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How and When to Refer: Mental Health Crisis.

How and When to Refer: Mental Health Crisis. Sabrena "Bre" Suggs Arman Siddiqui, MD February 20 th , 2019.

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How and When to Refer: Mental Health Crisis.

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  1. How and When to Refer:Mental Health Crisis. Sabrena "Bre" Suggs Arman Siddiqui, MD February 20th, 2019

  2. What is a Mental Health Crisis:A mental health crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or othersand or prevents them from being able to care for themselves or function effectively in the community. Sabrena "Bre" Suggs Arman Siddiqui, MD February 20th, 2019

  3. What can lead to a crisis?Stressors at home Health Conditions of Spouse, Death of a spouse (Grief) Divorce Marital Separation ImprisonmentStressors at workStressors at schoolTraumaSubstance AbuseMedication changesStopping Treatment Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  4. Physical Symptoms of CrisisHeadaches and loss of appetite are common. Stomach and digestive upset, joint pains, fatigue and other somatic symptoms are often related to depression. Pain and depression are linked because a person’s mood is influenced by the same neurotransmitters that send pain signals.Emotional Symptoms of CrisisDepression AnxietyScattered, unfocused thinkingSelf-doubtLoss of motivationIsolationAngerPoor self care Lack of patience or irritabilityParanoiaHopelessness Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  5. Depression DSM-5 Diagnostic CriteriaThe DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or moresymptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.1. Depressed mood most of the day, nearly every day.2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).5. Fatigue or loss of energy nearly every day.6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition. Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  6. DSM V Criteria for Generalized Anxiety DisorderA. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). B. The individual finds it difficult to control the worry. C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more daysthan not for the past 6 months): Note: Only one item required in children. 1. Restlessness, feeling keyed up or on edge. 2. Being easily fatigued. 3. Difficulty concentrating or mind going blank. 4. Irritability. 5. Muscle tension. 6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  7. DSM V Criteria for Generalized Anxiety DisorderD. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F. The disturbance is not better explained by another medical disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation fromattachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder) Sabrena "Bre" Suggs Arman Siddiqui, MD February 20th, 2019

  8. Signs that a child may be experiencing a mental health crisis include:- Feeling sad most of the time, mood swings- Extreme energy or lack of it- Sleeping all the time, or being unable to sleep- Severe agitation, pacing- Speech: talking rapidly or non-stop- Confused or irrational thoughts- Paranoia (Thinking everyone is out to get them or bizarre delusions)- Hallucinations or delusions- Making threats to others or themselves- Isolating themselves from friends and family, not coming out of their room- Appetite Disturbances: Not eating or eating all the time, rapid weight loss or gain- Suicidal thoughts, Passive Suicidal Ideations Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  9. When To Refer:thoughts of hurting self or othersfrequent or persistent feelings of sadness, anger, fear, worry, or anxietyfrequent emotional outbursts or mood swingsconfusion or unexplained memory lossdelusions or hallucinationsintense fear or anxiety about weight gaindramatic changes in eating or sleeping habitsunexplained changes in school or work performanceinability to cope with daily activities or challengeswithdrawal from social activities or relationshipsdefiance of authority, truancy, theft, or vandalismsubstance abuse, including alcoholism or use of illegal drugsunexplained physical ailments Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  10. How to get help:Call 911The National Suicide Prevention Lifeline's24 hour toll-free crisis hotline, 1.800.273.TALK (1.800.273.8255)  The Child-Help USA1.800.4.A.CHILD (1.800.422.4453) crisis line assists both child and adult survivors of abuse, including sexual abuse. The hotline, staffed by mental health professionals, also provides treatment referrals. 24 hour , 7 days a week in 140 different languages.www.childhelp.orgSAMHSA Treatment Referral Helpline, 1-877-SAMHSA7 (1-877-726-4727)Get general information on mental health and locate treatment services in your area. Speak to a live person, Monday through Friday from 8 a.m. to 8 p.m. EST. Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

  11. Local Referral Options: - Adult & Child Mental Health - 317-882-5122 (Access Center from 8 AM-5 PM, 24 Hour Crisis Line) - Aspire - 1800-560-4038 or 317-574-1252 (24 hours, 7 days a week Crisis Line) - 317-574-1254 ( Access Center, from 8 AM-5 PM, M-F) - Community Health Network - 1800-273-8255 or 317-621-5700 (24 hours, 7 days a week) - Eskenazi Health Midtown Community Mental Health - 317-880-8485 (24 hours, 7 days a week) Sabrena "Bre" Suggs Arman Siddiqui, MD February, 20th 2019

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