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KEGANASAN & PENYAKIT MENTAL Dr Tuti Iryani Mohd Daud Pensyarah & Pakar Psikiatri, Pusat Perubatan UKM.
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Part 1: Keganasan dan penyakit mental
Part 2:
Teknik de-escalation
Part 3: Seclusion and restraints
MENANGANI PESAKIT AGRESIF
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DI AKHIR SESI INI, ANDA BOLEH:
Membincangkan kaitan keganasan dan penyakit mental (masalah lapuran media)
Faktor yang menyumbang kepada kelakuan agresif
Kitaran keganasan (cycle of assault)
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Kelakuan agresif vs kelakuan ganas
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Kelakuan ganas
Kelakuan agresif
References:Anderson, C. A. and L. R. Huesmann (2007). Human aggression: A social-cognitive view. The Sage Handbook of Social Psychology, Revised Edition. M. A. Hogg and J. Cooper. London, Sage Publications: 296-323.World Health Organization (2002). World report on violence and health: summary. Geneva, World Health Organization.
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Adakah pesakit mental cenderung untuk menjadi
agresif dan ganas berbanding orang lain?
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Kelakuan ganas
Populasi masyarakat awam
Kelakuan ganas dan agresif di komuniti (Rueve & Welton, 2008)
Reference:Asnis GM, Kaplan ML, Hundorfean G, Saeed W. Violence and homicidal behaviors in psychiatric disorders. Psych Clin N Am. 1997;20: 405–425. Rueve, M. E. and R. S. Welton (2008). "Violence and Mental Illness." Psychiatry (Edgmont) 5(5): 34-48.
Individu yang mengalami
penyakit mental
3.7% (masyarakat US) 4% dari individu yang
mengalami penyakit mental
(in an urban setting) (Asnis et al, 1997)
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Mentally ill
Violence and aggression in the community
individuals with major mental disorder
who did not abuse substances
individuals without mental disorder
who did not abuse substances
=
}
Substance abuse (risk of violence increases by 2 fold)
References: Monahan J, Steadman HJ, Silver E et al. Risk
assessment: the MacArthur Study of Mental Disorder and Violence. Oxford: Oxford University Press, 2001.
Steadman HJ, Mulvy EP, Monahan J et al. Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighbourhoods. Arch Gen Psychiatry 1998;55:393-404.
Prospective study (Steadman et al, 1998) 18% - major mental illness 31% - major mental illness + comorbid substance use 43% - major mental illness + comorbid substance use + personality disorder
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RISK FACTORS FOR VIOLENCE
Statik (ciri-ciri yang tidak boleh diubah dengan intervensi klinikal)
• Pernah menjadi agresif atau ganas • Lelaki • Dewasa yang muda • Kurang pandai • Pernah cedera di bahagian kepala /
saraf • dissociative states • history of military service • pernah dilatih di dalam penggunaan
senjata • pernah mengalami penyakit mental yang
serius • latarbelakang keluarga yang bermasalah • pernah didera semasa kecil
Dynamik (ciri-ciri yang boleh diubah dengan intervensi klinikal)
• Mengambil dadah • Persecutory delusions (percaya
bahawa ada yang hendak mencederakan beliau)
• Halusinasi yang menyuruh berbuat sesuatu
• tidak mengambil ubat-ubatan untuk penyakit mental yang beliau alami
• lmpulsif • keinginan untuk membunuh orang lain • kemurungan • putus asa • keinginan bunuh diri • perancangan untuk membunuh orang
lain (metod yang senang dilaksanakan) • mudah memperoleh senjata
Rueve, M. E. and R. S. Welton (2008). "Violence and Mental Illness." Psychiatry (Edgmont) 5(5): 34-48.
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1. Majoriti mereka yang mengalami penyakit mental tidak ganas • Faktor utama: muda, lelaki, dari kelas sosioekonomi yang rendah
2. Masyarakat awam membesar-besarkan hubungkait keganasan dan penyakit mental • Individu yang mengalami penyakit mental lebih cenderung untuk menjadi mangsa keganasan
3. Penggunaan dadah merupakan faktor utama • 1/3 dari kelakuan ganas yang dilapurkan oleh individu itu sendiri (a third of self-reported violent
acts)
• 7 dari 10 jenayah kelakuan ganas yang melibatkan pesakit mental (7 out of every 10 crimes of violence among mentally disordered offenders)
4. Kajian-kaijan yang lepas memberi mengenai keganasan terlalu memberi tumpuan kepada individu yang mengalami penyakit mental • Perlu fokus terhadap pencetus agresif
Stuart, H. (2003). "Violence and mental illness: an overview." World Psychiatry 2(2): 121-124.
KEGANASAN & PENYAKIT MENTAL
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http://tinyurl.com/j484clv dari beritasemasa.com.my
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http://www.mstar.com.my/berita/berita-mahkamah/2015/04/08/bunuh-anak-bongsu/
!!!!!!!!!!!!!
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Source: https://www.time-to-change.org.uk/sites/default/files/film-report-screening-madness-time-to-change.pdf
PENYAKIT MENTAL YANG DIGAMBARKAN DI DALAM MEDIA
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Source: https://www.time-to-change.org.uk/sites/default/files/film-report-screening-madness-time-to-change.pdf
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Liputan negatif oleh media
Sikap negatif terhadap!penyakit mental!
Reference:McKeown, M. and B. Clancy (1995). "Media influence on societal perceptions of mental illness." MENTAL HEALTH NURSING-LONDON-COMMUNITY PSYCHIATRIC NURSES ASSOCIATION 15: 10-10.
Fules / menyemarakkan lagi..
Response to / respon kepada
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https://youtu.be/buCU6eP9iVA
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Perubahan bahan kimia di dalam badan ketika
sesorang individu berkelakuan agresif
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Reference: Siever, L. J. (2008). "Neurobiology of aggression and violence." Am J Psychiatry 165(4): 429-442.
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Reference: Siever, L. J. (2008). "Neurobiology of aggression and violence." Am J Psychiatry 165(4): 429-442.
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Reference: Siever, L. J. (2008). "Neurobiology of aggression and violence." Am J Psychiatry 165(4): 429-442.
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Kitaran Keganasan (Cycle of assault)
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Kitaran Keganasan (Cycle of assault)
(Kaplan & Wheeler,1983)
Perceived as serious threat
body and mind prepare for a fight.
Violent act
body and mind relaxes
fatigue, depression, and
guilt.
Source: http://www.ala.org/pla/sites/ala.org.pla/files/content/onlinelearning/webinars/Assault_Cycle_Rev.pdf
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Kitaran Keganasan (Cycle of assault)
(Kaplan & Wheeler,1983)
Perceived as serious threat
body and mind prepare for a fight.
Violent act
body and mind relaxes
fatigue, depression, and
guilt.
Source: http://www.ala.org/pla/sites/ala.org.pla/files/content/onlinelearning/webinars/Assault_Cycle_Rev.pdf
De-escalation technique
Seclusion & restraints Breakaway technique
Observation
Communication Counselling
Negotiation and observation
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KESIMPULAN • Majoriti mereka yang mengalami penyakit mental
tidak ganas • Di kalangan mereka yang mengalami penyakit
mental, sebilangan kecil sahaja yang lebih cenderung untuk bertindak ganas: • i.e. Penyalahgunaan dadah, kecelaruan personaliti, gejala penyakit
yang tidak terkawal
• Untuk memahami bagaimana menangani pesakit agresif, lebih mudah dengan cara memhami: • Perubahan biologi / bahan kimia
• Kitaran keganasan
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This work by Dr. Tuti Mohd Daud is licensed under a Creative Commons Attribution-NonCommercial-
NoDerivatives 4.0 International License.
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This work by Dr. Tuti Mohd Daud is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.