Working with people experiencing psychosis MHBiz 9 December 2015 Working with people experiencing psychosis Dr. Leanne Craze, Sydney, Australia

What we will cover today What is psychosis Common types How many Australians? Some important facts Gold Class care, support & treatment Emerging approaches Skills & strategies for Hume Helpful resources

What we will cover today How healing happens Effective treatment and support Where to get help Trauma informed care Relevance to working with Hume customers How to help Helpful resources

What is psychosis? A mental health problem that causes people to lose some touch with reality Causes people to misinterpret or confuse what is going on

Key symptoms or signs Key symptoms include: Confused thinking False beliefs (delusions) Hallucinations – all senses Changed feelings e.g. feeling strange, mood changes Changed behaviour and actions e.g. withdraw from others, lack of energy or too much energy, angry etc

Key messages A first episode usually occurs late teens or early adulthood Often frightening for the person and misunderstood by others It can be treated and most people make a full recovery Without treatment, psychosis can seriously disrupt a person’s life Earlier the help the better

What to look for or take notice of Film: Get on Top – recognising young people’s mental health problems and getting help early At the beginning how did Lee’s friends describe him? What differences had they recently observed? What signs of psychosis did Lee display? How was it affecting Lee?

Common types of psychosis Drug-induced psychosis – e.g. using or withdrawing from drugs, especially ice, cannabis and amphetamines Brief reactive psychosis - appears suddenly after a major stress Schizophrenia Bipolar disorder - people can experience psychotic symptoms as part of this disorder Psychotic depression – generally serious

Schizophrenia A mental illness characterised by disordered thoughts and perceptions Delusions Hallucinations Thinking difficulties e.g. concentration, reasoning & planning Difficulty in communicating Loss of drive Changed emotions Withdrawal

Schizophrenia continued Very scary for the person Many people develop PTSD, anxiety disorders and depression Many will turn to alcohol and drugs to manage If untreated and because of age of unset, a person’s life and development can be severely disrupted

Bipolar with psychosis Bipolar is a mental illness characterised by severe mood swings A person swings between an episode of depression and mania Different for different people During both phases psychosis can be experiecned

How many Australians? 3% of us will experience psychosis at some point in our lives 1/100 will experience schizophrenia – more males 1/100 will experience bipolar – similar rates for men and women

First episode 77% of people with schizophrenia onset before 30 years; 40% before 20; 4% before 10; males earlier 60% with bipolar before 30; 35% before age 20; 5% before age 10

Phases in the development of schizophrenia and bipolar Premorbid Prodromal Acute Recovery Relapse We want to prevent psychosis in the first Alternatively catch it as early as possible

Some important facts 5-10% of people with schizophrenia end their life by suicide – 12x national average 50% with schizophrenia attempt suicide 25% of people with schizophrenia have 1-2 episodes and completely recover 50% have more episodes, need ongoing support and treatment and good quality of life 25% have a long term illness with severe effects but with appropriate support and treatment can have a good quality of life

Some important facts Schizophrenia and bipolar rank in the top 10 causes of disability in Australia People with schizophrenia have 2.5x the death rate Life expectancy of people with schizophrenia is 18-20 years less 85% receive welfare benefits – low participation rate compared to comparable countries

Some important facts Schizophrenia has profound personal, social and economic costs $2.6B per annum in direct health costs & loss productivity Across a life time costs multiply significantly Schizophrenia is often misunderstood – perception of dangerousness

Exercise Understanding the impact of psychosis Film: One in Five – Stephen’s experience What did Stephen experience in his interactions with service providers? What responses and things helped Stephen? What didn't help? If you were working or otherwise interacting with Stephen, what could you do to help him feel more comfortable? If you were in Stephen’s help, what response would you want from Hume?

Goldclass support, care and treatment Early psychosis program Support, care & treatment as early as possible Psycho-education & psychological therapies Help with lifestyle & health challenges & risks Supportive GP Medication Personal support team Peer support Recovery support and social skills training

Goldclass support, care and treatment Getting back on track – education, training, employment, housing, income, doing normal everyday stuff Family support and education

Emerging and promising approaches Hearing voices training Recovery colleges Peer run crisis programs Peer-run warm lines Peer run hospital to home programs

Skills and strategies for Hume Group exercise What skills do you think are needed to interact effectively with someone with psychosis? What contribution might the different teams make: Customer Service Assets IT & HR Management Do any P&Ps require review?

Helpful resources Headspace –http://headspace.org.au/assets/Uploads/Resource-library/Young- people/psychosisfactsheet.pdf Schizophrenia Research Institute - http://www.schizophreniaresearch.org.au/ Blackdog Institute – http://www.blackdoginstitute.org.au/public/bipolardisorder/bipolardisorderexplained/ Hearing Voices Network Australia - http://hvna.net.au/ SANE Australia - https://www.sane.org/ BEING – http://being.org.au/ ARAFMI NSW support for families and friends - http://www.arafmi.org/ I