1. Mental Health and Client Engagement

2. What is Mental Health?

3. Mental Health
…mental health is described as more than the absence of mental disorders or disabilities. Mental health is a state of well-being in which: an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community. World Health Organisation 3

4. What is Mental Ill Health?
Ask them to do exactly the same thing again perhaps mix up the pairs if you like.
You’re asking them for a definition or if its too difficult perhaps what attributes might make up poor mental health.
If you want, you can specifically ask them not to reverse what they’ve just done. Many people will and that’s fine.
Give them 5-10 minutes and then you follow the same technique again:
Ask people for their responses and write them up on the flip chart.
Again don’t be afraid to ask people why they have suggested what they’ve suggested – encourage discussion.
Qs/curveballs: sometimes people will suggest Anger, Alcholosim or drug addiction. Its important to address these…
Anger – some people may become angry or frustrated along with their mental health but anger in itself isn’t a mental health problem and people that don’t have mental health problems can have problems with anger
Alcoholism or addiction: these are not mental health problems but people with mental health problems may choose to drink or take drugs as a consequence of their circumstances. Equally, drink or drug abuse can lead to mental health problems.

5. Mental Ill Health
A more than temporary state of mind that adversely affects your ability to function on a day to day basis
Ok, again this is an absolutely key slide:
This definition is one that you’ll constantly refer back to throughout the rest of the session.
Read out the definition and then break it down.
‘More than temporary’ its not just a one off. Its sustained or perhaps a pattern.
‘state of mind’ – yes its stating the obvious but we’re not talking about a physical injury or impediment
‘that adversely affects your ability to function’ – this is a critical phrase. it describes the fact that it is the impact on your function that is the issue. The fact that we’re talking about ‘function’ allows room for the context and choice that someone wants in their life. You could be trying to function as a musician, a mother, a banker, a support worker or a deep sea diver. The point is that your ability to function within this context is impaired. The use of the idea of function also allows room for cultural interpretation and context.
‘on a day to day basis’ – this is important as it further emphasises the importance of a sustained or continued impact
The next message on this slide is the diagram. I usually ask people what it is. It really is a mixed bag as to what people will suggest at this point. Have fun with it but eventually someone will say continuum or spectrum…
This is the second most important point of the day. The first is that everyone has mental health, and some times some people have mental health problems. The second, the point of this slide is that your mental health fluctuates. Rises and falls along the spectrum as you go throughout your day, week, months etc. it’s influenced by your circumstances.
Q: is it caused by chemicals?
A: as to the causes of mental health problems we know that circumstances definitely play a part. We also know that chemicals change as your state of mind, emotions and feelings change. There is also evidence to suggest that Mental Health Problems can run in families, but this doesn’t necessarily mean that there are biological or genetic causes as we are all influenced in our development by people around us.
Drive home the main point at the bottom of the slide…
If you have managed to get this point across, and the everyone has mental health point across you already made a difference. The rest is detail, important detail, but these points alone can change behaviour and influence decisions.
Good Mental Health
Mental Ill Health
We all have Mental Health, some of us have Mental Health Problems

6. Mental Health Problems
Depression
Anxiety
Obsessive Compulsive Disorder
Bi-Polar
Schizophrenia
Personality Disorder

7. Stress or
Pressure?
Performance
Pressure
Stress
Stress - HSE definition: "The adverse reaction people have to excessive pressures or other types of demand placed on them at work."

8. Stigma What is it? How does it impact the individual?
How does it impact client/customer relationship?

9. Client Journey Pause for thought… and group discussion.
At what point during the client journey is a persons mental health likely to be discussed? Disclosed?
At what point in the client journey is the persons Mental health likely to be threatened/under pressure
How is your relationship with the client affected at that point? 9

10. Boundaries What do we mean by this term? Why are boundaries important?10

11. What do we mean by this term?
Boundaries
What do we mean by this term?
“the limits that allow for a safe connection based on the client’s needs” (Peterson, 1992, p. 74)
- the limits that allow a healthy and effective client worker relationship – (me) 11

12. Boundaries
Emotional and behavioural but with logistical/practical outputs
Caller may not be given helpful or appropriate services, which could affect his/her willingness to accept other services Caller may feel betrayed, abandoned and poorly served Could lead to unmet expectations Worker may become emotionally attached The reputation of the service provider may be compromised 12

13. Boundaries Why are boundaries important? Emotional/
Psychological impact
Ability to do your role
Impact the service, capacity and quality
Prevent Empowerment
Team function
Prevent Effective Support and safety 13

14. Boundaries You - Being clear about your role and your outcomes
Client - Being clear about your role and outcomes with your client – your purpose, your time, your availability
Manager - Being clear about your role and outcomes with your manager
Agreements - Ensuring the above is set out in black and white
Emotions/Personal Impact - Awareness of the emotions and psychological elements of the relationship
Support - Seeking support and on how to deal with those emotions
Signposting – where does your job and someone elses begin? You are not a clinician or social worker, not there to disclose.
Responsibility – where does your job end and the clients responsibility begin?
Whatever the client outcome how can you go home knowing you’ve done enough? – discuss this with your team. 14

15. Client Agreement Client Agreement
Initial discussion and details vital:
Adequate information on support network
Adequate information on individuals needs
Chance to set out clarity and boundaries around role
Chance to think about additional support requirements
Chance to set the limits and expectations of involvement
Chance to empower client with information to advance own needs – support lines, local service information etc
Chance to discuss clients MH and relevant support needs
Confidentiality – and when you might need to break it 15

16. Disclosed Mental Health conditions – thinking ahead
If a client has a disclosed health condition or discloses to you – thinking about how it may be affected throughout the relationship is important.
Parachute Tool
What does that mean? – can you describe your health condition to me.​ ​
How does this impact our work together? How would I know if your health is deteriorating? – triggers?​
What can we do to support you? 16

17. Strange or Challenging behaviour
Sometimes people do not disclose but their behaviour may be off difficult to deal with
Your MHA can help to provide a framework of understanding but ultimately your only ever dealing with behaviour
So how do we deal with it?
Discussion in groups – what kinds of difficult behaviour can there be? How have you dealt with it? 17

18. Strange or Challenging behaviour
Notice what is happening – allow time in interaction to do this.
Precisely what is the behaviour and what is it’s impact on you?
Safety/Physical and emotional first – whatever you suspect cause maybe
Allow time for diffusion of anger, or tangental behaviour to subside
Refocus – restate relationship, purpose, limits of time and your role – how can we achieve this
Reflect back behaviour
State impact on you and the role you’re trying to conduct
Given this pattern, what adjustments can be made – in long term, and on one off – is this the right time? – if possible agree in writing – refer back to it!
Set limits – there are times when you might need additional help 18

19. Questioning Skills
What are the different kinds of questions and when would you use them?
Open:
What outcome are you looking for?
What support can I provide you with?
How does that condition affect you?
How will this affect our work together?
What steps can we take to make this work?
Closed:
So if we changed that, would it meet your needs?
Was the complaints procedure made available to you?
Have you got a support network?

20. Signposting Where does your job end and someone else's begin?
Where does your job end and someone else's begin?
National…
Local…
Build a map. 20

21. Staying Well
What support is available in work? How can wellbeing be supported?