WHAT’S GOING ON AROUND HERE? News from the mental health front lines

But first, a word from our sponsorBut first, a word from our sponsor Robin Steed, PhD, LOTR National Alliance on Mental Illness Northwest Louisiana Affiliate

Agenda Keeping All Students Safe Act Stop Bullying Act Changes in Mental Health Care in Louisiana Motivational Interviewing Stages of Change

KEEP OUR STUDENTS SAFEKEEP OUR STUDENTS SAFE

Keep Our Students Safe ActKeep Our Students Safe Act S.2020 in the Senate and H.R in the House Government Accountability Office study:  teen hung himself  child smothered to death  children with disabilities Only 14 states currently restrict use of restraint (Louisiana is not one of them)

What the Act will do:What the Act will do: Ban:  physical restraint unless an emergency  restraints interfering with breathing  chemical restraints Parents to be notified on same day

What you can do:What you can do: US legislators using NAMI's legislative action center Educate school officials, teachers and case workers!

STOP BULLYINGSTOP BULLYING

Keeping kids safe from bullyingKeeping kids safe from bullying Children with disabilities bullied 2-3x more Bullied Children: depressed, lonely, anxious low self-esteem headaches, fatigue, stomachaches, poor appetites truant suicidal youthviolence.edschool.virginia.edu

School Bullying Prevention ActSchool Bullying Prevention Act House Bill 407 Senate Bill 619  Fills the gaps in meeting federal regulations  Will specifically name at risk groups  Identifies process for reporting  Defines specific types of bullying

You can help!You can help! Stopbullyinglouisiana.org To find out more, contact Stephanie Patrick at or , ext

CHANGES IN MENTAL HEALTH CARE IN LOUISIANA

Merger 2011Merger 2011 ● Office of Mental Health and Office of Addictive Disease to create Office of Behavioral Health OMHOADOBH

Magellan  Coordinated System of Care 2,400 children most severely affected  SMO: Service Management Office  50,000 children and 100,000 adults  Requires providers re-cert every 14 days

MOTIVATIONAL INTERVIEWINGMOTIVATIONAL INTERVIEWING

What for?What for?

Definition of MIDefinition of MI Directive, client-centered To elicit behavior change Clients explore and resolve ambivalence

Concepts of MIConcepts of MI Readiness to change Ambivalence Resistance

Principles of MIPrinciples of MI 1.Express Empathy 2.Roll with Resistance 3.Support Self-efficacy 4.Develop Discrepancy

Empathetic Listening PracticeEmpathetic Listening Practice So, what have you noticed about the effect of alcohol on your mood? How is the new exercise program going for you? How do you feel about going back to work?

Self-Motivating Statements Self-Motivating Statements Client: I hate feeling like an old man with this walker, like I’m weak and frail, but when I don’t use it I’m afraid to go anywhere because I might fall. Therapist: So you feel like the walker makes you look weak but you’d like to get out more? Evil Therapist: Well, you really will be frail if you fall again, so you better use the walker. Silly Therapist: It doesn’t make you look weak!

More self-motivatingMore self-motivating Client: It’s not fair! I’ve had to give up everything- eating sweets is the only thing that makes me feel good anymore. Of course, I don’t like the insulin shots. Therapist: It seems that eating sugary food comforts you but you would rather not be dependent on insulin?

Pros and Cons ApproachPros and Cons Approach ProsCons Take meds Don’t hear voices as much I can live by myself I can go to school Side effects Cost money Have to remember Don’t take meds No side effects A little more $ The voices make me feel like killing myself, Can’t take care of myself, Can’t remember anything

Client with MSClient with MS Consistent care PT and OT Positive support Counseling Scary, bad memories Husband mad Stress increases fatigue Familiar home Husband happy Easier Depend on husband Stressful environment Miss therapy In pt. Out pt. In pt. Out pt. Pros Cons

Brainstorm ApproachBrainstorm Approach 1.What exactly is the problem? 2.What have you tried so far? 3.What are things to try- no matter how crazy? 4.Select one option. 5.Select an option to try if the first one doesn’t work.

What NOT to doWhat NOT to do  Argue  Assume expert role  Talk all the time  Should on your client  Tell the client they have a problem  Prescribe solutions (especially without listening!)

STAGES OF CHANGE MODELSTAGES OF CHANGE MODEL

What do you want to change?What do you want to change? Exercise more Eat healthier Stop smoking Stop drinking Be less co-dependent Kick that heroin habit once and for all!

Pre-contemplation manmeetsscale.blogspot.com

Contemplation diggingalot.org

Preparation

Action

Maintenance

Know your client’s stageKnow your client’s stage resistance Mismatch between intervention and client’s readiness for change = resistance

Transfer to practiceTransfer to practice How can you use motivational interviewing in your practice? In what stage of change are your clients? How can you move them from one stage to the next?

Resources Rollnick, S. & Allison, J. (2004). Motivational interviewing. In The essential handbook of treatment and prevention of alcohol problems (Heather, N. & Stockwell, T. eds.) John Wiley and sons. com