week 4

• Core Skills for Working with Mental Health?

  • Being respectful of religion

  • Respecting confidentiality

  • Engaging the person

  • Keeping a professional distance

  • Communicating with families

  • Clear and relevant documentation

  -SOAP notes: subjective, objective, assessment and plan
• Core Skills for Yourself?

  Staying Safe

  • Make your space safe

  • Be alert to warming signs of violence

  • Take proper safety steps if there are warning signs

  Keeping on learning
• communicating respect and preserving dignity?

  ● address person directly, introduce yourself, explain what you are doing and what is

  going to happen

  ● clearly show person that you value them the same as any other person
• being warm, encouraging, and empathetic?

  ● an encouraging smile and a friendly attitude can give a person the confidence to open up about their problems

  ● empathy: putting yourself in the person’s position and imagining how they must be feeling
• -not judging the person?

  ● even if a person’s actions go against your moral standing, you have to remember that your role as a health care worker is to help and not to judge. focus on the difficulty that the person is coming to you with
• -listening actively?

  ● try not to interrupt them, resist the temptation to start giving advice before you have even had the chance to understand the problem properly.

  ● show the person you are listening by keeping still and focused, looking at them, summarizing the main points of what they have been telling you, and making encouraging noises (ex: uhuh)
• -asking questions in the right way: open ended questions?


  ● example: how have you been feeling recently? vs. have you been feeling sad? Avoid yes/no questions
• -keeping calm?

  ● regardless of the person’s behavior, it is important to keep calm and have a professional manner at all times
• -being observant?

  ● observe the physical appearance of the person, whether there is a mismatch between what the person is saying and their emotional state and behavior, and how the person makes us feel (ex: frightened)
• -being respectful of religion?

  ● the care you give should be respectful of the person’s religious beliefs, not allowing your personal beliefs to influence the care you offer.

  ● if people are looking for spiritual care then they can be guided to the appropriate religious or spiritual professional
• -respecting confidentiality?

  ● explain that what the person tells you will be kept confidential and only shared with your colleagues if you wanted to consult them for advice. (ex: if they are wanting to harm themselves or someone else
• -engaging the person?

  ● effective mental health care requires the health care worker to make an effort to engage and motivate the person to continue with the treatment to derive the maximum benefits. ways to engage the person includes:

  ○ good communication, getting the person to feel understood

  ○ focus on the person’s priorities

  ○ educating the person on the mental health problem and treatment

  ○ say encouraging things

  ○ give the person a reason to come back to a follow up appointment
• -keeping a professional distance?

  ● boundaries must be established between you and your patient including:

  ○ accepting gifts

  ○ asking the person to carry out work for you without proper renumeration

  ○ developing an intimate or romantic relationship

  ○ any form of sexual contact
• -communicating with families?

  ● try to speak to the person’s carers as well as to the person to help you carry out your assessment

  ● you can find out whether there is a difference between how the person sees the problem and how the problem is seen by others, discovering the nature and impact of the mental health issue
• -clear and relevant documentation?

  ● clear and focused clinical notes will allow you to easily monitor progress over time, reduce the risks of prescribing mistakes and communicate your assessment to your colleagues

  ○ subjective: the main problems reported by the person

  ○ objective: the main problem identified by the health worker (ex: depression)

  ○ assessment: current status of person

  ○ plan: advice given, the focus of any counseling, goals set
• -staying safe?

  ● make your space safe

  ● be alert to warning signs for violence

  ● take proper safety steps if there are warning signs
• -managing stress?

  ● relaxation and meditation

  ● creative and fun activities

  ● improving your surroundings

  ● sharing and socialising

  ● forming a support group
• -seeking professional help in these situations:?

  ● suicidal feelings

  ● problems with alcohol or dugs

  ● if you developed a mental disorder that needs treatment
• Pros of Telehealth?

  • Can be just as effective

  • Good option for remote areas

  • Accessibility for people with physical limitations

  • Convenience and affordability

  • Treatment can be more approachable
• Cons of Telehealth?

  • Might not be covered by insurance

  • Some states don’t allow out-of-state providers

  • Confidentiality, privacy and unreliable technology

  • Lack of response to crisis situations

  • Not appropriate for serious psychiatric illnesses

  • Overlooks body language

  • Ethical and legal concerns
• Am I capable of examining a person with a mental health issue?

  • Frustration that the interview might take too long• Amusement at the odd behavior• Anger that the person is wasting time with no “real” issue• Fear• Disgust in person’s appearance• Worry that they might not do a good assessment-The most important aspect is making sure you have enough time!
• Who may have a mental health issue?

  • Problems sleeping

  • Lost interest in activities

  • Feeling sad, unhappy or irritable

  • Tired

  • Worrying too much

  • Feeling scared or frightened

  • Drinking or using drugs
• What to ask when you suspect a mental health issue?

  TYPES OF QUESTIONS--

  • Basic information on age, address, family details, employment, etc.

  • Information about the problem—symptoms, etc.

  • Person’s social situation and what they think is the cause (who are they living with, social support, etc.)
• How do I conduct the interview?

  • Introduce yourself to the person

  • Establish rapport

  • Use good communication skills

  • Try to ensure privacy

  • Keep safety in mind

  • Ask everyone the “golden questions”

  • Keep in mind the main mental health issues and symptoms (Chapter 1)

  • Try not to feel pressured for time

  • Give person chance to talk without family members around

  • Try to speak to family members

  • Use right amount of eye contact

  • Record key information
• What to look for?

  • Facial expressions

  • Restlessness

  • Strange movements

  • Irrelevant answers

  • Very fast rate of talking

  • Very slow rate of talking

  • General hygeine
• Assessing Physical Complaints?

  • Alcohol and drug dependence

  • Domestic violence

  • Confusion and agitation

  • Taking medications

  • Elderly people with disturbed behaviors