Overview of Mental Illness: Common Mental Health Concerns with Court Involved Adults

Transcription

1 Overview of Mental Illness: Common Mental Health Concerns with Court Involved Adults Christopher Zacny, M.A., LCPC, LMHC, CADAC-IV, SAP Pre-doctoral Intern The Chicago School of Professional Psychology-The Forensic Center

2 Purpose and Objectives General Understanding of Mental Illness What is and what is not a mental illness or problem Help your clients receive the proper treatment and care Increasing positive communication Make appropriate referrals Expectations/outcomes from treatment Advocate for those with mental illness Help your client navigate through the legal system Help explain the rational for your recommendations to the court

3 Quiz 1. Is Anger Disorder the most diagnosed mental health disorder? T / F 2. Antisocial behavior is considered a mental illness? T / F 3. Mental illness looks the same in adults and children? T / F 4. People with mental illnesses are more dangerous than individuals who do not have a mental illness? T / F 5. Schizophrenia is the most common mental illness? T / F

4 Introduction Most common mental health problems found in adults Mood Substance Abuse Anxiety Psychosis Personality Cognitive Trauma and Adjustment reactions How these disorders and symptoms present differently in adults and children How these disorders affect client s decision making, ability to parent, behaviors, and overall presentation Treatments options

5 What is Mental Illness? Mental disorders are associated with significant distress or impairment in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as a death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts between society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual.

6 Mental Illness Labeling an individual with a mental illness should have clinical utility: Treatment planning Prognosis Potential Treatment Outcomes However, clinicians may encounter individuals whose symptoms do not meet criteria of a mental disorder who are in need of treatment

7 Mental Illness-Prevalence Nearly one in five adults experience a mental health issue during the year One in four adults have serious mental illness Half of population have a family member with a psychiatric illness Symptoms range from mild, moderate, severe, and disabling (depression/schizophrenia) Mental illness can be deadly

8 Mental Illness Myths Individuals with mental health problems are violent and unpredictable Mental illness causes one not to tolerate stress, hold down a job, or take care of self or children Children and adults with mental illnesses are the same

9 What causes Mental Illness? BIOLOGIC AL Genetics, brain chemistry PSYCHOL OGICAL Thought process, coping skills SOCIAL Environ ment, family

10 SYMPTOMS ANGER

11 SYMPTOMS ANXIETY

12 SYMPTOMS PARANOIA

13 SYMPTOMS DEPRESSION

14 SYMPTOMS MANIA

15 SYMPTOMS MOOD SWINGS

16 SYMPTOMS ANTISOCIAL BEHAVIORS

17 SYMPTOMS SUBSTANCE ABUSE

18 SYMPTOMS DECEITFULNESS

19 SYMPTOMS DENIAL

20 SYMPTOMS PSYCHOSIS

21 SYMPTOMS PERSONALITY DISORDERS

22 MOOD DISORDERS Bipolar DisorderI& II Cognitive Affective Behavioral Grandiosity, flight of ideas, distractibility, invincible Elevated, expanse, or irritable, depression Decreased need for sleep, pressured speech, increased goal directed activities and pleasure acts Major Depressive Disorder Beliefs that one is worthless or inappropriate guilt, diminished ability to concentrate or make decisions, thoughts of death Sad, empty, diminishedor no pleasure in activities Tearful, insomniaor hypersomnia, significant weight loss or gain, psychomotor agitation or retardation, fatigue Persistent Depressive Disorder Poor self-esteem, poor concentration or difficulty making decisions, hopelessness Persistentlow level depressed mood (2years) insomnia or hypersomnia, low energy, poor appetite or overeating

23 ANXIETY DISORDERS Cognitive Affective Behavioral Panic Attacks Believing oneis going to die or losing control Intense fear Increasedheart rate, sweating, trembling, shortness of breath, choking, nausea, dizziness Obsessive- Compulsive Disorder Obsessions (i.e., sex, hurting others) Anxiety Compulsions aimed at reducinganxiety, ritualistic behaviors Generalized Anxiety Disorder Apprehensive expectations Anxiety/worry (difficultto control), irritability, worry despite continuous reassurance Restless, on edge, fatigued,difficulty concentrating, muscle tension, sleep disturbances

24 PSYCHOTIC DISORDERS Cognitive Affective Behavioral Delusional Disorder Delusions 1month or longer Depends on delusion (e.g., anxiety, paranoia, & depression) Depends on delusion Schizophrenia Delusions, hallucinations Diminished emotional expression Disorganized speech and behaviors

25 NEUROCOGNITIVE DISORDERS Cognitive Affective Behavioral Major/Minor Neuro cognitive disorder Attention deficit hyperactivity disorder Steadyprogressive declinein memory or learning Adultsmay have doubts on their ability to function at work Anxiety, depression, paranoia Disinhibition, apathy, loss of sympathy or empathy, perseveration, executive functiondecline, decline in ability to speak - Does not give attention to details, difficulty sustaining attention or holding conversations, does not follow through on instructions, disorganized, often losses things, easily distracted and forgetful, restless, fidgety, often leaves seat, unable to engage in leisure activities, talks excessively, driven by amotor, talks out of turn, difficulty waiting turn, intrude on others

26 TRAUMA/ADJUSTMENT DISORDERS Cognitive Affective Behavioral Adjustment disorder Depends on situation Withdepressed mood, with anxiety and depressed mood With disturbance of conduct, with disturbance of emotions and conduct Post traumatic stress disorder (longer than 1 month) Acute Stress Disorder (less than one month) Recurrent, involuntary and intrusive distressing thoughts about trauma, dissociative features (flashbacks), inability to remember traumatic event, persistent negative beliefs about self and others, selfblaming beliefs Persistent negative emotional states(anger, fear, inability to feel positive emotions, detachment Recurrent distressing dreams about event, persistent avoidance of cues (memories, external reminders) that remind individual of traumatic event, hypervigilance, reckless self-destructive behavior

27 PERSONALITY DISORDERS Cognitive Affective Behavioral Dependent Personality Disorder Believesothers should assume responsibility, lacks self-confidence Fear of loss of support or approval, feels helpless when alone, preoccupiedwith fears of being alone Difficulty making decisions without advice, difficulty expressing disagreement, obsessivelengths to obtain nurturance, urgently seeks relationships when alone Borderline Personality Disorder Identitydisturbance, stress related paranoid ideation Affective instability, chronic feelings of emptiness, inappropriate intense anger Frantic efforts to avoid real or imagined abandonment, impulsivity,recurrent suicidal behaviors, Antisocial Personality Disorder Beliefs that people will get me if I don t get them first Irritability, lack of remorse Failure to conform to social norms, deceitfulness,impulsive, aggressiveness, reckless disregard for the safety of others, consistent irresponsibility Narcissistic Personality Disorder Grandiose sense of selfimportance, preoccupied with fantasies of success, believes he/she is special, requires excessive admiration, sense of entitlement, envious of others Lacks empathy Interpersonally exploitative, arrogant behaviors

28 QUESTIONS?