associated with trauma (thoughts, places, people, memory, detachment) </li></ul></ul><ul><ul><li>increased arousal (sleep, anger, concentration, hypervigilance, startles easily) </li></ul></ul>
    17. 17. What you can do <ul><li>Don’t enable avoidance </li></ul><ul><li>Don’t panic with panic </li></ul><ul><li>Tell them “It’s ok to be anxious” </li></ul><ul><li>Patience </li></ul><ul><li>Ask “what is the threat” </li></ul>
    18. 18. What you can do <ul><li>Don’t fight the panic </li></ul><ul><li>Don’t Say “don’t be anxious” </li></ul><ul><li>Assist to stay in the present </li></ul><ul><li>Concentrate on a simple task </li></ul><ul><li>Relaxation </li></ul><ul><li>Label emotions, sensations </li></ul>
    19. 19. Psychosis <ul><li>Inability to distinguish what is real — there is a loss of contact with reality </li></ul><ul><li>Confused thinking disordered thinking, confused, disjointed, paranoid </li></ul><ul><li>Delusions false belief, which is not held by others of the same cultural background </li></ul><ul><li>Hallucinations seeing, hearing, feeling, smelling or tasting something that is not actually there </li></ul>
    20. 20. What you can do <ul><li>Ensure safety of all </li></ul><ul><li>Don’t agree with them </li></ul><ul><li>Acknowledge that is how they see the world </li></ul><ul><li>Move to a less stimulating environment </li></ul><ul><li>Refer to GP or local community mental health </li></ul>
    21. 21. Mindfulness of Yourself <ul><li>Past Present Future </li></ul>
    22. 22. General Head Works <ul><li>Minimal to no drug use </li></ul><ul><li>Exercise </li></ul><ul><li>Balanced diet </li></ul><ul><li>Sleep </li></ul><ul><li>Regular social interactions </li></ul><ul><li>Regular meaningful activities </li></ul><ul><li>Say Yes!!! </li></ul><ul><li>The matter test </li></ul>
    23. 23. Know your Local Resources <ul><li>Community Mental Health Team </li></ul><ul><li>Local GP’s </li></ul><ul><li>HIV specific services </li></ul><ul><li>Lifeline </li></ul><ul><ul><li>131 114 </li></ul></ul><ul><li>Other Helplines </li></ul><ul><ul><li>GLBT Counselling Line 1800 184 527 </li></ul></ul><ul><ul><li>Mensline 1300 78 99 78 </li></ul></ul>
    24. 24. Know your Local Resources <ul><li>Websites: </li></ul><ul><ul><li>www.blackdoginstitute.org.au </li></ul></ul><ul><ul><li>www.crufad.org </li></ul></ul><ul><ul><li>www.sane.org </li></ul></ul><ul><ul><li>moodgym.anu.edu.au </li></ul></ul><ul><ul><li>www.glccs.org.au </li></ul></ul>