Instructor MHFA Slides Jan 07

Instructor
Date
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
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
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
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
Other expressions of distress
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.
The Mental Health Continuum

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
What are Mental Health Problems?

A mental health problem causes major
changes in a persons thinking, emotional
state and behaviour, and disrupts the
persons ability to work and carry on their
usual personal relationships.
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.
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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 dont 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
One Standard Drink
=
Regular Beer
12 oz/341 mL
(5% alcohol)
=
Table Wine
5 oz/142 mL
(12% alcohol)
Centre for Addiction and Mental Health
Spirits
1.5 oz/43 mL
(40% alcohol)
20
Low-Risk Drinking Guidelines

0 drinks = lowest risk of an alcoholrelated 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

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

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

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

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

Opioids
Examples: heroin, morphine, codeine,
oxycodone
Effects can include pain relief,
drowsiness, constipation, tiny pupils
Overdose can result in coma and
death
28

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
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

Encourage the person to get
appropriate professional help
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
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Crisis First Aid for an Overdose

If they are unconscious:
Make sure the persons 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

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

Be attentive
Keep eye contact comfortable (dont
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
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
36
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Step 4
Encourage the Person to Get

Appropriate Professional Help
Family doctor or physician

Drug and alcohol specialists
Mental health team
38
The Change Model

Relapse
Maintenance
Action
Pre-contemplation
Contemplation
Determination/
Preparation
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.
39
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
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
Then you are almost
as good as your dog
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
44
What is Depression?
Clinical depression lasts at least two
weeks, affects the persons 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)
51
Suicide in Canada
About 4,000 Canadians die by suicide each
year
In 2001, there were 3.5 suicides among men
for every suicide among women.
People in their 40s accounted for almost one in
four suicides.
Deaths by suicide surpassed deaths
by motor vehicle accidents in
that same year.
52
Suicide Rates by Province

Per 100,000 population, 2001
11.3
Canada
Prince Edward Island
Nova Scotia
New Brunswick
Quebec
Ontario
Manitoba
Saskatchewan
Alberta
British Columbia
0
10
9
13.2
16.5
7.7
11.4
11.3
14.1
10.4
6
12
15
18
53
First Aid for Depression


or Harm
If you determine the person is at risk,
follow the steps for Crisis First Aid for
Suicidal Behaviour
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Crisis First Aid for Suicidal Behaviour

1. Engage the person in serious
conversation about how they are
feeling
2. Determine if the person has thoughts
of suicide
3. Explore and assess the risk further
4. Find out about prior suicidal behaviour
5. Find out about their supports
56
Crisis First Aid for Suicidal Behaviour

6. Ensure the person is not left alone
7. Seek additional help
8. If they are consuming alcohol or drugs,
try to ensure they do not take more
9. Try to ensure they do not have ready
access to some means to take their life
10. Encourage the person to talk
11. Ensure your own personal safety
57
Self Care
Supporting a suicidal person can be
unsettling and stressful
Do not underestimate the effect on your
own well-being
Find ways of reducing the immediate
stress (exercise, relaxation techniques,
sleep)
Find someone to talk to about your
experience
58
Step 2
Listen Non-Judgmentally
Listen to the person without judging.

Do not be critical of the person.
Do not express frustration with the
person for having these symptoms.
Do not give glib advice such as pull
yourself together.
Avoid confrontation unless necessary to
prevent harmful acts.

Information
Depression is a real medical condition
Depression is a common illness
Depression is not a weakness or
character defect
Depression is not laziness
Effective help and treatments are
available
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60
Step 4

Community-based care
Counsellors and clinical psychologists
Psychiatrists
61
What Helps for Depression?

Medical Treatments
Rating
Antidepressants
Adults
Adolescents
Electroconvulsive therapy (ECT)
Very severe
depression only
Very good evidence

Good evidence
Promising treatment
62
63
64

Psychological Treatments
Rating
Cognitive behaviour therapy (CBT)
Interpersonal psychotherapy
Reading depression self-help books based on CBT
Psychodynamic psychotherapy
65
Ten Common Thinking Distortions

1. Black and white
thinking
2. Setting unrealistic
expectations
3. Selective thinking
4. Converting
positives into
negatives
5. Over generalizing
6. Exaggerating
unpleasantness
7. Catastrophizing
8. Personalizing
9. Mistaking feelings
for facts
10. Jumping to negative
conclusions
Step 5
Encourage Self-Help
Strategies
Self-help strategies have proven

therapeutic effects
They also help people to feel they are
regaining control of their lives
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67

Lifestyle & Alternative Treatments Rating
Exercise
Light therapy
Yoga breathing exercises
Massage therapy
Relaxation therapy
Winter depression
Non-seasonal
depression
68

Lifestyle & Alternative Treatments
Rating
Acupuncture
St Johns wort*
Alcohol avoidance for people with drinking problems
Folate
* St Johns wort should not be taken with antidepressants.

This herb has interactions with a number of prescribed
medications.
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Resources
Refer to MHFA Canada Manual
Section 2, page 11
75
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
76
What are Anxiety Disorders?

An anxiety disorder differs from normal
anxiety
Anxiety disorders are more severe, they
last longer and they interfere with work
or relationships
There are several types of anxiety
disorders symptoms will vary.
77
Mind Racing?
Possible sleep
disturbance?
Feeling
breathless,
breathing fast &
Shallow?
Nausea, lack
of appetite?
Restless?
Jelly-like legs?
Dizzy, disoriented,
lightheaded?
Vision strange or
blurry?
Difficulty swallowing?
Heart racing,
palpitations?
Trembling?
Sweating or
shivering?
Wanting to
run?
78
General Symptoms of Anxiety

Physical
Cardiovascular: palpitations, chest
pain, rapid heartbeat, flushing
Respiratory: hyperventilation,
shortness of breath
Neurological: dizziness, headache,
sweating, tingling and numbness
79

Physical
Gastrointestinal: choking, dry mouth,
nausea, vomiting, diarrhea
Musculoskeletal: muscle aches and
pains (esp. neck, shoulders),
restlessness, tremors and shaking
80

Psychological
Unrealistic and/or excessive fear and
worry (about past or future events)
Mind racing or going blank
Decreased concentration and memory
81

Psychological
Difficulty making decisions, confusion
Restlessness, feeling on edge or
nervousness
Tiredness, sleep disturbances, vivid
dreams
Irritability, impatience, anger
82

Behavioural
Avoidance of situations
Obsessive or compulsive behaviour
Distress in social situations
Phobic behaviour
83
Types of Anxiety Disorders

Generalized anxiety disorder (GAD)
Panic disorder (with or without
agoraphobia)
Agoraphobia
Social anxiety disorder (social phobia)
Phobic disorders
Obsessive-compulsive disorder (OCD)
Post traumatic stress disorder (PTSD)
Acute stress disorder
84
Do You Worry All the Time?

Which problems have you had often over the
last 6 months?
I never stop worrying about things big
and small
I have headaches or aches and pains for
no reason
I am tense a lot and have trouble relaxing
I have trouble keeping my mind
on things
85
Do You Worry All the Time?

Which problems have you had often over
the last 6 months?
I get crabby or grouchy
I have trouble falling asleep or staying
asleep
I sometimes have a lump in my throat or
feel like I need to throw up when I am
worried
I sweat and have hot flushes
86
Generalized Anxiety Disorder (GAD)

Overwhelming and unfounded anxiety
Physical and psychological symptoms
of anxiety and tension for more than
6 months
General worries over money, health and
family etc. even when no problem exists
Do You Have Sudden Bursts of

Fear for No Reason?
87
Which problems have you had during these

bursts of fear?
I have chest pains or a racing heart
I have a hard time breathing or a choking
feeling
I feel dizzy, or I sweat a lot
I have stomach problems or feel like I
need to throw up
Do You Have Sudden Bursts of

Fear for No Reason?
88
Which problems have you had during these

bursts of fear?
I shake, tremble, or tingle
I feel out of control
I feel unreal
I am afraid I am dying or going crazy
89
Panic Disorder
A person with a panic disorder has
panic attacks
A panic attack is the sudden onset of
intense fear or terror
The attacks develop suddenly
The fear is inappropriate for the
circumstances in which it is occurring
90
Agoraphobia
Fear of panic attacks
Fear of being in a situation with no help
or escape
Avoidance of places where it is felt that
a panic attack could happen
91
Do You Feel Afraid or Uncomfortable

When You are Around Other People?
Is it hard to be at work or school?
I have an intense fear that I will do or say
something and embarrass myself in front
of other people
I am always very afraid of making a
mistake and being watched and judged
by other people
My fear of embarrassment makes me
avoid doing things that I want to do or
speaking to people
92
Do You Feel Afraid or Uncomfortable

When You are Around Other People?
Is it hard to be at work or school?
I worry for days or weeks before I meet
new people
I blush, sweat, tremble, or feel like I have
to throw up before or during an event
where I am with new people
I usually stay away from social situations
such as school events and making
speeches
I often drink to try and make
these fears go away
93
Social Anxiety Disorder

Common anxiety disorder
Fear of humiliation, embarrassment or
scrutiny by others
Fear that others are thinking negatively
about them
Tends to develop in shy children as they
move into adolescence
94
Phobic Disorders
A person with a phobia avoids or
restricts activities because of fear
The fear appear persistent, excessive
and unreasonable
The fear will cause the person to avoid
specific things, events or places
Have You Lived Through a Very

Scary or Dangerous Event?
95
Which problems have you had after the

event?
I jump and feel very upset when
something happens without warning
I have a hard time trusting or feeling close
to people
I stay away from places that remind me of
the event
I feel guilty because others died
and I lived
Have You Lived Through a Very

Scary or Dangerous Event?
96
Which problems have you had after the

event?
I have trouble sleeping and my muscles
are tense
I feel like the terrible event is happening
all over again. This feeling often comes
without warning
I have nightmares and scary memories of
the terrifying event
I get mad very easily
Post-Traumatic Stress Disorder

and Acute Stress Disorder
Post-Traumatic Stress Disorder (PTSD)
and Acute Stress Disorder (ASD) occur
after experiencing a distressing event
ASD distress is usually resolved
within a month
PTSD distress lasts longer than a
month
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Do You Feel Trapped in a Pattern of

Unwanted and Upsetting Thoughts?
Are any of these problems interfering with
your life?
I have upsetting thoughts or images
enter my mind again and again
I feel like I cant stop these thoughts or
images, even though I want to
I worry a lot about terrible things that
could happen if Im not careful
99
Do You Feel Trapped in a Pattern of

Unwanted and Upsetting Thoughts?
Are any of these problems interfering with
your life?
I have unwanted urges to hurt someone
but know I never would
I have a hard time stopping myself from
doing things again and again, like
counting, checking on things, washing
my hands, re-arranging objects, doing
things until it feels right,
collecting useless objects
100
Obsessive-Compulsive Disorder
Obsessive thoughts and compulsive
behaviours accompany feelings of anxiety.
Obsessive thoughts are unwanted and
inappropriate recurrent thoughts, impulses
or images the person cannot get rid of.
Compulsive behaviours are repetitive
behaviours or mental acts such as
counting, checking or washing.
101
Risk Factors for Anxiety Disorders
Gender
People with an anxious parent
Difficult childhood (abuse, neglect)
Some medical conditions
Side-effects of some prescription drugs
Some non-prescription drugs (caffeine,
amphetamines, cocaine, etc.)
102
First Aid for Anxiety Disorders


or Harm
People with anxiety disorders are at
greater risk of dying by suicide,
particularly if they also have depression.
Suicidal Behaviour.
Step 2 Listen Non-Judgmentally.
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Crisis First Aid for Panic Attacks

1. If you are unsure if it is a panic attack
or a heart attack call an ambulance.
2. If you are sure it is a panic attack,
move the person to a quiet safe place.
3. Help calm the person by helping them
control their breathing.
4. Be a good listener, without judging.
105
Crisis First Aid for Panic Attacks

5. Explain they are having a panic attack
and it is not life threatening.
6. Explain the attack will be over soon
and they will recover.
7. Assure them that someone will stay
with them until the attack stops.
Crisis First Aid for Acute

Stress Reaction
1. Let the person tell their story but do not
push them to do so.
2. Be a patient and sympathetic listener.
3. Reassure the person that stress
reactions are normal responses to
abnormal events and in time most
people have a normal recovery of
their emotions.
106
Crisis First Aid for Acute

Stress Reaction
4. Encourage the person to share
feelings with others.
5. Advise the person not to use alcohol
or drugs to cope.
6. If the stress reaction persists for more
than a month, encourage the person
to seek professional help.
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108
Step 2
YOU ARE NOT LISTENING TO ME WHEN:

You say you understand.
You say you have an answer to my
problem, before Ive finished telling you
my problem.
You cut me off before Ive finished
speaking.
You finish my sentences for me.
109
Step 2
YOU ARE NOT LISTENING TO ME WHEN:

You are dying to tell me something.
You tell me about your experiences,
making mine seem unimportant.
You refuse my thanks by saying you really
havent done anything.
110
Step 2
YOU ARE LISTENING TO ME WHEN:

You try to understand me, even if Im not
making much sense.
You grasp my point of view, even when
its against your own sincere convictions.
You realize the hour I took from you has
left you a bit tired and a bit drained.
111
Step 2

You allow me the dignity of making my
own decisions, even though you think
they may be wrong.
You do not take my problem from me,
but allow me to deal with it in my own
way.
You hold back the desire to give me
good advice.
112
Step 2

You do not offer me religious solace
when I am not ready for it.
You give me enough room to discover for
myself what is really going on.
You accept my gratitude by telling me
how good it makes you feel to know that
you have been helpful.

Information
Anxiety is a real medical condition.
An anxiety disorder is a common
illness.
An anxiety disorder is not a weakness
or character defect.
Effective help and treatments are
available.
Anxiety can be unpleasant but is rarely
harmful.
113
114
Step 4


Counselling or psychotherapy for
specific anxiety disorder
Step 5
Encourage Self-Help
Strategies
Anxiety is best overcome by confronting

fear rather than avoiding it
Use evidence-based self help books
Practice daily relaxation methods to
reduce physical symptoms of tension
Exercise regularly and get enough sleep
Reduce caffeine intake
Engage in leisure time
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What Helps for Anxiety Disorders?

Treatments
Anxiety Disorder
Rating
CBT self-help books
Specific phobias
Physical exercise
Generalized anxiety disorder
Relaxation training
Acupuncture
117
What Helps for Anxiety Disorders?

Treatments
Anxiety Disorder
Rating
Meditation
Relaxing Music
Alcohol Avoidance
Range of anxiety disorders
118
Resources
Section 3, page 10
119
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
Other expressions of distress
120
What is Psychosis?
Psychosis is a mental health problem in
which a person has lost some contact
with reality
Severe disturbances in thinking,
emotion and behaviour
Psychotic illnesses are not common
compared to other mental health
problems
121
What is Psychosis?
Psychosis may appear as a symptom in
a number of mental health problems
including:
Schizophrenia
Schizoaffective disorder
Brief psychotic disorder
Psychotic disorder due to a general
medical condition
Substance induced psychotic
disorder
122
Symptoms of Psychosis
Changes in emotion and motivation
Depression or anxiety
Suspiciousness
Blunted, flat or inappropriate emotion
Irritability
Change in appetite
Reduced energy and motivation
123
Changes in thinking and perception
Difficulties concentrating
Sense of alteration of self or others
feeling that self or others have changed
or are acting differently
Odd ideas
Unusual perceptual experiences
reduced or greater intensity of smell,
sound, colour
124
Changes in behaviour
Sleep disturbance
Social isolation or withdrawal
Reduced ability to work or carry out
social roles
Odd or strange behaviour
125
Changes in speech
Disorganized speech
Speech becomes rapid
126
Schizophrenia
Schizophrenia is a chronic and
disabling disorder
Mental function changes and thoughts
and perceptions become disordered
Schizophrenia is not a constant or static
condition severity of symptoms
fluctuate or do not appear at all
127
Symptoms of Schizophrenia
Delusions
Hallucinations
Thinking difficulties
Loss of drive
Blunted emotions
Social withdrawal
128
Other Psychotic Disorders

Psychotic depression a depression so
intense it causes psychotic symptoms
Schizoaffective disorder Symptoms of
both schizophrenia and mood disorder
(depression, bipolar disorder)
Substance induced psychosis psychosis
brought on by drug use. Drug use may
also trigger another psychotic
illness such as schizophrenia
129
Risk Factors for Psychotic Disorders

It is believed that psychosis is caused by
a combination of factors including:
Genetics
Biochemistry
Stress
130
First Aid for Psychotic Disorders


or Harm
Psychotic disorders involve high risk of
suicide
Suicidal Behaviour
131
What if a Psychotic Person is

Threatening Violence?
1. Do not get involved physically
2. Call the police
3. Try to create a calm, non-threatening
atmosphere
4. Try to get the person to sit down
5. Do not try to reason with acute psychosis
6. Express empathy for the persons emotional
distress
7. Comply with reasonable requests
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Step 2
Listen to the person without judging

Speak calmly, clearly and in short
sentences
Do not be critical of the person and do
not express frustration with the person
Do not give glib advice such as pull
yourself together
134
Step 2
Avoid confrontation unless necessary to

prevent harmful acts
Do not argue with the person about
their delusions and hallucinations but
do not pretend they are real to you

Information
When a person is in a psychotic state it
is difficult and inappropriate to give
them information about psychosis wait
until they are in touch with reality
Do not make promises you cannot keep
and do not lie
135

Information
When the person is thinking more
clearly explain:
You want to help them
They have a real medical condition
Their condition is not a common illness but
well known and researched
Psychosis is not a weakness or character
defect
Effective medications are available
136
137
Step 4

Early intervention is important. The

person needs to be placed on
appropriate medication
Psychiatrist
Community mental health teams
Family and friends
Step 5
Encourage Self-Help
Strategies
Have an agreement with family/friends

Many people with a psychotic disorder
also have depression and/or anxiety
The self-help strategies for these
conditions may help but should not be
the main source of treatment
138
139
Resources
Section 4, page 8

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Instructor

Course Outline Session 1

Mental Health First Aid

Course Outline Session 2

Course Outline Session 3

What are anxiety disorders?

Course Outline Session 4

What are psychotic disorders?

World Health Organization

The Mental Health Continuum

What are Mental Health Problems?

What is Mental Health First Aid?

The Five Basic Steps

Assess risk of suicide or harm

Encourage self-help strategies

Why Mental Health First Aid?

Imagine if we treated everyone like

Why Mental Health First Aid?

The ALGEE Rap

Assess situation and evaluate the risk

What is a Substance Use Disorder?

One Standard Drink

Centre for Addiction and Mental Health

Low-Risk Drinking Guidelines

Long-Term Effects of Alcohol

Other Abused Substances

Other Abused Substances

Other Abused Substances

Other Abused Substances

Other Abused Substances

Other Abused Substances

Other Abused Substances

First Aid for Substance Use Disorders

Assess risk of suicide or harm

Encourage self-help strategies

Step 1 Assess the Risk of Suicide

Crisis First Aid for an Overdose

Phone 911 for an ambulance

Crisis First Aid for an Overdose

Step 2 Listen Non-Judgmentally

Step 2 Listen Non-Judgmentally

Step 3 Give Reassurance and

Encourage the Person to Get

Family doctor or physician

The Change Model

Many people with a substance use

If you can always be cheerful

Depression in the Workplace

Bipolar Disorder (Manic Depression)

Symptoms of Bipolar Disorder

Risk Factors for Depression

Risk Factors for Depression

Side effect of medications or drugs

Suicide Rates by Province

First Aid for Depression

Assess risk of suicide or harm

Encourage self-help strategies

Step 1 Assess the Risk of Suicide

Crisis First Aid for Suicidal Behaviour

Crisis First Aid for Suicidal Behaviour

Listen to the person without judging.

Step 3 Give Reassurance and

Encourage the Person to Get

What Helps for Depression?