Basic Topics on Mental Health

1
Basic Topics on Mental Health

• Trainer's guide

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Module One Introduction

• Lesson 1 What is mental disorder
• (3 training hours)
• Lesson 2 Psychiatric evaluation
• (2 training hours) 
• TOTAL TIME (5 training HOURS)

3
Lesson 1

• WHAT IS MENTAL DISORDER
• TIME
• 135 MINUTES (3 training hours of 45 minutes)
•  

4
Step 1 Brainstorming (10?)  

• which do you think that are, in general, the
  human needs so that they have good mental health?

5
Step 2 Group discussion(20?)

• Why persons with psychiatric problems might have
  extra difficulties?

6
Step 3 theory presentation (15?)

• The term mental disorder comprise a variety of
  problems that are connected to the mental
  situation and the behavior of the person
• Various mental disorders are manifested through
  a variety of symptoms, such as delusions,
  sentimental instability, conduct disorders,
  memory decline, etc.

7
Step 3 (continued)

• The mental disorder might be the result of a
  physical illness or to be manifested through
  physical symptomatology
• A large group of mental disorders is psychosis in
  which the patients loose in a degree the
  conscience of reality and manifest symptoms like
  delusions or aberrative ideas (hallucinations).
  Such disorders are Schizophrenia and Bipolar
  Disorder.

8
Step 3 (continued)

• Another group includes the disorders related to
  anxiety (neurosis). This includes the Anxiety
  Disorders, Phobias, Obsessive Compulsive
  Disorders etc
• The conduct disorders comprise the different
  situations where the personality has implanted
  elements that make difficult the adaptation and
  the social behavior of the person

9
Step 3 (continued)

• Some mental disorders might be connected with the
  damage of encephalic structure. These are called
  Organic Mental Disorders and an example is
  Dementia. Alcohol and toxic agents abuse might
  also cause mental disorders.

10
Step 3 (continued)

• The mental disorders can be separated to many
  diagnostic categories. At diagnosis are used two
  official Classification Systems that are
  internationally recognized. One is The
  Diagnostic and Statistical Manual of Mental
  Disorders, 4th Edition, known as DSM-IV, which
  comes from the USA. The other is ICD 10
  International Classification of Diseases, 20th
  edition of WHO (World Health Organisation),
  Chapter 4 Mood (affective) disorders

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Step 3 (continued)

• The use of classification Systems is additional
  to the accurate diagnosis of mental disorders, to
  educational purposes and to facilitate the
  communication of the professionals in mental
  health and in research. Especially with DSM- IV
  apart from the categories of the diseases, it is
  possible to evaluate important psychological and
  social factors that influence a patient, as well
  as its efficiency in total.

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Step 4 Exercice (15?)

• leaflet 1.1Causal Factors of Mental Disorders
• Who do you think are in priority the most
  important factors that cause mental disorders?

13
Step 5 discussion (10?)

• What are the treatment choices used for treating
  mental disorders?

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Step 6 new ideas (15?)

• What is your opinion for
• The rate of incidence of mental disorders?
• The participation of men and women in these?
• The social predisposition factors?
•       

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Step 6 (continued)

• The mental disorders can be manifested at in any
  age (children, adults, elderly).
• A research in USA proved that about one third of
  adults manifested a mental disorder within 12
  months.
• About half the population presents a mental
  disorder during its life.

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Step 6 (continued)

• Some types of mental disorders are more common
  than others.
• Women in general manifest more often mental
  disorders.
• Social factors that predispose the manifestation
  of mental disorders include situations such as
  poverty, isolation, immigration, unemployment,
  widowhood, divorce etc.

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Step 7 Summary (5?)

• Which are the needs of the person that should be
  satisfied in order to enjoy good mental health.
• Why the persons with mental disorders might have
  additional needs.
• Which are the mental disorders.

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Step 7 (continued)

• Which factors contribute to their cause ?
• Which are the ways of treatment?
• What is their rate of incidence and in which
  categories of persons are more often.

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Step 8 Exercise (30?)

• Paper and pen
• Think and write a problem or a difficulty you or
  someone that you know had during supporting
  persons with mental disorders.

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Step 9 Conclusion (5?)

• In order to diagnose the needs of persons with
  psychiatric disorders, you should know the
  following
• Why the persons with mental disorders need the
  understanding of their biological, psychological
  and social problems.
• How can these problems be manifested.
• What can professionals offer.

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Step 10 questions and comments (5?)

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Step 11 lessons evaluation(5?)

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Lesson 2

• PSYCHIATRIC EVALUATION
• TIME
• 90 Minutes (2 instructive hours of 45 minutes)
•  

24
Step 1 Introduction (10?)

• When the patient is examined from a psychiatrist
  or another professional in mental health, he
  always does a psychiatric evaluation.
• This is usually done in the context of an
  interview with the patient and eventually with a
  relative or a person that knows him very well.

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Step 1 (continued)

• Additional information are also collected from an
  older medical report of the patient (if it
  exists) or from members of the personnel that
  know him
• Furthermore there are some tests to be done,
  where it is judged necessary, but the main source
  of information is the psychiatric interview.

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Step 1 (continued)

• Even though the psychiatric interview has to be
  done in a calm space without interventions or
  disturbances, there are unfortunately occasions
  that it is done in noisy and crowded places, as
  for example the Out-patients clinics of a
  hospital.

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Step 1 (continued)

• The interview constitutes a way of collecting
  information through the appropriate questions and
  observation. It is however a good way to create a
  good relation with the patient, which is
  therapeutic by itself.
• The patient might also consider useful to ask
  some questions and have information for his
  problem.

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Step 2 Slide projection(15?)

• Slide 1.2.1 what a psychiatric evaluation
  includes
• Psychiatric interview
• Personal data
• ???? pa?ap?µp??
• Main disturbances and problems
• Case history of these problems
• Development history
• Family history
• Medical report
• Report of substances used
• Examination of mental functions

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Step 2 (continued)

• Psychological tests
• Physical examination and lab tests
• Haematological tests
• X-rays
• Brain Electro Scan
• Brain Section Scans

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Step 3Slide projection (20?)

• Slide 1.2.2 examination of mental functions
• Appearance and behavior
• Clothing and appearance
• Posture and walking
• Physical characteristics
• Face expression
• Eye contact
• Gesture activity
• Mannerisms

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Step 3 (continued)

• Talking it can be examined by observing the way
  that the patient talks
• Rhythm
• Tone, Volume, Clearness
• Disturbances

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Step 3 (continued)

• emotional situation Comprises the examination of
  the mood that is related to how the patient
  himself feels and the feeling that is the
  manifestation to the outside of this mood. The
  examination of the mood is done thanks to a
  series of questions (for example how is your
  mood like lately?), while the evaluation of the
  feeling is done by observation.
• Mood
• Emotion (variety, intensity, mutability,
  unsuitability)

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Step 3 (continued)

• Thought the evaluation of thinking is based on
  what the patient says either by himself either
  responding to questions.
• Coherence (flow of ideas, quality of association
  of ideas)
• Content
• Distortions (aberrative ideas)
• Obsessional activities (compulsions, phobias,
  hypochondriasis)
• Morbid activities (depressive aberrative ideas)
• Suicide or homicide tendency

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Step 3 (continued)

• Perception It is related to the stimulus income
  from the environment with the sensations of the
  person. The perception whether it is examined
  simply by observation whether with appropriate
  questions (ex. has ever happened to hear people
  talking around you while other people could not
  hear it?
• Hallucinations
• Delusions
• Depersonalization, ap?p?a?µat?p???s?

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Step 3 (continued)

• Emotional situation and mental functions There
  are mainly used special questions for the
  examination of these functions.
• Conscience and orientation
• Concentration
• ???µ? (?µes?, ???sfat?, ?p?te??) Memory ()
• ?p??eµa ???s??
• ?fa??et??? ??a??t?ta abstraction
• ???s? judgment
• ??a?s??s?a

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Step 4slide projection (15?)

• Slide 1.2.3psychological tests
• IQ test (WAIS-R IQ tests)
• Personality tests
• ???ß??t??? test (Rorschach, ???)
• Personality Inventory (MMPI, EPQ)
• Neuropsychological tests (Bender Gestalt)
• Diagnostic tests (PSE, SADS, SCID)
• Psychiatric Rating Scales (BPRS, Hamilton Rating
  Scale for Depression, Beck Depression Inventory
  and Mini Mental State Examination)

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Step 5Group Discussion (20?)

• What is the purpose of psychiatric evaluation ?
• Who is conducting it?

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Step 6 Questions and comments (5?)

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Step 7 lessons evaluation (5?)