True or False? How much do we really know about mental illness?

1. True or False?How much do we really know about mental illness?

2. True or False? Mental illness is the leading cause of disability burden in Australia. Click!

3. True ! Mental illness is the leading cause of disability burden in Australia! Mental illness has overtaken physical injury as the greatest burden of disability according the Australian Bureau of Statistics’ Social Trends (2011).

4. True or False? Schizophrenia is a ‘split personality’, where an individual changes from one person to another.

5. True or False? FALSE: The word schizophrenia comes from the Greek roots skhizein ("to split") and phrēn, ("mind"), hence the confusion, but it does not imply a "split personality". Rather schizophrenia is a psychotic disorder hallmarked by a breakdown in thought processes and disturbance of reality. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. Multiple personality disorder (now known as Dissociative Identity disorder) is a condition where an individual displays multiple personalities (at least 2), living within the one body who may not be aware of the others. The different personality states may also have different reactions, emotions, and body functioning. Click to continue

6. True or False? People living with schizophrenia hear voices in their heads, and always do what ‘they’ tell them.

7. True or False? FALSE: Not all people with schizophrenia hear voices in their heads. Auditory symptoms are more likely to be external, from outside of their body than inside their mind. Other symptoms can include hallucinations (actually seeing, hearing, smelling, or feeling things that don’t exist), delusions (believing in unrealistic or bizarre ideas), disordered thoughts, lack of affect (no appearance of emotions), and a loss of motivation or pleasure. Schizophrenia is a complex disorder with a wide range of possible symptoms. Click to continue

8. True or False? People with OCD are just neurotic neat freaks.

9. True or False? FALSE: Many people believe that OCD is when an individual is very neat or careful about cleanliness, or a germophobe, not realising that it’s a lot more complex than that. OCD is an anxiety disorder with two characteristics. People with OCD have recurring unwanted thoughts (obsessions), usually of something they find disturbing or not at all in their character (ego-dystonic). Obsessions can be about germs or contamination, or of not having properly locked doors, or turned off appliances Other common obsessions can include harm befalling families, or worries about hurting or killing someone, or any other undesirable idea. These obsessions or worries create extreme anxiety in the individual, so they engage in a ritual to help reduce the anxiety. The rituals, or compulsions could be washing hands, keeping their house in perfect order, checking that the door is locked, thinking certain words, avoiding odd numbers, or just about anything imaginable. These rituals or compulsions don’t make the thoughts go away for very long, so the ritual is repeated. Not everyone who has OCD cares about germs, or does the rituals that we usually hear about. Not everyone even has compulsions an observer would actually notice, since a lot of them are mental. Perfectionism and neatness are not OCD.

10. True or False? Just like the rest of the population, around 1 in 5 people who are homeless have a mental illness.

11. True or False? FALSE! The estimated prevalence of mental disorders among people who are homeless varies, reflecting the area in which the research was conducted, the definition of mental illness and the methodological approach. Despite these limitations there is consistent evidence that people who are homeless have a much higher prevalence of mental illness than the general population. There is debate in the Australian literature, where some studies report that 72 to 82 per cent of homeless people are mentally ill, whereas others report that between 12 and 44 per cent have a mental illness. A review of 4291 homeless people in Melbourne found that 31% were living with a mental illness Homelessness and mental health linkages: review of national and international literature, Department of Health and Aging , May 2005 Guy Johnson and Chris Chamberlain, 2011. Are the Homeless Mentally Ill? Australian Journal of Social Issues Vol.46 No.1 AUTUMN 2011

12. True or False? Over 40% of people with a mental illnessretain employment.

13. True or False? Approximately 50% of people with a psychotic disorder do not complete secondary education.

14. True or False? 1 in 4 people with schizophrenia are violent and dangerous.

15. True or False? FALSE A 2006 Australian study found however that a quarter of people believe those with Schizophrenia are dangerous. And nearly 2 in 3 thought they were unpredictable; 42% also thought that those with Depression were unpredictable. Research indicates people receiving treatment for a mental illness are no more violent or dangerous than the general population. The lifetime risk of someone with an illness such as schizophrenia seriously harming or killing another person is 0.005%, while the risk of them killing themselves is nearly 10% The Macarthur Violence Risk Assessment Study found a diagnosis of a major mental disorder -- especially a diagnosis of schizophrenia -- was associated with a lower rate of violence than a diagnosis of a personality or adjustment disorder. However, a co-occurring diagnosis of substance abuse was strongly predictive of violence. Findings by Dr. Paul Mullen, most people with a mental illness are not violent. For instance, of the 1 in 100 people who have schizophrenia, only 0.1% are sometimes violent. There is good evidence to show that people with mental illness who are receiving treatment are no more likely to perpetrate violence than people in general. The risk of someone who is being treated for schizophrenia, for instance, harming or killing another person is almost exactly the same as for the general population. One in ten people with schizophrenia, however, will suicide. This is ten times the risk compared to the general population. Sane Australia: Mental Illness and Violence Factsheet. http://www.sane.org/information/factsheets-podcasts/209-violence-and-mental-illness   Steadman HJ, Mulvey EP, Monahan J, et al: Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry 55:393—401, 1998. Mullen, P. E., (2006) Schizophrenia and violence: from correlations to preventive strategiesAdvances in Psychiatric Treatment 12: 239-248

16. True or False? Mental illnesses as we know them are found everywhere across the world.

17. True or False? TRUE/FALSE It is known that people across the world from developing and third-world nations experience mental disturbances that influence their ability to think and their emotions. However people from cultural backgrounds outside of Australia would not recognise the diagnoses we use here, or that are used in most western speaking countries. Cultural background affects how people experience mental illness, understand and interpret symptoms of mental illness, and ‘treat’ mental illness. Interesting information is found in ; ‘Crazy Like Us: The Globalisation of the American Psyche’, by Ethan Watters Click to continue!

18. True or False? Homosexuality WAS ONCE a diagnosable mental illness.

19. True or False? TRUE Homosexuality was declassified by the APA (American Psychiatric Association in 1973, as it was a diagnosable mental illness in the DSM-II. It was removed it as it was motivated to reduce effects of social oppression that came from the diagnosis; this was despite substantial protests at the time to leave it in. However, it was not removed altogether, with the inclusion of the ‘Sexual Orientation Disturbance’ category and ‘Ego-diatonic homosexuality’ – where someone’s individual sexual preference is viewed as an ‘abnormal’ variant, in the DSM-III which was released in 1980, and was not scrapped altogether until the DSM-IV. (NOTE: DSM-IV still includes a category of "sexual disorder not otherwise specified" which can include "persistent and marked distress about one’s sexual orientation”. The focus is on the distress caused by the orientation, not the orientation itself.)

20. True or False? Mental illness is caused by abusive or neglectful parenting.

21. True or False? FALSE If we consider the biopsychosocial model of mental illness we would conclude that if anything parenting practices are an environment (social) factor and for some may play a part in the development of mental illness – for example there may be a lack of skills teaching or modeling behavior in relation to regulating or tolerating emotions, HOWEVER parents are not to blame for mental illness. (traumatic abuse from parents/guardians may greatly contribute to a mental illness, but not ALWAYS result in one.) As any other factor in the development of mental illness, for some parenting and the family system may have played a larger role for some people compared to others.

22. True or False? Drug use is more prevalent in those with a mental illness.

23. True or False? Twice the number of people with a mental illness smoke than those without a mental illness.

24. True or False? People with a mental illness are less intelligent, but more creative than people without mental illness.

25. True or False? FALSE Most studies have found that mental illness is not connected to creativity. In one study comparing creativity in people living with schizophrenia, major depression, or anxiety disorders, and patients having a personality disorder, schizophrenia patients showed the lowest level of creativity. However, there does appear to be a connection to mood, and creativity. Manic and mixed state patients had higher creativity scores than depressive individuals. Creativity was influenced by executive function measures only in manic patients. The mood cycling dimension of the bipolar spectrum is linked to creativity, and this link is likely to result from increased involvement in pleasurable activities, including creative ones. Creative cognition may share common biological vulnerabilities with psychopathologies that grant access to altered states of consciousness, and these vulnerabilities may include a tendency toward transient cognitive disinhibition. As for intelligence, although some mental illnesses like schizophrenia can affect thought processes and cognitive functioning, most do not affect intelligence. A study by MacCabe et al (2012) also found some patients with schizophrenia remain indistinguishable from healthy controls on all cognitive tests. Rubinstein, G. (2008). Are schizophrenic patients necessarily creative? A comparative study between three groups of psychiatric inpatients. Personality and Individual Differences, Volume 45, Issue 8, Pages 806–810 Soeiro-de-Souzaa, M. G., Diasb V. V., Bioa D. S., Postc R. M., Morenoa R. A. (2011) Creativity and executive function across manic, mixed and depressive episodes in bipolar I disorder, Journal of Affective Disorders, Volume 135, Issues 1–3, Pages 292–297 Vellantea M., Zuccaa G., Pretia A. B., Sistic D., Rocchic M. B. L., Akiskald K. K., Akiskald H. S. (2011) Creativity and affective temperaments in non-clinical professional artists: An empirical psychometric investigation. Journal of Affective Disorders, Volume 135, Issues 1–3, Pages 28–36  Carson, S.H., (2011), Creativity and Psychopathology: A Shared Vulnerability Model. Canadian Journal of Psychiatry, 56. 3: 144-53. MacCabe J. H., Bre´bion G., Reichenberg A., Ganguly T., McKenna P.J., Murray R. M., David A. S. (2011) Superior Intellectual Ability in Schizophrenia: Neuropsychological Characteristics, Neuropsychology, Vol. 26, No. 2, 181–190.

26. True or False? People who intentionally harm themselves either want to die or are looking for attention.

27. True or False? FALSE Many people believe that self-injurers are just seeking attention. This is true of a few people, especially since self-injury is becoming more well-known, but most self-injurers actively try to hide their injuries by wearing long sleeves or pants, or by cutting in a place that is usually covered by clothing, like their upper thighs or stomach. Some self-injurers desperately want someone to find out about their behaviour so they can get the help they need, but even many of them are too frightened of another person’s reactions, and ashamed of themselves, to actually point out their injuries. Many people, particularly teenagers and young adults, who suffer from a variety of mental disorders cope with their inner pain by physically harming themselves, most commonly by cutting. No matter what it looks like, self-injury is not a failed suicide attempt. Some self-injurers harm themselves over and over for years without having a single injury that would threaten their life. Many people who self-injure are actually trying to avoid suicide by letting out their feelings in a (somewhat) safer way.

28. True or False? Suicide is responsible for more deaths than road accidents in Australia.

29. True or False? TRUE Suicide remains a major external cause of death, accounting for more deaths in Australia than transport accidents. In 2010, 1.6% of all deaths registered were attributed to suicide, approximately the same proportion as in 2007 and 2008(whereas car accidents accounted for 1.0%. There were 2,361 deaths from suicide registered in 2010, 229 more than has been recorded for 2009. 3303.0 - Causes of Death, Australia, 2009, Australian Bureau of Statistics 3303.0 - Causes of Death, Australia, 2010, Australian Bureau of Statistics Click to continue!

30. True or False? A mental illness is a true medical condition, like heart disease and diabetes.

31. True or False? TRUE The most common view is that disorders tend to result from genetic dispositions and environmental stressors, combining to cause patterns of distress or dysfunction or, more sharply, trigger disorders (Diathesis-stress model). A practical mixture of models may often be used to explain particular issues and disorders, although there may be difficulty defining boundaries for indistinct psychiatric syndromes. The primary model of contemporary mainstream Western psychiatry is the biopsychosocial model (BPS), which merges biological, psychological and social factors. It may be commonly neglected or misapplied in practice due to being too broad or relativistic, however. Biological psychiatry has tended to follow a biomedical model focused on organic or "hardware" pathology of the brain, where many mental disorders are conceptualized as disorders of brain circuits likely caused by developmental processes shaped by a complex interplay of genetics and experience., . Many mental illnesses can be treated effectively with medications. Ghaemi SN (November 2006). "Paradigms of psychiatry: eclecticism and its discontents". CurrOpin Psychiatry. 19 (6): 619–24. Kendler KS (1 December 1999). "Setting boundaries for psychiatric disorders". Am J Psychiatry. 156 (12): 1845–8

32. True or False? People cannot fully recover from mental illness. They will always be ‘in recovery.’

33. True or False? TRUE/FALSE Mental illness is not necessarily a life sentence. Most people will recover fully, especially if they receive help early. Some people have only one episode of mental illness and recover fully. For others, mental illness occurs only occasionally with years of wellness between episodes. For a minority of those with a more severe illness, periods of acute illness will occur regularly and, without medication and effective management, leave little room for recovery. Though some people experience significant disability as a result of a chronic mental illness, many others live full and productive lives while receiving ongoing treatment and medication. Use analogy of diabetes – people will live with it for the rest of their lives, but if managed, they can still live successful, fulfilled and productive lives. Click to continue!

34. True or False? Electro convulsive therapy (ECT) is a painful, barbaric procedure no longer approved for use as a treatment for mental illness.

35. True or False? FALSE ECT is where seizures are electrically induced in anaesthetised patients. It is used mostly on patients with severe depression (often with catatonic of psychotic features) where other treatments have not been successful or where there is a need for a rapid and decisive response (e.g. To prevent further suicide attempts, or where there have been good responses to ECT on previous occasions. In New South Wales, administration of ECT must be authorised by the Mental Health Review Tribunal.

36. True or False? Mental illness does not affect my workplace.

37. True or False? FALSE There is a common misconception that unless you work in mental health, or with someone with a known mental illness, mental illness will not affect your workplace. Providing a healthy and safe workplace benefits all workers, including those with mental illness. It also makes good business sense. Excess stress, left untreated, can manifest as a mental illness, or a variety of physical conditions. A total of 3.2 days per worker are lost each year through workplace stress Stress-related workers’ compensation claims have doubled in recent years, costing over $10 billion each year A survey of over 5000 workers indicated that 25% of workers took time off each year for stress-related reasons Furthermore, a study by the Inspire Foundation has found mental illness in young men alone costs the Australian economy $3.3 billion a year. It also found that Australia loses an average 9.5 days per person each year and that the cost to business was around $237 million a year due to extra leave taken.  Remind provides a variety of learning tools to suit the needs of your specific workplace or industry. From helping your staff to understand and work day to day with people living with mental illness, to self care and mental health tips within the workplace, Remind can provide for your needs. Medibank Private (2008) The Cost of Workplace Stress in Australiap7. Australian Council of Trade Unions (ACTU) survey as cited at Price Waterhouse Coopers website – Workplace Stress (2008)Counting the Cost: The Impact of Young Men’s Mental Health on the Australian Economy, (2012), Inspire Foundation and Ernst & Young Click to contact Remind

38. www.remind.org.au