Mental Illness 101

Mental Illness 101
Presentation at the New Grantees Conference

US Department of Labor
Homeless Veterans Reintegration Program
August 1, 2006
Cynthia Bisbee, Ph.D.

CC Bisbee & Associates
Montgomery, AL
Types of Mental Illness
Copyright 2006 Cynthia Bisbee, Ph.D.

Definition of
Mental Disorder
A clinically significant behavioral or
psychological syndrome or pattern
that occurs in an individual and that is
associated with present distress or
disability or with a significantly
increased risk of suffering death,
pain, disability or an important loss of
freedom.

Definition of
Mental Disorder
Not merely an expectable and
culturally sanctioned response to a
particular event such as death of a
loved one
Must be within an individual
Classifies disorders, not people

Serious Mental Illness
Always Included in Definition
Schizophrenia
Major Depression
Bipolar Disorder
Sometimes Included
Severe Anxiety Disorders
Cognitive Disorders
Some Personality Disorders

Criteria for Schizophrenia
Characteristic Social/Occupational
symptoms Dysfunction
Delusions Lasting at Least Six
Hallucinations Months
Disorganized Speech
Disorganized Behavior
Negative Symptoms
FlatAffect
Lack of Motivation

Criteria for Major
Depression
Depressed Mood Feelings of

Diminished Interest Worthlessness or
Weight Loss or Gain
Excessive Guilt
Difficulty Thinking
Sleep Disturbance
& Concentrating
Restlessness or Being
Symptoms Occur
Slowed Down
Every Day
Fatigue & Loss of
Significant
Energy
Distress &
Thoughts of Death Impairment
Criteria for Bipolar Disorder
Manic Episodes Marked

Elevated mood Impairment
Grandiosity Occupation
Decreased need for Social relationships
sleep (or) Hospitalization
Talkativeness
(or) Psychotic
Racing thoughts
Features
Increased goal-
directed activity May Alternate with
Depressive
Episodes
Symptoms of Mental Illness
Perceptions
Thoughts
Moods
Behavior

Substance-Related
Disorders
Types of Disorder Substances
Substance-induced Alcohol
Amphetamines
Intoxication
Caffeine
Withdrawal
Cannabis
Various psychiatric Cocaine
symptoms Hallucinogens
Substance Use Inhalants
Nicotine
Dependence
Opioids
Abuse
Phencyclidine
Sedative-hypnotics
Polysubstance
Causes of Mental Illness

Causes of Mental Illness
Biological Causes
Environmental Effects
Interaction of Biology and
Environment

Biology of
Serious Mental Illnesses
Brain Disorder
Anatomy
Function (metabolism)
Chemistry
Causes of Brain Disorder
Genetics
Viral Theories
Brain Injury

Schizophrenia:
Chemical Imbalance in the Brain
Copyright 1998 Patricia L. Scheifler MSW, PIP

Synapse
Dopamine
Receptor
Site
Speaking Listening
Brain Cell
Brain Cell
Vesicle
Too Much Dopamine =

Positive Symptoms
The Role of Environment
Some Disorders May Be Learned
Some Result from Trauma
Environment Affects the Course of
the Disorders
Stigma

Treatment of
Mental Illness

Intervention Goals
Remission of Symptoms
Positive
Negative
Maintenance of Stability
Enhanced Quality of Life
Role Recovery

Medications
Antipsychotics
Antidepressants
Mood Stabilzers
Anxiolytics
Side Effects Medications

Anti-psychotic Medications
Used to combat psychotic symptoms
Hallucinations
Delusions
Confused Thinking
Altered Perceptions
Disorganized Speech
Other signs of psychosis

Antipsychotic Medications Block
Dopamine

Dopamine
Speaking Listening
Brain Cell Brain Cell
Antipsychotic
Medication
Blocks Receptor Site
Examples of
Anti-psychotic Medications
Zyprexa Haldol
Risperdal Loxitane
Seroquel Thorazine
Geodon Mellaril
Clozaril Stelazine
Abilify Prolixin
Navane
Serentil

Anti-depressant Medications
Used to Relieve Symptoms of
Depression
Sadness
Feelings of Failure
Loss of Interest in Life
Sleep Disturbances
Excessive Guilt
Loss of Energy/Fatigue
Thoughts of Death and Suicidal Thoughts
Examples of
Anti-depressant Medications
Prozac
Desyrel
Zoloft
Elavil
Effexor
Tofranil
Celexa
Serzone Pamelor
Remeron Marplan
Paxil Nardil
Wellbutrin Ascendin
Lexapro Sinequan

Mood Stabilizers
Used to Treat Symptoms of Mania
Rapid Talking
Decreased Need for Sleep
Racing Thoughts
Distractibility
Irritability
Behavioral Excesses
Grandiosity
Examples of
Mood Stabilizers
Lithium Note: Some of
Eskalith these medications
Lithobid are also used to
Lithane treat seizures
Depakote
Tegretol
Neurontin
Zyprexa
Topamax

Anti-anxiety Medications
Used to Treat Symptoms of Anxiety
Nervousness
Panic
Shortness of Breath
Trembling
Feeling of Choking
Heart Palpitations
Obsessions & Compulsions
Examples of
Anti-anxiety Medications
Xanax Valium
Ativan Librium
Klonapin Serax
Buspar Equanil
Miltown
Vistaril
Tranxene

(Anti-parkinsonians)
Used to Relieve Side Effects of Anti-
psychotic Medications
Stiff Muscles
Unsteady Gait
Tremors
Eyes Rolling Back
Restless Feeling

Examples of
Cogentin
Artane
Benadryl
Akineton

Stimulants (special use)
Used to Treat Symptoms of
Attention Deficit/Hyperactivity
Disorder
Mainly Used in Children
Hyperactivity
Inability to Pay Attention
Distractibility
Examples of
Stimulant Medications
Ritalin
Adderall
Dexedrine
Cylert
Concerta

Side Effects of
Medications
Drowsiness High Heart Rate
Dry Mouth Weight Gain
Blurred Vision Slurred Speech
Dizziness Sensitivity to Sun
Tremors Some Are Addictive
Sexual Dysfunction
Psychosocial Interventions
Assessment Rehabilitation
Education about Social Skills
Illness Self Vocational
Management Family Services
Counseling/Therapy Education
Individual Family Therapy
Group Case Management
Crisis Intervention

Illness Self Management/
Patient Education
Giving Information about the Illness
Symptoms
Treatment
Course
Helping Client Learn to Manage Own
Illness

Management Skills
for Recovery
Medication Adherence
Healthful Lifestyle
Therapeutic Environment
Illness Monitoring
Relapse Prevention
Medication Adherence
Adherence = Sticking to the

Medication Plan
Barriers to Adherence
The Persons Condition
Chronic Illness
Complex Medication Plan

Antipsychotic Medications Block
Dopamine

Dopamine
Speaking Listening
Antipsychotic
Medication
Blocks Receptor Site
Stop Taking Antipsychotics
Blockade Gradually Disappears

Speaking Listening

No Antipsychotic Medication:
Positive Symptoms Reappear
( Relapse)

Speaking Listening

What Is
Illness Monitoring?
Learning about Illness
Developing Awareness of Symptoms
Watching for Signs of Relapse
Mapping Illness Cycles

Importance of
Illness Monitoring
Helps Prevent Relapse
Look for Illness Cycle
Indicate Possible Need for Medication
Adjustment
Helps Measure Effects of Treatment

Relapse Checklist*
Medication Change
Physical Illness
A Stressful Event or Overstimulation
Alcohol or Drugs
Sugar, Caffeine, or Change of Diet
Too Many Fluids
Illness Cycle
Copyright 1982 Patricia Scheifler

Taking Action
Ensure Compliance with Meds
Seek Medical Treatment & Rest
Daily Relaxation Skills
Decrease Stimulation
Avoid Drugs & Alcohol
Cut Caffeine, Sugar & Fluids
Consult MD for Possible Medication
Adjustment
Psychotherapy and
Counseling
Reality Based
Real-life Problem Solving
Individual Coping with Illness
Group Support and Peer Learning
Flexible Participation Standards

Crisis Intervention
Telephone
Clinic Based
Mobile Outreach
In-Home Intervention

Skills Training
Social Skills
Academic Skills
Vocational Skills

Psychiatric Rehabilitation
Readiness Assessment
Readiness Development
Choosing Rehabilitation Goals
Living
Learning
Working
Socializing
Getting & Keeping Environments of Choice

Continuum of Living
Environments
Long Term Hospital
Crisis Stabilization Facility
Group Treatment Setting
Family Living
Supported Living Apartments
Independent Living

Continuum of Learning
Environments
Hospital Treatment
Partial Hospitalization Services
Outpatient Therapies
Clubhouse
Adult Education
Supported Education

Continuum of Working
Opportunities
Pre-vocational Training
Vocational Training
Volunteer Jobs
Jobs in Mental Illness Facilities
Supported Employment
Transitional Employment
Part-time and Full-time Regular
Employment
Consumer-run Business
Family Services
Support
Education
Consultation
Therapy
Case Management
Service Coordination
Linkage
Connection to One Person
Help with Basic Needs
Broad View of Service Plan

Interacting with a Person
with Mental Illness Symptoms:
Communication Skills
(Copyright Patricia Scheifler, MSW)
Give clear directives Express caring and

Ask open-ended support
questions Use parroting
Check out the whys of Be concrete and brief
behavior
Express empathy; Watch for signs of fading
reflectfeelings Be low-key and low EE
Use no-choice choices Avoid power struggles
Criticize behavior not Allow for time out to de-
person stim
Use I statements Do not tell lies
Interacting with a Person
with Mental Illness Symptoms:
Safety
Remain calm
Speak slowly and clearly
Avoid invading personal space
Do not move quickly, especially toward
the person
Do not touch the person
Do not challenge the person

Special Issues for Homeless
People with Mental Illness
Lack of Trust
Hierarchy of Needs
Disability Caused by Mental Illness
Effect of active symptoms
No energy to accomplish daily tasks
Inability to plan
Consistent Need for Support

Interventions for
Mental Illness
No One
Intervention Is
Sufficient
We Have to
Approach from All
Directions

Mental Illness 101

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Mental Illness 101

Uploaded by

Copyright:

Available Formats

Mental Illness 101

Presentation at the New Grantees Conference

Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Depressed Mood Feelings of

Manic Episodes Marked

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Interaction of Biology and

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 1998 Patricia L. Scheifler MSW, PIP

Too Much Dopamine =

Some Disorders May Be Learned

Some Result from Trauma

Environment Affects the Course of

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Side Effects Medications

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 1998 Patricia L. Scheifler MSW, PIP

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Dry Mouth Weight Gain

Blurred Vision Slurred Speech

Dizziness Sensitivity to Sun

Tremors Some Are Addictive

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Adherence = Sticking to the

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 1998 Patricia L. Scheifler MSW, PIP

Copyright 1998 Patricia L. Scheifler MSW, PIP

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 1998 Patricia L. Scheifler MSW, PIP

Copyright 2006 Cynthia Bisbee, Ph.D.

Learning about Illness

Developing Awareness of Symptoms

Watching for Signs of Relapse

Mapping Illness Cycles

Copyright 2006 Cynthia Bisbee, Ph.D.

Helps Prevent Relapse

Look for Illness Cycle

Indicate Possible Need for Medication

Helps Measure Effects of Treatment

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.

Real-life Problem Solving

Individual Coping with Illness

Group Support and Peer Learning

Flexible Participation Standards

Copyright 2006 Cynthia Bisbee, Ph.D.

Copyright 2006 Cynthia Bisbee, Ph.D.