Basic Topics on Mental Health

Trainer's guide

Module One Introduction

Lesson 1: What is mental disorder

(3 training hours) Lesson 2: Psychiatric evaluation

(2 training hours)  TOTAL TIME (5 training HOURS)

Lesson 1

WHAT IS MENTAL DISORDER

TIME :

135 MINUTES (3 training hours of 45 minutes)

 

Step 1: Brainstorming (10΄)  

which do you think that are, in general, the human needs so that they have good mental health?

Step 2: Group discussion(20΄)

Why persons with psychiatric problems might have extra difficulties?

Step 3: theory presentation (15΄)

The term mental disorder comprise a variety of problems that are connected to the mental situation and the behavior of the person

Various mental disorders are manifested through a variety of symptoms, such as delusions, sentimental instability, conduct disorders, memory decline, etc.

Step 3 (continued) The mental disorder might be the result of a

physical illness or to be manifested through physical symptomatology

A large group of mental disorders is psychosis in which the patients loose in a degree the conscience of reality and manifest symptoms like delusions or aberrative ideas (hallucinations). Such disorders are Schizophrenia and Bipolar Disorder.

Step 3 (continued) Another group includes the disorders

related to anxiety (neurosis). This includes the Anxiety Disorders, Phobias, Obsessive – Compulsive Disorders etc

The conduct disorders comprise the different situations where the personality has implanted elements that make difficult the adaptation and the social behavior of the person

Step 3 (continued)

Some mental disorders might be connected with the damage of encephalic structure. These are called Organic Mental Disorders and an example is Dementia. Alcohol and toxic agents abuse might also cause mental disorders.

Step 3 (continued) The mental disorders can be separated to many

diagnostic categories. At diagnosis are used two official Classification Systems that are internationally recognized. One is “The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, known as DSM-IV, which comes from the USA. The other is ICD – 10 “International Classification of Diseases”, 20th edition of WHO (World Health Organisation), Chapter 4: Mood (affective) disorders

Step 3 (continued) The use of classification Systems is additional to

the accurate diagnosis of mental disorders, to educational purposes and to facilitate the communication of the professionals in mental health and in research. Especially with DSM- IV apart from the categories of the diseases, it is possible to evaluate important psychological and social factors that influence a patient, as well as its efficiency in total.

Step 4: Exercice (15΄)

leaflet 1.1:Causal Factors of Mental Disorders

Who do you think are in priority the most important factors that cause mental disorders?

Step 5: discussion (10΄)

What are the treatment choices used for treating mental disorders?

Step 6 : new ideas (15΄)

What is your opinion for:

The rate of incidence of mental disorders? The participation of men and women in these? The social predisposition factors?

      

Step 6 (continued) The mental disorders can be manifested at in any

age (children, adults, elderly).

A research in USA proved that about one third of adults manifested a mental disorder within 12 months.

About half the population presents a mental disorder during its life.

Step 6 (continued) Some types of mental disorders are more

common than others. Women in general manifest more often mental

disorders. Social factors that predispose the manifestation of

mental disorders include situations such as poverty, isolation, immigration, unemployment, widowhood, divorce etc.

Step 7: Summary (5΄)

Which are the needs of the person that should be satisfied in order to enjoy good mental health.

Why the persons with mental disorders might have additional needs.

Which are the mental disorders.

Step 7 (continued)

Which factors contribute to their cause ?

Which are the ways of treatment? What is their rate of incidence and in which

categories of persons are more often.

Step 8: Exercise (30΄)

Paper and pen

Think and write a problem or a difficulty you or someone that you know had during supporting persons with mental disorders.

Step 9: Conclusion (5΄)In order to diagnose the needs of persons with

psychiatric disorders, you should know the following :

Why the persons with mental disorders need the understanding of their biological, psychological and social problems.

How can these problems be manifested. What can professionals offer.

Step 10: questions and comments (5΄)

Step 11: lesson’s evaluation(5΄)

Lesson 2

PSYCHIATRIC EVALUATION

TIME :

90 Minutes (2 instructive hours of 45 minutes)

 

Step 1: Introduction (10΄)

When the patient is examined from a psychiatrist or another professional in mental health, he always does a psychiatric evaluation.

This is usually done in the context of an interview with the patient and eventually with a relative or a person that knows him very well.

Step 1 (continued)

Additional information are also collected from an older medical report of the patient (if it exists) or from members of the personnel that know him

Furthermore there are some tests to be done, where it is judged necessary, but the main source of information is the psychiatric interview.

Step 1 (continued)

Even though the psychiatric interview has to be done in a calm space without interventions or disturbances, there are unfortunately occasions that it is done in noisy and crowded places, as for example the Out-patients clinics of a hospital.

Step 1 (continued) The interview constitutes a way of collecting

information through the appropriate questions and observation. It is however a good way to create a good relation with the patient, which is therapeutic by itself.

The patient might also consider useful to ask some questions and have information for his problem.

Step 2: Slide projection(15΄)Slide 1.2.1: what a psychiatric evaluation includesPsychiatric interview

Personal data Πηγή παραπομπής Main disturbances and problems Case – history of these problems Development history Family history Medical report Report of substances used Examination of mental functions

Step 2 (continued)

Psychological tests Physical examination and lab tests

Haematological tests X-rays Brain Electro Scan Brain Section Scans

Step 3:Slide projection (20΄) Slide 1.2.2: examination of mental functions

Appearance and behavior Clothing and appearance Posture and walking Physical characteristics Face expression Eye contact Gesture activity Mannerisms

Step 3 (continued)

Talking : it can be examined by observing the way that the patient talks

Rhythm Tone, Volume, Clearness Disturbances

Step 3 (continued) emotional situation: Comprises the examination of

the mood that is related to how the patient himself feels and the feeling that is the manifestation to the outside of this mood. The examination of the mood is done thanks to a series of questions (for example “how is your mood like lately?”), while the evaluation of the feeling is done by observation. Mood Emotion (variety, intensity, mutability,

unsuitability)

Step 3 (continued) Thought: the evaluation of thinking is based on what

the patient says either by himself either responding to questions. Coherence (flow of ideas, quality of association of

ideas) Content Distortions (aberrative ideas) Obsessional activities (compulsions, phobias,

hypochondriasis) Morbid activities (depressive aberrative ideas) Suicide or homicide tendency

Step 3 (continued) Perception: It is related to the stimulus income

from the environment with the sensations of the person. The perception whether it is examined simply by observation whether with appropriate questions (ex. “has ever happened to hear people talking around you while other people could not hear it?” Hallucinations Delusions Depersonalization, αποπραγματοποίηση

Step 3 (continued) Emotional situation and mental functions:

There are mainly used special questions for the examination of these functions. Conscience and orientation Concentration Μνήμη (Άμεση, Πρόσφατη, Απώτερη)

Memory () Απόθεμα γνώσης Αφαιρετική ικανότητα abstraction Κρίση judgment Εναισθησία

Step 4:slide projection (15΄)

Slide 1.2.3:psychological tests IQ test (WAIS-R IQ tests) Personality tests

Προβλητικά τεστ (Rorschach, ΤΑΤ) Personality Inventory (MMPI, EPQ)

Neuropsychological tests (Bender –Gestalt) Diagnostic tests (PSE, SADS, SCID) Psychiatric Rating Scales (BPRS, Hamilton

Rating Scale for Depression, Beck Depression Inventory and Mini Mental State Examination)

Step 5:Group Discussion (20΄)

What is the purpose of psychiatric evaluation ?

Who is conducting it?

Step 6: Questions and comments (5΄)

Step 7: lesson’s evaluation (5΄)