1 Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health...

Instructor

Course Outline – Session 1

• Mental Health First Aid • Common mental health problems • Five basic actions of mental health first aid • What is a substance-related disorder? • Symptoms • Risk factors• MHFA for substance-related problems

– Crisis first aid for overdose

• Treatment and resources

• What is a mood disorder?• Types of mood disorders• Symptoms• Risk factors• Substance use and mood disorders• Suicide in Canada• MHFA for mood problems

– Crisis first aid for suicidal behaviour

• What is an anxiety disorder?• Symptoms • Types of anxiety disorders• Risk factors• Substance use and anxiety disorders• MHFA for anxiety problems

– Crisis first aid for panic attacks– Crisis first aid for acute stress reaction

• What is a psychotic disorder?

• Types of psychotic disorders

• Symptoms

• Risk factors

• Substance use and psychotic disorders

• MHFA for psychosis problems– Crisis first aid for a psychotic episode

World Health Organization

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

World Health Organization

• 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.”

The Mental Health Continuum9

Maximum 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

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.

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.

Aims of Mental Health First Aid

• Preserve life where a person may be a danger to themselves or others

• Provide help to prevent the mental health problem from becoming more serious

• Promote the recovery of good mental health

• Provide comfort to a person experiencing a mental health problem

The Five Basic Actions

Assess risk of suicide and/or harm

Listen non-judgmentally

Give reassurance and information

Encourage the person to get appropriate professional help

Encourage other supports

Why Mental Health First Aid?

• Mental health problems are common– 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

• Professional help is not always on hand

• People often do not know how to respond

• Not everyone seeks treatment or realizes they need help

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

There is stigma associated with mental

health problems

Imagine if we treated everyone like we treat people with mental illness.

Impact of Mental Health Problems

In the workplace– 23% of workers experienced physical

health problems caused by stress, anxiety or major depression

– 1 in 5 workers experienced fatigue, sleeping problems, headaches and anxiety

– 20% of all sick leaves are related to mental health

What is a Substance-Related Disorder?• Use does not equal disorder

• Physical or psychological dependence

• Problems affect a person’s life– Social– Personal– Work/school

Types of Substance-Related Disorders

• Substance use disorder– Substance Abuse– Substance Dependence

• Substance-induced disorder

Types of Substances

• Depressants

• Stimulants

• Hallucinogens

Depressants – Alcohol

• Most widely used substance in Canada

• Found in numerous substances

• Effects vary from person to person

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)

Harmful Effects of Excess Alcohol27

• Nervous system

Physical Effects:

• Nervous system

• Heart

Physical Effects:

• Nervous system

• Heart

• Liver, pancreas, stomach

Physical Effects:

• Nervous system

• Heart

• Muscles

Physical Effects:

• Nervous system

• Heart

• Muscles

• Reproductive system

• Bones

• Throat

Physical Effects:

Harmful Effects of Excess Alcohol

Social Effects:

• Money

• Work

• Legal

• Relationships

Emotional Effects:

• Personality

Depressants – Barbiturates

• Amytal ® and phenobarbital

• Street names: reds, yellow jackets, blue heaven

• Produce a feeling of calm, drowsiness and well-being

• First developed as sleeping pills

Depressants – Benzodiazepines

• Valium® and Ativan®

• Street names: tranks, downers, roofies

• Produce a feeling of calm, drowsiness and well-being

• Commonly prescribed for anxiety, sleep problems

Depressants – Inhalants

• Cleaning fluids, glues, paint thinners and removers, hair and deodorant sprays, gasoline, etc.

• Produce feelings of euphoria, light-headedness, exhilaration and vivid fantasies or hallucinations

• Sniffed or inhaled

Depressants – Opiates

• Heroin, codeine, morphine, fentanyl oxycodone and others

• Produce a short-term feeling of euphoria and well-being and relieve pain

• Have a high risk of creating dependence

Stimulants – Amphetamines

• Dexedrine® and Ritalin®

• Street names: speed, crystal meth, ice, uppers, crank

• Have the temporary effect of increasing energy and apparent mental alertness

• Risk of amphetamine psychosis – symptoms similar to schizophrenia

Stimulants - Caffeine

• Can be found in many substances including tea, coffee, chocolate, cola drinks or medication

• Causes mild mood elevation and reduced drowsiness and fatigue

Stimulants – Cocaine

• Street names: Coke, C, snow, flake

• Two forms – powder and crack

• Produces intense pleasure, euphoria, hallucinations, twitching, agitated behaviour and fever

• Psychological dependence produced by cocaine is believed to be among the strongest of all drugs

Stimulants – Nicotine

• Comes from tobacco leaves

• Can be burned and inhaled or absorbed

• Smoking affects the metabolism of many medications prescribed for the treatment of mental disorders and of other substances

Hallucinogens - Cannabis

• Street names: marijuana, grass, pot, weed, hashish, hash oil

• Most widely used illegal drug

• Can cause both hallucinogenic and depressant effects

• May contribute to development of psychosis in people who are vulnerable

Risk Factors

• Genetic predisposition

• Age

• Psychological stress

• Physical illness

• Social factors

• Alcohol sensitivity

• Dependence risk

First Aid for Substance Problems

• Assess risk of suicide and/or harm– Crisis first aid for overdose

• Listen non-judgmentally

• Give reassurance and information

• Encourage the person to get appropriate professional help

• Encourage other supports

Action 1 Assess the Risk of Suicide and/or Harm

• If a person is thinking of suicide, alcohol will increase the chances that they will harm themselves or die by suicide

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

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

• If the person does not seem to be at risk, move on to Action 2 – Listen Non-Judgmentally

Crisis First Aid for an Overdose

If they are unconscious:

• Ensure personal safety

• Place person in recovery position

• Call emergency services

• If possible, determine type of substance taken

• Keep the person warm

Crisis First Aid for an Overdose

If the person is conscious:

• Call emergency services

• Don’t give food or water

• Reassure that help is coming

• If possible, determine type of substance taken

• Keep the person warm

Action 2 Listen Non-Judgmentally

• Attitudes

• The effective listener

• Verbal skills

• Non-verbal skills

Action 3 Give Reassurance and Information

• They have a real medical condition

• Substance problems are common

• Some people are more prone to these problems than others

• Substance use can cause harm

• Programs are available to help people deal with alcohol or drug problems

• Often mood and/or anxiety problems underlie a substance problem

Action 4 Encourage the Person to Get Appropriate Professional Help

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

Stages of Change Model52

Action 5 Encourage Other Supports

• Support groups

• Family and friends

• Self-help strategies used for other mental health problems

• 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

• 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 wrong

Then you are almostas good as your dog

Session 2

• What is a mood disorder?• Types of mood disorders• Symptoms• Risk factors• Substance use and mood disorders• Suicide in Canada• MHFA for mood problems

– Crisis first aid for suicidal behaviour

What is a Mood Disorder?

Mood disorders are characterized by disturbances:

•In the way a person feels

•In the way a person experiences emotion

This makes it difficult for the person to function day-to-day.

Types of Mood Disorders

Two main forms

• Depressive disorders – Clinical depression (major depressive

disorder)– Postpartum depression– Seasonal affective disorder

• Bipolar disorder

What is Depression?

• Clinical depression lasts at least two weeks

• It affects a person’s behaviour and has physical, emotional and cognitive effects

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

Signs and Symptoms of Depression

• Emotions: sadness, mood swings, hopelessness, anxiety

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

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

• Physical: Lack of energy, sleeping too much/too little, weight loss/gain

Depression in the Workplace

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

aches/pains• Alcohol and/or drug abuse

Bipolar Disorder (Manic Depression)

• Characterized by extreme mood swings

• A person has periods of depression and mania with periods of “normal” mood in between

Symptoms of Bipolar Disorder

• Depression• Mania

– Increased energy and overactivity– Elevated or elated mood– Needing less sleep than usual– Irritability– Rapid thinking and speech– Lack of inhibitions– Grandiose delusions– Lack of insight

Risk Factors for Depression

• Distressing life event

• Having a baby

• Medical conditions

• Side effect of medications or drugs

• Stress from another mental disorder

• Hormonal changes

• Lack of exposure to bright light in winter

Risk Factors for Depression

• Substance dependence

• Family history of depression

• Previous episodes of depression

• Difficult childhood (abuse, neglect)

• Exposure to harassment, bullying, discrimination

Risk Factors for Bipolar Disorder

• Family history

• Chemical changes in the brain

• Stress

• Drugs

Suicide in Canada

• Many Canadians die by suicide each year

• Out of all causes of death in Canada, suicide ranks 9th highest

• More women than men attempt suicide• More men than women die by suicide

Suicide Rates by ProvincePer 100,000 population, 2004

80.9Nunavut

25.7NWT

19.4Yukon

15.3Que

14.0Alta

11.8NB

11.3Man

11.2Sask

11.1BC

10.2Nfld

8.2Ont

5.8PEI

11.3Canada

First Aid for Mood Problems

• Assess risk of suicide and/or harm– Crisis first aid for suicidal behaviour

Crisis First Aid for Suicidal Behaviour

• Engage the person in a serious conversation

• Look and listen for warning signs of suicide

Warning Signs of Suicide

• Expressing negative comments about self

• Expressing intent to die by suicide and having a plan to do so

• Expressing suicidal thoughts

• Putting personal affairs in order

• Repeated expressions of hopelessness, helplessness or desperation

Crisis First Aid for Suicidal Behaviour

• Ask about suicide

• Explore risk– Plan– Prior suicidal behaviour– Support

• Engage the person in a plan for safety

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

• Engage the person in a discussion

• Listen to the person without judging them

• Do not be critical

• Do not express frustration with the person for having such symptoms

• Do not offer glib advice

• Avoid confrontation

Depression

• It is a real medical condition

• It is a common illness

• It is not a weakness or character defect

• It is not laziness

• Effective help and treatments are available

• It is a real medical condition

• Although not common, it is very well known and researched

• It is not a weakness or character defect

• Effective help and treatments are available

• Community-based care

• Family doctor/physician

• Counsellors, mental health therapists and clinical psychologists

• Psychiatrists

• Voluntary sector

• Telephone helplines

What Helps for Depression?

Medical Treatments Rating

Electroconvulsive therapy (ECT)

Very severe depression only

Antidepressants Adults Adolescents

Very good evidence Good evidence Promising treatment

What helps for Depression?

Psychological Treatments Rating

Cognitive behaviour therapy (CBT) Interpersonal psychotherapy Reading depression self-help books based on CBT

Psychodynamic psychotherapy

Ten Common Thinking Distortions

1. Black and white thinking

2. Setting unrealistic expectations

3. Selective thinking4. Converting positives

into negatives5. Over generalizing

6. Exaggerating unpleasantness

7. Catastrophizing

8. Personalizing

9. Mistaking feelings for facts

10.Jumping to negative conclusions

• Family and friends can provide support

• Self-help strategies have proven therapeutic effects

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

Lifestyle & Alternative Treatments Rating

Exercise Light Therapy Seasonal

Non-seasonal

Acupuncture Massage Therapy Relaxation Therapy

Lifestyle & Alternative Treatments Rating

Yoga breathing exercises St. John’s wort* Alcohol avoidance – people with drinking problems

Folic acid

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

Session 3

• What is an anxiety disorder?• Symptoms• Types of anxiety disorders• Risk factors• Substance use and anxiety disorders• MHFA for anxiety problems

– Crisis first aid for panic attacks– Crisis first aid for acute stress reaction

What is an Anxiety Disorder?

• Anxiety is a state of worry, apprehension or uneasiness

• Anxiety disorders differ from “normal” anxiety

• Excessive levels of anxiety that interfere with day-to-day living

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?

General Symptoms of Anxiety

Psychological

• Sense of impending doom or imminent danger

• Excessive inappropriate worry

• Fear of dying

• Decreased attention and concentration

Psychological

• Feeling detached from oneself

• Speeding or slowing of thoughts

• Easily distracted, insomnia, vivid dreams

• Irritability, impatience, anger

Physical

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

• Respiratory: hyperventilation, shortness of breath

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

Physical

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

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

Types of Anxiety Disorders

• Generalized anxiety disorder• Panic disorder (with or without

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

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

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 flashes

Generalized Anxiety Disorder (GAD)

• Overwhelming and unfounded anxiety

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

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

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

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

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

Agoraphobia

• Fear of having a panic attack

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

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

Specific Phobia Disorders

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

• The fear appears persistent, excessive and unreasonable

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

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

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

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

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

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

Obsessive-Compulsive Disorder

• Obsessions and compulsions accompany feelings of anxiety

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

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

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

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

Acute Stress Disorder and Post-Traumatic Stress Disorder • Acute Stress Disorder (ASD) and Post-

Traumatic Stress Disorder (PTSD) occur after experiencing a distressing event

• ASD – distress is usually resolved within a month

• PTSD – distress lasts longer than a month

Risk Factors

• Gender

• Family history or people with an anxious parent

• Stressful life events (abuse, neglect, trauma)

• Other mental health problems

• Drugs

First Aid for Anxiety Problems

• Assess risk of suicide and/or harm– Crisis first aid for panic attacks – Crisis first aid for acute stress reaction

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

• If the person appears to be having a panic attack, follow the steps for Crisis First Aid for Panic Attacks

• If the person is having a reaction to a traumatic event, follow the steps for Crisis First Aid for Acute Stress Reactions

Crisis First Aid for Panic Attacks

• Call for help

• If possible, move to a quiet location

• Encourage slow breathing

• Listen without judging

• Explain that it could be a panic attack and not life threatening

• Stay with the person until help arrives or the panic attack is over

Crisis First Aid for Acute Stress Reaction• Let the person tell their story, if they want

• Be empathetic

• Validate normal responses to abnormal events

• Encourage personal supports (where appropriate)

• Suggest they avoid alcohol and drugs

• Encourage professional help

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.

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.

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.

• 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.

• 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.

• Listen to the person without judging

• Do not be critical of the person

• Do not express frustration at the person for having such symptoms

• Do not give glib advice such as “pull yourself together”

• Anxiety disorder 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• Skills can be learned to reduce the effects

of stress and anxiety

• Family doctor or physician

• Counselling or psychotherapy for specific anxiety disorder

• 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

What Helps for Anxiety Disorders?

Treatments Anxiety Disorder Rating

CBT self-help books Specific phobias Physical exercise Generalized anxiety

disorder

Relaxation training Generalized anxiety disorder

Acupuncture Generalized anxiety disorder

What Helps for Anxiety Disorders?

Treatments Anxiety Disorder Rating

Meditation Generalized anxiety disorder

Relaxing music Generalized anxiety disorder

Alcohol avoidance Range of anxiety disorders

Session 4

• What is a psychotic disorder?

• Types of psychotic disorders

• Symptoms

• Risk factors

• Substance use and psychotic disorders

• MHFA for psychosis– Crisis first aid for a psychotic episode

What is a Psychotic Disorder?

• Causes a person to lose some touch with reality

• Severe disturbances in thinking, emotion and behaviour

• Not as common compared to other mental health problems

What is a Psychotic Disorder?

• Psychosis may appear as a symptom in a number of mental health problems including:– Schizophrenia– Schizoaffective disorder– Psychotic depression– Substance-induced psychotic

disorder

Four phases of psychosis

• Premorbid: Time before symptoms start

• Prodrome: Symptoms are barely noticeable

• Acute: Psychotic symptoms experienced

• Recovery: With treatment, people can recover

Symptoms of Psychosis

Changes in emotion and motivation

• Depression

• Mood swings

• Increased anxiety

• Suspiciousness

Changes in emotion and motivation

• Blunted, flat or inappropriate emotion

• Irrational, angry or fearful responses

• Change in appetite

• Reduced energy and motivation

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

• Inability to turn off imagination, odd ideas

Changes in thinking and perception• Unusual perceptual experiences –

reduced or greater intensity of smell,sound, colour

• Inappropriate use of language – words don’t make sense to others

• Difficulty controlling thoughts

Changes in behaviour

• Sleep disturbances

• Loss of appetite

• Withdrawal from activities and social contacts

• Deterioration in studies or work

• Deterioration in personal hygiene

• Physical symptoms

• Sudden excesses

Schizophrenia

• Schizophrenia is a chronic and disabling disorder

• Mental function changes and thoughts and perceptions become disordered

• It is not a constant or static condition

Symptoms of Schizophrenia

Positive Symptoms

• Delusions

• Hallucinations

Negative Symptoms

• Thinking difficulties

• Loss of drive

• Blunted emotions

• Social withdrawal

Other Psychotic Disorders

• Schizoaffective disorder

• Psychotic depression

• Substance-induced psychosis

Risk Factors

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

•Family history

•Chemical changes

•Stress

•Other factors

First Aid for Psychosis Problems

• Assess risk of suicide and/or harm– Crisis first aid for a psychotic episode

• Psychotic disorders involve high risk of suicide

• If the person is having a psychotic episode, follow the steps for Crisis First Aid for Psychotic Episodes

Crisis First Aid for a Psychotic Episode

• Ensure personal safety• Call the police or emergency medical

services, if necessary• Try to create a calm, non-threatening

atmosphere• Express empathy

• Listen to the person without judging them as weak

• Speak calmly, clearly and in short sentences – repeat things if necessary

• Do not be critical of the person and do not express frustration with the person for having such symptoms

• Do not offer glib advice such as “pull yourself together”

• Do not argue with a person about their delusions and hallucinations

• Do not pretend the delusions and hallucinations are real for you

• 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

Step 3 Give Reassurance and Information

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

known and researched– Psychosis is not a weakness or character

defect– Effective medications are available

• Early intervention is important

• The person needs to receive appropriate treatment– Family doctor or physician– Psychiatrist– Community mental health programs

• Family and friends

• Support groups

• Crisis lines

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

1 Instructor Date. 2 Course Outline – Session 1 Mental Health First Aid Common mental health...

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