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This presenation by Jodie Butler from St Vincents Hospital discusses the spectrum of mental health issues and how to recognise problems and support and refer people. This presentation was given at the AFAO Positive Services Forum in June 2009.
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Understanding & ManagingMental Health
Jodie Butler St Vincents Hospital
HIV, Hep C and Mental Health (H2M)
All things are on a Spectrum
“Normal” --------------------------- “Clinical”
What is Clinical? Significant distress or impairment in
functioning: social occupational or other important areas
Rule out other mental health condition, medical condition, drug or medication effects.
CHANGE CHANGE CHANGE
Past Present Future
Depression Anxiety
Depression and Dysthymia Physical Behavioural Emotional
Physical Change in sleep pattern Change in eating pattern Fatigue Loss of energy Body aches and pains (somatic)
Behavioural Loss of interest in pastimes/pleasure* Difficulty concentrating Difficulty making decisions Neglecting responsibilities Neglecting looking after yourself Slowed movements
Emotional Inappropriate guilt Crying Feeling down, apathetic, irritable,
pessimistic, negative, “black” Thinking negatively about yourself Feeling hopeless/helpless/worthless Feeling suicidal or recurrent thoughts of
death
Remember, everyone has down
days.
What you can do
Encourage Encourage Encourage exercise decrease in alcohol, substances balanced diet time in the sun if appropriate decrease in caffeine access to support networks
Label emotions
Listen Use problem solving skills Do relaxation exercises Set boundaries, routine & structure Any activity is helpful Adherence to medications Refocus on valued areas of life GP or specialist referral
Anxiety Social and Specific Phobias
persistent and excessive fear exposure to feared object/situation
provokes immediate response avoidance
Panic physical sensations related to
adrenaline Breathing increases Heart rate increases Dizzy, tingling sensations Nausea, sweaty or clammy
fear of losing control/dying
Generalised Anxiety excessive worry about a variety of
topics difficult to control worry physical symptoms
Restless Irritable Tense Sleep disturbed, tired Poor concentration
Obsessive Compulsive Disorder disturbing, intrusive, inappropriate
thoughts, images, impulses and: attempts to ignore, neutralise or suppress
repetitive behaviours or mental rituals to neutralise obsessions
Acute and Post Traumatic Stress traumatic event response involved fear, helplessness,
horror event is re-experienced by recollection,
dreams, reliving, flashbacks avoidance of things associated with
trauma (thoughts, places, people, memory, detachment)
increased arousal (sleep, anger, concentration, hypervigilance, startles easily)
What you can do Don’t enable avoidance Don’t panic with panic Tell them “It’s ok to be anxious” Patience Ask “what is the threat”
What you can do Don’t fight the panic Don’t Say “don’t be anxious” Assist to stay in the present Concentrate on a simple task Relaxation Label emotions, sensations
Psychosis Inability to distinguish what is real — there is a loss of
contact with reality
Confused thinkingdisordered thinking, confused, disjointed, paranoid
Delusionsfalse belief, which is not held by others of the same cultural background
Hallucinationsseeing, hearing, feeling, smelling or tasting something that is not actually there
What you can do Ensure safety of all Don’t agree with them Acknowledge that is how they see the
world Move to a less stimulating
environment Refer to GP or local community
mental health
Mindfulness of Yourself
Past PresentFuture
General Head Works Minimal to no drug use Exercise Balanced diet Sleep Regular social interactions Regular meaningful activities Say Yes!!! The matter test
Know your Local Resources Community Mental Health Team Local GP’s HIV specific services Lifeline
131 114 Other Helplines
GLBT Counselling Line 1800 184 527 Mensline 1300 78 99 78
Know your Local Resources Websites:
www.blackdoginstitute.org.au www.crufad.org www.sane.org moodgym.anu.edu.au www.glccs.org.au