chapter 7 Flashcards
Priorities for social workers
- improve access services and supports
- Reduce stigma
Mental health and substance
use cross multiple systems
that receive different levels of
funding and are administered
in different ways across
different levels of government,
including:
Health care
social services
criminal justice systems
dual diagnosis
people struggling simultaneously with both substance use and mental health issues Substance use Mental health
Mental health and substance use
have impacts in both
private and
public sphere
Mental health and substance: They do not impact just the person facing the issue but also…
others in
their social ecology
“The capacity of each and all of us to
feel, think, act in ways that enhance
our ability to enjoy life and deal with
the challenges we face. It is a positive
sense of emotional and spiritual well-
being that respects the importance of
culture, equity, social justice,
interconnections and personal dignity”
Mental health
“Characterized by changes in how we
think, feel, and behave that are
associated with significant distress and
interfere with our ability to function at
school, work, and home”
Diagnosed by mental health providers
Example: Depression and Anxiety
Mental illness
True or false : People may have a diagnosed mental illness but still have strong mental health and experience positive emotions and functioning
TRUE
someone who does not have a diagnosed
mental illness cannot be experiencing emotions that are distressful and/or that interfere with their
functioning
False: the can experience emotions that are distressful and/or that interfere with their
functioning.
Complicated because the use of substances that can alter a person’s mood, cognition, or behavior is _________ in our society
common
Substance use includes substances that are:
- Legal (e.g. alcohol, caffeine, cigarettes)
- Illegal (e.g. heroin, meth)
- Misused legally prescribed medications (e.g. Adderall)
- Misused items outside of their designated use (e.g. “huffing gasoline”, whippets)
When the use of substances is chronic
and repetitive and begins to impair
one’s functioning, social relationships,
health, and life
substance misuse or abuse
are conditions that are diagnosed by
mental health professionals
substance use disorders
General considerations for substance abuse
- cravings
- Desiring to reduce or stop use but not being able to.
- Using larger amounts of substances or for a longer period of time than intended.
- using substances when it puts you in danger
- Continuing to use substance even when it causes problems in relationships.
- Neglecting responsibilities and other life activities
due to substance use. - Developing withdrawal symptoms when you try to stop.
- Developing a tolerance such that it requires more use to get desired effect
About 1 in 5 Canadians self-report that they are
flourishing and in excellent mental health
About 1 in 5 Canadians report a
mental illness or substance abuse disorder in any given year, most commonly mood and anxiety disorders
true or false: almost a third of people who experience mental illness or substance abuse issues experience them both
true
9 out of 10 Canadians who die by suicide have a
diagnosed mental illness or substance abuse disorder
Estimated that mental illness and substance abuse
cost Canadian society over $50 billion a year due to:
direct service costs
Economic impacts in the workplace
Decreased tax revenue
health care, income security, and social services for people facing these issues
direct service costs
decreased productivity (presenteeism), absenteeism, workplace injuries, etc. which resulted in
reduced revenue for employers
loss of tax revenue for the
government when people cannot work due to
mental illness or substance abuse issues
Decreased tax revenue
Caregiving costs:Due to the chronic and
unpredictable nature of mental
illness and substance abuse, family
members often have to
take time from work to care for family
members experiencing these
issues
Due to the criminalization of some substances as well as criminal justice system responses that focus on ______ rather than ______approaches to both mental illness and substance use (especially for racialized, poor, and Indigenous peoples) there are also significant criminal justice system costs
punitive rather than rehabilitative
Rather, the primary response for dealing with
excessive and public drunkenness was
incarceration
substance abuse was the result of
low moral character
Because it was believed that excessive substance use was the result of low moral character, it was
believed that the only way to address it was
to limit the source and deter use through punishment (jail time)
structural issues and injustices also contribute
to
trauma
trauma can cause
mental health and substance issues
people with race, class, and ability privilege
Empathy and rehabilitation
people with disabilities,
poor people, racialized people, and Indigenous
people
Fear and criminalization:
Mental health and substance use services are covered when they are provided by
physicians or hospitals
Pre-confederation through
the early 1900’s, public
responses to both mental
illness and substance use
were framed by a concern
with:
Morality, and social control
Post WW2
- Advances in the field of psychology + birth of
Alcoholics Anonymous movement - Rejection of idea that mental health issues
and substance use are about moral failings - Embrace of the “disease model”
- Soldiers returning after WWII with urgent
mental health and substance use concerns - Increased empathy for those impacted and
sense of public responsibility - Increased government investment in services
(but not enough to meet the demand)
Deinstitutionalization mouvement
Large scale move in the 1960’s-1970’s to close mental hospitals
closing mental hospitals was driven by
- Growing advocacy and recognition of the deplorable and inhumane conditions
in many mental health institutions - Advances in pharmacological and psychiatric treatments which would allow
individuals to be served in the community - Cost pressures
result of closing the hospitals
people who were released from mental
institutions fell threw the cracks and ended up homeless, in poor housing, in prison, or back in mental hospitals
integrated model highlights how people can move upward toward recovery and well-being along any of the four distinct but related continua
Harm reduction
is a housing and harm reduction model that
argues that housing is a human right for all and should not be
contingent upon individual behavior (including the use of
substances or the management of mental health symptoms)
apid access to housing without
requiring people to first stop using drugs or other substances or
to first have their symptoms of mental illness under control
Housingfirst
efforts to reduce the negative impacts from the use of illegal drugs and other substances without requiring abstinence”
harm reduction
Examples of harm reduction policies:
- Needle exchange programs
- Supervised consumption sites
- Substitution therapies that substitute safer drugs for
more harmful ones (ex: methadone for heroin)
Stressed pragmatic benefits
* People will use drugs anyway, so it’s beneficial to
reduce the risk to them and to others by providing
the mechanisms for them to do so safely
Public health
- Stressed the human rights of people who use
substances, specifically the right to self-determination - People have the right to make choices without the risk of stigma, punishment, or censure
Activism
Activism
___________ are at the forefront of developing
innovative and evidence-based practices to reduce
substance-related harm. Harm reduction principles
are congruent with _______________, which
promote a ___________ approach to substance use, recognizes self-determination, perceive that outcomes are in the hands of people who are living. substance use problems, and provide options in a
non-coercive way”
Social workers, social work values , non judgemental
People with substance use and mental illnesses
over- represented among the homeless population
is a housing and harm reduction model that
argues that housing is a human right for all and should not be contingent upon individual behavior (including the use of substances or the management of mental health symptoms)
Housing First
Housing First provides
rapid access to housing without
requiring people to first stop using drugs or other substances or to first have their symptoms of mental illness under control
participants in At
Home/Chez Soi were more likely to
get and keep housing and to improve their over-all quality of life”
As the number of deaths from
the opioid crisis have climbed
the case for stronger harm
reduction policies has gained
momentum.
Both activists and
public health specialists argue
that supervised consumption
sites and needle exchanges do
not go far enough and are
calling for decriminalization
Not a single approach but a set of principles and policies grounded in harm reduction.
Recognizes the specific harms that result not solely from use but also specifically with criminal justice system involvement as a result of substance use
DECRIMINALIZATION
was developed through consultations with thousands of canadians and hundreds of stakeholders groups and through careful review of the latest research and the experiences of the other countries in developing national mental health strategies. In order to respond to the needs of people with mental illness but to also be meaningful for all people in canada, the strategy rests upon a paradigm shift in mental health policy toward not just recovery but well-being also
Mental health strategy for canada
a comprehensive, collaborative, compassionate and evidence based approach to drug policy
Canadian drugs and substance strategy
prevention
treatment
harm reduction
enforcement
preventing problematic drug and substance use
prevention
supporting innovative approaches to treatment and rehabiliation
treatment
supporting measures that reduce the negative consequances of drug and substance use
harm reduction
addressing illicit drug production, supply and distribution
enforcement
envisions suicide prevention as a shared national regional and community wide effort that engages individuals, families, and communities.
NATIONAL INUIT SUICIDE PREVENTION STRATEGY (NISPS)
Risk Factors (nisps) :impacts of colonialism, residential schools, relocations and dog slaughter
historical trauma
Risk Factors (nisps) : social inequalities including crowded housind, food insecurity, lack of access to services
community distress.
Risk Factors (nisps) : intergentational trauma, family violence, family history of suicide
wounded family
Risk Factors (nisps): experiencing acute or toxic stress in the womb, witnessing or experiencing physical or sexual abuse
traumatic stress and early adversity
Risk Factors (nisps) : depression, substance misuse, mental health disorder, self-harm
mental distress
Risk Factors (nisps) recent loss, intoxication, acess to means, hopelessness, isolation
acute stress or loss
protective factors (nisps): strongly grounded in unnuit languages
cultural continity
protective factors (nisps): adequate economic, educational, health and other resources support and foster resilience
social equity
protective factors (nisps): safe, supporting and nurturing homes
family strength
protective factors (nisps): providing children with safe environments that nurture social and emotional development
health development
protective factors (nisps): acess to inuit-specific mental health services and supports
mental wellness
protective factors (nisps): ability to cope with distress, access to social supports and resouces
coping with acute stress
