Module 5: Mental Health Awareness: Prevention, Early Recognition, and Support Flashcards
What is managing distress
-being able to manage distress refers to learning how to cope with negative or difficult emotional status
What is the “tipping point”
-is the point at which someone begins showing signs and symptoms of the strain/burden of perceived stress
Components of the stress diathesis model
-stress
-diathesis
Stress in the stress-diathesis model
-stress triggers several interconnected biological systems
-body adapts to this stress through allostasis
Diathesis in the stress diathesis model
-refers to the concept of vulnerability
-can be biological through genetic inheritance, a psychosocial vulnerability created by exposure to a stressor early in life
Steps in brain plasticity due to stress
- the brain and regulation
- stress
- stress and health
- brain structure
- The brain and regulation
-the brain is central to stress diathesis model
-determines what are threatening and what are positive experiences
- Stress
-stress if manageable can lead to positive growth and adaptation
- Stress and health
-too much stress, takes a toll on the brain and body, and is associated with mental and physical health outcomes
- Brain structure
-when stressed, the brain changes its structure in an adaptive or maladaptive way in response
-the loss of resilience is a key feature of disorders related to stress
The brain and perceived stress
-given your genetics and life experiences, your brain reacts differently to the same stress
Physiologic responses to stress
-brain then controls and coordinates physiological and behavioural response to perceived stress
-this can include metabolism, heart rate, anxiety levels, emotions etc
-responses result though signalling of various systems including HPA axis
Allostatic load and stress
-wear and tear on body and brain from chronic disregulation
Interventions that can relieve allostatic load
-healthy diet
-regular cardiovascular exercise
-social support
-connectedness
-good quality sleep
How does genotype and environment interact to influence susceptibility to experiences
-reduces risks
-flourish
Reduces risks
-genetic make-up interacts with life experiences good and bad to determine resiliency and sensitivity to stress
-developing health ways to cope can reduce risk
Flourish
-young people are at a particularly important time in development when a healthy lifestyle together with accelerated brain development increases the likelihood of positive effects on well being
Most common mental health disorders in canada
-anxiety
-depression
Rates of depression and anxiety among canadian youth
-similar numbers among youth compared to the general population
Are depression and anxiety disorders more prevalent in females or males
-more prevalent in in females
Emotional signs and symptoms of anxiety
-feeling on edge
-feeling irritable
-not fully enjoying things
Physical signs and symptoms of anxiety
-restlessness
-chest tightness
-muscle tension
-shortness of breath
-headaches
-sweaty palms
-changes in appetite
Behaviour signs and symptoms of anxiety
-avoidance of feared situations
-short temper and at times angry
-difficulty sleeping
-difficulty concentrating
Cognitive signs and symptoms of anxiety
-apprehension
-over-worry
-distracted
Emotional signs and symptoms of depression
-feeling sad
-non-reactive mood
-feeling despair
-loss of enjoyment of normally enjoyable experiences
Physical signs and symptoms of depression
-changes in sleep
-changes in appetite
-feeling slowed down in movements, or agitated and restless
-pain, headaches
Behavioural signs and symptoms of depression
-withdrawing from friends and family
-staying in more, missing work or university
Cognitive signs and symptoms of depression
-feelings of guilt
-suicidal thoughts, feelings of hopelessness
-difficulty concentrating
-dwelling on the negative
-thinking over past bad memories and experiences
-difficulty making decisions
Indicators differentiating stress from mental health disorders
-disproportionate reaction
-time
-impairment
-out of character
Disproportionate reaction
-severity or intensity of symptoms and level of distress are disproportionate to the situation
Time
-symptoms persistent for an extended period of time
Impairment
-symptoms are associated with impairment and interfere with day-to-day life
Out of character
-others notice that the person does not seem themselves or is “off”
Aspects of a mental disorder diagnosis
-mental health concerns and conditions require assessment by a mental health professional who takes into account the whole person
Components included in a diagnostic assessment of a mental disorder
-developmental history
-family history
-symptoms
-treatment
-other factors
-relational and social factors
Developmental history
-learning, communication and/or neuromotor problems
-childhood adversity
Family history
-family history of mental disorders to identify a predisposition, or genetic and familial vulnerability
Symptoms
-clinical course of distressing and impairing symptoms, in terms of onset and natural and relationship to context/stressors
Treatment
-response or paradoxical worsening to any treatment tried to date and other physical or medical problems that might be contributing
Other factors
-includes lifestyle, misuse of alcohol and/or recreational/illicit drugs, current stressors etc
Relational and social factors
-nature of relationships, social connectedness and environment
Student first contact for mental health care options
-psychiatry
-counselling
-self-help and peer support
-psychological therapy
-primary care provider
Psychiatry
-particularly well suited for assessing and treating moderate to severe mental health conditions or disorders that require a combined psychological and pharmacological treatment approach
Counselling
-often short term and problem-focused
-addresses healthy coping during periods of stress, strengthening problem-solving skills, and managing emotional responses to an identified stressor
Self-help and peer support
-many universities have peer mentor schemes such as a buddy system
-self help refers to using available resources, such as books, websites or apps
Psychological therapy
-often well-suited to help with and support young people with emotional, social, and mental health problems typically of moderate
Primary care provider
-should be thought of as central to coordinating you health and mental health
-first line for assessment of a mental health concern and provide continuity and coordinate care
Steps of stepped care from generalized to specialized
-campus-based health promotion
-student mental health care team
-community mental health services
-emergency and urgent care services
What does effectiveness of the stepped care model rely on
-minimally require intervention has itself benefits and gains
-this is a way to rationalize and economize healthcare resources that are often limited
-the care provided is acceptable to patients so that each level is convenient, accessible, and has flexibility
Who provides mental health support
-occupational therapist
-clinical psychologist
-counsellor
-psychiatrist
-psychotherapists
Occupational therapist mental health support
-focus on helping people resume or maintain participation in activities such as work school, recreation, and activities of daily living
Counsellor mental health support
-can support healthy coping, emotional and behavioural regulation, and healthy lifestyle choices
Psychotherapist mental health support
-often well suited to support individuals with emotional, social and mental health problems of mild to moderate severity
Clinical psychologist mental health support
-are particularly well-suited to help with a variety of mental health problems and disorders and to work as part of a multidiciplinary team supporting patients with more moderate to severe mental disorders
Psychiatrist mental health support
-medical doctors with extensive training in diagnosis and treatment of mental disorders integrating pharmacological treatment with other aspects of educational, psychological and social and family care
Queen’s university student wellness resources
-student wellbeing services
-emotional and mental health support
-educational welfare support
-disability advisor
-student wellness services
Ideal mental health system model
-would start with a welcoming clinic visit to determine students support need
-followed by referrals to appropriate level of service and support
-ideally there would also be seamless flow between levels of service and between community-based and campus-based services
Current campus resources at Queen’s
-queens student health and wellness services
-queens student accessibility services
-psychology clinic at queens university
Queen’s student health and wellness services
-supports personal, academic, and social health development of students by providing a range of programs and services, including physical and mental healthcare
Queens student accessibility services
-supports the personal and mental health of students, and their academic success through providing a range of resources and services
Psychology clinic at queens university
-provides psychological assessments, treatment, and consultation for queens students and members of the kingston community
-operates on a fee-for-service model
-however a sliding scale is based on family income
Community-based services
-hospital-based services
-publicly funded community-based services
-private and fee-for-service options
Hospital-based services
-include emergency or urgent care and various subspecialty programs which typically have defined criteria for admission
Publicly funded community based services
-high demand plus limited finding often means that publicly funded community-based services have long waitlists and prioritize the most ill people
Private and fee-for-service options
-OHIP and many provincial health plans do not cover psychotherapy outside of what is offered on campus
-many people have to rely on private and fee-for-service options
Barriers to mental health care
-stigma-related barriers
-attitudinal barriers
-practical barriers
Stigma related barriers
-stigma and fear of being evaluated negatively as a result of a mental health problem presents a significant barrier in accessing mental health services and supports
Attitudinal barriers to mental health care
-not uncommon for people to invalidate their own or others mental health concerns or diagnosis as there is not a clear diagnosable test such as an x ray or lab test to provide clear objective proof and validation of a mental health disorder
Practical barriers
-long wait times
-financial barriers
-challenges navigating the system
Long wait times
-high demand plus limited funding for resources often means that there are long wait times for accessing mental health services
Financial barriers
-finances can limit timely access and access to certain specialized services
Challenges navigating the system
-can be difficult to know what level of services you need and where you can best access those services
How many categories are there in regard to severity of symptoms and/or distress
-4
Category 1
-no symptoms
-prevention and health promotion
Category 2
-mild symptoms
-self help for targeted signs and symptoms
Category 3
-mild to moderate symptoms
-social and/or psychological approaches
Category 4
-moderate to severe symptoms
-pharmacological and psychological approaches
Self-help resources available
-workbooks such as “mind over mood”
-apps such as “headspace” “silvercloud” and “iSpero”
Social approaches to mental health
-social skills workshops
-interest groups and clubs
-health promotion
-support groups
Psychological approaches
-cognitive processing therapy
-cognitive behavioural therapy
-interpersonal psychotherapy
-supportive counseling
-behavioural activation
-mindfulness-based stress reduction
Cognitive processing therapy
-type of CBT that focuses on evaluating and changing upsetting thoughts
-has been used for ptsd
Cognitive behavioural therapy
-has been shown effective in treating mild-moderate sleep problems, anxiety and depression
Interpersonal psychotherapy
-focuses on relieving symptoms by improving interpersonal functioning
-focuses on understanding and strengthening relationship with yourself and others
Supportive counseling
-involves having a supportive person to explore current issues and difficulties and look for different ways of approaching them
Behavioural activation
-evidence-based treatment based on increasing activity level, especially in pleasurable activities to combat low mood
Mindfulness-based stress reduction
-useful for being mentally present, focused, and relaxed
Steeling effect
-refers to evidence of more resistance to later stress having successfully coped with a stress or challenge
