Mental health - paeds & adolescent Flashcards
Assessment of child development?
- are the behaviours limited OR persistent ?
- diagnosis from a temporal assessment
- Based on the level of disruption to family and child’s development e.g. school progress
What are the two types of mental health problems and mental disorders in childhood?
- Internalising disorders
2. Externalising disorders ( disruptive behaviour disorders)
What are internalising disorders?
= over controlled behaviours such as anxiety and depression
- Feelings of loneliness, sadness, low self-esteem anxiety, general fears
- Separation anxiety
What are externalising disorders?
= antisocial behaviours such as delinquency or aggression
- Break rules, bulling, fighting, tantrums
- ADHD/ADD
Conduct disorder
- Disruptive with severe and persistent behaviour problems
Autism spectrum disorder
- Lifelong developmental disability
- Characterised by deficits in social communication and fixated interest
What are the treatment options for mental disorders in childhood?
- Adequate assessment
- psychological interventions
- pharmacological interventions
- educational interventions
- reward dominance
- family interventions
Nursing goals of childhood mental health disorders?
Nursing goals
- being loved and safe, having strong relationships, positive experiences and supportive environments, actively participating in
community and social activities
- building an adaptive capacity allows the child to manage the transition and stresses they will experience in childhood/life
List 5 common mental health disorders in children:
- depression
- suicide
- Psychotic disorders
- Substance use disorders (SUD)
- Trauma
What is the overview and symptoms of depression in children ?
- Different in adolescence to adults
- More agitation and less melancholy
Symptoms
• Unusually sad or irritable mood that doesn’t go away
• Loss of enjoyment and interest in loved activities
• Lack of energy and tiredness
• Feeling worthless
• Thinking about death
• Difficult concerntation, moving slowly, Difficulties sleeping, Loss of interest in food
What is the treatment for depression in children?
First line: therapy • Cognitive behaviour therapy • Acceptance and commitment therapy • Psychodynamic therapy • Family therapy • Medication considered if needed • Antidepressants
What are the symptoms of Suicide in children ?
- Threatening to hurt or kill themselves
- Seeking access to things to kill themselves
- Talking or writing about death
- Hopelessness
- Rage, anger
- Engaging in risky activities
- Feeling trapped
What is the treatment for suicide in children
Preventing Assessing for risk: • Asking does not give them ideas • Are you having thoughts of suicide? • Are you thinking of killing yourself? • Do not leave a young person alone if they disclose thoughts of suicide
What is the overview and symptoms of psychotic disorders in children ?
- Schizophrenia
- Bipolar disorder with psychosis
- Drug induced psychosis
- Schizoaffective disorder
Symptoms
• Changes in thinking, perception. Behaviour, mood, and motivation
Symptoms when psychosis is present
• Delusions, hallucinations, thinking difficulties, loss of drive, blunted emotions, social withdrawal
What is the treatment for psychotic disorders?
Medication is first line
• Antipsychotic medication (1st & 2nd generation)
• Therapy is also important
• Management of physical health
What is the overview for substance use disorders in children?
- Dependence on alcohol or other drugs Needing more, craving and withdrawal symptoms
- Leads to Love, liver, livelihood, and law
What is the treatment for substance use disorders in childhood?
Motivational interviewing
• Treatment of any underlying MH condition
• Psychoeducation around harm minimisation
What is the overview of trauma during childhood?
• DV screening • All disclosures need to be taken seriously • Ensure they are safe • All HC workers are mandatory reporters •
What is the treatment for trauma in childhood?
Therapy is not possible while still in unsafe environment
• Establishing safety first
• Building rapport and creating a therapeutic relationship
• Trauma informed care
• Non-talking therapies
• Narrative therapy
• Supportive counselling
What is community treatment for MH in childhood?
GP or paediatrician (first call)
- services available: school counsellor, youth services, headspace etc
What are the early interventions for MH in children?
= aim to avoid disruption to development
- cognitive, social, psycholgical, physical,
- longer the illness is left the harder it is to treat
What are the nursing goals for children with MH disorders?
- engage patient and make them feel like you are safe to speak to
- feel confident to assess for risk
- speak to them about strategies they may already have
