revised Mental health 101 workshop from David Oddie, CAMH

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David Oddie, BSc, MA, MSW, RSW
Social Determinants of Health (SDH) Service
Access and Transitions Program
Centre for Addiction and Mental Health
Mental illness
What is it?
Myths and facts
Accommodation
Recovery

2. Agenda
• Mental Illness
• Myths and Facts
• Accommodating People’s Needs
• Recovery
• Centre for Addiction and Mental Health

3. Mental Illness

4. Mental Illness
Mental illness encompasses a wide range of
illnesses that can affect a person’s:
• mood
• thoughts
• perceptions
• behaviour

5. Diagnosis
• Based on observation of behaviours
• Requires no x-ray, blood test, CAT scan, swab, etc.
• Diagnostic and Statistical Manual of Mental
Disorders (DSM)
• can help to identify common
patterns and support
research with the goal of
providing relief
• does not predict a person’s
ability to function at work or
school
• may imply a greater
understanding of the condition
than actually exists

6. Categories
1. Mood disorders
2. Schizophrenic disorders
3. Anxiety disorders
4. Personality disorders

7. Mood disorders
Depression
 prolonged feelings of sadness
and despair
 sense of hopelessness and
helplessness
 fatigue, lack of energy
 slowed thinking
 forgetfulness
 loss of interest in activities
 changes in eating and
sleeping patterns
 agitation
 affects 10-25% of women and
10-15% of men
Bipolar disorder
 mania
 depression
 mixed state
 hypomania
 affects 1-2% of the population
Dysthymia
 chronic, mild depression
 affects about 1.5% of the
population
(U.S. National Institute of Mental Health)

8. Schizophrenic disorders
• Involve a problem with brain
chemistry/development
• Affect men and women equally
• Genetic predisposition
• Appear in cycles of remission and relapse
• Treated with medication, therapy,
psychosocial rehabilitation
• Affect about 1% of the population

9. Anxiety disorders
• Involve anxiety that is disproportionate to
reality
• Undermine a person’s ability to do everyday
activities
• May accompany other psychiatric disorders
• Often appear in adolescence or early
adulthood
• Affect more than 12% of the population
Examples:
• panic disorder
• generalized anxiety
disorder
• obsessive
compulsive disorder
• phobias
• post-traumatic
stress disorder

10. Personality disorders
• Include many forms; often a secondary diagnosis
• Involve patterns of behaviour, thoughts, feelings,
relationships that differ significantly from those
of the culture
• Feature inflexibility, difficulty with interpersonal
relationships
• Appear during adolescence or early childhood
• Affect 4-14% of the population; up to 50% in
prison populations
Examples:
• paranoid personality
disorder
• antisocial personality
disorder
• borderline personality
disorder
• narcissistic personality
disorder

11. Common associated issues
• Pharmacological side-effects
o cognitive delay, lethargy/drowsiness, weight
gain, fatigue
o frustration with drugs and side-effects
• Secondary disability
o loss of vocational trajectory
o loss of family/friend networks
o feeling trapped by the system
• Poverty

12. Summary
• Mental illness is about mood, thoughts,
perceptions and behaviour
• Mental illnesses can have few or many
symptoms
• Symptoms can have varying degrees of
intensity, from negligible to extreme
• The impact of mental illness on people’s lives
varies

13. Myths and facts

14. Myths and facts
• 1 in 5 people in Ontario will experience some
form of mental illness
• Only about 30% seek assistance

15. Fact: Reasons people don’t access support
• No insight into own mental illness
• Don’t know who to tell or how to access support
• Try to handle symptoms on their own
• Feel ashamed or embarrassed about needing help

16. Fact: Difficulties with disclosure
• Experiencing stigma
• Feeling different/not belonging
• Not wanting to be labeled
• Fear of rejection, discrimination
• Concerns about confidentiality
• Fear of not being treated with compassion
• Fear that this will become their identity

17. Myth
Recovery from mental
illness is not possible.
Fact
Most people with
mental illness show
genuine improvement
over time and go on to
lead stable, productive
lives.
More myths and facts

18. Myth
All people with
mental illness are
unpredictable,
violent and
dangerous.
Fact
The vast majority of
people with mental
illness are not
dangerous or violent.
Myth sensationalized
by the media.
 Incidence of dangerous or
violent behaviour by a person
with schizophrenia is the same
as for the general population.
 People with schizophrenia are
3x more likely than members
of the general population to
be victims of violence.
More myths and facts

19. Myth
Employees with
mental illness are
second-rate
employees.
Fact
Employers report higher-
than-average attendance
and punctuality among
employees with mental
illness.
Among employees with
mental illness, motivation,
quality of work and job
tenure are reported to be
as good as, or better than,
that of other employees.
More myths and facts

20. Points to remember
• Mental illness is treatable, and most people
make a good recovery
• Not everyone with a mental illness takes, or should
take, medication
• There is significant variation in symptoms and degree
of symptom severity within each mental illness
• How people with mental illness cope and how the
illness affects their lives varies significantly
• Each person is the expert on what is problematic for
them

21. Actions to remember
• Don’t assume that you know what a person can or
cannot handle
• Don’t attribute every behaviour to mental illness
• Demonstrate understanding and support, but set
reasonable expectations
• Don’t assume that everyone with mental illness requires
accommodation
• Respect confidentiality – build a trusting relationship

22. Accommodating
people’s needs

23. Accommodations
• Involve modifications to the school/workplace or
its procedures
• Allow a qualified employee/student with a mental
or physical disability to perform essential tasks
• Minimize or remove barriers to success for a
person with a mental or physical disability

24. Accommodations
• A request for accommodation requires some
degree of disclosure (one of the most difficult
aspects of accommodation)
• The act of disclosure is always assisted by an
explicit discussion of confidentiality
• Accommodation and the process of instituting it
must ensure individual dignity and respect

25. Accommodations
• Costs, if any, are usually quite low (averaging
$500 for non-physical barriers)
• People who need accommodations don’t
necessarily need them all the time
• Accommodations last only as long as they are
needed

26. Examples of accommodations
• Flexible working/classroom hours
• Part-time attendance in workplace/classroom
• Instructions given both orally and in writing
• Longer learning period
• Buddy or mentor
• Assistive devices

27. Examples of accommodations
• Job modification or restructuring
• Training workplace/teaching staff or supervisors
(workplace)
• Modifying exam time and/or environment
• Modifying physical environment (e.g., using
environments with less distraction/stimulation)

28. Recovery

29. The recovery framework
“It is important to understand that persons do
not ‘get’ rehabilitated the way that a car ‘gets’
tuned up.”
— Pat Deegan (psychiatrist and consumer-survivor)

30. The recovery framework
Recovery means:
• developing a sense of belonging, meaning and
identity apart from one’s diagnosis or disability
• building or rebuilding a life in the community
• successfully coping with a disability
• redefining treatment as aiming for recovery, not
a “cure”

31. What are people recovering from?
• Loss of self, connection, hope
• Loss of roles, opportunities
• Multiple recurring traumas
• Loss of educational/employment trajectory
• Devaluing programs, practices and environments
• Social discrimination
• Internalized oppression and shame

32. Recovery outcomes
• Gaining/regaining valued roles
• Experiencing success and satisfaction with roles
• Reducing/managing symptoms
• Increased self-esteem and well-being
• Making healthy interpersonal connections
• Experiencing improved physical health

33. Principles of recovery
• Hope
• Self-determination
• Personal empowerment
• Responsibility
• Focus on strengths, not deficits
• Personal choice
• Respect

34. The social determinants of health
• Income and income
distribution
• Education
• Unemployment and job
security
• Employment and
working conditions
• Early childhood
development
• Food insecurity
• Housing
• Social exclusion
• Social safety network
• Health services
• Aboriginal status
• Gender
• Race
• Disability
Mikkonen & Raphael. (2010). The Canadian Facts.

35. Centre for Addiction
and Mental Health
(CAMH)

36. The Centre for Addiction and Mental Health
• One of the first organizations to bring mental
health and addiction services together
• Formed in 1998, merging two mental health
and two addiction facilities
• Brings together specialized care, research,
province-wide education, health promotion and
public policy development
• Research and clinical practice are intertwined

37. The Social Determinants of Health Service
• The Social Determinants of Health Service (SDH
Service) of the Access and Transitions Program
(ATP) provides centralized intake and access to
CAMH services and consolidates outreach and
partnerships under one clinical program.
• SDH Service works with CAMH clinicians by
providing ongoing training and consultation in
the areas of housing, income, employment,
education and related supports, engages in
local community development and collaborates
with a network of community, agency,
academic, family and consumer partners.

38. CAMH by the numbers
• 3,052 staff
• 30,729 unique clients
• 482,574 outpatient visits
• 4,476 inpatient admissions
• 7,422 visits to Emergency
• 50.1 average length of stay (days)
• Top 3 diagnostic categories: schizophrenia and
other (31.0%), substance-related disorders
(29.9%), mood disorders (29.2%)
• Top 4 languages at the time of admission (other
than English or French): Spanish, Portuguese,
Italian, Chinese

39. Referral to CAMH
• No referral required for Addictions Assessment
Service
• Clients should contact the general intake
telephone line at (416) 535-8501 , Option 2.
• A physician referral is required for a mental
health assessment. The referral form is available
at www.camh.ca
• Emergency Services–250 College St. do not
require a referral. Short-term follow-up is
provided by the Crisis Clinic

40. Fore more information
Mental Health and Addictions 101 series
www.camh.ca/en/education