1. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 1 Objectives Identify the roles and responsibilities of personnel in mental health care, including the jobs and job responsibilities of mental health aides and mental health technicians.

2. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 2 Objectives (cont.) Compare the roles and responsibilities of licensed mental health care providers, including psychologists, psychiatrists, social workers, and counselors. Understand safety and legal issues related to the use of restraints. Successfully complete 3 mental health procedures.

3. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 3 World Health Organization (WHO) International organization concerned with the health of the world population Definition of Health “Health is not merely the absence of disease but total physical, social, and psychological health” Wholistic Health – Treating the whole person

4. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 4 Careers in Mental Health 16-1 The Mental Health Aide The Mental Health Technician The Social Worker The Counselor The Psychologist The Psychiatrist

5. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 5 The Mental Health Aide Job Responsibilities – provide assistance with everyday activities of daily living (ADL’s)

6. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 6 The Mental Health Aide In general, high school diploma needed Certification as a Nursing assistant

7. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 7 The Mental Health Technician Job Responsibilities – Provide direct patient care by changing dressings, taking vital signs, turning and moving patients and helping patients bathe, groom and eat. – observe and record behavior presenting findings to the team – lead educational and recreational activities – accompany clients to and from examinations, treatments – may lead small groups – Assist in giving medications

8. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 8 The Mental Health Technician Also known as a psychiatric technician. Work under the direct supervision of a psychiatrist or psychologist Training may be a 2 year degree at a Career and Technical Center or College

9. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 9 The Social Worker Minimum of a bachelor’s degree for entry into the field Many positions require a master’s degree

10. Copyright © The McGraw-Hill Companies, Inc. Job Description Aid people who have difficulty coping with various problems by helping them make adjustments in their lives and /or by referring them to community resources for assistance Chapter 16 10

11. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 11 The Social Worker – Help clients solve personal and family problems. – Work with clients who have social problems ie: housing, unemployment, lack of job skills, financial distress – may help clients living in inappropriate conditions. – Perform direct counseling

12. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 12 The Social Worker – Assist clients in finding effective solutions and community resources, refer clients to specialists, emotional support, arrange adoptions, foster care – May help resolve abusive situations such as spousal or child abuse.

13. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 13 The Social Worker (cont.) Job Responsibilities (cont.) – Provide emotional support during crisis. – Evaluate individuals in the criminal justice system and perform pre-sentencing assessments. – Make recommendations to courts regarding clients. – Arrange adoptions and foster homes.

14. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 14 The Counselor Someone who gives advice about problems Nearly two-thirds have a master’s degree.

15. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 15 The Counselor (cont.) Types – School and college counselors – Rehabilitation counselors work with clients who may have social and/or vocational disabilities. – Mental health counselors may work with clients dealing with addictions, substance abuse, thoughts of suicide, stress, and self-esteem problems.

16. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 16 The Counselor (cont.) – Assist clients with common social and behavioral problems. – Offer drug and alcohol prevention programs. – Assist clients in anger management. – Identify and intervene in abuse situations. – Help clients overcome the effects of disabilities.

17. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 17 The Psychologist Most work in clinical area; others work in research. May also be consultants. Four years of education with postgraduate work leading to a doctorate degree

18. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 18 The Psychologist It is better to have a master’s in psychology than a bachelor degree!!!!!

19. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 19 The Psychologist (cont.) Job Responsibilities – study the human behavior and the mind – help mentally and/or emotionally disturbed clients design and plans to deal with ADLs – help clients adjust to life changes – work through personal crisis.

20. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 20 The Psychiatrist A psychiatrist is a physician who specializes in mental health. A medical Doctor… 4 years of undergraduate 4 years of medical school Internship of 3-8 years of residency and internship

21. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 21 The Psychiatrist (cont.) Job Responsibilities – Medical doctor who heads up a mental health team – In charge of assessment, diagnosis of the client. – Oversees plan of care

22. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 22 Psychiatrist vs. Psychologist Psychiatrist – Medical doctor Psychologist – Not a medical doctor – Education to bachelor’s, master’s or doctorate

23. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 23 Mental Health Procedures 16-2 Physical Restraints Chemical Restraints Reality Orientation

24. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 24 Physical Restraints Must be ordered by a physician and must never be used as punishment. All other methods of ensuring the client’s safety must be assessed and eliminated prior to using restraints. If used inappropriately considered “false imprisonment”

25. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 25 Chemical Restraints Chemical restraints should not be used unless the client presents a clear and present danger that cannot be treated through other means. A physician must prescribe the medication. The 5 patient rights for medication must be followed and reviewed 3 times. Positively identify the client. Make sure the client has taken all the medication.

26. Copyright © The McGraw-Hill Companies, Inc. Chapter 16 26 Reality Orientation Reality orientation is helping the client to become aware of his or her surroundings, the date and time, and other information about his or her present situation. TODAY IS: Monday, March 31 THE WEATHER IS: Sunny and Warm ACTIVITIES: Group Mtg. 2:00 pm in dining room An orientation board may be posted in the client’s room.

27. Copyright © The McGraw-Hill Companies, Inc. Types of Mental Disorders Depression – a mental state characterized by a sense of inadequacy, sadness, and a lack of activity Obsessive-compulsive behavior – an anxiety disorder characterized by recurrent and persistent thoughts and feelings and repetitive, ritualized behaviors Chapter 16 27

28. Copyright © The McGraw-Hill Companies, Inc. Types of Mental Disorders Panic disorder – an anxiety disorder characterized by unpredictable panic attacks; the attacks are usually severe but brief Chapter 16 28

29. Copyright © The McGraw-Hill Companies, Inc. Paranoid disorder – a psychological disorder characterized by delusions of persecution or grandeur Phobias – an anxiety disorder characterized by extreme and irrational fear of simple things or social situations Chapter 16 29

30. Copyright © The McGraw-Hill Companies, Inc. Post-traumatic stress disorder – any condition that develops following some stressful situation or event; such as sleep disturbance, recurrent dreams, withdrawal or lack of concentration Chapter 16 30

31. Copyright © The McGraw-Hill Companies, Inc. Bipolar disorder (manic / depressive) – presence of episodes of abnormally elevated mood clinically referred to as mania… mixed with episodes of severe depression Chapter 16 31

32. Copyright © The McGraw-Hill Companies, Inc. Schizophrenia – several psychotic disorders characterized by distortions of reality and disturbances of thought and language and withdrawal from social contact – Hallucinations… see and hear things that are not real Chapter 16 32

33. Copyright © The McGraw-Hill Companies, Inc. Self-mutilation – deliberate infliction of tissue damage or alteration to oneself without suicidal intent Chapter 16 33

34. Copyright © The McGraw-Hill Companies, Inc. Anorexia – Irrational fear of becoming fat if person eats Bulemia – eating disorder characterized by recurrent binge eating, followed by defensive vomiting, sometimes called purging; fasting, the use of laxatives, enemas, diuretics, and over exercising Chapter 16 34

35. Copyright © The McGraw-Hill Companies, Inc. SAD (Seasonal Affective Disorder) – a mood disorder with depressive symptoms in the winter Chapter 16 35