Post on 23-May-2020
Mental Illness
101 – Children &
Teens Building the Heart of Successful
Schools Conference
December 12, 2014
Defining Mental Health
“Mental Health is a state of well being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” (World Health Organization)
Mental Health
Problems vs.
Mental Illness
What’s the
difference?
1. Clear trigger (often situational) 2.Coping skills relieve symptoms 3.Defined period of time
Defining
Mental Illness Mental illnesses are medical conditions that disrupt a person’s thinking, feeling, mood, behavior and ability to relate to others, and causes the person distress and difficulty in daily functioning. (The Science of Mental Illness. National Institutes of Health; National Institute of Mental Health)
How common is mental illness? 1 in 4 adults –
approximately
65 million Americans
• Mental illnesses can affect persons of any age, race, religion, or income.
• Mental illnesses are NOT the result of personal weakness, lack of character, or poor upbringing.
• Mental illnesses are treatable.
ADDICTION and MENTAL ILLNESS
Two problems, One person
If you don’t treat them together,
you can’t beat either – integrated treatment
is essential.
What causes mental illness?
Biological
Genetics Environmental exposures before birth (viruses, toxins, alcohol, drugs)
Social/ Environmental
Negative life experiences including trauma, stress and loss Adverse childhood experiences
Chemical Biochemical changes Hormonal imbalances Neurotransmitters
Stigma Hurts
Stigma: 1950’s – 2000’s
Stigma
Knowledge and
Understanding of the Brain and Mental
Disorders
“Person First” Language
Instead of: “She’s bipolar” Use: “She has bipolar disorder”
Instead of: “Crazy” or “Insane” Use: Wild, outrageous, extreme, silly, idiotic, senseless, etc.
The Impact of Mental Illness
All together, America’s cumulative mental health issues are costing the U.S. economy
about a half-trillion dollars.
(That’s more than the government spent on all of Medicare during the last fiscal year)
Scope of the issue: Poverty Mental health problems in adults occur across
all levels of income and education
and within all cultural and racial groups
But…
Children living in poverty are six times as likely to develop mental illness, regardless of genetics. (CDC data)
41% of families in which there is parental mental illness are living in poverty. (nmha data)
Less than a quarter of those parents have had steady employment in the last month. (nmha data)
The “chronic illness” of the young… CDC Wisconsin 2013: 1 in 5 children/teens
½ by age 14 and ¾ by age 24
Childhood Mental Illness Local Prevalence
(US Census Data 2009)
Children between the ages 5 – 18
Outagamie County – 31,711 6,342 w/ MH Diagnosis Winnebago County – 24,865 4,973 w/ MH Diagnosis Calumet County – 8,679 1,736 w/ MH Diagnosis
“Over 50% of students with a mental disorder age 14 and older drop out of school – the highest dropout rate of any disability group.” U.S. Dept. of Education, 2006
More than 90% of those who die
by suicide have a diagnosable mental disorder
NAMI Fox Valley is here to help
Suicide is the cost of undiagnosed, untreated
and undertreated mental illness
Children and Mental Illness
Youth Risk Behavior Study Wisconsin 2007 Wisconsin Youth Risk Behavior Survey
Suicide
12.8
15.3
17.2
14.1
12.3
9.910.5
8.7
0
2
4
6
8
10
12
14
16
18
20
9th 10th 11th 12th
Grade
Pre
cen
tag
e
considered
suicide
made a
plan
15% of WI high school students “seriously considered” attempting suicide in the past year
7.3% indicate that they “attempted suicide” at least once in the last year
People with mental illness live, on
average, 29 years less than other
Americans
People with mental illness AND substance
use live, on average,
42 years less than
other Americans
Co-Morbidity = Risk of Early Death
More than 50% report being a victim of a crime in the past year. 5x more likely to experience physical or sexual assault (women = 10x)
Studies have found that reports to police were often dismissed or not believed.
People with Mental Illness are FAR more likely to be victims than perpetrators
“A state of being in
which the demands,
responsibilities, and
requirements of daily
life are PERCEIVED to
outweigh the resources
with which to manage
them.”
Mental health problems
may inhibit the ability
to maintain balance by
eating away at resources
Demands
Resources
Good Stress vs. Bad Stress
Good Physical Performance
Mental agility
Bad Irritable
Poor health
Panic
Depression
Paranoia
Impact & Prevalance of Trauma
The Trauma Continuum Acute Trauma
Adult-onset
Single incident
Adequate child development
No co-morbid psychological disorders
Complex Trauma Early onset
Multiple incidents
Extended over time
Highly invasive
Interpersonal
Significant amount of stigma
Vulnerability
Mediating or Exacerbating Factors Person
Age/developmental stage Past experiences Strengths and coping skills Cultural beliefs
Environment Supportive responses from significant others and
community Access to safety and resources
Event Severity & chronicity Interpersonal vs. act of nature Intentional vs. accidental
Immediate Impact
Fight / Flight / Freeze
Fight: resist
Flight: run away
Freeze: stay still
Impact of Trauma on World View
The world is an unsafe place to live in
Other people are unsafe and cannot be trusted
My own thoughts and feelings are unsafe
I expect crisis, danger and loss
I have no self-worth and no abilities
Trauma & the Brain The chemicals generated by “toxic stress”
impact brain development. Damage the hippocampus – area of the
brain responsible for learning and memory. Can result in a “smaller” brain (less mass) For Girls – reduction was in the area
associated with emotional regulation For Boys – reduction was in the area
associated with impulse control
Collaboration between Dr. Vincent Felitti at Kaiser Permanente Insurance and Dr. Robert Anda at Centers for Disease Control and Prevention (CDC).
More than 17,000 participants had a standardized physical examination and completed a confidential survey that contained questions about childhood maltreatment and family dysfunction.
The ACE Study was originally
designed to assess for
“scientific gaps” in the origins
of risk factors.
33
ACE – Adverse Childhood Experiences
Abuse:
Psychological (by parents)
Physical (by parents)
Sexual (by anyone)
Physical neglect
Emotional neglect
Household with:
Substance abuse
Mental illness
Separation/divorce
Domestic violence
Imprisoned household member
Fellitti & Anda
39%
21%
15%
25%
1 ACE 2 ACEs
3 ACEs 4+ ACEs
Figure 1. Distribution of ACE Scores among Those with Any ACEs
35
58% of Wisconsin
adults reported
growing up
experiencing at
least one ACE of
those 25% of
Wisconsin
Residents reported
having 4 or more
ACEs.
Impact of Trauma Over the Life Span
Effects of adverse childhood experiences: •Neurological •Biological •Psychological •Social
Center for Disease Control
Adverse Childhood Experience (ACE)
Study www.acestudy.org
Wisconsin ACE Study http://wichildrenstrustfund.org/files/WisconsinACEs.pdf
Center for Disease Control http://www.cdc.gov/ace/questionnaires.htm http://www.cdc.gov/nccdphp/ACE/
MYTH: Self-injury is a failed suicide attempt.
Understanding Behaviors Explanation vs. Excuse
Outward Expressions
Anger/defiance
Violence toward others
Truancy
Criminal acts
Perfectionism
Inward Expressions
Withdrawal
Substance use
Eating Disorders
Violence to self
Spacing out
Understanding Maladaptive Coping Skills What is self-injury?
Self-injury occurs when someone intentionally and repeatedly harms herself/himself.
Methods include cutting, burning, punching or drinking something harmful.
Who does it? More than 2 million people in the U.S. The majority are teenagers or young adults with
young women outnumbering young men.
Why? To express emotional pain or feelings they can’t put into words. To have control over your body when you can’t control anything
else in your life. Although they usually aren’t trying to kill themselves, sometimes
they’re unable to control the injury and die accidentally.
Eating Disorders Include extreme emotions, attitudes, and behaviors
surrounding weight and food issues.
Eating disorders are real, complex and devastating conditions that can
have serious consequences for
health, productivity, and relationships.
They are not a fad, phase or lifestyle choice.
Eating disorders affect males and females.
20 million females, 10 million males
By age 6, girls especially start to express concern about their weight/shape. 40-60% of girls aged 6-12 are concerned about their weight.
Suicide – Death by Mental Illness
The Veteran suicide rate just jumped from 18 to 22 per day or one suicide every 65 minutes
- 38,364 people completed suicide in 2010 (792 in Wisconsin) - Suicide is the 10th leading cause of death. - Approximately 101 people died by suicide every day.
•That’s one person every 15 minutes or a jumbo jet crashing EVERY DAY.
- 90% who died by suicide have a diagnosable psychiatric disorder.
Youth & Suicide Youth Risk Behavior Study (2010)
15% of WI high school students “seriously considered” attempting suicide in the past year
7.5% indicate that they “attempted suicide” at least once in the past year.
6th leading cause of death among 5-14 year olds.
3rd leading cause of death 15-24 year olds.
2nd leading cause of death for college students.
“Ask a question, save a life.”
QPR
Question
Persuade
Refer
Why do MI & SA Co-occur Self-medication
Substance abuse begins as a means to alleviate symptoms of mental illness
Causal effects
Substance abuse may increase vulnerability to mental illness
Common/correlated causes
Risk factors that give rise to mental illness and substance abuse may be related or overlap
Treatment Success Rates:
60-80% MI – significant reduction of symptoms and improved quality of life (varies by disorder 60% for schizophrenia vs. 80% for anxiety & depression)
40-60% surgical/medical interventions for heart disease
Good News! Treatment Works!
SO…if Treatment WORKS, Why Don’t People Get Treatment? Stigma
Self stigma
Community stigma
Cultural stigma
“Time will heal” – mental health problems are perceived as less “real” than physical health problems
Barriers to Treatments Scientific knowledge
Diagnostic tools
Lack of knowledge about available treatments, evidence-based treatments
Needed treatment is not available (i.e. trauma specific, eating disorders, etc.)
Cost/coverage
Shortage of providers esp. psychiatrists
Recovery “A process of change through which
individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”
Building Resiliency
Resilience is described as “bounce back” ability
Process encompassing positive adaptation within the context of adversity.
Resiliency A dynamic process
encompassing positive adaptation within the context of significant
adversity
Protective Factors Risk Factor Resiliency
Resiliency Research Why do some children genetically at risk for
developing mental illness who experience stress or adversity languish, while others flourish?
Norman Garmezy developed three categories of protective factors for “thriving” trauma survivors: 1. Child’s “inherent” disposition: Felt good about
themselves, self-reliant and believed they were in control of themselves and their lives.
2. Family cohesion & warmth: The support of a caring, loving adult.
3. Availability and use of “external” supports – other adults, children and community.
Building Protective Factors Caring and healthy adult and peer relationships
Healthy habits – eating, sleep, exercise
Developing hobbies and interests
Encouraging and supporting learning and “learning to learn”
Building healthy and “active” coping skills
Developing and supporting self-esteem
Developing and supporting healthy social skills
Creating an “internal locus of control”
Teaching a balance between seeking help and autonomy
Capitalize on opportunities to reduce risk and enhance resiliency
Protect and enhance the attachment relationship
Focus on child’s adaptive skills, self regulation, and capacity for relationship building
Compassionately engage with Mom/Dad around their desire to parent well
How Caregivers Can Help Understanding fears: Will the event will happen again? Will my family be hurt? Will I be separated from family? The importance of security and routine: Provide reassurance of safety and that s/he is loved, cared
for and protected Keep distractions to a minimum Provide extra physical reassurance (hugs, cuddles) Give comfort objects Be available for talking, listening and comfort
Communication with Children Open, thoughtful communication
Use active listening skills to reflect and encourage feelings
Try to be patient when your child asks the same question many times. Children often use repetition of information as a source of comfort. Try to be consistent with answers and information.
Talk with your child about your own feelings, but try to find other adults to talk with about your anxieties and frustrations.
Shield your child from graphic details and pictures in the media.
Tools for Recovery Peer support
Education
Healthy coping skills
Art/creative outlets
Exercise
Meditation
Healthy diet
Spirituality, etc.
Wellness Plans vs. Treatment Plans (WRAP)
Relapse prevention planning
The
“Neuroplastic
” Brain
“Current perspectives suggest a dynamic brain, physically changed by both internal and external factors…The concept of neuroplasticity is opening the doors to new ways of understanding illness and recovery, as well as how these processes can be utilized to influence and direct outcomes.”
http://www.mentalhealthscreening.org/screening/NEW
Free, online, anonymous, confidential
screening tool for mood disorders,
anxiety, AODA and eating disorders.
Q: What makes NAMI unique?
A: Building better lives,
shaping perceptions,
raising awareness and hope,
people helping people
Hope. Help. Recovery.
Want to Learn More? Visit our website for descriptions and dates of our program offerings: www.namifoxvalley.org Call (920)954-1550 Join our mailing list! (Post and/or Electronic) For more resources, check out www.nami.org