Australianhighcommission

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Introduction to Mental Health
Australian High Commission – Feb 2016
Welcome

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Outline of PresentationOutline of Presentation
 What is mental health?
 Facts & Figures
 Who experiences mental distress?
 Some common mental health conditions
 A Case Study.
 Helpful and Unhelpful Responses.
 Q&A

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Gained First Class Honours at University

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But also…But also…
I have a serious mental health
condition and have been a service
user for over 30 years.

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What is Mental Health?
“Mental health is defined as a state of well-being in
which every individual realizes his or her own
potential, can cope with the normal stresses of life,
can work productively and fruitfully, and is able to
make a contribution to her or his community.” (World
Health Organisation)
“A person’s condition with regard to their
psychological and emotional well-being” (Dictionary
Definition)

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Who has mental healthWho has mental health?
EVERYBODY!

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5 a day – mental health5 a day – mental health
Connect
Developing relationships with family, friends, colleagues and
neighbours will enrich your life and bring you support
Be active
Sports, hobbies such as gardening or dancing, or just a daily stroll will
make you feel good and maintain mobility and fitness
Be curious
Noting the beauty of everyday moments as well as the unusual and
reflecting on them helps you to appreciate what matters to you
Learn
Fixing a bike, learning an instrument, cooking – the challenge and
satisfaction brings fun and confidence
Give
Helping friends and strangers links your happiness to a wider
community and is very rewarding.

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1 in 4 experiences mental distress
1 in 200 goes to hospital.
Mixed anxiety and depression most common
experience (9-12%)
UK has one of the highest rates of self-harm in
Europe.
2% have phobias that need treatment.
2-3% have diagnosed OCD
87% of people with a mental health problem will
have experienced some form of discrimination.
Some Facts and Figures aboutSome Facts and Figures about
Mental HealthMental Health

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Facts & FiguresFacts & Figures
People who have mental health problems are more likely to:
• Experience isolation / exclusion: 9 out of 10 people with mental
health problems do not go out or apply for jobs due to the stigma
• Receive dismissive or disrespectful treatment They feel
most discriminated against by their family (36%), followed by their
employers (35%), neighbours (31%) and friends (25%) (survey by Rethink
2008)
• Not have a valued role or job More than half of all employers
asked would not hire someone with a known mental disorder
(survey by The Shaw Trust 2009)
• Experience poverty and social deprivation (More than 50% of
people with mental health problems have poor social contact, as defined by
the Oslo Social Support Scale, compared with 6% of the general
population)

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Who experiences mental distress?

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What is Normal?What is Normal?
Telepathy 45%
Ability to predict the future
45%
Hypnotism 42%
Life after death 39%
Faith healing 39%
Ghosts 31%
Alien abduction 70%
U.F.O‘s 35%
A Gallup survey (1995) found the following rates of belief:
•Studies find it
hard to
differentiate
between ‘normal’
and ‘deluded’
people

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Some Mental Health CategoriesSome Mental Health Categories
 Mood (affective disorders)
 Depression
 Bi-polar affective disorder
 Eating Disorders
 Anorexia nervosa
 Bulimia nervosa
 Personality Disorders
 Psychotic Disorders
 Schizophrenia

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Some Facts and Figures aboutSome Facts and Figures about
Mental HealthMental Health
 1 in a 100 have
the diagnosis of
schizophrenia/psy
chosis
1 in a 100 have
the diagnosis of
Bipolar Disorder
 1 in 10 have the
diagnosis of
Personality
Disorder

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DepressionDepression
•Feelings of sadness &
hopelessness
•Losing interest in things
•Feeling numb
•Tiredness
•Sleep Problems
•Work & relationships affected
•Poor concentration
•Negative self-view
•Social withdrawal

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Depression (cont’d)Depression (cont’d)
‘That’s the thing about depression: a human being can survive
almost anything, as long as s/he sees the end in sight. But
depression is so insidious and it compounds daily, that it’s
impossible to ever see the end. The fog is like a cageThe fog is like a cage
without a key.’without a key.’
Elizabeth Wurtzel, Prozac Nation
“Depression turned my body, mind and soul into concrete;
procrastination turned my heart into a block of dirty ice.”
Dolly Sen, The World is Full of Laughter.

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Some ways people look afterSome ways people look after
depressiondepression
 Meditation
 Exercise
 Therapy or Counselling
 Arts/Creativity
 Medication
 Identifying Triggers
 Relaxation Exercises
 Social support/Peer Support
 Challenging negative thinking
 Resolving Issues

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AnxietyAnxiety
 In 2013, there were 8.2 million cases of anxiety in the UK.

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Ways to help anxietyWays to help anxiety
Self Care
 talking to someone you trust
 breathing exercises
 shifting your focus
 listening to music
 reassuring thoughts
 physical exercise
 keeping a diary
 eating a healthy diet
 complementary therapies
 joining a support group
Treatments
Talking therapies
CBT
Medication
Applied Relaxation Therapy
Mindfullness

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Anxiety ResourcesAnxiety Resources
https://www.anxietyuk.org.uk
http://www.nopanic.org.uk/

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What is OCD?What is OCD?
OCD causes severe
anxiety in those affected.
OCD involves both
obsessions and
compulsions that take a
lot of time and get in the
way of important
activities the person
values.

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OCD ResourcesOCD Resources
www.ocduk.org/

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Eating DisordersEating Disorders

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What is an eating disorder?What is an eating disorder?
 Eating disorders are a range of conditions that can affect
someone physically, psychologically and socially. They include
anorexia, bulimia and binge eating disorder. Over 725,000 men
and women in the UK are affected by eating disorders.
 Young women are most likely to develop an eating disorder,
particularly those aged 12 to 20, but older women and men of
all ages can also have an eating disorder. Children as young
as seven can develop anorexia and there is a greater
proportion of boys in this younger age group.
 Eating disorders claim more lives than any other mental health
condition – one in will die prematurely

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Eating Disorders – waysEating Disorders – ways
forwardforward
 Psychological Treatment
 Self help/ Peer Support
/Support Groups
 Family Therapy
 Nutritional Counselling
 Finding other ways to cope
with difficult emotion
 Self-image work
 Arts & Creativity

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Eating Disorders ResourcesEating Disorders Resources
https://www.b-eat.co.uk/

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Does not mean a split
personality
To get the diagnosis
there has to be both
the presence of
delusion and
hallucination.
Schizophrenia and PsychosisSchizophrenia and Psychosis

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PsychosisPsychosis
 Decreased motivation
 Lack of emotion
 Poor concentration
 Inability to experience pleasure in things you once
enjoyed e.g. golf/socialising
 Avoiding social situations
 Reduced speech
 Neglecting personal appearance

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PsychosisPsychosis
 Hallucinations: seeing, hearing or smelling things that are
not there e.g. auditory hallucination of voices (which the
sufferer may respond to)
 Delusions: firmly held beliefs which are untrue i.e. you are
Jesus or a member of royalty/you are being controlled by an
outside force.
 Thought disorder: confused thoughts or speech which do
not make any sense.

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Is hearing voices
always a sign of a
psychiatric condition?

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Studies have found that between four and 10 per cent of people across
the world hear voices.
Between 70 and 90 cent of people who hear voices do so following
traumatic events.
Voices can be male, female, without gender, child, adult, human or
non-human.
People may hear one voice or many. Some people report hearing
hundreds, although in almost all reported cases, one dominates above
the others
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Voices can be experienced in the head, in the ears, outside the head,
in some other part of the body, or in the environment.
Voices often reflect important aspects of the hearer’s emotional state –
emotions that are often unexpressed by the hearer.

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Hearing Voices - exerciseHearing Voices - exercise

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Schizophrenia -ResourcesSchizophrenia -Resources
http://www.hearing-voices.org

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Bipolar DisorderBipolar Disorder

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BipolarBipolar
Mania (cont’d)Mania (cont’d)
 Thinking they possess all abilities and powers
 High energy on no sleep
 Easily distracted, cannot concentrate
 Impaired judgment
 Wildly impulsive
 Reckless, despite the consequences
 Hallucinations
 Totally uninhibited
 Giving away cherished valuables
 Unending pursuit of pleasures/substance
abuse

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BipolarBipolar
Depression (cont’d)Depression (cont’d)
 Irritable
 Cannot experience pleasure
 Loss of interests
 Appetite and weight changes
 Sleep – restless, excessive, insomnia
 Lack of concentration
 Memory Problems

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Bipolar DisorderBipolar Disorder
 The difference between bipolar 1 and Bipolar 2 is severity
of the ‘high’ and ‘low’ experiences.
 Bipolar 1 is more severe, the person experiences
mania/severe depression.
 Bipolar 2 means the person experiences hypomania.
 The difference between the two is not clear cut. If the
person is at risk from harm, or has developed psychosis,
this is seen as mania.
 Rapid Cycling: Going from high to low, or vice versa,
without periods of normality.

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The differenceThe difference
Hypomania buys 10 pairs of shoes.
Mania buys 100 to walk to the moon with.

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Bipolar Disorder - ResourcesBipolar Disorder - Resources
http://www.bipolaruk.org.uk/

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DisclosureDisclosure
 Before support
can be offered, the
student has to
disclose, but many
students with
mental health
difficulties don’t.
 The main reason
is fear of
discrimination.

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Some FearsSome Fears
 Being teased or harassed by others
 Being assumed to be a less productive student
 Having fewer opportunities
 Being treated as more vulnerable than others or as
having everything (anger, excitement, time off sick, or a
grievance) associated with your mental health problem.
 Having to work harder to gain the same respect.
 Thought of as being dangerous

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You shouldn’t do it…You shouldn’t do it…

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Case Study - BipolarCase Study - Bipolar
Male, in mid 20s, very recently diagnosed, has not
had his condition for more than a year, no support in
place.
One day started talking over colleagues, being
inappropriate, giving away his money, tells people he
is God. Takes a break, gets better, but does not
want to return to job because of embarrassment.
What do you do?

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Case Study One - PsychosisCase Study One - Psychosis
Female – mature student, discloses her mental
health
When well is a good student, punctual and
involved, excellent attendance and high achiever.
When her psychosis is present: hears loud and
negative voices, becomes withdrawn, paranoid,
stops attending classes Misses assignments.
Becomes suicidal.

What do you do?

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Some Responses to Self-HarmSome Responses to Self-Harm
 If injury is severe, go to A&E
❏ refraining from telling young
person to stop, as this can
make things worse.
❏ explaining your role and the
limits of your confidentiality;
❏ giving information/education
about self-harm and causes
in a straightforward and
matter of fact manner
❏ being aware that the person
may be feeling guilty and
ashamed;

❏ being aware of the stigma
associated with self-harm;

❏ being non-judgmental;

❏ treating young person with
respect;

❏ listening empathetically with a
view to joint problem solving;

❏ providing reassurance that
problems can be solved.

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What the organisation can doWhat the organisation can do
 Have a strong mental health policy
 Have good support services
 develop a culture where everyone is treated with respect and
dignity and issues such as bullying and harassment are not
tolerated
 develop a culture where open and honest communication is
encouraged and support and mutual respect are the norm.
Encouraging an ethos where staff know that it is OK to talk
about mental health and that it is safe to disclose their own
mental health conditions.

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Helpful ResponsesHelpful Responses
 Try to remain calm. Think about body language.
 Be as gentle and non-critical as you can.
 Do not make judgments. What they are feeling is their unique
experience and you should refrain from giving your opinions or
views
 Let the person know that you want to help
 Listen quietly and reflectively to what they have to say - let
them express their worries and tell you how they see life.

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 Ask how you can help?
 If the person is in delusion or denial, don’t try to argue them out
of it. But don’t agree with them either.
 Example: “I am rotting, can you smell it? I can smell it.”
 One possible response: “I can’t smell anything. I don’t think you
are rotting. But I can see you are upset by that. Do you want to
talk to someone about it?
 Try and come up with ways with the person to reduce fear.

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Fear…Fear…
Think about these experiences as fear free
What is paranoia without fear?
What are voices without fear?
What is anxiety without fear?
Can you have a panic attack without fear?

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 Make meetings/spaces/emails feel safe. Warmness/lack of
harshness.
 Example: Dolly, you didn’t come in last week. You must come
in, otherwise this be reported and you might lose your place on
the course.
 Could have been phrased: Dolly, how you doing? I noticed you
didn’t come in last week. Are things ok? I hear you struggling
with things. Do you want to come in for an informal, relaxed
chat, so we can talk through any difficulties you may have, and
see how we can work this through together. You are missed.
Take care

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Be a bit of a hog
Hopeful
Honest
Open
Gentle

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Unhelpful Responses (cont’d)Unhelpful Responses (cont’d)
 Over-interpreting “You have a fear of
men, that’s why you are like this.”
Labeling and diagnosing “You’re paranoid.”
Interrogating “Do you self harm?
Empty out your pockets”
Placing Time Pressures “I have only five
minutes, tell me what’s up?”
Guilt-tripping “You’re letting your
whole class down.”

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Unhelpful ResponsesUnhelpful Responses
 Blaming “It’s all your own fault.”
 Getting Aggressive “Can’t you ever do anything right?”
 Moralising “This is just a sign of weakness, you need to do
this…”
 Advising without trust and validation
 Not accepting another’s feelings “I don’t know why
you are so depressed.”

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Thank you for your time!
Dolly Sen
dollysen70@hotmail.com
http://www.dollysentraining.com

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Editor's Notes