Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health problems The five basic steps of mental health first aid What.

Instructor

Date

2

Course Outline – Session 1

• Mental Health First Aid • Common mental health problems • The five basic steps of mental health first aid • What are substance use disorders? • Symptoms and risk factors• Crisis first aid for overdose• Mental health first aid for substance use

disorders• Treatment and resources

3


• What is depression?

• Symptoms of depression

• Risk factors for depression

• Alcohol, drugs and depression

• Suicide in Canada

• Crisis first aid for suicidal behaviour

• Mental health first aid for depression

• Treatment and resources

4


• What are anxiety disorders?

• Symptoms of anxiety disorders

• Risk factors for anxiety disorders

• Alcohol, drugs and anxiety disorders

• Crisis first aid for panic attacks

• Crisis first aid for acute stress reaction

• Mental health first aid for anxiety disorders


5


• What are psychotic disorders?

• Symptoms of psychotic disorders

• Risk factors for psychosis

• Alcohol, drugs and psychotic disorders

• Crisis first aid for acute psychosis

• Mental health first aid for psychosis


• Other expressions of distress

6

World Health Organization

• Health is “a state of (complete) physical, mental and social well-being and not merely the absence of disease or infirmity.”

• Mental Health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

7

The Mental Health ContinuumMaximum

Mental Health

Minimal Mental Disorder

Minimal Mental Health

Maximum Mental Disorder

Diagnosis of a serious illness and poor

mental health

Diagnosis of a serious illness but copes well and has positive mental health

No illness or disorder and positive mental health

No diagnosable illness or disorder but has poor mental health

8

What are Mental Health Problems?

A mental health problem causes major changes in a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work and carry on their usual personal relationships.

9

What is Mental Health First Aid?

Mental Health First Aid is the help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional help is received or until the crisis is resolved.

10

The Five Basic Steps

Assess risk of suicide or harm

Listen non-judgmentally

Give reassurance and information

Encourage the person to get appropriate professional help

Encourage self-help strategies

11

Why Mental Health First Aid?

There is stigma associated with mental

health problems

Imagine if we treated everyone like we treated the mentally ill.

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13

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Why Mental Health First Aid?

• There is stigma associated with mental health problems

• Mental health problems are common

• Many people are not well informed about mental health/problems

• Professional help is not always on hand

• People often do not know how to respond

15

Prevalence

• At least 1 in 3 Canadians will experience a mental health problem at some point in their life

• At least 1 in 5 Canadians will experience a mental health problem in a year

• In Canada 20 per cent of all sick leaves are related to mental health

16

Impact

• The economic costs of mental illnesses in Canada was estimated to be at least $14.3 billion in 1998

• Mental illnesses are disabling

• Six of the 10 leading causes of ‘years lived with disability’ are mental health problems

17

The ALGEE Rap

• Assess situation and evaluate the risk

• Listen very carefully and don’t tsk tsk

• Give reassurance and the good info

• Encourage them to see appropriate pro

• Encourage them to use self help ideas

And that is the ALGEE rap my dears!

18

What is a Substance Use Disorder?

• Using alcohol or drugs does not in itself mean that a person has a substance use disorder (SUD)

• Dependence on a substance

• Use leads to problems at work, school, home

• Use causes damage to health

19

One Standard Drink

Centre for Addiction and Mental Health

= =Table Wine5 oz/142 mL

(12% alcohol)

Regular Beer12 oz/341 mL (5% alcohol)

Spirits1.5 oz/43 mL (40% alcohol)

20

Low-Risk Drinking Guidelines

• 0 drinks = lowest risk of an alcohol-related problem

• No more than 2 standard drinks on any one day

• Women: up to 9 standard drinks a week

• Men: up to 14 standard drinks a week

21

Long-Term Effects of Alcohol

• Brain

• Heart

• Lungs

• Liver, pancreas, stomach and intestines

• Genitals and reproductive system

• Muscles, nervous system, motor skills

• Skin

22

Other Abused Substances

Tobacco• Nicotine is a powerful stimulant• Male smokers are twice as likely to

experience impotence• Spit tobacco contains more than 3,000

chemicals• Withdrawal symptoms include anxiety,

insomnia, restlessness• Some long term effects - heart disease,

stroke, cancer

23


Cannabis (marijuana, hashish, joints, reefers)

• Most widely used illegal drug in Canada

• About 2% of the population have problem with cannabis abuse/dependence. – More than twice as likely to suffer from an

anxiety disorder or depression– More than three times the risk of suffering

from psychotic symptoms

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Cannabis (marijuana, hashish, joints, reefers)

• Adolescents using cannabis are more likely to suffer from depression, conduct problems, drinking and other drug use

• More frequent use of cannabis increases risk of diagnosis of schizophrenia over next 15 years

25


Amphetamines – a stimulant drug

• Examples: crystal meth, ice, speed, uppers, bennies, crank, ecstasy

• Amphetamines have the temporary effect of increasing energy and apparent mental alertness

• Users develop a tolerance and need to take more to get same effects

26


Amphetamines – a stimulant drug

• An overdose can cause delusions, hallucinations, high fever, coma, death

• A particular mental health risk is amphetamine psychosis or “speed psychosis” which involves symptoms similar to schizophrenia

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Opioids• Examples: heroin, morphine, codeine,

oxycodone• Effects can include pain relief,

drowsiness, constipation, tiny pupils• Users develop a tolerance and need to

take more to get same effects• Overdose can result in coma and

death

28


Cocaine (crack, coke, C, snow, flake)

• A cocaine high can last from 5 minutes to 2 hours

• Overdose can cause seizures, strokes heart attacks, coma, death

• Users develop a tolerance and need to take more to get same effects

29

Risk Factors

• Family history of substance abuse

• Childhood abuse or neglect

• Acceptance of substance use (community, peer)

• Low parental support/monitoring

• Poor social skills

30

First Aid for Substance Use Disorders

• Assess risk of suicide or harm

• Listen non-judgmentally

• Give reassurance and information

• Encourage the person to get appropriate professional help

• Encourage self-help strategies

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Step 1 Assess the Risk of Suicide or Harm

• If you determine the person has taken an overdose, follow the steps for Crisis First Aid for an Overdose

• If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally

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Crisis First Aid for an Overdose

If they are unconscious:• Make sure the person’s airway is clear and roll

them into the recovery position

• Phone 911 for an ambulance• Try to find out what substances were used• Keep the person warm, especially if

alcohol is involved

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Crisis First Aid for an Overdose

If the person is conscious• Phone or take the person to the nearest

emergency department• Do not give any food or fluids• Reassure the person• Try to find out what substances were

used• Keep the person warm, especially if

alcohol is involved

34

Step 2 Listen Non-Judgmentally

• Listen without interrupting

• Ask appropriate questions to make sure you are both clear on what is being said

• Listen to the word and tone of voice and watch their body language

• Restate what the person has said

• Summarize facts and feelings

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• Be attentive

• Keep eye contact comfortable (don’t stare or avoid eye contact)

• Keep an open body position

• Sit down, even if they stand

• Try not to sit directly opposite (facing) the person

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Step 3 Give Reassurance and Information

• Tell the person you want to help them

• Substance use disorder is a real medical condition

• It is a common illness

• Programs are available to help

• Often depressive and anxiety disorders underlie SUDs and can be treated

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Step 4 Encourage the Person to Get Appropriate Professional Help

• Family doctor or physician• Drug and alcohol specialists• Mental health team

38

The Change Model

Contemplation

Pre-contemplation

Determination/Preparation

Relapse

Maintenance

Action

39

Step 5 Encourage Self-Help Strategies

• Many people with a substance use disorder may also have another underlying mental health problem such as depression or anxiety.

• The self-help strategies for these conditions may help but should not be the main source of treatment.

40

Resources

• Alberta Alcohol and Drug Abuse Commission

http://www.aadac.com

• Centre for Addiction and Mental Health

http://www.camh.net/

41

If

• If you can always be cheerful

• If you can sleep without drugs

• If you can relax without alcohol

• If you can start the day without caffeine

• If you can take blame without resentment

• If you can resist without complaining

• If you can eat the same food every day without complaining and be grateful

42

If

• If you can understand when your loved ones are too busy to spend time with you

• If you can overlook it when those you love take things out on you when, through no fault of yours, something goes wrongThen you are almostas good as your dog

43

Session 2

• What is depression?• Symptoms of depression• Risk factors for depression • Alcohol, drugs and depression• Suicide in Canada• Crisis first aid for suicidal behaviour• Mental health first aid for depression• Treatment and resources

44

What is Depression?

Clinical depression lasts at least two weeks, affects the person’s behaviour and has physical, emotional and cognitive effects.

It interferes with the ability to work and have satisfying personal relationships.

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Symptoms of Depression

• Emotions: sadness, mood swings, hopelessness, anxiety

• Thoughts: Self-criticism, indecisiveness, thoughts of suicide, pessimism

• Behaviour: Crying spells, neglect personal appearance, withdrawal, no motivation

• Physical: Lack of energy, sleeping too much/too little, overeating/loss of appetite

46

Depression in the Workplace

• Decreased productivity• Morale problems• Lack of co-operation• Safety problems• Absenteeism• Complaints of being tired, having

aches/pains• Alcohol and/or drug abuse

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Bipolar Disorder (Manic Depression)

• Bipolar disorder is characterized by extreme mood swings

• A person has periods of depression and mania with periods of ‘normal’ mood in between

• A person must have episodes of both depression and mania to be diagnosed

48

Symptoms of Bipolar Disorder

• Depression• Mania

– Increased energy and over activity– Elated mood– Needing less sleep than usual– Irritability– Rapid thinking and speech– Lack of inhibitions– Grandiose delusions– Lack of insight

49

Risk Factors for Depression

• Break up of relationship or living in conflict

• Having a baby

• Job loss, unsuccessful job hunting

• Long term illness or disability or caring for someone with illness/disability

• Being a victim of a crime

• Alcohol or drug abuse

50

Risk Factors for Depression

• Side effect of medications or drugs

• Stress from another mental disorder

• Hormonal changes

• Lack of exposure to bright light in winter

• Family history of depression

• Previous episodes of depression

• Difficult childhood (abuse, neglect)

51

Suicide in Canada

• About 4,000 Canadians die by suicide each year

• In 2001, there were 3.5 suicides among men for every suicide among women.

• People in their 40s accounted for almost one in four suicides.

• Deaths by suicide surpassed deaths by motor vehicle accidents in that same year.

52

Suicide Rates by ProvincePer 100,000 population, 2001

180 6 93 12 15

AlbertaSaskatchewanManitoba

Ontario

Quebec

New Brunswick

Nova Scotia

Prince Edward Island

Canada

British Columbia

11.3

109

13.2

7.7

16.5

11.411.3

14.110.4

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First Aid for Depression






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• If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour


55

Crisis First Aid for Suicidal Behaviour

1. Engage the person in serious conversation about how they are feeling

2. Determine if the person has thoughts of suicide

3. Explore and assess the risk further

4. Find out about prior suicidal behaviour

5. Find out about their supports

56

Crisis First Aid for Suicidal Behaviour

6. Ensure the person is not left alone7. Seek additional help8. If they are consuming alcohol or drugs,

try to ensure they do not take more9. Try to ensure they do not have ready

access to some means to take their life10.Encourage the person to talk11. Ensure your own personal safety

57

Self Care

• Supporting a suicidal person can be unsettling and stressful

• Do not underestimate the effect on your own well-being

• Find ways of reducing the immediate stress (exercise, relaxation techniques, sleep)

• Find someone to talk to about your experience

58


• Listen to the person without judging.

• Do not be critical of the person.

• Do not express frustration with the person for having these symptoms.

• Do not give glib advice such as ‘pull yourself together’.

• Avoid confrontation unless necessary to prevent harmful acts.

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• Depression is a real medical condition

• Depression is a common illness

• Depression is not a weakness or character defect

• Depression is not laziness

• Effective help and treatments are available

60


• Community-based care

• Family doctor or physician

• Counsellors and clinical psychologists

• Psychiatrists

61

What Helps for Depression?

Very severe depression only

Electroconvulsive therapy (ECT)

Adults

Adolescents

Antidepressants

Rating Medical Treatments

Very good evidence

Good evidence

Promising treatment

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Reading depression self-help books based on CBT

Psychodynamic psychotherapy

Interpersonal psychotherapy

Cognitive behaviour therapy (CBT)

Rating Psychological Treatments

65

Ten Common Thinking Distortions

1. Black and white thinking

2. Setting unrealistic expectations

3. Selective thinking4. Converting

positives into negatives

5. Over generalizing

6. Exaggerating unpleasantness

7. Catastrophizing

8. Personalizing

9. Mistaking feelings for facts

10.Jumping to negative conclusions

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• Self-help strategies have proven therapeutic effects

• They also help people to feel they are regaining control of their lives

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Massage therapy

Relaxation therapy

Yoga breathing exercises

Winter depression

Non-seasonal depression

Light therapy

Exercise

Rating Lifestyle & Alternative Treatments

68


Alcohol avoidance – for people with drinking problems

Folate

St John’s wort*

Acupuncture

Rating Lifestyle & Alternative Treatments

* St John’s wort should not be taken with antidepressants. This herb has interactions with a number of prescribed medications.

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Resources

• Refer to MHFA Canada Manual Section 2, page 11

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Session 3

• What are anxiety disorders?

• Symptoms of anxiety disorders

• Risk factors for anxiety disorders

• Alcohol, drugs and anxiety disorders

• Crisis first aid for panic attacks

• Crisis first aid for acute stress reaction

• Mental health first aid for anxiety disorders


76

What are Anxiety Disorders?

• An anxiety disorder differs from normal anxiety

• Anxiety disorders are more severe, they last longer and they interfere with work or relationships

• There are several types of anxiety disorders – symptoms will vary.

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Mind Racing?

Vision strange or blurry?

Possible sleep disturbance?

Heart racing, palpitations?

Difficulty swallowing?

Dizzy, disoriented, lightheaded?

Trembling?

Sweating or shivering?

Wanting to run?

Feeling breathless,

breathing fast & Shallow?

Nausea, lack of appetite?

Restless?

Jelly-like legs?

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General Symptoms of Anxiety

Physical

• Cardiovascular: palpitations, chest pain, rapid heartbeat, flushing

• Respiratory: hyperventilation, shortness of breath

• Neurological: dizziness, headache, sweating, tingling and numbness

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Physical

• Gastrointestinal: choking, dry mouth, nausea, vomiting, diarrhea

• Musculoskeletal: muscle aches and pains (esp. neck, shoulders), restlessness, tremors and shaking

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Psychological

• Unrealistic and/or excessive fear and worry (about past or future events)

• Mind racing or going blank• Decreased concentration and memory

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Psychological

• Difficulty making decisions, confusion• Restlessness, feeling ‘on edge’ or

nervousness • Tiredness, sleep disturbances, vivid

dreams • Irritability, impatience, anger

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Behavioural

• Avoidance of situations

• Obsessive or compulsive behaviour

• Distress in social situations

• Phobic behaviour

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Types of Anxiety Disorders

• Generalized anxiety disorder (GAD)• Panic disorder (with or without

agoraphobia)• Agoraphobia• Social anxiety disorder (social phobia)• Phobic disorders• Obsessive-compulsive disorder (OCD)• Post traumatic stress disorder (PTSD)• Acute stress disorder

84

Do You Worry All the Time?

Which problems have you had often over the last 6 months?

I never stop worrying about things big and small

I have headaches or aches and pains for no reason

I am tense a lot and have trouble relaxing

I have trouble keeping my mind on things

85

Do You Worry All the Time?

Which problems have you had often over the last 6 months?

I get crabby or grouchy I have trouble falling asleep or staying

asleep I sometimes have a lump in my throat or

feel like I need to throw up when I am worried

I sweat and have hot flushes

86

Generalized Anxiety Disorder (GAD)

• Overwhelming and unfounded anxiety

• Physical and psychological symptoms of anxiety and tension for more than 6 months

• General worries over money, health and family etc. even when no problem exists

87

Do You Have Sudden Bursts of Fear for No Reason?

Which problems have you had during these bursts of fear?

I have chest pains or a racing heart I have a hard time breathing or a choking

feeling I feel dizzy, or I sweat a lot I have stomach problems or feel like I

need to throw up

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Do You Have Sudden Bursts of Fear for No Reason?

Which problems have you had during these bursts of fear?

I shake, tremble, or tingle I feel out of control I feel unreal I am afraid I am dying or going crazy

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Panic Disorder

• A person with a panic disorder has panic attacks

• A panic attack is the sudden onset of intense fear or terror

• The attacks develop suddenly

• The fear is inappropriate for the circumstances in which it is occurring

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Agoraphobia

• Fear of panic attacks

• Fear of being in a situation with no help or escape

• Avoidance of places where it is felt that a panic attack could happen

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Do You Feel Afraid or Uncomfortable When You are Around Other People?

Is it hard to be at work or school? I have an intense fear that I will do or say

something and embarrass myself in front of other people

I am always very afraid of making a mistake and being watched and judged by other people

My fear of embarrassment makes me avoid doing things that I want to do or speaking to people

92

Do You Feel Afraid or Uncomfortable When You are Around Other People?

Is it hard to be at work or school? I worry for days or weeks before I meet

new people I blush, sweat, tremble, or feel like I have

to throw up before or during an event where I am with new people

I usually stay away from social situations such as school events and making speeches

I often drink to try and make these fears go away

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Social Anxiety Disorder

• Common anxiety disorder

• Fear of humiliation, embarrassment or scrutiny by others

• Fear that others are thinking negatively about them

• Tends to develop in shy children as they move into adolescence

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Phobic Disorders

• A person with a phobia avoids or restricts activities because of fear

• The fear appear persistent, excessive and unreasonable

• The fear will cause the person to avoid specific things, events or places

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Have You Lived Through a Very Scary or Dangerous Event?

Which problems have you had after the event?

I jump and feel very upset when something happens without warning

I have a hard time trusting or feeling close to people

I stay away from places that remind me of the event

I feel guilty because others died and I lived

96

Have You Lived Through a Very Scary or Dangerous Event?

Which problems have you had after the event?

I have trouble sleeping and my muscles are tense

I feel like the terrible event is happening all over again. This feeling often comes without warning

I have nightmares and scary memories of the terrifying event

I get mad very easily

97

Post-Traumatic Stress Disorder and Acute Stress Disorder

• Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) occur after experiencing a distressing event

• ASD – distress is usually resolved within a month

• PTSD – distress lasts longer than a month

98

Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts?

Are any of these problems interfering with your life?

I have upsetting thoughts or images enter my mind again and again

I feel like I can’t stop these thoughts or images, even though I want to

I worry a lot about terrible things that could happen if I’m not careful

99

Do You Feel Trapped in a Pattern of Unwanted and Upsetting Thoughts?

Are any of these problems interfering with your life?

I have unwanted urges to hurt someone but know I never would

I have a hard time stopping myself from doing things again and again, like counting, checking on things, washing my hands, re-arranging objects, doing things until it feels right, collecting useless objects

100

Obsessive-Compulsive Disorder

• Obsessive thoughts and compulsive behaviours accompany feelings of anxiety.

• Obsessive thoughts are unwanted and inappropriate recurrent thoughts, impulses or images the person cannot get rid of.

• Compulsive behaviours are repetitive behaviours or mental acts such as counting, checking or washing.

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Risk Factors for Anxiety Disorders

• Gender

• People with an anxious parent

• Difficult childhood (abuse, neglect)

• Some medical conditions

• Side-effects of some prescription drugs

• Some non-prescription drugs (caffeine, amphetamines, cocaine, etc.)

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First Aid for Anxiety Disorders






103


• People with anxiety disorders are at greater risk of dying by suicide, particularly if they also have depression.

• If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour.

• If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally.

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Crisis First Aid for Panic Attacks

1. If you are unsure if it is a panic attack or a heart attack call an ambulance.

2. If you are sure it is a panic attack, move the person to a quiet safe place.

3. Help calm the person by helping them control their breathing.

4. Be a good listener, without judging.

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Crisis First Aid for Panic Attacks

5. Explain they are having a panic attack and it is not life threatening.

6. Explain the attack will be over soon and they will recover.

7. Assure them that someone will stay with them until the attack stops.

106

Crisis First Aid for Acute Stress Reaction

1. Let the person tell their story but do not push them to do so.

2. Be a patient and sympathetic listener.3. Reassure the person that stress

reactions are normal responses to abnormal events and in time most people have a normal recovery of their emotions.

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Crisis First Aid for Acute Stress Reaction

4. Encourage the person to share feelings with others.

5. Advise the person not to use alcohol or drugs to cope.

6. If the stress reaction persists for more than a month, encourage the person to seek professional help.

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YOU ARE NOT LISTENING TO ME WHEN:

• You say you understand.• You say you have an answer to my

problem, before I’ve finished telling you my problem.

• You cut me off before I’ve finished speaking.

• You finish my sentences for me.

109


YOU ARE NOT LISTENING TO ME WHEN:

• You are dying to tell me something.• You tell me about your experiences,

making mine seem unimportant.• You refuse my thanks by saying you really

haven’t done anything.

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YOU ARE LISTENING TO ME WHEN:

• You try to understand me, even if I’m not making much sense.

• You grasp my point of view, even when it’s against your own sincere convictions.

• You realize the hour I took from you has left you a bit tired and a bit drained.

111



• You allow me the dignity of making my own decisions, even though you think they may be wrong.

• You do not take my problem from me, but allow me to deal with it in my own way.

• You hold back the desire to give me good advice.

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• You do not offer me religious solace when I am not ready for it.

• You give me enough room to discover for myself what is really going on.

• You accept my gratitude by telling me how good it makes you feel to know that you have been helpful.

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• Anxiety is a real medical condition.• An anxiety disorder is a common illness.• An anxiety disorder is not a weakness

or character defect.• Effective help and treatments are

available.• Anxiety can be unpleasant but is rarely

harmful.

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• Family doctor or physician

• Counselling or psychotherapy for specific anxiety disorder

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• Anxiety is best overcome by confronting fear rather than avoiding it

• Use evidence-based self help books

• Practice daily relaxation methods to reduce physical symptoms of tension

• Exercise regularly and get enough sleep

• Reduce caffeine intake

• Engage in leisure time

116

What Helps for Anxiety Disorders?

Generalized anxiety disorderPhysical exercise

Generalized anxiety disorder


Specific phobias

Anxiety Disorder

Acupuncture

Relaxation training

CBT self-help books

Rating Treatments

117

What Helps for Anxiety Disorders?

Generalized anxiety disorderMeditation

Range of anxiety disorders


Anxiety Disorder

Alcohol Avoidance

Relaxing Music

Rating Treatments

118

Resources


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Session 4

• What are psychotic disorders?

• Symptoms of psychotic disorders

• Risk factors for psychosis

• Alcohol, drugs and psychotic disorders

• Crisis first aid for acute psychosis

• Mental health first aid for psychosis


• Other expressions of distress

120

What is Psychosis?

• Psychosis is a mental health problem in which a person has lost some contact with reality

• Severe disturbances in thinking, emotion and behaviour

• Psychotic illnesses are not common compared to other mental health problems

121

What is Psychosis?

• Psychosis may appear as a symptom in a number of mental health problems including:– Schizophrenia– Schizoaffective disorder– Brief psychotic disorder– Psychotic disorder due to a general

medical condition– Substance induced psychotic

disorder

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Symptoms of Psychosis

Changes in emotion and motivation

• Depression or anxiety

• Suspiciousness

• Blunted, flat or inappropriate emotion

• Irritability

• Change in appetite

• Reduced energy and motivation

123


Changes in thinking and perception• Difficulties concentrating• Sense of alteration of self or others –

feeling that self or others have changed or are acting differently

• Odd ideas• Unusual perceptual experiences –

reduced or greater intensity of smell,sound, colour

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Changes in behaviour

• Sleep disturbance

• Social isolation or withdrawal

• Reduced ability to work or carry out social roles

• Odd or strange behaviour

125


Changes in speech

• Disorganized speech

• Speech becomes rapid

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Schizophrenia

• Schizophrenia is a chronic and disabling disorder

• Mental function changes and thoughts and perceptions become disordered

• Schizophrenia is not a constant or static condition – severity of symptoms fluctuate or do not appear at all

127

Symptoms of Schizophrenia

• Delusions

• Hallucinations

• Thinking difficulties

• Loss of drive

• Blunted emotions

• Social withdrawal

128

Other Psychotic Disorders

• Psychotic depression – a depression so intense it causes psychotic symptoms

• Schizoaffective disorder – Symptoms of both schizophrenia and mood disorder (depression, bipolar disorder)

• Substance induced psychosis – psychosis brought on by drug use. Drug use may also trigger another psychotic illness such as schizophrenia

129

Risk Factors for Psychotic Disorders

It is believed that psychosis is caused by a combination of factors including:

• Genetics

• Biochemistry

• Stress

130

First Aid for Psychotic Disorders






131


• Psychotic disorders involve high risk of suicide

• If you determine the person is at risk, follow the steps for Crisis First Aid for Suicidal Behaviour


132

What if a Psychotic Person is Threatening Violence?

1. Do not get involved physically

2. Call the police

3. Try to create a calm, non-threatening atmosphere

4. Try to get the person to sit down

5. Do not try to reason with acute psychosis

6. Express empathy for the person’s emotional distress

7. Comply with reasonable requests

133


• Listen to the person without judging

• Speak calmly, clearly and in short sentences

• Do not be critical of the person and do not express frustration with the person

• Do not give glib advice such as ‘pull yourself together’

134


• Avoid confrontation unless necessary to prevent harmful acts

• Do not argue with the person about their delusions and hallucinations but do not pretend they are real to you

135


• When a person is in a psychotic state it is difficult and inappropriate to give them information about psychosis – wait until they are in touch with reality

• Do not make promises you cannot keep and do not lie

136


• When the person is thinking more clearly explain:– You want to help them– They have a real medical condition– Their condition is not a common illness but

well known and researched– Psychosis is not a weakness or character

defect– Effective medications are available

137


• Early intervention is important. The person needs to be placed on appropriate medication– Family doctor or physician– Psychiatrist– Community mental health teams– Family and friends

138


• Have an agreement with family/friends

• Many people with a psychotic disorder also have depression and/or anxiety

• The self-help strategies for these conditions may help but should not be the main source of treatment

139

Resources


Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health problems The five basic steps of mental health first aid What.

Documents

mental health crisis

positive mental health

overdose mental health

poor mental health slide

acute psychosis mental

poor mental health diagnosis

basic steps of mental

anxiety disorders crisis