Understanding students' mental health issues:

Demystifying  psychiatric services

Dr. Paula CookAugust 17, 2010 - pcook59@shaw.ca

Living on Earth is expensive,

but it does include a free

trip around the sun every year.

Outline

• What are mental health issues?

• How prevalent are mental health issues?

• What resources are available to address students with mental health issues?

What is Mental Health?

Mental health means striking a balance in all aspects of one’s life: -social,

-physical,

-spiritual,

-economic, and

-mental aspects (CMHA)

1. significant altercations of thinking, mood, behaviour and emotional functioning,

2. significant distress & discomfort for the person, and

3. impaired functioning, over an extended period of time, in one or more of the following areas:

at school, at work, in social situations and with family interactions and relationships.

Mental illnesses (mental health issues) are brain disorders that cause:

What are its effects?

Disrupts and influences:

• behavior,

• mood,

• feelings,

• thinking processes,

• coping skills, and

• the ability to relate to others

Causing behavioral & emotional symptoms that:

1. delay the development of social skills,

2. impede progress at school,

3. affect family & peer relationships

4. affect family & peer interactions,

5. cause poor coordination, and

6. affect recreational, social &

athletic pursuits.

What causes mental illness?

disturbances in the brain’s "wiring" process (brain

development) during pre and post natal growth,

genetic or biological influences,

chemical imbalances,

brain trauma,

severe life stress or

a combination of the above

Combination of factors including:

Childhood onset brain disorders can be more severe and more complex than adult onset disorders.

Indicators of Mental Illness in Children & Adolescents

1. severe, persistent behaviour problems2. behaviour problems that impact on daily activities/functioning3. changes in appetite and/or sleep 4. social withdrawal5. fearfulness6. behaviour that regresses to earlier phases, like bedwetting7. signs of distress, ex. sadness or tearfulness8. self-destructive behavior, ex. head banging,

self mutilation 9. tendency to have frequent

injuries

But……

• Because many everyday stresses cause changes in behavior, youth with suspected mental illnesses

must be thoroughly evaluated by trained pediatric mental health professionals.

Real women don’t have hot flashes…

...they have power surges

Outline

• √ What are mental health issues?

• How prevalent are mental health issues?

• What resources are available to address students with mental health issues?

Mental health issues, (mental

illnesses) are the leading cause

of disability (lost years of

productive life) in North America,

Europe and other industrialized

countries.

How Prevalent?

It is estimated that 1in 5 of Canadian youth are affected by a mental illness or disorder

- the single most disabling group of disorders worldwide (CMHA).

Canada's youth suicide rate the third highest in the industrialized world (CMHA).

Suicide is among the second leading causes of death in 15-24 year olds (CMHA).

Stats• On average, there is a 10 yr gap between the onset of symptoms and

diagnostic interventions (Papolaos & Papolos, 2002)

• Only 20% of children with mental health disorders get needed treatment (DeAngelis, 2004).

• Pediatricians miss 83% of children with psychiatric diagnoses (NIMH, 2004).

• Mental disorders in youth are ranked as the 2nd highest hospital care expenditure in Canada (CMHA, 2008).

• Serious mental illnesses can now be treated effectively, bringing a 70-90% percent reduction in symptoms (NIMH, 2005).

• Usual treatment includes a combination of pharmacological and psychosocial support (NIMH, 2005).

• Early treatment of the major psychiatric disorders can lessen the severity of recurrence over a lifetime (NIMH, 2003).

I read this article that said the typical symptoms of stress are eating too much, impulse buying,

and driving too fast.

Are they kidding? That is my idea of a perfect day!

Outline

• √ What are mental health issues?

• √ How prevalent are mental health issues?

• What resources are available to address students with mental health issues?

Diagnosis

1. Based on DSM-VI….the 5 Axis System

2. a review of the child’s development,

3. any important medical problems he/she might have had,

4. family history of mental disorders, &

5. physical and psychological traumas or situations that may have caused stress

DSM IV Diagnostic Criteria

Axis I - Clinical disorders• LD, ADHD, depression, depression, anxieties, Bipolar, phobias, etc

Axis II - Personality Disorders• long lasting personality disorders, metal retardation, autism

Axis III - Acute medical conditions/physical disorders • -brain injuries and physical conditions

Axis IV - Contributing psychosocial and environmental factors

Axis V• -general functioning levels according to Childrens’ Global Assessment Scale

Description of Mental Health Services Available Through the Winnipeg Regional Health Authority (WRHA)

Centralized Intake – Mental Health• Provides the single port of entry for all services in the

Winnipeg Regional Health Authority (WRHA) Child and Adolescent Mental Health Program

• Focus is to enable clients and families to access appropriate programs and services based on their individual needs

• Referrals for service can be made by families, caregivers, physicians, mental health professionals, or

the clients themselves

Basic PrincipalsRegarding mental health issues

1. Seek specific diagnoses to

be used to help others (and that includes us!)

to understand and to provide guidance for the interventions used.

Principle #1

Diagnoses ARE NOT to be used: 1.as an excuse for unacceptable

behaviour:

-on the part of the person with the diagnosis, or

-yourself and others-the people interacting with the person

2.as an excuse for automatic exclusion

Principle #1 continued…

2. Language difficulties can be common. That is having problems with:

• Identifying,

• articulating,

• expressing,

issues, feelings, situations, etc.

Principle #2

3. The same behaviour may mean something different every time it is displayed.

Principle #3

4. If problem behaviours and other symptoms occur in most or

all settings, it is MORE likely due to mental health issues.

Principle #4

5. If there is little or no change in behaviour or other symptoms even with appropriate, consistent behavioural interventions, it is MORE likely due to mental health issues.

Principle #5

Good judgment comes from

experience, and a lot of that comes

from bad judgment.