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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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?

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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 years less
85% receive welfare benefits – low participation rate compared to comparable countries

17. 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

18. 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?

19. 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

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

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

22. 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?

23. Helpful resources
Headspace – people/psychosisfactsheet.pdf
Schizophrenia Research Institute -
Blackdog Institute –
Hearing Voices Network Australia -
SANE Australia -
BEING –
ARAFMI NSW support for families and friends - I