A Guide for New Mental Health Staff - Coursework Example

A Guide for New Mental Health Staff 2 Introduction This guide is prepared for the new mental health service staff, detailing the necessary information about three kinds of mental health illnesses that they should be familiarized with in relation to the discharge of their duties to the service users. The three mental illnesses that are dealt with elaborately in this guide are Phobias, Depressive Illness and Generalized Anxiety Disorders. The provided pieces of information include the definitions of the illnesses, their causes, symptoms, effects, and the comprehensive overview of the illnesses. The concepts of media images and perceptions are also explored, offering the possible negative and positive effect of media perceptions. Interestingly, the legal aspect of this issue is also detailed in the guide. A Case Study of Mental Health Service User X Cindy has a responsible job as a software engineer in a multinational company but she feels she is unable to advance in her career because of her inability to contribute in group meetings. It’s almost more than what she could bear just to sit in on meetings, let alone offer her opinions. Yesterday, her boss approaches her about the possibility of giving a presentation about their latest product to some customers. At that point, she began to be nervous and could not open her mouth to talk at all. He walks out of her boss’s office with lack of self-confidence and later refuses to give the presentation. 3 Phobias Phobias can be defined as the persistent and irrational fears that affect some people when they come into contact with external factors (stimuli) (Morgan, 2003). There are different categories of phobias based on the sources of stimuli, to which the persons affected withdraw or move away from. Examples of these categories are:- (i) Agoraphobia:- this is irrational and persistent fears about being in a place crowded with many other people, and which might make escape impossible in case there is a sudden danger (Gray, 1994). This may happen with or without a panic attack. (ii) Social phobia:- This is irrational and persistent fears about participating in a social or public event. A chronic form of social phobia also leads to avoidance behavior as the affected person keep running away from social duties (Kleiman, 1988). Cindy is affected by this kind of phobia as she dodges her duties. (iii) Specific phobias:- These are irrational and persistent fears to some specific stimuli. Examples of these stimuli include but are not limited to animal types, natural environment types, situational types, blood-injection injury etc. (Lefton, 1997). 4 Causes of Phobias Several researches have been conducted on the issue of phobias in order to detect their main causes. Although it is not quite certain what is responsible for one particular phobia; however, it has become known in recent years that phobias could occur based on (i) genetical factor—that is, certain fears may affect some families consciously or unconsciously; for example, twins that were raised in different environments still show fear for a certain object or condition; (ii) cultural factor—owing to their cultures, different people entertain different kinds of phobias; (iii) personal experiences—it is also believed that personal experiences constitute mainly the cause of phobias people have today; past unfavorable experiences may beat fear into people’s hearts that would last forever (Gray, 1994); (iv) uncertainty—it is also considered a fact that people tend to exercise some fears to uncertain conditions or things they could not control like their future, job interviews and meeting new and unfamiliar people (Lefton, 1997). Symptoms of Phobias The symptoms exhibit by patients affected by phobias depends on the types of phobias and their severity. For those suffering from blood-injection injury, they do not normally feel afraid but experience disgust at the sight of needles (Morgan, 2003). However, there are some general symptoms of phobias, which include but are not limited to shortness of breath; pounding hearts or palpitations, chest pain or discomfort; profusely sweating; numbness or tingling sensation; fear of losing control or going crazy; nausea or stomach 5 distress; feeling dizzy or unsteady; worried by uncertainty and other hopelessness (Morgan, 2003). It is possible to detect these symptoms right away in some patients suffering from chronic phobias; on the other hand, some patients do cleverly hide their symptoms. But It takes conscientious scrutiny to discover the real cause of fear in some people. Treatment of Phobias The commonest form of treatment or interventions for people suffering phobias are either psychological or/and pharmacological. The details of the psychotherapeutic and pharmacotherapeutic interventions are described as follows: (a) Psychotherapeutic treatment:- This intervention is based on behavioral and cognitive-behavioral approaches. This entails that the behavior of the affected person towards the stimuli that cause the fear in him or her is controlled through some psychological modulations (Marks, 1987). Examples of these behavioral treatment involves exposure treatment, whereby the patients should be exposed to the exact stimuli that arose the sense of fears in them until they would be able to overcome the fears such stimuli invoke in them. At that point in time, the patients are said to be going through systematic desensitization when they had developed enough confidence to face the source of their fears and reduced or completely eradicated the fears such objects or situations cause in them (Bernstein et al., 1997). 6 (b) Pharmacotherapeutic intervention:-As the name implies, phobia patients are given doses of drugs that would help sway their moods before they are allowed to pass through the cognitive-behavioral treatment (Marks, 1987). Although the pharmacotherapeutic treatment is only recommended for a chronic case of phobia that behavioral treatment could not easily rectify (Marks, 1987). Depressive Illness Depressive illness, which can also be called clinical depression or unipolar depression or major depressive disorder or recurrent depressive disorder is a chronic mental illness which causes the affected persons to have low mood that could result in some social maladies like engaging in self-debasement and showing apparent disinterestedness in normal activities around them, like playing, shopping, studying etc (Beck and Alford, 2009). Cindy also seems depressed. Depression is prevalent in many countries of the world, and it is reported to have caused more disability in 1990 worldwide (Beck and Alford, 2009). 7 Symptoms of Depression The main symptoms of depression are those that are classified under manifestations (physical signs) that could be seen by the mental health staff or physicians. Examples of these manifestations are highlighted as follows: Dejected mood—feeling down most of the time. Cindy was in dejected mood. Self-dislike—this is an example of negative perspective of oneself. Loss of gratification—this means the persons suffering from depression cannot appreciate any good things around them. Loss of attachment—this occurs when the minds of the patients have been weighed down by low mood; at this point in time, it will be difficult to feel emotionally attached to people, things, places, events etc. Crying spells—sometimes too much self-debasement and bad mood could ignite spells of crying. Loss of mirth response—those who are affected by unipolar depression often finds it difficult to reflect happiness back to the people around them (Hammen, 1997). 8 Causes of Depression It is complicated to state precisely what causes depression in people, because depression may be caused by different factors depending on the circumstances surrounding the affected people. Some of the known causes of depression are as follows: Changes in brain chemical could cause depression in some people—this follows the research findings which describe the possibility of biochemical reactions occurring in human body that are capable of causing mood swings in some people, leading to chronic depression (Peacock and Casey, 2000 ). It is also believed that a person can become depressed as a result of his or her hereditary or inherited tendencies—this accounts for why some members of the same can exhibit some form of depression in their lifetime. It is not rare for a son to be depressed in the same way that his grandfather was. Emotional shock has also been identified as one of the causative factors of depression in people. Stress and illness are also responsible for depression in some people, as discovered by scientific findings etc. 9 Lastly, it is believed that substance abuse can also make people’s mood goes down. Those who have abused cocaine and other stimulants are found to show some forms of depressions (Peacock and Casey, 2000). Treatment of Depression The twenty-first century has brought many kinds of treatment for depression. Although, these treatments are applied based on how chronic the illness is. Below are the three commonest forms of treatment for depression: (i) Use of antidepressants:- There are various types of antidepressants that are used to help depressed people get out of their low moods. Though the kind of depressants that are used depends on the local practice at the mental health center in different locations across the world (Weissman, ). There are tricyclic and heterocyclic antidepressants. (ii) Use of Monoamine Oxidase (MAO) Inhibitor—this enzyme is found throughout the body and it helps to ignite the neurotransmitters. MAO inhibits the metabolism of monoamines in the body that could cause changes in the brain chemicals (Weissman,2001 ). 10 (iii) Undergoing ElectroConvulsive Therapy (ECT:- This is one of the latest sophisticated therapies that aims at helping depressed people attain a higher state of activity. (iv) Analytically Oriented Therapy:- This therapy is applied after the depressed person’s health has been properly analyzed. (v) Psychotherapy:- This entails using cognitive-behavioral approach to help depressed people lighten up and improve their moods. Generalized Anxiety Disorders Generalized Anxiety Disorder (GAD) is a condition of irrational and perpetual worry and anxiety about inconsequential things. As a matter of fact, a person affected by GAD worries a lot about things that do not necessarily warrant such high level of worry or anxiety. For example, people may have unnecessary anxiety about death, loss of job, loss of friends, money, police etc (Heimberg, 2004). GAD is prevalent in every culture, but it is noted to begin its manifestation in the children and becomes fully blown in adults. Cindy also appears to be suffering from GAD. Symptoms of GAD Some of the symptoms of Generalized Anxiety include but are not limited to sleeplessness, problem of concentrating, bodily shaking, sweating, restiveness, difficulty in 11 breathing, problem of swallowing, feeling irritable, rashes and agitation (Rygh and Sanderson, 2004). These symptoms are visible, and mental health staff can assess their patients to detect the presence of these symptoms on their body. Therefore, assessment is an integral aspect of treating GAD. It has been discovered that different people exhibit different symptoms, even though assessment reveals that they are both affected by GAD. Causes of GAD While it is difficult to detect the causes of Generalized Anxiety Disorder, researches have shown that the following factors described below could be responsible for its occurrence: Cindy’s case can also be explained using the facts below (a) Hereditary factor may be responsible for the occurrence of GAD. People in the same family have shown relative manifestations of GAD from one generation to the other. This confirms the fact that GAD, as a matter of fact, may be transferrable from one parent to their children (Dugas and Robichaud, 2006). (b) Use of substances like cocaine, heroin etc has also been discovered as the possible cause of GAD. People who abuse substances often show high possibility of being affected by bouts of irrational worry and anxiety (Nutt et al., 2001). 12 (c) Neurological factor for causing GAD is concerned about the disrupted functional connectivity of the amygdala, which is believed to be responsible for the bout of fear and anxiety in some people (Portman, 2009). Treatment of GAD There are two main methods of treating people that suffer from the Generalized Anxiety Disorder: (i) through pharmacotherapy and (ii) cognitive-behavioral therapy. (i) Pharmacotherapy entails using drugs that would help reduce the release of neurotransmitters that may cause constant anxiety and worry in people. Examples of these drugs include Propanolol, Buspirone, Duloxetine, etc (Nutt et al., 2001). (ii) Cognitive-Behavioral Therapy:- This requires the application of psychological principles and theories to help people suffering from GAD to recover naturally. (Portman, 2009). Sufferers are made to undergo some rigorous cognitive therapies that will help them adjust to a better life. 13 Comprehensive Summary of the Three Mental Health Illnesses The three mental health illnesses discussed above, namely the phobias, depression and generalized anxiety disorder occur regularly in every society. They may become more severe depending on a number of external factors, which are also useful in analyzing these illnesses. Some of these external factors include: Social factor:- The society contributes largely to people’s mental health; during the time of crises, people tend to become worried, anxious and fearful. If the circumstances do not normalize in time, this could affect people’s mental state (Myers and Wee, 2005). Environmental factor:- It has been discovered that natural disaster like earthquakes, hurricanes etc could affect people’s mental health if valuable things are lost in the disaster—for instance, the loss of one’s family members (Myers and Wee, 2005). Interpersonal factor:- People who have stressful relationships before are likely going to experience more tension as they continue in the relationship. And this can affect their mental state. Example of this scenario is at the workplace where one of the workers has trouble getting along with the rest of the people at the office (Myers and Wee, 2005). 14 Media Images and Perceptions of Mentally Ill People Over the years Media have portrayed people with mental illness in both positive and negative ways. And these images have affected people suffering from mental illnesses in a number of ways. Some typical examples of these images are shown below: (i) Negative image:- Mentally ill people are shown as depraved, criminal, dangerous, unpredictable and asocial. These images are far too serious for any society to gladly welcome a mentally ill person, because of the belief that they could cause bodily harm to other people in the society (Loue, 2009). Sometimes, mental health professionals are also scared by these negative images as they approach their patients. This situation may disrupt smooth medical attention to them since no one wanted to stay near someone with mental problem. In some critical cases, mentally ill people are even driven out of their family homes because of the fear that they may turn violent one day (Loue, 2009). (ii) On the other hand, media also portrays mentally ill people as disabled who need constant cares and medical attention. They are shown as help-seeking and dependent people, who could not help themselves out except the government or other private institutions come to their aid (Loue, 2009). Not that this image or perception is completely positive, but it provide the correct information that the public should know about people with mental illness so as to devise the best way to help them. 15 However, it is unfortunate that the public mainly stick to the negative image of mentally ill people. This stigma sometimes makes it difficult for the mentally ill people to mix evenly with the other members of society (Loue, 2009). In recent years, private organizations and non-governmental organizations like BasicNeeds, Mind, SANE have been providing the appropriate information to the public about people suffering from mental health problem—this is a direct attempt to counter the bad news in the media. These organizations can help Cindy recover. There is still much to be done in this area because the media enjoy wider coverage than the NGOs with little budget to run their activities. Another interesting way to spread good image about mentally ill people is to hold community activities that would have a lot of people in attendance. This could help remove the stigma mentally ill people have in their localities (Loue, 2009). And this would make mental health professionals accessible to them in order to provide them the latest treatment that would take them out of their predicament. Legislation about Mental Health Issues The UK Mental Act of 1983 is an example of legislation enacted to mainly cater for the needs of mentally ill people. It details the kinds of good treatment a disabled or mentally ill person must be subjected to: there are provisions about compulsory hospital admission and guardianship; discharge of patients; treatment of patients sentenced to prisons; treatment of patients that are a child; 16 appointment by court of acting nearest relative in case the direct relatives are unavailable. These and many other benefits a mentally ill person could derive from this legislation. The legislation serves to protect the interest of the disabled (who is also described as mentally ill persons). To prevent any mental health service providers from exploiting money from them, the legislation details the appropriate treatment procedures that should be taken to achieve this purpose. Conclusion It is interesting to have noticed that Cindy was affected by three mental illnesses: social phobia, depression and generalized anxiety disorder. Considering the facts described above, it is possible to give two definitions of a mental health problems: (i) it is an uncomfortable condition that cause social detachment in the people affected, like Cindy; (ii) mental health problem reduced people’s self-confidence and makes them doubt their capability, like Cindy. One good point from the presentation in this guide is that all the causes of the three mental illnesses are interrelated; and they tend to have similar treatments, too. 17 References Beck, A.T., and Alford, B.A. (2009). Depression: causes and treatments, 2nd ed. Philadelphia, PA: University of Pennsylvania. Bernstein, D. A., Clarke-Stewart, A., Roy, E. J., & Wickens, C. D. (1997). Psychology, 4th ed. New York: Houghton Mifflin. Dugas, M.J., and Robichaud, M. (2006). Cognitive-behavioral treatment for Generalized Anxiety Disorder: from science to practice. New York: Routledge. Gray, P. (1994) Psychology, 2nd ed. New York: Worth. Hammen, C.L. (1997). Depression. London: Psychology Press. Heimberg, R.G. (2004). Generalized anxiety disorder: advances in research and practice. New York: Gilford Press. Kleinman, A. (1988). Rethinking psychiatry. New York: Macmillian. Lefton, L.A. (1997) Psychology, 6th ed. Boston: Allyn & Bacon. Loue, S. (2009). Determinants of minority mental health and wellness. New York: Springer. 18 Marks, I. M. (1987). Fears, phobias, and rituals: Panic, anxiety, and their disorders. New York: Oxford University Press. Myers, D.G., and Wee, D.F. (2005). Disaster mental health services: a primer for practitioner. London: Psychology Press. Nutt, D.J., Argyropoulos, S., and Forshall, S. (2001). Generalized anxiety disorder: diagnosis, treatment and its relationship to other anxiety disorders. London: Martin Dunitz. Morgan, S. (2003). Phobia: a reassessment. London: Karnac Books. Peacock, J., and Casey, J. (2000). Depression. Bloomington, MN: Capstone Press. Portman, M.E. (2009). Generalized Anxiety Disorder across the lifespan: an integrative approach. New York: Springer. Rygh, J.L., and Sanderson, W.C. (2004). Treating generalized anxiety disorder: evidence-based strategies, tools, and techniques. London: Guilford Press. Weissman, M.M. (2001). Treatment of depression: bridging the 21st century. Arlington, VA: American Psychiatric Pub. Read More