1. Overview of Mental Illness
Officer Chad Stiles, RN/Paramedic
Crisis Assessment Response Team

2. Definition of Mental Illness
Disorder of emotional, thought, or cognitive process that impairs judgment, behavior or capacity to recognize reality.
Disorder: a disruption of normal physical or mental functions
DSM V – Diagnostic and Statistical Manual

3. Mental Illness is a disease
Disease process as well as medical condition with symptoms that come and go.
Genetic component
Biochemical component
Structural abnormalities in the brain
Treatable with medications, therapy and support
Who likes cake?

4. Myths about mental illness
Individuals with mental illness are violent
(Rueve and Welton, 2008)
Individuals with mental illness are less intelligent
People can convince those with delusions that are not real

5. Descriptions of the problem
Downsizing and closing of psychiatric hospitals
Discharging patient into communities without adequate community resources and support
Lack 0f insurance coverage for mental health care

6. Major Mental Illness Schizophrenia Bipolar Disorder
Schizoaffective Disorder
Major Depressive Disorder
Anxiety Disorders

7. Schizophrenia Positive Symptoms: Negative Symptoms: Delusions
Hallucinations
Disorganized speech/behavior
Negative Symptoms:
Diminished speech or thought
Flat affect
Lack of motivation
Lack of connectedness

8. Approaching someone with schizophrenia
Calm, even tone
Maintain distance – don’t trap or move in too close
Minimize stimulation
Short, concrete questions
Simple explanations, simple instructions
Ask about hallucinations

9. Avoid Lie, deception, false promises Arguing Agree with delusions
Violate personal space
Raising your voice

10. Bipolar Disorder Mania/Hypomania Depression Mixed State Cycling
May also have psychosis

11. Mania Increase energy Decrease need for sleep Racing thoughts
Impulsiveness
Poor Judgment
Distractible
Grandiose thinking (I am the president/I am God)
Sexually promiscuous behavior
Impulsive spending

12. Mixed State Hyper Easily Agitated Irritable, angry
Hypersensitive to stimuli
May mimic drug abuse
High suicide risk

13. Depression Loss of interest, energy, motivation Hopelessness
Increased/decreased sleep/appetite
Suicidal thoughts
Slowed thinking and/or response
Guilt

14. Managing Mania Expect rapid mood changes Be alert for impulsiveness
Gently refocus when asking questions
Give simple, short directions

15. Things to remember with Bipolar Disorders
May present with mixed state
Mania or depression may last days or months
Treatable
Mania looks like cocaine or amphetamine high
Often associated with substance abuse

16. Major Depression Develops over days to weeks, not minutes
Episodic or chronic
Treatable
May or may not be triggered by life events
High suicide risk, especially in early treatment

17. Schizoaffective Disorder
A mixture of mood disorder and schizophrenia
Better prognosis that schizophrenia but not as but not as good as mood disorder only

18. Observations of depression
May avoid eye contact
Speech may be soft, slow, hesitant
May have poor hygiene, eating habits
Poor concentration
Loss of interest in activities

19. Management of Depressive
Be patient
Assess suicide risk
Consider possibility that person may have already harmed self (overdose)
Validate their feelings
Don’t try to out of depression or minimize feelings

20. Anxiety Disorders Agoraphobia Generalized Anxiety Disorder OCD
Panic Disorder
Social Anxiety Disorder
Hoarding

21. PTSD Flight,Fight,Freeze response Trauma – Primary or Secondary
Re-experience symptoms
Avoidance symptoms
Hyperarousal symptoms
Chidlren experience other symptoms
Bedwetting
Age appropriate behavior regression
Acting out the event during playtime
Being clingy with a parent or an adult

22. Flight Fight Freeze