Mental Illness 101

PSYCHIATRIC & MENTAL HEALTH

MAY 7, 2018

PRINCE RENER PERA, RN,MSN,EMT

Types of Mental Illness
 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
 Flat Affect
 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 Impairment

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

 Perceptions

 Thoughts

 Moods

 Behavior
 Substance-Related
Disorders
 Types of Disorder  Substances
 Alcohol
 Substance-induced  Amphetamines
 Caffeine
 Intoxication
 Cannabis
 Withdrawal  Cocaine
 Various psychiatric  Hallucinogens
symptoms  Inhalants
 Nicotine
 Substance Use  Opioids
 Phencyclidine
 Dependence
 Sedative-hypnotics
 Abuse  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

Copyright © 2006 Cynthia Bisbee, Ph.D.

 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
Copyright © 2006 Cynthia Bisbee, Ph.D.
 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

Copyright © 2006 Cynthia Bisbee, Ph.D.

 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

Copyright © 1998 Patricia L. Scheifler MSW, PIP

Speaking Listening
Brain Cell Brain Cell

Antipsychotic
Medication
Blocks Receptor Site
 Examples of
Anti-psychotic Medications
 Zyprexa  Stelazine
 Risperdal  Haldol
 Seroquel  Navane
 Geodon  Thorazine
 Clozaril  Loxitane
 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
 Celexa  Tofranil
 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
Side Effects Medications
(Anti-parkinsonians)
 Used to Relieve Side Effects of Anti-
psychotic Medications
 Stiff Muscles
 Unsteady Gait
 Tremors
 Eyes Rolling Back
 Restless Feeling
 Examples of
Side Effects Medications
 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

Copyright © 2006 Cynthia Bisbee, Ph.D.

 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 Person’s Condition
 Chronic Illness
 Complex Medication Plan
Antipsychotic Medications Block
Dopamine

Copyright © 1998 Patricia L. Scheifler MSW, PIP

Dopamine

Speaking Listening
Brain Cell Brain Cell

Antipsychotic
Medication
Blocks Receptor Site
 Stop Taking Antipsychotics
Blockade Gradually Disappears

Copyright © 1998 Patricia L. Scheifler MSW, PIP

Speaking Listening
Brain Cell Brain Cell
 No Antipsychotic Medication:
Positive Symptoms Reappear
( Relapse)

Copyright © 1998 Patricia L. Scheifler MSW, PIP

Speaking Listening
Brain Cell Brain Cell
 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 support

 Ask open-ended questions 
Use parroting
 Check out the whys of  Be concrete and brief
behavior
 Watch for signs of fading
 Express empathy;
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

Copyright © 2006 Cynthia Bisbee, Ph.D.

 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