MENTAL HEALTH AWARENESS TRAINING FOR PROBATION WORKERS

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MENTAL HEALTH AWARENESSTRAININGFOR PROBATION
WORKERS
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• Trainer and Group Introductions
• Housekeeping
• Ground Rules
• Confidentiality
• Take time out and seek further support if
  needed
• Respect yourself and each other
• Allow each other time to talk
• Look after our own and each others wellbeing
• Ice Breaker Exercise

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CONTENTS
Course Structure Defining mental health and
coping What is mental illness The mental health
continuum Mental Illness and Stigma Mental
disorders The Offender with Anxiety The Offender
with Depression The Offender with Eating
Distress The Offender with Bi-Polar Disorder The
Offender with Schizophrenia The Offender with a
Personality disorder Young Offenders and Mental
Health Mental health in Older Offenders Self
injury and Suicidal Behaviour The Offender
with Dual Diagnosis Communication Working with
risk Diversity and Equality
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MENTAL HEALTHGroup activity

• How would you define good mental health?
• How would you define poor mental health?

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MENTAL ILLNESS AND STIGMA

• 25 of us may experience mental distress at
  some point in our lives.
• We can all have positive and negative life
  experiences which have an impact on how we
  think, feel and engage with the world.
• Certain circumstances increase the risk of
  mental illness.

The stigma surrounding mental illness adds to the
distress and isolation felt by offenders who
experience mental health problems
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COPING MECHANISMSGroup activity

• What coping mechanisms do you use to maintain
  or improve your mental health?
• What resources might offenders use to help
  themselves cope?

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HOW WOULD YOU DEFINE MENTAL HEALTH?
Mental health is the emotional and spiritual
resilience which enables us to enjoy life and to
survive pain, disappointment and sadness. It is a
positive sense of well-being and an underlying
belief in our own, and others dignity and
worth. Mental Health Promotion 2006
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MENTAL DISORDER
What are the causes of mental disorder?
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WHAT FACTORS COULDCAUSE MENTAL DISTRESS
Many theories, many factors, complex reasons
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THE MENTAL HEALTHCONTINUUM
Where are you on the continuum at the moment?
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THE MAIN CATEGORIES OF MENTAL DISORDERS
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WHAT IS ANXIETY?

• Anxiety is physiological sense of unease we
  experience in response to environmental
  stressors.
• More prevalent amongst offenders.
• Often associated with other mental illnesses,
  such as depression and Post Traumatic Stress
  Disorder.
• Considered a mental health problem when it is
  prolonged, severe and interferes with everyday
  activities.
• If left unmanaged may develop into other
  problems such as panic attacks, phobias and
  obsessive compulsive disorders.

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ANXIETY

• What are the physical and psychological effects
  of anxiety?
• How can we recognise it?

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THE EFFECTS OF ANXIETY
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PANIC ATTACKS
Anxiety may take the form of a panic attack..

• Panic attacks are a rapid build-up of powerful
  sensations generally associated with physical
  feelings
• Pounding and sometimes irregular heartbeat
• Chest pains, inability to breathe
• Feeling faint and/or sick, sweating
• Shaky limbs, legs turning to jelly
• Feelings of losing control
• Offenders fear that they are going mad,
  blacking out or having a heart attack.
• It can be a terrifying experience.

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WHAT IS DEPRESSION?

• Symptoms of depression vary from offender to
  offender but may include
• Low mood low energy neglect of personal
  hygiene.
• Disturbed sleep or appetite.
• Withdrawing from social situations.
• Loss of interest in usual activities.
• Low self-worth
• Depression can be a long-term illness or may
  last for just one episode.
• The severity and effect it has on the offender
  varies significantly

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DEPRESSION

• Make a list of some of the symptoms of
  depression

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HOW DO YOU THINK AN OFFENDER WITH DEPRESSION
MIGHT BEHAVE?
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EATING DISTRESS

• Eating disorders are treatable medical
  conditions.
• Although eating disorders are experienced
  predominantly by women men can be also be
  affected
• Offenders with an eating disorder may also have
  other mental health problems such as
  generalised anxiety or depression.
• In severe cases eating disorders can lead onto
  physical health problems including heart
  conditions and kidney failure.

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EATING DISTRESS

• How would you define eating normally?
• Is it the same for everyone?

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UNDERSTANDING OFFENDERS WITH BIPOLAR DISORDER

• Bipolar illness (manic depression) is a mood
  disorder which can involve extreme swings of mood
  ranging from severe depression to severe mania
  (lows to highs).
• There may be long periods of stability in
  between.
• Each individual will have a unique pattern of
  severity and duration.
• The most common types of Bipolar disorder are
  known as Bipolar I and Bipolar II

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BIPOLAR I AND BIPOLAR II
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HOW DOES MANIA AFFECT INDIVIDUALS

• Incoherent, rapid or disjointed thought
• Paranoia
• Hallucinations affecting vision, hearing or
  perception
• Grandiose delusions or ideas
• Psychosis losing touch with reality

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HOW DOES HYPOMANIA AFFECT INDIVIDUALS

• Hypomania is a less severe form of mania.
• Self confident and euphoric but may also react
  with sudden anger, impatience, or become
  irritable.
• More ideas than usual, very creative.
• More reckless, more talkative or more
  challenging.

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THE DEPRESSIVE PHASE IN BIPOLAR DISORDER IS
SIMILAR TO DEPRESSION

• Severe depression usually follows an episode of
  mania.
• Feelings of emptiness or worthlessness.
• Loss of energy and motivation for many or all
  day-to-day activities.
• Pessimism and negativity about most things (or
  everything).
• Thoughts of death and suicide can be common but
  may be hard to discuss.

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WHAT IS SCHIZOPHRENIA?
Schizophrenia is a severe mental disorder,
characterized by profound disruptions in
thinking, affecting language, perception, and the
sense of self. It often includes psychotic
experiences, such as hearing voices or delusions.
It can impair functioning through the loss of an
acquired capability to earn a livelihood, or the
disruption of studies. (W.H.O. 2009).
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STIGMA AND SCHIZOPHRENIA

• Its important to say that Schizophrenia is not
• Split or Multiple Personalities
• Caused by parents or the way someone was
  brought up
• Untreatable
• A guarantee that a person will be in hospital
  for life.
• A guarantee that the offender will be
  dangerous.
• People with Schizophrenia are more likely to
• Harm themselves
• Be passive
• Withdraw

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SCHIZOPHRENIA

• Generally 1 in 100 people experience
  Schizophrenia
• The highest incidence is in the late teens and
  early twenties
• It affects men and women equally
• Onset of illness is earlier in men than women
• 25-50 of sufferers make a full recovery
• 25 may experience long lasting problems

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HOW ARE INDIVIDUALS AFFECTED BY SCHIZOPHRENIA?

• Hallucinations
• Delusions
• Agitation
• Disorganised thinking
• Slowness to move, think, speak, react
• Social withdrawal
• Apathy
• These experiences may occur separately, together
  or alternately.

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UNDERSTANDING HALLUCINATIONS

• Hallucinations are when a person hears, sees,
  smells or feels things that others do not.
• The most common type are auditory
  hallucinations - i.e. hearing voices.
• To the person experiencing them the voices are
  very real.
• These experiences can be very frightening.

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DELUSIONS

• Delusions happen when a person has a belief that
  seems very real to them but others do not share.
• Examples include
• Having special powers - e.g. the ability to
  read other peoples minds.
• Believing that people are against them.
• Thinking that people may be trying to harm
  them.
• Their thoughts are being broadcast out loud.
• Everybody knows what they are thinking.
• It is important to bear in mind the cultural
  context strange behaviour in our culture may
  not be considered strange in other cultures.

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PERSONALITY DISORDERS

• An offender with a personality disorder may show
  some of the following traits
• Aggression and sudden outbursts of
  inappropriate anger.
• Signs of anxiety or depression.
• Deliberate acts of self harm.
• Signs of eating distress.
• Provocative and antagonistic behaviour.
• Pre-occupation with routine.
• Lack of emotion and remorse and/or taking
  everything personally.
• Constantly seeking approval.
• Dependence on others, deceitfulness, bullying
  and disregard for others.

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OLDER PROBATION SERVICE USERSGroup activity

• Why might older adults in the criminal justice
  system be more vulnerable than younger adults?
• What particular problems do older adults face
  within the criminal justice services?

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SELF HARM AND SUICIDEGroup activity

• What are the causes of self harm?

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DUAL DIAGNOSIS

• The term dual diagnosis can be defined in a
  number of ways but for the purpose of this
  publication it will be taken to mean the
  co-existence of severe mental health and
  substance misuse problems.
• It is generally accepted that individuals with
  dual diagnosis suffer poorer health outcomes and
  present significant challenges to both health and
  criminal justice services.

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HOW ARE MENTAL DISORDERS TREATED?

• Prescribed medication
• Self and advocacy groups
• Talking therapies
• Advocacy
• Complementary therapies
• Some people find prescription medicine helpful,
  while others find that talking treatments are
  better. For some people find that a combination
  works best.
• Everyone is different and what works for one
  offender may not work for another.

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REFERRING ON

• When would you need to refer to Mental Health
  services?
• Where do you refer to?
• Is there a single entry to Mental Health
  services?
• Are you aware of local care pathways?
• Group to discuss