Instructor

1. Instructor Date

2. Course Outline – Session 1 • Mental Health First Aid • Common mental health problems • The five basic steps of mental health first aid • What are substance use disorders? • Symptoms and risk factors • Crisis first aid for overdose • Mental health first aid for substance use disorders • Treatment and resources

3. Course Outline – Session 2 • What is depression? • Symptoms of depression • Risk factors for depression • Alcohol, drugs and depression • Suicide in Canada • Crisis first aid for suicidal behaviour • Mental health first aid for depression • Treatment and resources

4. Course Outline – Session 3 • What are anxiety disorders? • Symptoms of anxiety disorders • Risk factors for anxiety disorders • Alcohol, drugs and anxiety disorders • Crisis first aid for panic attacks • Crisis first aid for acute stress reaction • Mental health first aid for anxiety disorders • Treatment and resources

5. Course Outline – Session 4 • What are psychotic disorders? • Symptoms of psychotic disorders • Risk factors for psychosis • Alcohol, drugs and psychotic disorders • Crisis first aid for acute psychosis • Mental health first aid for psychosis • Treatment and resources • Other expressions of distress

6. World Health Organization • Health is “a state of (complete) physical, mental and social well-being and not merely the absence of disease or infirmity.” • 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.”

7. Maximum Mental Health Diagnosis of a serious illness but copes well and has positive mental health No illness or disorder and positive mental health Maximum Mental Disorder Minimal Mental Disorder Diagnosis of a serious illness and poor mental health No diagnosable illness or disorder but has poor mental health Minimal Mental Health The Mental Health Continuum

8. What are Mental Health Problems? A mental health problem causes major changes in a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work and carry on their usual personal relationships.

9. What is Mental Health First Aid? Mental Health First Aid is the help provided to a person developing a mental health problem or in a mental health crisis. The first aid is given until appropriate professional help is received or until the crisis is resolved.

10. The Five Basic Steps Assess risk of suicide or harm Listen non-judgmentally Give reassurance and information Encourage the person to get appropriate professional help Encourage self-help strategies

11. Why Mental Health First Aid? There is stigma associated with mental health problems Imagine if we treated everyone like we treated the mentally ill.

14. Why Mental Health First Aid? • There is stigma associated with mental health problems • Mental health problems are common • Many people are not well informed about mental health/problems • Professional help is not always on hand • People often do not know how to respond

15. Prevalence • At least 1 in 3 Canadians will experience a mental health problem at some point in their life • At least 1 in 5 Canadians will experience a mental health problem in a year • In Canada 20 per cent of all sick leaves are related to mental health

16. Impact • The economic costs of mental illnesses in Canada was estimated to be at least $14.3 billion in 1998 • Mental illnesses are disabling • Six of the 10 leading causes of ‘years lived with disability’ are mental health problems

17. The ALGEE Rap • Assess situation and evaluate the risk • Listen very carefully and don’t tsk tsk • Give reassurance and the good info • Encourage them to see appropriate pro • Encourage them to use self help ideas And that is the ALGEE rap my dears!

18. What is a Substance Use Disorder? • Using alcohol or drugs does not in itself mean that a person has a substance use disorder (SUD) • Dependence on a substance • Use leads to problems at work, school, home • Use causes damage to health

19. = = Regular Beer 12 oz/341 mL (5% alcohol) Table Wine 5 oz/142 mL (12% alcohol) Spirits 1.5 oz/43 mL (40% alcohol) One Standard Drink Centre for Addiction and Mental Health

20. Low-Risk Drinking Guidelines • 0 drinks = lowest risk of an alcohol- related problem • No more than 2 standard drinks on any one day • Women: up to 9 standard drinks a week • Men: up to 14 standard drinks a week

21. Long-Term Effects of Alcohol • Brain • Heart • Lungs • Liver, pancreas, stomach and intestines • Genitals and reproductive system • Muscles, nervous system, motor skills • Skin

22. Other Abused Substances Tobacco • Nicotine is a powerful stimulant • Male smokers are twice as likely to experience impotence • Spit tobacco contains more than 3,000 chemicals • Withdrawal symptoms include anxiety, insomnia, restlessness • Some long term effects - heart disease, stroke, cancer

23. Other Abused Substances Cannabis (marijuana, hashish, joints, reefers) • Most widely used illegal drug in Canada • About 2% of the population have problem with cannabis abuse/dependence. • More than twice as likely to suffer from an anxiety disorder or depression • More than three times the risk of suffering from psychotic symptoms

24. Other Abused Substances Cannabis (marijuana, hashish, joints, reefers) • Adolescents using cannabis are more likely to suffer from depression, conduct problems, drinking and other drug use • More frequent use of cannabis increases risk of diagnosis of schizophrenia over next 15 years

25. Other Abused Substances Amphetamines – a stimulant drug • Examples: crystal meth, ice, speed, uppers, bennies, crank, ecstasy • Amphetamines have the temporary effect of increasing energy and apparent mental alertness • Users develop a tolerance and need to take more to get same effects

26. Other Abused Substances Amphetamines – a stimulant drug • An overdose can cause delusions, hallucinations, high fever, coma, death • A particular mental health risk is amphetamine psychosis or “speed psychosis” which involves symptoms similar to schizophrenia

27. Other Abused Substances Opioids • Examples: heroin, morphine, codeine, oxycodone • Effects can include pain relief, drowsiness, constipation, tiny pupils • Users develop a tolerance and need to take more to get same effects • Overdose can result in coma and death

28. Other Abused Substances Cocaine (crack, coke, C, snow, flake) • A cocaine high can last from 5 minutes to 2 hours • Overdose can cause seizures, strokes heart attacks, coma, death • Users develop a tolerance and need to take more to get same effects

29. Risk Factors • Family history of substance abuse • Childhood abuse or neglect • Acceptance of substance use (community, peer) • Low parental support/monitoring • Poor social skills

30. First Aid for Substance Use Disorders • Assess risk of suicide or harm • Listen non-judgmentally • Give reassurance and information • Encourage the person to get appropriate professional help • Encourage self-help strategies

31. Step 1 Assess the Risk of Suicide or Harm • If you determine the person has taken an overdose, follow the steps for Crisis First Aid for an Overdose • If the person is not at risk, move on to Step 2 – Listen Non-Judgmentally

32. Crisis First Aid for an Overdose If they are unconscious: • Make sure the person’s airway is clear and roll them into the recovery position • Phone 911 for an ambulance • Try to find out what substances were used • Keep the person warm, especially if alcohol is involved

33. Crisis First Aid for an Overdose If the person is conscious • Phone or take the person to the nearest emergency department • Do not give any food or fluids • Reassure the person • Try to find out what substances were used • Keep the person warm, especially if alcohol is involved

34. Step 2 Listen Non-Judgmentally • Listen without interrupting • Ask appropriate questions to make sure you are both clear on what is being said • Listen to the word and tone of voice and watch their body language • Restate what the person has said • Summarize facts and feelings

35. Step 2 Listen Non-Judgmentally • Be attentive • Keep eye contact comfortable (don’t stare or avoid eye contact) • Keep an open body position • Sit down, even if they stand • Try not to sit directly opposite (facing) the person

36. Step 3 Give Reassurance and Information • Tell the person you want to help them • Substance use disorder is a real medical condition • It is a common illness • Programs are available to help • Often depressive and anxiety disorders underlie SUDs and can be treated

37. Step 4 Encourage the Person to Get Appropriate Professional Help • Family doctor or physician • Drug and alcohol specialists • Mental health team

38. Relapse Pre-contemplation Maintenance Contemplation Action Determination/Preparation The Change Model

39. Step 5 Encourage Self-Help Strategies • Many people with a substance use disorder may also have another underlying mental health problem such as depression or anxiety. • The self-help strategies for these conditions may help but should not be the main source of treatment.

40. Resources • Alberta Alcohol and Drug Abuse Commission http://www.aadac.com • Centre for Addiction and Mental Health http://www.camh.net/

41. If • If you can always be cheerful • If you can sleep without drugs • If you can relax without alcohol • If you can start the day without caffeine • If you can take blame without resentment • If you can resist without complaining • If you can eat the same food every day without complaining and be grateful

42. Then you are almostas good as your dog If • If you can understand when your loved ones are too busy to spend time with you • If you can overlook it when those you love take things out on you when, through no fault of yours, something goes wrong

43. Session 2 • What is depression? • Symptoms of depression • Risk factors for depression • Alcohol, drugs and depression • Suicide in Canada • Crisis first aid for suicidal behaviour • Mental health first aid for depression • Treatment and resources

44. What is Depression? Clinical depression lasts at least two weeks, affects the person’s behaviour and has physical, emotional and cognitive effects. It interferes with the ability to work and have satisfying personal relationships.

45. Symptoms of Depression • Emotions: sadness, mood swings, hopelessness, anxiety • Thoughts: Self-criticism, indecisiveness, thoughts of suicide, pessimism • Behaviour: Crying spells, neglect personal appearance, withdrawal, no motivation • Physical: Lack of energy, sleeping too much/too little, overeating/loss of appetite

46. Depression in the Workplace • Decreased productivity • Morale problems • Lack of co-operation • Safety problems • Absenteeism • Complaints of being tired, having aches/pains • Alcohol and/or drug abuse

47. Bipolar Disorder (Manic Depression) • Bipolar disorder is characterized by extreme mood swings • A person has periods of depression and mania with periods of ‘normal’ mood in between • A person must have episodes of both depression and mania to be diagnosed

48. Symptoms of Bipolar Disorder • Depression • Mania • Increased energy and over activity • Elated mood • Needing less sleep than usual • Irritability • Rapid thinking and speech • Lack of inhibitions • Grandiose delusions • Lack of insight

49. Risk Factors for Depression • Break up of relationship or living in conflict • Having a baby • Job loss, unsuccessful job hunting • Long term illness or disability or caring for someone with illness/disability • Being a victim of a crime • Alcohol or drug abuse

50. Risk Factors for Depression • Side effect of medications or drugs • Stress from another mental disorder • Hormonal changes • Lack of exposure to bright light in winter • Family history of depression • Previous episodes of depression • Difficult childhood (abuse, neglect)