Caring for the Mind: Providing Reference Services for Mental Health Information Michelle Eberle NN/LM New England Region

Objectives 1)Gain awareness of mental health issues 2)Learn to respond to challenging consumer health questions for mental health 2)Be informed of tools for collection development and mental health research

Prevalence 1 in 4 adults suffer from a diagnosable mental disorder in a given year 4 of 10 leading causes of disability in the US are mental disorders Many people suffer from more than one at the same time Source: NIMH, The Numbers Count

Classification Current = DSM IV – TR DSM V = to be released May 2013 History 1840 = single classification “idiocy” 1952 (DSM1); 1965 (DSM II); 1979 (DSM III); 1983 (DSM IV)

DSM V – May 2013 Proposed changes: Mental retardation to intellectual disability Substance abuse and dependence to addiction related disorders Creating a single diagnostic category for autistic spectrum disorders Source:

Definitions Can you separate mental disorders from physical disorders? Need for a more accurate term that represents the body/mind connection (DSM IV – TR)

Expressions Avoid expressions like: “a schizophrenic or an alcoholic” In favor of: “a person with schizophrenia” or “an individual with alcohol dependence”

more about definitions Mental health = Applies to everyone! Mental health problems ◦ Signs and symptoms of insufficient intensity and duration to meet criteria for a mental health disorder (DHHS) Mental disorders ◦ Characterized by abnormalities in cognition, emotion or mood or the highest integrative of behavior such as social interaction or planning future activities (DHHS) Mental illness ◦ Medical term applied to specific diagnosed conditions from the DSM IV TR

Stigma Misconceptions portrayed by news & media Inaccurate linking of mental illness and violent behavior Prompts subtle and overt prejudice, discrimination, fear, and stereotyping Results in avoidance to work, socialize, and live with persons with mental illness Impedes persons with mental illness to seek help NAMI fights stigma with StigmaBusters! Sources: NAMI and Mental Health America

“People with mental illlness enrich our lives” [NAMI] Abraham Lincoln Virginia Woolf Ludwig van Beethoven Robert Schumann Leo Tolstoy Tennessee Williams Vincent Van Gogh Isaac Newton Ernest Hemingway Sylvia Plath Michelangelo Winston Churchill Vivian Lee Patty Duke Charles Dickens Diane Sawyer

Systems theory dynamic relationship between parts and the whole Individual Social Systems Environment & Society

Factors Physical Social Financial Environmental Sexual Spiritual Emotional Intellectual Occupational Systems theory = Relationship between components and whole

Mental Health Literacy Knowledge, beliefs and abilities that lead to the recognition, management and prevention of mental health problems. Benefits: Prevention, early recognition & intervention, reducing stigma Source: Canadian Alliance on Mental Health and Illness,

Mental Health Continuum Period of Stability Elevated Stress Less Severe Disorders Severe Persistent Disorders Source: University of North Carolina, Greensboro, Mental Health Literacy.

Why is health literacy so critical? Essential life skill ◦ It is the bridge between knowledge and behavior.

Information Seeking 21 % of internet users have searched for information on depression, anxiety, stress or mental health issues These are the 8 th most commonly searched health topics Health searching is the 3 rd most popular online activity after and shopping E-patients on the rise! Source – Pew Internet, 2006

Quality Only ¼ of searchers look at the source or date of online health information. (Pew Report, 2006) AccuracyAuthorityBiasCurrencyCoverageUsability

Reference Best practices Respecting Confidentiality Active Listening Be empathetic and patient

Emotional patrons Four step approach 1) STOP 2)BREATHE 3)REFLECT 4)CHOOSE Source: Spatz, M. Answering Consumer Health Questions. 2008

Open ended questions “What kind of information on …are you looking for? Would you tell me more about …? When you say…, what do you mean? What do you already know about …?

RESOURCES YOU CAN TRUST

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LactMed Free online database with information on drugs and lactation Over 500 drugs Data mined from scientific literarue Fully referenced Links to PubMed citations Breastfeeding links

LactMed

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Mental health blogs Blogs.com lists top ten mental health blogs Many persons with mental illness are finding comfort and community in blogging and reading about their experience and knowledge of coping with chronic disease. Among these include: Finding Optimismhttp://findingoptimism.comhttp://findingoptimism.com Storied Mindhttp://storiedmind.comhttp://storiedmind.com Postpartum Progresshttp:// Please keep in mind as with any web resources, use your ABCs of evaluation: Look at the accuracy, authority, bias, currency, coverage and user- friendliness of each site. A critical analysis of health information is necessary.

Search tips Keep in mind there may be more than one term for disorders Be aware of comorbid disorders Conditions may manifest in completely different ways Though inaccurate, many resource use terms like disease, disorder, spectrum and syndrome interchangeable Start out with a general site like MedlinePlus to get an overview of your topic Source: Anderson PF, Allee N. The Medical Encyclopedic Guide to Searching and Finding Health Info on the Web, 2004

MedlinePlus search tips For phrase searching, use quotes ◦ “Asperger’s Syndrome” Can search a specific site ◦ Ex/ bullying site:kidshealth.org Not case sensitive Will spell check Can use Boolean searching ( OR, NOT ) With +, can limit search term to exactly what you With *, can search for variations of a word

National Library of Medicine 19 million citations from the biomedical literature Use Advanced Search and Limits to customize your search

Portal to search many NLM resources For the new searcher *Only NLM resource with meeting abstracts

PILOTS Published International Literature on Traumatic Stress Largest database on PTSD

Other databases ERIC – for educational psychology PsychInfo PsychArticles CINAHL Social Work Abstracts Social Sciences Citation Index AGELINE

Testing Mental Measurements Yearbook Educational Testing Service Tests and Measurements, U. of Texas Eric Clearinghouse in Assessment & Evaluation HaPI Many in print too!

Collection development

Bibliotherapy MeSH definition =“A supportive psychotherapy in which the patient is given carefully selected material to read”. Librarians often asked for such resources

Community Resources? Local public health dept mental health div. Mental health libraries, public libraries Support groups Counseling Alternative Therapy Faith based organizations Health hotlines – Other?

Professional Development Association of Mental Health Librarians Medical Library Association Mental Health SIG

The Future of Mental Health The Science of Happiness “I realized that my profession was half-baked. It wasn’t enough for us to nullify disabling conditions and get to zero. We needed to ask, what are the enabling conditions that make human beings flourish? How do we get from zero to plus five?” Martin Seligman, Time, Feb 7, 2005

Positive Psychology Actions: Mindfulness Flow Spirituality Self-efficacy Learned Optimism Source: psychology psychology Empowers: positive emotions positive individual traits positive institutions. Source:

HANDS ON EXERCISES

Take home points Stay aware of developments in mental health research Fight stigma Fine tune your reference skills Cultivate your knowledge of top information sources for mental health information

Thank you! Michelle Eberle Consumer Health Coordinator NN/LM New England Region This project is supported under contract #N01-LM with the NN/LM New England Region from the National Library of Medicine. (updated March 2010)