Mental Health Ombudsman Training Manual. Advocacy and the Adult Home Resident. Module V: Substance Abuse and Common Mental Health Disorders

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1 Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004

2 Goals Increase personal comfort and confidence Increase ability to advocate

3 Remember Classification is for disorders, not for people

4 Objectives Define terms Name common mental disorders Describe features of each Describe impact on function

5 Overview Neurotic vs. psychotic Minor vs. major Situational vs. biological (endogenous)

6 Domains Thinking Feeling Behaving

7 Common Terms Psychosis Affect and mood Hallucinations Tardive dyskinesia Delusions Disorganized thinking Illogical Not goal directed

8 THINKING Diagnostic Categories Thought disorders Cognitive disorders Schizophrenia Dementia Delirium

9 Schizophrenia Positive Hallucinations Delusions Negative Flatness Apathy Without will Disorganized Confused thinking and speech Loose associations

10 Schizophrenia Medication Antipsychotics Psychosocial Family education CBT Coordination Rehabilitation Job Life skills Self-management Recovery

11 Schizophrenia Trouble with attention Others anxious Limited social networks social support resources

12 FEELING Diagnostic Categories Mood Disorders Depression Depression plus mania = Bipolar disorder Anxiety

13 Bipolar Disorder Depression Sad mood, affect Irritability Loss of interest Anhedonia Anxiety Hopelessness Guilt Thoughts of death or suicide Pessimism

14 Bipolar Disorder Mania Euphoria, expansiveness Irritability energy sex drive Interest in multiple projects need for sleep Grandiosity

15 Bipolar Disorder Mania Pressured speech Infectious humor Lability of affect Disorganized thinking flight of ideas puns, word play, rhyming

16 Bipolar Disorder Mania Medications Mood stabilizers Recovery Illness self management

17 What have you learned? Let s find out!

18 Terms Hearing, seeing, or smelling something that isn t there are all examples What are hallucinations?

19 Terms This fixed belief has no basis in reality What is a delusion?

20 Terms How a person s feelings look from the outside What is affect?

21 Terms Apparent indifference to surroundings or circumstances What is apathy?

22 Terms I saw a cat with a hat and a bat but where oh where has my little dog dog gone oh where what should I wear is an example. What is flight of ideas?

23 Back to the disorders

24 Anxiety Anxiety Fear Avoidance Unease Generalized Specific Phobias: Of social situations Of open spaces Of heights

25 Anxiety Panic Unexpected attacks Worry about recurrence Stress Acute Post traumatic Arousal Flashbacks Avoidance

26 Anxiety Education Cognitive behavioral therapy Medications SSRIs (Benzodiazepines)

27 BEHAVING and RELATING Diagnostic Categories Personality disorders Substance Use disorders

28 Personality Disorders Personality We all have one Way of being in the world Patterns which endure Disorder Not working (maladaptive) Inflexible Cause significant distress

29 Substance Use Disorders Drug abuse: Continued use despite negative consequences

30 Substance Use Disorders Effects 50 % individuals Resources lacking Violence Suicide

31 Dual Disorders Alcohol marijuana --cocaine Prescription drugs Ping-pong therapy Refused treatment by each service

32 Dual Disorders Recreational Self-medicating reduce anxiety and depression treat symptoms treat side effects

33 Dual Disorders Substance use can cause symptoms mimic disorders initiate a psychiatric disorder provoke re-emergence worsen a disorder mask symptoms

34 Dual Disorders Difficult to engage Lose support systems Difficult to diagnose Suffer relapses and hospitalization

35 Integrated treatment Treat both Same time Same place Same team

36 Disorders

37 Signs and symptoms There s nothing positive about these positive symptoms What are hallucinations and delusions?

38 Signs and symptoms In mania, this is something you don t care if you lose What is sleep?

39 Signs and symptoms Flat affect, loss of motivation, self neglect are examples What are negative symptoms?

40 Signs and symptoms This unusual movement of the fingers, mouth, tongue or even torso can be caused by medication What is tardive dyskinesia?

41 Signs and symptoms Smoking marijuana everyday and not being able to work might be an example What is drug abuse?

42 And the winner is.

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