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2. MHFA (Wales) Session 4 (3 hours) What are psychotic disorders (schizophrenia, bipolar disorder)? Symptoms of psychotic disorders. Risk factors for psychosis. Crisis first aid for acute psychosis. Support and resources for psychosis. Action planning for using MHFA (Wales). 2

3. Mental health problems and crime The number of homicides committed by people with a severe mental health problem has halved since 1960. However, since the 1950s the number of homicides committed by the general population has increased by 500%. ( Study carried out in England and Wales in 1999) 3

4. Common symptoms when a psychotic disorder is developing Changes in emotion and motivation. Changes in thinking and perception. Changes in behaviour. 4

5. Common symptoms when a psychotic disorder is developing Changes in emotion and motivation: depression anxiety irritability suspiciousness blunted, flat or inappropriate emotion change in appetite reduced energy and motivation. 5

6. Common symptoms when a psychotic disorder is developing (cont.) Changes in thinking and perception: difficulties with concentration or attention sense of alteration of self, others or the outside world (for example, feeling that self or others have changed or are acting differently in some way) odd ideas unusual perceptual experiences (for example, a reduction or greater intensity of smell, sound or colour). 6

7. Common symptoms when a psychotic disorder is developing (cont.) Changes in behaviour: sleep disturbance social isolation or withdrawal reduced ability to carry out work and social roles. 7

8. Common symptoms in mania Increased energy and over-activity. Elated mood. Needing less sleep than usual. Irritability. Rapid thinking and speech. Lack of inhibitions. Grandiose delusions. Lack of insight. 8

9. Recovery from psychosis 33% of people will have no further symptoms. 33% of people will have some repeated symptoms that they can get relief from with the help of medication and other support. 33% of people will have repeated symptoms and need a range of help and support. 9

10. Alcohol, drugs and psychosis Alcohol can interfere with some anti-psychotic medications. Consumption of alcohol can increase the risk of acting on suicidal thoughts. Cannabis may trigger mental health problems in people who are vulnerable to developing psychosis. 10

11. First aid for psychosis Ask about suicide. Listen non-judgmentally. Give reassurance and information. Encourage the person to get appropriate help and support. Encourage self-help strategies. 11

12. Acute psychosis protocol 1.Identify self clearly. 2.Talk in a quiet, non- threatening, non- judgmental tone. 3.Acknowledge but do not contribute to delusional behaviour. 12

13. What to do if a psychotic person is threatening violence Ensure your own safety at all times. Do not get involved physically. Call the police and explain what is happening, unless the person has a mental health crisis card with clear steps describing how you can help. Try to create a calm, non-threatening atmosphere. Try to get the person to sit down. Be reassuring, calm and concerned. Do not try to reason with someone who is experiencing acute psychosis. Express empathy for the person’s emotional distress. Comply with reasonable requests. 13

14. What helps for psychosis? Early diagnosis. Medication. Good information. Support from friends and family. Something meaningful to do, somewhere safe to live, enough money and a ‘safety net’ of support. Support from professionals. Self-help support groups. Click to play sound clip 14

15. MHFA (Wales) Session 4 What are psychotic disorders (schizophrenia, bipolar disorder)? Symptoms of psychotic disorders. Risk factors for psychosis. Crisis first aid for acute psychosis. Support and resources for psychosis. Action planning for using MHFA (Wales). 15

16. Marina Ballinger marina.ballinger@torfaenmind.co.uk Andrew Pugh a.pugh1980@gmail.com