PSYC1002 MHC Lecture 1 2024_v2 (3).pdf

PSYC1002: Mental Health Conditions Lesson 1 Introduction to Mental Health Conditions and Professionals Dr Elizabeth Seeley-Wait (Credit for slides: Dr Rebekah Laidsaar-Powell) Acknowledgment of Country I would like to acknowledge the traditional owners of this land: the Gadigal people. I would lik...

PSYC1002: Mental Health Conditions Lesson 1 Introduction to Mental Health Conditions and Professionals Dr Elizabeth Seeley-Wait (Credit for slides: Dr Rebekah Laidsaar-Powell) Acknowledgment of Country I would like to acknowledge the traditional owners of this land: the Gadigal people. I would like to pay my respect to elders past and present and any First Nations students we might have among us. We stand on this land today as beneficiaries of an unreconciled dispossession that occurred over 200 years ago. We acknowledge both our privilege and our obligation to redress the situation as best we can. About me Dr Elizabeth Seeley-Wait A lecturer and supervisor in the Clinical Psychology Unit and a Clinical Psychologist Trained in the USA Have worked in Australia for over 20 years In-patient, out-patient and private practice Various universities - very happy to be at USYD! I truly love my job (more like a vocation) Mental Health Conditions Lessons 1. Tanja Hirvonen's Lecture 1 2. Tanja Hirvonen's Lecture 2 3. Introduction to Mental Health Conditions and Professionals 4. Theoretical Models of Mental Illness & Classification/Diagnosis 5. Anxiety and related disorders I 6. Anxiety and related disorders II 7. Depressive disorders 8. Eating disorders Important Many of you will have a lived personal or family history of mental health challenges. For extra support visit: https://www.sydney.edu.au/students/counselling-and- mental-health-support.html, visit your GP, or contact Lifeline on 131114 Before we begin... Please also RESIST the urge to diagnose yourself and others Diagnosis + treatment needs to be reserved for highly qualified and skilled professionals (e.g. Clinical Psychologists > 6 years University study + professional supervision) Recommended reading If you need further explanation Chapter 15 ‘Psychological Disorders’ (pages 554-602) in: Passer M. W., Smith R. E. and David (2015). Psychology: the science of mind and behaviour. Australian Edition. Read sections associated with topics covered in the lecture It is in the library reserve Search for the unit code; download the PDF Today’s Lesson Mental Health Conditions – language and stigma What is “Psychopathology” What is “Abnormal” behaviour, what is “Normal”? Models of mental ill-health Mental Health Practitioners: Types, training & qualifications (e.g., what each type is, the approach from which they practice, and the populations they might work with) Abnormal Psychology >>> Mental Health Conditions >>> Language matters! Mental Health Stigma Is having a mental health condition really “abnormal”? ** Spoiler alert – looking at the new Australian statistics on mental health conditions, they are very common** https://mindframe.org.au/mental- health/communicating-about-mental-ill- health/language Mental Health Conditions in Australia Over two in five (43.7% or 8.6 million people) had experienced a mental disorder at some time in their life One in five people (21.4% or 4.2 million people) had a mental disorder some time in the past 12-months https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and- wellbeing/latest-release What is “psychopathology”? Psychology Scientific study of behaviour, emotion and cognition We study these elements to understand and explain why we behave, think and feel the way that we do. Abnormal Psychology Scientific study of abnormal behaviour, emotion, cognition Psychopathology Psyche- mind Pathology – illness or disease Study of mental illness – including classification, causes, development, treatment, outcomes Understanding psychopathology- Empirical method When we try to understand mental health concerns- including “abnormal” or “pathological” thinking, behaviours and emotions, we use the empirical (scientific) method Empirical method used at different levels: Description Classification Diagnosis Causation (bio-psycho-social) Biological Psychological Social Treatment Effectiveness Understanding psychopathology- Using the Empirical Method Description: Classification and Diagnosis To define a MHC, need to be able to tell what is normal/healthy vs abnormal/unhealthy = NOT EASY! Physical illness: health vs illness more easily distinguishable (e.g. blood glucose levels) Mental illness: line between health/illness often blurred Once illness/abnormality determined, needs to be classified and differentiated E.g. Someone vomiting > sick > Pregnant? Drunk? Gastro? Early medicine – “the fevers” – description of a symptom, not illness Psychopathology – presentations of symptoms, diagnosis is cluster of symptoms E.g. Restlessness, inability to concentrate MHCs are not as concrete as many physical illnesses (e.g. everyone agrees that a bone is broken) - Concepts- still trying to define, draw borders around Understanding psychopathology- Using the Empirical Method Causation Causation of MHCs = extremely complex Nature / Nurture Interaction of biology, individual psychological factors, upbringing, social environment Important area to study: causative models Understanding psychopathology- Using the Empirical Method Treatment Empirical method is critical in understanding then treating MHCs Need rigorous testing of treatments (e.g. control groups) Placebo effect, treatment 1 vs treatment 2 What is “abnormal” Not NORMAL? >>>But then WHAT IS NORMAL?? Where is the line between normal and abnormal? Where is the line between mental health and mental ill-health? Mental illness not as readily defined as physical illness Mental illness is subjective – varies greatly across cultures, times, theoretical approaches Clues to help us understand “Normal” vs “Abnormal” The '3 D's of defining ‘abnormality’: Deviates Distressing Dysfunctional 3Ds: Deviates Deviates from statistical norm (unusual/unexpected/rare) Often 1st step in deciding between “normality” and “abnormality “Do lots of people experience this?” Positive exceptions or statistical rarities E.g. exceptional artistic talent What is normal is culturally and time bound E.g. “hysterical” women with “pathological independence” Cannot use rarity as only factor 3Ds: Distress Distress in oneself or others Often integral part of mental health condition Anxiety / Depression = Distress is often clear BUT > Normal distress Distress not always necessary – E.g. Bipolar manic episode 3Ds: Dysfunction Causes dysfunction in person’s ability to carry out important life goals BUT...dysfunction is based on social expectations Definition of “dysfunction” depends on definition of FUNCTION in society Some disorders don’t necessarily involve dysfunction as you would expect e.g. some people with personality disorders with psychopathic tendencies What is “abnormal” / psychopathology? Psychological abnormality exists on a continuum with normality  What is “abnormal” / “psychopathology?” Presence of psychopathology (mental health condition) is not as readily definable as physical illness Definitions of psychopathology reflect cultural values and social norms Mental health conditions are included in the latest version of DSM or ICD-10. Published by American Psychiatric Association Change definitions of disorders: NEW and REMOVED Reflects biological/medical model of “mental illness” What causes psychopathology? Bio-psycho-social model Biological Cause: Internal physical problems (=biological dysfunction) Treatment: diet, exercise, rest, medication Psychological Cause: Beliefs, attitudes, perceptions, thoughts Treatment: ‘talking therapy’; psychotherapy; Sociocultural Cause: Poverty, prejudice, cultural norms, experiences Treatment: Social work – fix social ills; help relationships Mental health Professionals in Australia Psychiatrist- Qualifications and training Fully-qualified medical doctor Specialist training and qualifications in the diagnosis, treatment and prevention of mental illness Specialised knowledge of neurobiological changes/causes of mental disorders In general, treat people with a diagnosed mental disorder Can prescribe medication for mental health conditions Treatment takes a bio-medical approach (some also take a psychological approach) Psychiatrist Medical degree 4-6 years (depending on whether you are coming into the degree as a university undergraduate or graduate Internship 1 year of hospital rotations/placement Residency 1 year of specialised hospital rotations/placements Vocational Training 5 years to complete a Fellowship of the Royal Australian and New Zealand College of Psychiatrists (FRANZCP) Clinical Psychologist Specialist training and qualifications in psychological assessment, treatment formulation and prevention of behavioural, mental and emotional health issues In general, treats people with a diagnosed mental disorder; diagnoses Cannot prescribe medication (but may have ‘Dr’) Trained in psychological testing (e.g. IQ testing, Memory testing etc) Therapy takes a bio-psycho-social approach Aims to enable patients/clients to: Building insight and understanding into their patterns Develop skills and strategies to cope and function better, to prevent ongoing problems/improve quality of life (with/out the use of medication) Clinical Psychologist- Qualifications and training Undergraduate Psychology Degree (~3-4 years) Honours Psychology Degree (1 year) Master of Clinical Psychology (~ 2 years) > Registered Psychologist Clinical Psychology Registrar practicing under supervision (~1-2 years) > Clinical Psychologist Registered Psychologist Some do only UG training and then Supervised Training Others a mix of UG +PG + Supervised Training Some but not all will have psychological testing as a skills set In general, treats people with or without diagnosed serious mental disorder Assist people with a range of mental health issues such as: Depression, Anxiety and Stress Relationship difficulties Other emotional problems Retirement of the 4+2 internship program by 2029 The 4+2 internship program is being retired as a pathway to registration in favour of the 5+1 internship program to reduce regulatory burden of psychology training The key transition dates are: 30 June 2022 - the last day to begin a 4+2 internship program. 30 June 2027 - the last day to apply for general registration on the basis of completing a 4+2 internship program. 1 January 2029 - the 4+2 internship pathway to general registration will be retired. More Info: https://www.psychologyboard.gov.au/Registration/Provisional/Retirement-of-4-2- internship.aspx Social Worker 1. Work in direct services (e.g., healthcare, welfare, housing etc.) Helping people cope with problems related to social cultural issues including but not limited to poverty, legal issues or human rights 2. Work in the clinical field (more similar to psychologists) Diagnose and treat mental, behavioural or emotional health issues Focus: environment and cultural factors (sociological approach) rather than psychological or personal characteristics (i.e. Family Therapy) Help clients develop practical plans to improve personal well-being and make referrals for services Qualifications & Training Bachelor of Social work (4 years) Masters of Social Work (2 years + other 3 year Bachelor degree) Counsellor Assist people to gain understanding of themselves and make changes in their lives: May simply provide a non-judgmental ‘listening ear’ May work in a particular area (e.g. marriage/family/school counsellors) Qualifications & Training: Level of training is wide and varied Ranging from weekend correspondence course to Bachelor degree The term ‘counsellor’ can be used without any particular qualification To register as fully qualified: Bachelor of Counselling (3 years) Graduate Diploma in Counselling (2 years) + previous Bachelor degree Restricted vs Unrestricted Titles RESTRICTED USE “Psychologist” Psychology Board Register https://www.psychologyboard.gov.au/ Cannot use this title without being registered UNRESTRICTED USE Counsellor, Therapist, Psychotherapist, Life Coach, Spiritual Advisor Qualifications vary widely https://mashable.com/article/tiktok- mental-health-therapist-psychology There are professional bodies individuals may join Take home messages “Abnormal”: difficult to define - remember the 3 Ds. Theoretical approach influences description, causal explanations, treatment of ‘disorder’. Psychopathology is multiply determined: Need to consider reciprocal relations between biological, psychological, sociocultural factors There are several types, training and qualifications of Mental Health Practitioners Lesson One: Done