1. MENTAL HEALTH & MENTAL DISORDERS California Common Core Curricula for Child Welfare Workers

2. Outcome Objectives COMPETENCIES AND LEARNING OBJECTIVES Page 2

3. Adult Learning Needs  My brain is full!  Tell me how and why  Keep it real!  Variety is the spice of life!

4. Agenda  Introduction  Facts and Stats  Labeling and Stigma  Culture & Mental Health  Definitions  Strength Based Perspective  Overview of Common Diagnoses and Implications for Child Welfare  Resources, Interventions, & Referrals

5. Meet and Greet  Write down 3 symptoms of a mental illness  Meet at least 7 other people in the room at other tables  Share with them your 3 symptoms and hear their 3 symptoms

6. Facts and Stats  23% of adults suffer from a diagnosable disorder  Only 50% of those report daily impairment  3% have both mental and addictive disorders  5-7% have a serious mental illness (schizophrenia, major depression, bipolar)  Homeless stats

7. Facts and Stats Continued  Adults with serious mental illness die 25 years younger  Leading cause of disabilities for ages 15-44  Less than 1/3 receive MH services in a year  Delay of 10 years from the onset of symptoms until the first contact with treatment  CA: 300,000 with serious mental illness do no have access to services

8. Labeling and Stigmas p.6  What are some of the labels we put on mental illness?  What are the stigmas to be aware of with mental illness/disorders?  How does this impact CW?

9. Small Group Discussion Answer the following questions: 1.How did your family define “crazy”? 2.Was this how your larger culture defined it? 3.How did your culture handle parents who were mentally ill? 4.Did you know someone who fit this description growing up? Explain

10. Bias at Work  Early messages become our templates for biases in the future  What happens if you add other layers of potential bias?  What should your role be in helping with systemic bias?

11. Bias  On page 7, write down some biases of which you are aware concerning mentally ill people/parents  For your eyes only

12. Cultural Overlay of Mental Illness  Individually consider a cultural practice within your family’s culture that could be mistaken as a sign of mental illness (pgs. 8-9)  Share with small group  Compare answers around group

13. Implications for Practice  Biases can shape our decision making  Community and systemic bias can impact our client families negatively  Cultural practices can be misdiagnosed and misinterpreted  CW has a role in preventing and advocating  Ethical obligation to understand

14. Advocacy  Advocacy is….

15. Advocacy  In your small groups  Brainstorm a list of ways CW can act as advocate for the mentally ill client  Write down list  Prepare to share with rest of class

16. Definition Card Sort  In small groups  Sort the cards in the envelope to match the word/concept to the correct definition

17. Link  Acute vs. Chronic  What are the implications for parenting when referring to a symptom, sign, or prognosis?

18. Strengths and Protective Influences  Symptoms manifest differently for different individuals  Same diagnoses are more debilitating for some individuals than others

19. Mitigating Factors  Factors that decrease severity  Factors that can help risk be less severe  Factors that can help symptoms be more bearable and increase functionality

20. Strengths of the Mentally Ill  Consider factors that can help mitigate symptoms  Consider coping factors as strengths  Make a list of mitigating factors and strengths commonly seen with mentally ill clients

21. Anxiety Disorders  Panic Disorders with/without Agoraphobia  Obsessive Compulsive Disorder  Generalized Anxiety Disorder  Post-Traumatic Stress Disorder

22. Anxiety Symptoms  Pounding heart  Sweating  Trembling  Shortness of breath  Feeling of choking  Chest pain or discomfort  Nausea  Dizziness  Excessive anxiety and worry  Keyed up or on edge  Easily fatigued  Difficulty concentrating  Irritability  Muscle tension  Sleep disturbance  Paresthesias

23. Vignette One  In small groups  Read vignette one  Use the chart to consider what is diagnosis, signs of escalation, risk factors  Answer the questions following the vignette

24. Process Points  Strengths of family  Implications for parenting  Chronic vs. acute  Your role?

25. Mood Disorders  Major Depression: Recurrent, Single Episode  Dysthymia  Bipolar: Mixed, Manic, Depressed

26. Mood Disorder Symptoms  Sad or irritable mood  Loss of interest in activities  Significant change in appetite  Sleep disturbance  Psychomotor agitation or retardation  Loss of energy  Feelings of worthlessness or inappropriate guilt  Difficulty concentrating  Thoughts of death or suicide  Elevated, expansive or irritable mood,  Inflated self-esteem or grandiosity  Excessive talking  Flight of ideas  Risk taking behavior

27. Vignette Two  In small groups  Read vignette two  Use the chart to consider what is diagnosis, signs of escalation, and risk factors  Answer the questions following the vignette

28. Process Points  Strengths of family  Implications for parenting  Chronic vs. acute  What might be going on?  What are other considerations?

29. Psychotic Disorders  Schizophrenia  Mood Disorders with Psychotic Features

30. Signs/Symptoms  Hallucinations and delusions  Disorganized speech  Loss of ego boundaries  Grossly disorganized or catatonic behavior  Negative symptoms: –Flat affect –Poverty of speech –Poverty of content of speech –Lack of energy or drive/apathy  Disorganization: –in personal care –in social and professional performance  Profound disruption in cognition and emotions  Perceptions of reality strikingly different from the reality seen and shared by others around them

31. Beautiful Mind  View the video  Pick out signs/symptoms of psychosis  Small Group Discussion –List signs/symptoms –Relate to identified parental risks –How does MSLC impact a case with a schizophrenic parent?

32. Personality Disorders  Borderline  Narcissistic  Dependent  Antisocial

33. Unique U’s  As a small group  Review the information in the chart for each of the personality disorders  Come up with 2 words that start with U to describe each personality disorder  It can be a word to sum up, highlight risk, point out case plan implications

34. Fictitious Disorder  Attention seeking  Heroic or martyr  Exaggeration or exacerbation  Fabrication

35. Consider:  Safety  Risk  Protective capacity  MSLC

36. Case Plan Interventions  In small groups  Using case plan implications Column for each diagnosis  And Pages 27 and 28  Identify 3 interventions for each of the vignettes read earlier  Identify which aspects of the MH system of care will be utilized

37. Questions?  Any questions about anything we discussed today?  Any questions about anything that did not come up?

38. Thank You! Mary Garrison, LCSW marydgarrison@msn.com