Mental Health out of hours

OUT OF HOURS AND MENTAL HEALTH

Introductions- who are you? Who are we?

What services are out there?

Where do we all fit in the chain?

Risk

Scenarios

Main players

Q&A

Conclusion

OUT OF HOURS

Overview of the different MH services

Who works out of hours?

How are services accessed?

How The Services Integrate

CMHRC

GP

Ward

Crisis Resolution

Home Treatment

Assertive Outreach

A&E Liaison & Out of

Hours service

Early Intervention

Service

Specialist Services – CBT,

Work Rehab, Psychotherapy

IAPT

Follow the yellow brick road!

Patient presents to Harmoni

Home-GP

Home-CMHT

A&E

Ambulance

Emergency duty team

Police

A Risky business!

What about RISK?

Risk: A definition

A risk is the likelihood that a hazard will cause specified harm to someone or something

Risk management is the process that involves assessing the risks that arise in your workplace and putting sensible measures in place to lower such risk

www.hse.gov.uk

Measuring risks

The Workshop session!

Identify the Risk.

How to manage the risk?

Which service do you require?

Evaluate.

THE MAIN PLAYERS

Schizophrenia

Depression

Bi Polar disorder

SCHIZOPHRENIA

How common is schizophrenia? Schizophrenia is one of the most common serious

mental health conditions. One in 100 people will experience at least one episode of acute schizophrenia during their lifetime. Men and women are equally affected by the condition.

In men who are affected by schizophrenia, the condition usually begins between 15-30 years of age. In women, schizophrenia usually occurs later, beginning between 25-30 years of age.

http://www.nhs.uk/conditions/schizophrenia/pages/introduction.aspx

SYMPTOMS OF SCHIZOPHRENIA

The symptoms of schizophrenia are usually classified into one of two categories - positive or negative.

Positive symptoms - symptoms that represent a change in behaviour or thoughts, such as hallucinations or delusions.

Negative symptoms - symptoms that represent the reduction or total lack of thoughts or functions that you would usually expect to see in a healthy person. For example, people with schizophrenia often appear emotionless, flat and apathetic.

http://www.nhs.uk/conditions/schizophrenia/pages/introduction.aspx

DEPRESSION

Depression is a serious illness. Health professionals use the words depression, depressive illness or clinical depression to refer to it. It is very different from the common experience of feeling miserable or fed up for a short period of time.

Depression is quite common, and about 15% of people will have a bout of severe depression at some point in their lives.

http://www.nhs.uk/conditions/depression/pages/introduction.aspx

SYMPTOMS

Psychological symptoms: continuous low mood or sadness, feelings of hopelessness and helplessness, low self-esteem, tearfulness, feelings of guilt, feeling irritable and intolerant of others, lack of motivation and little interest in things, difficulty making decisions, lack of enjoyment, suicidal thoughts or thoughts of harming someone else, feeling anxious or worried, and reduced sex drive. http://www.nhs.uk/conditions/depression/pages/introduction.aspx

Physical symptoms: slowed movement or speech, change in appetite or weight (usually decreased, but sometimes

increased), constipation, unexplained aches and pains, lack of energy or lack of interest in sex, changes to the menstrual cycle, and disturbed sleep patterns (for example, problems going to sleep

or waking in the early hours of the morning). http://www.nhs.uk/conditions/depression/pages/introduction.aspx

Social symptoms: not performing well at work, taking part in fewer social activities and

avoiding contact with friends, reduced hobbies and interests, and difficulties in home and family life.

http://www.nhs.uk/conditions/depression/pages/introduction.aspx

GRIEF AND DEPRESSION

Even though grief and depression share many of the same characteristics, there are important differences between them. Grief is an entirely natural response to a loss, while depression is an illness. However, sometimes, it can be hard to distinguish between feelings of grief and depression.

People who are grieving find that feelings of loss and sadness come in waves, but they are still able to enjoy things and are able to look forward to the future. However, those who are depressed have a constant feeling of sadness; they do not enjoy anything and have little sense of a positive future.

http://www.nhs.uk/conditions/depression/pages/introduction.aspx

BI POLAR DISORDER AKA MANIC DEPRESSION

The depression and mania that are associated with bipolar disorder are characterised as follows:

depression - where you feel very low, and

mania - where you feel very high; slightly less severe mania is known as hypomania.

http://www.nhs.uk/conditions/bipolar-disorder/Pages/Introduction.aspx

SYMPTOMS

Depression During a period of depression (low phase) your symptoms may include: feeling sad and hopeless, lacking in energy, difficulty concentrating and remembering things, a loss of interest in everyday activities, feelings of emptiness or worthlessness, feelings of guilt and despair, feeling pessimistic about everything, self-doubt, being delusional, having hallucinations, and disturbed, or illogical

thinking, lack of appetite, difficulty sleeping and waking up early, and suicidal thoughts. http://www.nhs.uk/conditions/bipolar-disorder/Pages/Introduction.aspx

Mania The manic (high) phase of bipolar disorder usually follows 2-4 periods of

depression and may include: feeling very happy, elated, or euphoric (overjoyed), talking very quickly, feeling full of energy, feeling full of self-importance, feeling full of ‘great’ new ideas and having ‘important’ plans, being easily distracted, being easily irritated, or agitated, being delusional, having hallucinations, and disturbed, or illogical thinking, not feeling like sleeping, not eating, and doing pleasurable things which often have disastrous consequences, such as

spending large sums of money on expensive and, sometimes, unaffordable, items.

http://www.nhs.uk/conditions/bipolar-disorder/Pages/Introduction.aspx

QUESTION TIME

CONCLUSION