Mental Health Basics

Ann-Marie Bandfield MSW

Clinical SupervisorPsychiatric Crisis CenterMarion County Health

Dept

Please describe your experiences with persons who

have a Mental Illness

Working with Mental Health Crisis

• Mental Health vs Psychiatric Crisis• Some basics• Defining Crisis (Urgent vs Emergent)• Basics on Mental Illness• Three Major Axis 1 Mental Illnesses Schizophrenia, Bi Polar Disorder &

Depression & Exercise

Mental Health vs Psychiatric Crisis

• Mental Health

• Relational Issues

• -parents

• -children

• - roommates/friends

• - acquaintances

• Situational Stressors

• Health

• Employment

• Psychiatric/Psychosis

• Irrational behaviors

• Strange responses (latent)

• States hears or sees things

• Paranoid

• Bizarre Appearance

• Possible Drugs & Alcohol Overdose

Some Basics

• This work is unpredictable

• Listen to your gut• Treat Clients with

Dignity & Respect• Use Common Sense• Set aside your

preconceived ideas & personal biases,

• It’s about the Client

Defining Crisis

• Webster’s definition

• Crisis Work is containing the immediate issue/s

• Be careful of opening up emotional wounds and leaving them gaping.

• Over 50% of the people who come to the crisis center are a one time visit.

• Mental Health Crisis• Not everyone deals

with crisis in the same way

• Beware of Hang nails/ Icebergs

Mental Illness• Mental illness is a Chemical Imbalance (Our

chemical balances are changing all the time)• People experience a certain set of

symptoms that creates a diagnosis. No 2 people with a shared diagnosis are the same.

• Approx 30% of population experience mild MI

• 3% of the population have a Severe and Persistent Mental Illness (Oregon approx. 90,000; 7,500 Salem area).

• These are intelligent people and they know they are not like you.

Some Things to Remember

• There are many ways to treat these symptoms, not just the medical model.

• There is no law stating clients must take

medications. - Self medicating

- Diet & Exercise- Alternative Options

• Quality of Life is Important• Hospitals can be a hindrance for our clients• People can remain safe in their community• There appears to be a genetic / hereditary

connection

Schizophrenia• Signs & Symptoms:• Loose Associations• Ideas of Reference• Flight of Ideas• Racing Thoughts• Unpredictability• Delusions (Belief

Systems)– Paranoia– Religiosity– Grandiosity– Hyper Sexual

• Hallucinations (all 5 senses)

• Responses:• Never assume you

know how this person will react

• Safety & Information are key (Who, what, when, where)

• Respect & Dignity• Always ask first,

decide second

Bi Polar Disorder

• Mania: Signs & Symptoms

• Racing Thoughts• Rapid, pressured

speech• Lack of rest needed• Irritability• Grandiosity/Euphoria• Change in Eating

Habits

Bi Polar Cont.

• Impulsive Behaviors:• Binge Drinking• Shopping/ Spending• Drug Binging• Promiscuity• Fast Driving• Others?

Responding to Bi Polar Behaviors

• Respect & Dignity Always• Check in, How do they

feel? Is there a problem? How would they like to resolve it? What has happened in the past?

• If a danger then what?• Why does PCC let them

go?• Difficulties of this Disorder

– Most easily medicated– Believe they are

recovered– The dip of depression is

deep.– They like the Euphoria

Depression• Most difficult for the

Community to Understand and Respond to.

• Signs & Symptoms:• Decreased interest in

Daily Activities• Decreased Motivation• Decreased Hygiene• Anger (Men &

Children)• Lack of Self Esteem

• Social Isolation• Change in eating

habits• Unable to Rest (Either

sleeping all the time or not at all)

• Thoughts of Self Loathing

• Thoughts of Self harm• Attempts to Harm Self• Suicide

Responding to Depression• Respect & Dignity• Need to be taken seriously• Be a good listener / Slow to offer remedies• You cannot rescue them• Become more danger as they lift out of the

depression• This is an on going problem, things will not

simply get better, they haven’t for some time. They need a long term counselor and commitment to change.

• If unsure about safety get them to PCC.

Engaging Clients• What do you want

to accomplish?• Quick assessment

and referral to appropriate service.

• Building rapport & sense of “same team” will move the encounter along much more quickly than confrontation.

• PCC vs Hospital• Not everyone will

engage well. You will still need to follow all your protocols.

• A bit more time at the front end, could save you hours on the back end.

Self Care –It’s IMPORTANT

• Know your own history and how this work will effect it.

• Find ways to debrief when the works get to be too much.

• Secondary Trauma – this stuff rubs off.

• Remember to be who you want to be.

• Find ways to celebrate healthy lives and healthy lifestyles. Your OWN and those around you.

This work is hard and Will eat you up.

You and your family Deserve the best of you When you arrive home.Not what’s left over.