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Transcript
Mental Illness in
Children and Adolescents: Early
Detection is the key
1
Introduction – self and topic
Alarming Statistics
Define Mental Illness/Good mental health
Why is this important
Children at risk and triggers
Types of Mental illness and Indicators
What can be done
An action Plan
Self Introduction
Introduction to Topic
Some General Statistics
• About 45% of adult Australians will
experience a mental illness at some stage
in their lives
• One in five Australians will experience a
mental disorder in any 12-month period.
• Each year a further 20 000 Australians are
found to have a mental illness.
• In 2004-2005, mental illness was the
leading cause of 'healthy life' lost due to
disability.
• Many of those who experience mental
health problems will experience more than
one mental illness at the one time, such as
depression and anxiety, which commonly
occur together.
• Three million Australians will experience a
major depressive illness during their
lifetime.
• In 2004-2005, mental and behavioural problems
were one of the most common reported long-term
health conditions of socially and economically
disadvantaged people.
• 21% of males and 22.1% of females with weekly
household incomes of less than $580 experienced
mental health problems, compared to 8.9% of
males and 9.1% of females living in households
with a weekly income of more than $1030.
• 5% of Australians experience anxiety so
crippling that it affects every aspect of
their lives.
• Almost one in 100 Australians will experience
schizophrenia during their lifetime.
• 3 in 100 Australians will experience a
psychotic illness such as schizophrenia or
bipolar disorder.
• Mental illness has the third highest burden
of disease in Australia, followed closely by
cancer and cardiovascular disease, second
only to cardiovascular disease.
• Those with a mental disorder average three
days out of role (i.e. not undertaking
normal activity because of health
problems) over a four week period. This
compares with one day out of role for
people with no physical or mental
condition.
 Mental health problems were the fourth
most common reason for seeing a GP in
2004-2005. Almost 1 in 9 GP encounters
involve a mental health-related problem mostly depression, anxiety and
sleep disorders.
 From 2005-2006, 4.4% of all
hospitalisations were for mental healthrelated principal diagnosis or specialised
psychiatric diagnoses.
 In 2004-2005, 11% of all persons selfreported a current long-term mental or
behavioural problem. Half had mood
disorders and nearly 50% had anxiety
related problems.
YOUTH
AND MENTAL ILLNESS
STATISTICS
• The greatest number of people with a
mental illness are within the 18-24 year
age group.
• Many people with schizophrenia first
experience symptoms in their mid to late
teen years.
• One third of people with a mental illness
who are admitted to public hospitals are
less than 30 years old.
• Depression is one of the most common
health conditions in young people and
increases during adolescence.
 Drug use can complicate diagnosis and
exacerbate or trigger illness in vulnerable
young people.
• In 2007, 26% of 16-24 year olds had
experienced a mental disorder in the
previous 12 months.
• Data published in 2008 revealed that
during a 12-month period, 7% of
Australian children and adolescents aged
0-17 were experiencing mental health
problems.
 In 2004-2005, one in 10 young Australians
had a long-term mental health or
behavioural problem.
• In 2003, mental disorders were the leading
contributor to the total burden of disease
among young Australians, accounting for
49% of that total.
• There is a higher prevalence of child and
adolescent mental health problems among
those living in low-income, step/blended
and sole-parent families.
• 25% of males and 19.7% of females living
in step/blended families, and 22.2% of
males and 26.7% of females living in soleparent families experienced mental health
problems, compared to 11.3% of males and
10.7% of females living with their original
parents.
• Only one out of every four young persons
with mental health problems had received
professional health care.
 Even among young people with the most
severe mental health problems, only 50%
receive professional help. Parents reported
that help was too expensive or they didn't
know where to get it, and that they thought
they could manage on their own.
• Adolescents with mental health problems
report a high rate of suicidal thoughts and
other health-risk behaviour, including
smoking, drinking and drug use.
• 12% of 13-17 year olds reported having
thought about suicide, while 4.2% had
actually made a suicide attempt. Females
had higher rates of suicide ideation than
males.
Of critical importance• 90% of those who die by suicide suffer
from diagnosable & treatable mental
illness
What is a Mental Illness?
– behavioural/psychological pattern
– pain or impairment
– not otherwise explainable by
physical condition
– not due to present unpleasant
circumstance i.e. death
What about good mental health?
• Possession of skills necessary to cope with life
and its challenges
• Ability to think clearly
• Develop socially
• Build fulfilling relationships
• Learn new skills
• Adapt to change
• Cope with adversity
Causes
Nature v Nurture
Heredity (genetics): Mental illness tends to
run in families, which means the likelihood
to develop a mental disorder may be
passed on from parents to their children.
Biology: Some mental disorders have been linked
to special chemicals in the brain called
neurotransmitters. Neurotransmitters help nerve
cells in the brain communicate with each other. If
these chemicals are out of balance or not working
properly, messages may not make it through the
brain correctly, leading to symptoms. In addition,
defects in or injury to certain areas of the brain
have also have been linked to some mental
illnesses.
• Psychological trauma: Some mental
illnesses may be triggered by
psychological trauma, such as severe
emotional, physical or sexual abuse; an
important early loss, such as the loss of a
parent; and neglect
Environmental stress: Stressful or traumatic
events can trigger a mental illness in a
person with a vulnerability to a mental
disorder
Foster Children are a Risk
Group
It is generally considered to be the case that mental illnesses
can be attribute to both genetic and environmental factors.
Certain risk factors lead to a higher change of the
development of a mental illness and one of those issues can
be family disturbance or trauma. It is for this reason that
children in Foster Care are a high risk group of developing
mental illnesses
Emerging research indicates that intervening early can
interrupt the negative course of some mental illness and may,
in some cases, lessen long-term disability.
48
Why Early Intervention?
• Vital for successful behavioral & educational outcomes.
• If treatment & support occurs from the 1st early warning
signs, there is a better chance for success as adults.
• Most mental health conditions worsen if not treated as
the brain’s development continues to be assaulted by
negative influences.
• Behavioral interventions, therapy, medications and other
interventions are proven to be effective treatment for
many serious emotional & mental disorders
49
The Consequences…
A Study
• A study co-written by Jung Min Park and
Joseph P. Ryan of University of Illinois
followed 5,978 children in foster care for
several years to determine how their
placements were affected by their histories
of mental illness.
• Children who receive inpatient psychiatric
care have a substantially greater risk for
parent-child separation.
• Children with inpatient psychiatric
episodes were at rgeater risk for frequent
placement disruptions and were less likely
to reunite with their families of origin or be
adopted.
• Inpatient mental health mental health
episodes among children increased the
likelihood of placement instability for them
by 75%
The conclusion…
• “Early identification of service needs and
related interventions for children with
mental health needs was more costefficient (in terms of dollars and health) as
it helped them achieve placement stability
and permanence.”
Triggers
External environmental and psychological
factors are also believed to be involved in
the development of bipolar disorder. These
external factors are called triggers.
Triggers can set off new episodes of mania
or depression or make existing symptoms
worse.
• Abuse
• Stress
• Substance abuse
• Medication
• Seasonal changes
• Sleep deprivation
• Reminders
• Bad news
• Isolation
• Financial issues
• Aggression
Types of Mental Illnesses
Common mental health problems include
problems such as anxiety, depression,
phobias, obsessive compulsive and panic
disorders
Severe and enduring mental health
problems include those mental health
problems such as psychotic disorders
(including schizophrenia) and bipolar
affective disorder (manic depression).
Personality disorder is defined as 'an enduring
pattern of inner experience and behaviours that
deviates markedly from the expectation of the
individual's culture, is pervasive and inflexible,
has an onset in adolescence or early adulthood,
is stable over time and leads to distress or
impairment.
Depression
• Definition: an illness when the feelings of sadness with
great intensity persist and interfere with a person’s
thoughts, feeling, and behavior.
63
Anxiety Disorders
• Anxieties severe enough to interfere with the
daily activities of childhood or adolescents.
• Terms you may hear:
–
–
–
–
–
–
Generalized Anxiety Disorder
Phobias
Social Phobia
Panic Disorder
Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorder
64
Indicators
•
•
•
•
•
•
Restlessness or feeling keyed up or on
edge
Being easily fatigued
Difficulty concentrating or mind going
blank
Irritability
Muscle tension
Sleep disturbance
Schizophrenia
• delusions
• hallucinations
• disorganized speech (e.g., frequent derailment or
incoherence)
• grossly disorganized or catatonic behavior
• negative symptoms, i.e., affective flattening,
alogia[1], or avolition[2]
[1] poverty of speech, is a general lack of additional, unprompted
content seen in normal speech
[2] Avolition is a psychological state characterized by general lack of
desire, drive, or motivation to pursue meaningful goals
Bipolar Disorder
A condition in which the patient has significant
mood changes that last from weeks to months at a
time. Patients will experience at least one manic
episode where the mood is an elevated one;
followed by a period of normalcy or balance for
at least two months before an onset of a major
depressive episode.
General Warning Signs
• The following may indicate the need for further
professional assistance or evaluation:
• Decline in school performance
• Poor grades despite strong efforts
• Regular worry or anxiety
• Repeated refusal to go to school or take part in normal
activities
• Hyperactivity or fidgeting
• Persistent nightmares
• Persistent disobedience or aggression
• Frequent temper tantrums
• Depression, sadness, or irritability
68
•
•
•
•
•
•
•
•
•
•
•
Withdrawal from friends & activities
hopelessness
Lack of enthusiasm, energy, or motivation
Anger and rage
Overreaction to criticism
Poor self-esteem or guilt
Indecision, lack of concentration or
forgetfulness
Restlessness and agitation
Changes in eating or sleeping patterns
Substance abuse
Problems with authority
69
What Can We Do?
• Be aware- look and listen for changes in behavior
• Offer help & listen: encourage teens to talk about
their feelings..
• Trust your instincts- if it seems serious, seek
prompt advice/help.
• Seek Professional advice – go to your GP discuss
and obtain a referral
70
Treatment Options
•
•
•
•
•
Counseling
Psychologists
Psychiatrists
Psychopharmacology
Support network
71
Paper & References
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