Why Mental Health? Dr Ed Beveridge Consultant Psychiatrist Wednesday August 24th 2016 Stephenson House

This session… Your speaker What is “Mental Health” Mental health – True or False? Mental Health Disorders Managing Mental Health Disorders Questions (make a note as you go…)

Career Path School in NE London Sciences (and French) at A-Level Medical School in Cambridge & Oxford, trained in Psychiatry in North London Consultant Psychiatrist, teacher and trainer, lead for Physical Health Blog, tweet, travel, TV, music, run

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“Mental Health”

True or False? “ Mental health problems are common”

Mental health problems are common 1 in 4 people in the UK will experience a mental health problem per year Bipolar Affective disorder (Manic Depression) affects 1-3 in 100 people within their lifetime Mental ill health costs the UK £70 bn per year

True or False? “Mental illnesses rarely get better, whereas physical health problems usually do”.

Mental illnesses rarely get better, whereas physical health problems usually do. Diabetes and high blood pressure are incurable 1/3 of people with psychosis recover fully There is evidence for treatment for mental health problems in the same way as there is for physical illness.

True or False? “Mentally ill people cannot work”.

“Mentally ill people cannot work” Mental ill health affects the productivity of those in work by impairing their ability to function at full capacity and it causes about 40% of all days lost through sickness absence 50% of employers would not wish to employ a person with a psychiatric diagnosis (Manning and White, 1995), 66% of employers […] report that they have never knowingly done so (Chartered Institute of Personnel and Development, 2007).

“Mentally ill people cannot work” However, those companies that have employed people with a mental health problem do not generally regret the decision. In one recent survey, only 15% of such employers reported it as having been a negative experience.

True or False? “Mentally ill people can be dangerous”.

Mentally ill people can be dangerous. 10% of homicide offenders have Schizophrenia …but if you have Schizophrenia your risk of committing homicide is 1 in each year Every homicide gets reported and this feeds stigma If you have Mental Illness your risk of being murdered if 5 times higher

True or False “ Psychiatrists mainly give people medication”.

True or False? There is a little scientific evidence about mental illness and its treatment.

True or False? “People with mental illness have worse physical health than the general population”.

People with mental illness have worse physical health than the general population “Adults with serious mental illness represent the greatest and least recognized health disparity... reflected in a 13- to 30-year reduced life expectancy. The primary cause... is cardiovascular disease associated with disproportionately high rates of obesity and tobacco use... the greatest current challenge to providing appropriate mental health services is not a knowledge gap, but an implementation gap.” Bartels, Am J Psych, 2015

Mental Health Disorders Organic (Physical) Disorders Psychotic Disorders “Affective” (or Mood) Disorders “Neurotic” (or Anxiety) Disorders Personality Disorders PLUS…substance use disorders, eating disorders, child and adolescent mental health disorders…the list goes on…

Managing mental health problems - 1 Most illness – physical and mental – is self-managed (or managed with the help of family and friends) People with mental illness may not seek help, or seek it very late. Many effective treatments of different kinds are available for mental illness. There are many very good resources to help people find the right kind of help for them.

Managing mental health problems - 2 Your GP can help with diagnosing a mental health problem or refer you for a specialist to do this. Most people with mental health problems are managed by their GPs/people working in primary care More severely unwell people may need to be managed in specialist services. When people are very unwell they can need hospital admission (but will be treated at home if possible).

Managing mental health problems - 3 Self help Bibliotherapy/online resources Talking therapies Social support Medication

Self-help Reduce your levels of stress Get friends and family involved Structure your days and look for meaningful activity Ensure you are looking after yourself Take exercise Sleep well Think about your diet Think about drugs and alcohol …and many others

Bibliotherapy/online resources NHS Choices offers a comprehensive list. –MIND –SANE –Rethink Mental Illness –Mental Health Foundation –Royal College of Psychiatrists …and many others!

Talking therapies Counselling Cognitive Behavioural Therapy (CBT) Psychodynamic Therapy Psychoanalytic Therapy Group Therapy …and many others…

Social support Befriending Community resources e.g. day centres Financial/Debt support Tenancy support Legal Advice …and many others!

Medication Only prescribed –When needed –When there is a good chance it will work. Can have side effects – like any medicine Can be life-saving or life-changing for some people with mental illness

Medication - 2 Anxiolytics and hypnotics (e.g. diazepam, zopiclone) Antidepressants (e.g. Fluoxetine) Mood Stabilisers (e.g. Lithium) Antipsychotics (e.g. Olanzapine) Sometimes combinations can be required

Working in mental health Psychiatrist Clinical Psychologist General Practitioner Educational Psychologist Psychiatric Nurse Social Worker Occupational Therapist Pharmacist Research Scientist Support Worker Peer Support Worker Psychotherapist Play Therapist Drama Therapist Music therapist Art Psychotherapist Counsellor Psychoanalyst

Thank you. Any