Pathways to Mental Health: Making Every Step Count€¦ · Pathways to Mental Health: Making Every...

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PathwaystoMentalHealth:MakingEveryStepCount

Table of Contents

Mental Health by the Numbers ................................................................................................... 3 How This Guide Can Help You .................................................................................................. 4 Things to Keep In Mind During the Journey .............................................................................. 5 8 Keys to Supporting a Child on their Journey ........................................................................... 6 Avoiding Burnout: Taking Care of the Caregiver .................................................................... 10 The Path to Better Mental Health Starts Here .......................................................................... 12 Knowing Your Professional Team ............................................................................................ 14 Useful Links and Phone Support .............................................................................................. 16 Tools: Preparing for the Mental Health Consultation ....................................................................... 19 Questions to ask During the Mental Health Consultation ..................................................... 21 Monitoring Symptoms and Side Effects – Physical/Medical Baselines ................................ 25 Medication Monitoring Tool (Anxiety & Depression) .......................................................... 26 Medication Monitoring Tool (For Antipsychotics) ............................................................... 28 ThisbookletwascreatedbyJeffSolbergaspartofacollaborativeprojectforALIGNAssociationofCommunityServicesandAlbertaFosterParentAssociationfromgrantfundingprovidedbytheAlbertaGovernment.

Aspecialthankyoutothefollowingindividualswholenttheirvaluabletimeandknowledgeasmembersofthesteeringcommitteeforthisproject:

RhondaBarracloughExecutiveDirectorALIGNAssociationofCommunityServices

SylviaThompsonVice-PresidentAlbertaFosterParentAssociation

SusanParkerProgramConsultantReunificationSupports

MelissaGeeAssistantExecutiveDirector,MentorshipProgramSupervisorAlbertaFosterParentAssociation

RhondaHollowayManager,HealthPartnershipsStrategicSupportandQualityAssuranceHumanServices

AdrienneSandharAnalyst,Policy,PracticeandProgramDevelopment

MichelleMeadahlExecutiveDirectorPathwaysFamilyServices

BarbaraJadischkeSupervisor,McManAgencyFosterCare

Dr.WandaPolzinDirector-CommunityClinicalServices,CASA

LindaKrauskopfFosterParent,Director,EdmontonRegion,AlbertaFosterParentAssociation

JeffreyChengMentalHealthNurseConsultantCASA

HanifSomjiClinicalNurseCASA

TracyPerkinsAnalyst,Policy,PracticeandProgramDevelopment

Mental Health by the Numbers

FromtheCanadianMentalHealthAssociation-CMHA(2014)

4,500,000

ThisnumberrepresentsthecurrentnumberofCanadianadultswhowillsufferamentaldisorderintheirlives.Thisrepresentsoneinfiveadults(21.3percent).Anxietydisordersanddepressionarethemostcommon,andapproximately2.5millionCanadianadults(over10%oftheadultpopulation)haveadepressivedisorder.

1,500,000

RepresentsthecurrentnumberofCanadianchildren,includingyouth,whoaresufferingthroughadiagnosablepsychiatricdisorder,afull20%ofallCanadianchildrenandyouth.Twothirdsofthesesufferfrommorethanonedisorder.Unfortunately,lessthan20%willreceivetherapeuticintervention.

70% The percentage of

mental health problems and

illnesses that have their onset during

childhood or adolescence.

Thisisthepercentageofpeoplewhobenefitfrompositivesupportduringamentalhealthcrisis.Staypositive.Thosewhosupportindividualswithmentalhealthissuescanhelpbyseeingpasttheoccasionallychallengingbehaviourstothegenuinepersonthatcanbecomeburiedbeneaththeillness.Becommittedtobelievingintheindividual’spersonalstrengths,positivecharactertraits,futurerecovery,andlifegoals,rememberingtheabundanceoflife’slittlegiftsthat,inspiteofstruggles,seemtosprinklethroughvirtuallyeveryone’slife.

AccordingtotheCMHAmostpeoplewithmentalillnessrecoverwellandareabletoleadfulfillingliveswhentheyreceiveappropriatetreatmentandsupport.However,only43%ofdepressedadultsseekcarefromahealthprofessional.

Ismentalillnesslife-threatening?

No,mentalillnessitselfisNOTlife-threatening.However,theCMHA(2014)reportsthatmorethan90%ofpeoplewhotaketheirownliveshaveadiagnosablementaldisorder,mostcommonlyadepressiveorsubstanceabusedisorder.

Reality Check Whensomeonewecareforexperiencesmentalhealthconcernswenaturallywanttoensurethatheorshereceivesthebestcareavailable,assoonaspossible.However,mostparentshavelittleexperiencenavigatingtheins-and-outsofthementalhealthsystem.Unfortunately,thesteeplearningcurvecanendupcostingvaluabletime,delayingtreatmentandaddingtothegrief,pain,andsufferingforboththechildandthefamilyaroundhim.Usingthisguidecanhelpyouavoiddelays.

Dealing With Your Own Feelings Itisnotuncommonforthecaregiverstofeelsomelevelofguilt,thinkingthattheysomehowfailed,didsomethingwrong,missedsomething,orcouldhavedonesomethingdifferentlythatwouldhaveavoidedtheproblem.Dispeltheideathatcaregiversorparentingstylesaresomehowthecauseoftheproblem.Mentalhealthproblemsaremuchmorecommonthanmostrealize,andourenergyisbestservedfocusingstrategies,solutions,andhealing,notonblame.

You Are Not Alone Whileeveryjourneymaybedifferent,allfamiliesexperiencesimilarstrugglesnomatterwhattheageofthechildortheirdiagnosis.Asyoustarttoresearchthecondition,youwillfindmanystoriesofhealing,hope,andvictoryregardingmentalhealthissues.Availyourselftothemanysupportsandresources,andbepreparedforaninterestingjourney.YOUCANDOTHIS!

How This Guide Can Help You:

1. AvoidTreatmentDelays

TheChild&FamilyServicesmanagerswhobeartheresponsibilityofapprovingmentalhealthtreatmentsforchildrenincareneedspecificinformationbeforetheycanapproveatreatmentplan.However,arecentsurveyofmanagementthroughoutAlbertahasrevealedthatgettingtherequiredinformationafteramentalhealthconsultationhastakenplacecanbeverydifficultandtimeconsuming.Caseworkersandmanagersoftenfindthemselvesscramblingafteraninitialmentalhealthconsultationtofillinthemissingpieces.Thiscreatesdelaysthataddweeksandoftenmonthstotheapprovalprocess,valuabletimelostthatisbetterspentontreatmentandhealing.Thisresourcewillhelpyouidentifyandrecordtheinformationthatisneededforaquickapproval.

2. BePreparedforInitialAppointment

Thisresourcewillhelpyoubecomeorganizedandpreparedfortheinitialmentalhealthconsultation,savingbothtimeandgriefforeveryoneinvolved.Byorganizingandpreparingtheinformationaheadoftime,youareprovidingthedoctorwithinformationthatiscriticaltoidentifyingtheunderlyingissuesandprovidingthemostappropriatetreatment.

3. ProvideInformationandSupportThatFoster&KinshipParentsNeed

TheauthorofthisbookletrecentlysurveyedfosterandkinshipparentsandtheresultsindicatedthatthecaregiversofchildrenexperiencingmentalhealthissuesWANTandNEEDthetypeofinformation,support,andtoolsprovidedhereinastheyguidechildrenintheircaredownthepathofhealing.

4. UnderstandandManagetheImpactinYourOwnLife

Whenanindividualinahouseholdexperiencesmentalhealthissues,itcanbesaidthateveryoneinthehomeisimpacted;thisbookletprovidesinformation,encouragement,andideasregardingself-care,basedontheideathatpeoplewhocareforothersneedtofirsttakecareofthemselves.

5. UsefulToolsforCaregivers

Thisresourceincludestoolstohelpyouprepareforaninitialmentalhealthconsultation.Itwilloutlinetheinformationyouwillneedtogatherfromtheinitialconsultationinordertogetquickapprovalfortreatment.Italsoincludesformstotrackchangesandmonitorsideeffectsoncetreatmenthasstarted.

6. LinkstoInformationandResources

Checkoutthelinkstoarangeofresourcesandinformationwhichmaybenefityouasyoumakeplanstoworktowardsbettermentalhealthforthechildinyourcare.

Takethefirststep,nomore,noless,andthenextwillberevealed.KenRoberts

Things to Keep in Mind During the Journey

It is Nobody’s Fault Donotblameyourself,Itisnotyourfault,youaredoingthebestyoucan.bekindtoyourself.Itisnotthechild’sfaulteither;heorshewoulddobetterifheorshecould.For1in5people,learningaboutandmanagingmentalhealthsimpybecomespartofthejourney.

Children DO Get Better Childhoodmentaldisorderscanbetreatedandmanaged.Therearemanyevidence-basedtreatmentoptions;talkwiththechild'shealthcareprofessionalifyouhaveconcernsaboutthewayyourchildbehavesathome,inschool,orwithfriends.Startingassoonaspossiblewillhelpyoutogetaheadoftheconcernsandpreventthesituationfromdevelopingintosomethingworse.Whentreatedappropriatelyandearly,manychildrencanfullyrecover,orlearntosuccessfullycontroltheirsymptoms.Eventhoughsomechildrenbecomedisabledadultsbecauseofachronicorseveredisorder,theencouragingtruthisthatmanypeoplewhoexperienceamentalillness,suchasdepressionoranxiety,areabletolivefullandproductivelives.

You Can Do This! Manyparentsandcaregivershavebeendownthispathaheadofyouandhavesuccessfullymadeitthrough.Youcanaswell.Youdonothavetohavealltheanswers;answerswillcome.Asthechild’sprimarycaregiverorparent,youknowthechildthebest,andyoucanuseyourknowledgeofthechildtohelpothersunderstandhimorherasyouadvocateforthem.Whilenooneintentionallychoosesthisjourney,manyhavefoundthemselvesonit.Youarenotalone;reachouttootherswhohaveexperiencedthesechallenges,andtalkwiththecaseworkeroryoursupportworkerabouttheresourcesandsupportsthatareavailabletoyou.Talkwithotherparentsandcaregiverswhohavebeendownthispath.

You can be the Difference: Family Support Critical Component for Those Suffering Youareinapositionthatallowsyoutomakeahugedifferenceinachild’slife,andyouCANdoit.Whenaskedaboutpersonalexperiencesinhelpingachildthroughthehealingprocess,numerousfosterandkinshipfamiliessharedtheirstories,suchasthetwobelow,demonstratingthedifferenceacaregiverandpromptcarecanmake:

“Iwasgettingsonervousandstressedoutallthetime.Icouldn’tsleepanymoreandwouldgo2or3nightswithoutsleepingatallbeforefinallygettingjust3or4hoursofsleep.ThiswasprobablytheworstofitallformebecauseIdidn’thaveanyenergyandcouldn’tfocusordomyschoolworkorevenhavefun,andIwasfeelingnervousmostofthetime.

MyDoctorgavemesomemedicineforanxietythatwasalsosupposedtohelpmesleeptoo.RightawayInoticedithelpedmesleepandafterawhileInoticedthattheanxietyandbadfeelingsweregettingless.Ialsotalkedwithacounselorandthisreallyhelpedmetoo.”

“Whatisreallyhelpingmeishowmyfamilyis.ItfeelslikethingsbuildupinmeandthenIsometimessaymeanthingsandblameeveryoneformakingmemad.Iprobablyhurtmom’sfeelingssometimesbutinsteadofgettingmadshejusthugsmeandtellsmeit’sOK.WhenIfeelbadMomtellsmegoodthingsaboutmeandithelpsmeandmakesmefeelbetter.ThisiswhatIwouldtellothermomstodoistorememberallthegoodthingsabouttheirkidswhentheyarefeelingbad.Myfamilyalwaystellsmetheybelieveinmeandthismakesmefeellikeitwillbeok.I`mgettingbettersometimesnow.“

8 Keys to Supporting a Child on their Journey #1UnderstandingtheDifferenceBetweenSymptoms&Behaviours

Itiscriticalforthosesupportingachildwithmentalhealthstrugglestounderstandthattheaffectedchild’sundesirableactionsorbehavioursarelikelysymptomsoftheillness,not“badbehaviour”.Bytakingthisview,caregiversarebetterpreparedtoreactinasupportiveway.

TakeforexamplethefollowingstoryafosterparentsharedaboutachildwhoismoderatelytoseverelyimpactedbyFetalAlcoholSpectrumDisorder(FASD),whichillustratesnicelythedifferenceitmakeswhenacaregiverinterpretstheirchild’sbadbehaviouras“symptoms”oftheircondition,asopposedtosimply“badbehaviours”.

Bad Behaviour or Symptoms?

Usingthestoryaboveasanexample,thefollowingchartillustratesthedifferenceitmakewhenacaregiverinterpretsthechallengingbehavioursas“symptoms”oftheconditioninsteadofsimple“badbehaviours”

UnderstandingtheDifferenceBetweenSymptoms&Behaviours(Cont.)

Whenactionsinterpretedas“BadBehaviours” Whenactionsinterpretedas“Symptoms”

Actionstakenpersonally

Whenaparenttakestheangryoutburstandhurtfulwordspersonally,theytoobecomeupset,andtheopportunitytomovequicklybacktoastateofpositiverelationshipislost.Thehurtfeelingsarelikelytolingerforbothcaregiverandchild.

Actionsnottakenpersonally

Realizingthechildisexhibitingsymptomsofhercondition,themotheractuallyexpected(fromexperience)thatthechildwouldstruggleduringthistransitiontime,needingto“vent”thepentupemotions.

Theparentignoredthechild’stantrumandwaitedfortherighttimetoredirecther.Bydoingso,themotherhelpsthechildmoverapidlybackintoastateofpositiverelationshipandeveryoneenjoyedtheridehome.

TheBirthdayParty

Thewholedayofthebirthdaypartywascarefullythoughtoutandstructuredfrommorningtonighttoensurethechilddidn’tgetderailedleadinguptotheparty;theeventbeganwithamovieforallthekids,followedbyatraditional“party”.Thefostermotherwenttolengthstocreateaspecialandmemorable10thbirthdayforagirlthathadbeeninhercaresincebirth.Thedaywentbywithoutanyproblems,andthepartywasasmashingsuccess!

Oncethebirthdaygirlwasinthecartogohomehowever,thefireworksbegan.Inlessthanaminuteshewasscreaming,kickingtheseats,andyellingthatshehatedhermomandthatthepartywasn’tanyfun.Theparentignoredthetantrumforseveralminutes,andthenwithastrategicquestionwasabletoredirectthechild,whorecoveredquickly.

Theparentexplainedthatitdidn’tmatterwhatwassaid,thatsheinfactexpectedthechildtostruggleandthrowsomesortofatantrum,andthatthechildwouldhavekeptengagingheruntilsomethingwassaidthatwould“cause”thetantrum.

AFosterMom’sExample

Consequencesgiven

Viewingthechild’soutburstassimplybadbehaviour,aparentmayconsequencethechild,punishingthemfor“unacceptablebehaviour”.

Thedangersofaddingapunishmentforthisbehaviouraremanifold;

a) Thechildlearnsitisnotsafetoventtoyou.

b) Thechildmaycometobelievethattheyareinfactjusta“badkid”,creatingaself-fulfillingprophecyofsorts.

c) Thechildandparentmisstheopportunitytounderstandandaddresstherootcauseofthebehaviour,anddevelopcopingstrategies.

Support&encouragementgiven

Understandingand,infact,expectingthebehavioursasasymptomofaninternalstruggle,theparentchoosesstrategiesthatsupportthechildintheirtimeofneed.

Thisallowsthechildtonotonlyventtoa“safe”person,butalsomay,overtime,helpthemtobetterunderstandtheirownissuesandcreateopportunitiestounderstandthemselves.

Thishelpsthechildrealizetheyareloved,andthatneitherthey(asaperson)northeirrelationshipsaredefinedbytheircurrentdifficulties.

Child’swordstakenastruefeelings/thoughts

Iftheparentbelievesthechildreallyfeelsthisway,therelationshipmaysufferascaregiversbuildswallstoprotectthemselvesfromthehurt.

Considerthis;Itismorelikelythatthechild“feels”thiswayinthemoment,butdoesnotactually“think”thisway.Thefeelingsmaybeoverwhelmingbuttemporary,andnotinagreementwithwhatthechildtrulythinks.

Actionsandwordsarebelievedtobeasymptomofinternal

struggle,NOTindicativeofhowtheyreallythinkorfeel.

Whenaparentunderstandsthattheactionsandwordsarea“symptom”ofthepainordifficultythechildisexperiencing,theyareabletoreactcompassionately,eveninthefaceofhurtfulwordsandbehaviours,andhelpthechildfindavoiceforwhattheyareexperiencing.

Remember: Sick, not BadChildrenwithmentalhealthissues(justlikechildrenwithcognitivedisabilities)canexhibitsomechallengingbehaviours,andthewaycaregiversinterpretthesebehavioursisgoingto

determinetheirresponse.Whenparentsrecognizethatundesirablebehavioursarecausedbysomethingoutsideofthechild’scontrol,andthatachildisdoingtheirbestwiththeirlimitedknowledge,theycanchangeexpectationstofitthechild’scurrentstrugglesandabilitiesandpositivelysupportthemthroughthetoughtimes.Thismaylaythegroundworkforthechildtoeventuallycometounderstandtheirownissuesandgrowbeyondthechallengesoftheday.

ASupport&RecoveryTeamMightInclude:

Â Thepersonwholiveswiththementalhealthcondition

Â Thedoctorwhodiagnosesthecondition

Â Atherapist/socialworker/counselor/psychologist/psychiatrist

Â Familymembers,friends,neighbors

Â Teachers,schoolnurse,youthleaders/mentors

#2Don’tBlameYourself

Discussionsbythisauthorwithbothparentsandmentalhealthprofessionalsrevealthatparentsandcaregiversofchildrenwithmentalhealthissuesarepronetofeelingsofguilt.Self-blaming,self-doubtandsecondguessingcanleadcaregiverstomisdirectedquestionsaboutparentingstylesandchoices,towonderingwhattheycouldhavedonedifferently,andgenerallybelievingthatthementalhealthissueisaresultofsomethingtheparentdidordidnotdo.Thisself-blamingandguiltcanundermineaparentorcaregiver’sconfidenceandpotentiallyhisorherownmentalhealth.

Remember,mentalillnessisahealthissue;itisnomoretheresultofparentingthenmedicalillnessessuchasasthma,Lymedisease,ortheflu.

#3BelieveIntheChildChildrengaininnerstrengthwhentheimportantpeopleintheirlivesareabletomaintainthevisionofwhotheyarewhentheyarefeelingwellandnotfightingamentalillness.Theydonotwanttobehavebadly, andwantnothingmorethantofeellikethemselvesagain.Helpthembyholdingontoandbelievinginthatvisionofthewellperson,thepersontheyarewithouttheillness.

#4CommunicateOften,DevelopStrategiesTogether

Whenthechildisinhisorherbetterstate,takethetimetotalkaboutstrategiesthatcanbeusedwhenheorsheisnotfeelingwell.Makeaplanthatoutlinesthestepsforastart-overorno-faultresetofthehomeandrelationships.Don’tletthebadtimesdefinethegoodtimesbyallowingbadfeelingstocarryover,butdotheopposite;allowthegoodtimesandgoodfeelingstocarryoveranddefinethebadtimes.

Beintentionalaboutdiscussingwaysthatthosearoundthechildcanoffersupportorcomforttheindividualwhentheyarestruggling.Tellyourchildthathecantalktoyouanytimeaboutanything,andbetheonetoinitiatethetalks.

#5ResearchtheConditionTherearemanydifferenttypesofmentalillnesses;readuponthechild’sspecificcondition.Thiswillhelpyoubetterunderstandtheconditionaswellaswhathelpsrecoveryandwhatcanbedonetopreventrelapsesinthefuture.

#6BuildaSupport&RecoveryTeam

Itistemptingforsometohideamentalhealthconcernfromfriendsandfamilybecauseofaperceivedstigma,butthisisnothelpful.Considerhowvariousindividualscanhelpsupportachildthroughrecovery;bybringingtheseindividualsintotheloopandontotheteamthelistofpeoplewhounderstandthechildandthecircumstancesgrows,asdoesthenumberofsafeplacesforthechild.

Whoarepossiblemembersofarecoveryteam?Tobegin,rememberthatthepersonlivingwiththementalhealthconditionisthemostimportantmemberofhisorherownrecoveryteamandhasanimportantvoiceintheprocess.

#7HelptheChildConfrontInaccuraciesinTheirThinkingItisnotuncommonforpeoplestrugglingwithmentalillnesstogetcaughtinnegativethinkingpatterns.Thesecyclicalpatternsaresodamagingbecausehowonethinkseffectshowonefeels,whicheffectsbehaviours.

Dr.Burns,inhismostrecentbook,“WhenPanicAttacks”(2007),discusseshowthiscyclebecomesentrenchedandharmfultoanindividual,notinghowone’sthoughtsarebasedonaninterpretationofanevent,andtheinterpretationoftheevent–theinnerthoughtsandinnervoice-leadstofeelings,whichleadstotheexternalizationofthesefeelingsthroughbehaviours,likethis:

Keepinmindthatthesenegativethoughtpatternsaren’tintentional–thechildisn’ttryingtobenegative,butinsteadthenegativethinking(andtheresultingbehaviours)aresymptomsofthementalillness.Gentlyreassuringandcommunicatingwithoutjudgementabouteventsandtheirinterpretationscanhelpayoungpersonmovetowardshealing.Yourmentalhealthprofessionalcanhelpyouunderstandhowthesecyclesbeginandhowtohelpyourchildconfrontandchangethem.Rememberthatconfrontingthenegativethinkingcycledoesnotmeanconfrontingthechild.

#8Live,Love,Laugh,Cry,andHugalot-It’sAllGoodLifecontinues;makeplans,Keepliving.Therewillbetimesthatachildwithmentalhealthstruggleswillnotfeellikeparticipatingintheregularplans,andthat’sOK.Bymakingplansandcontinuingasnormallyaspossible,youaresupportingnotonlythechild,buteveryoneelsearoundhimorherwhoissharinginthejourney.Keeplifemoving,anddon’tlettheillnessbecomethecenterofattention.

Mentalillnessissimplypartofthejourneyformany,asroughly1in4willstrugglewithitatsomepointinlife.Taketimetoenjoythegoodmoments,allowyourselfthegenuineemotionsthatcomeinboththegoodandbadtimes.Offerlotsofaffectionandhugs,agentletouchorpatontheback.Acknowledgeyourchild’sstrugglesandattemptstomoveahead,successfulornot,withsupportive,encouragingcomments.

Remember,whenthechildseemstheprickliest,thisislikelywhentheyneedsupportthemost.Expressyoursupportoutloudandoften–itwillstrengthenthem.

Avoiding Burnout - Taking Care of the Caregiver

events thoughts feelings behavioursWhen

somethinghappens

Myinnervoicetellsmesomethingabouttheevent

Myfeelingsfollowmythoughtsabouttheevent

Mybehavioursreflectmyfeelingsabouttheevent.

Example

Momhasnotbeenaroundmemuch

today;sheisn’thertypicalpositiveself

Example

Mommustbetiredofmeandavoidingme.Iburnedheroutandnowshecan’tstandme

anymore.

Example

IfeellikeIamnothingbuttroubletoeveryone.

Everyonehasgivenuponme.Idon’tblamethem;I’msuchajerk.Ihatemyself

morethanever.

Example

Angry,pouting,moody,defensive,explosive,distant.

Startbydoingwhat'snecessary;thendowhat'spossible;andsuddenlyyouaredoingtheimpossible.St.FrancisofAssisi

Careforyourselftohavethestrengthto

careforothers

Whydocaregiversburnout?AccordingtoWebMD(2014),burnoutoccurswhencaregiversdon'tgetthehelptheyneed,oriftheytrytodomorethantheyareableeitherphysically,emotionally,orfinancially.Caregiverburnoutcanleadtoahostofcomplicationsthatcanincludephysical,emotional,andmentalexhaustionaswellascompassionfatigue.

Whatdoesburnoutlooklike?Symptomsmayinclude(butarenotlimitedto):

• Emotionalandphysicalexhaustion• Irritability• Changesinsleeppatterns• Changesinappetite,weight,orboth• Feelingblue,irritable,hopeless,andhelpless• Strongnegativefeelingsaboutyourselforthepersonyouarecaringfor• Frequentsickness• Withdrawalfromfriendsandfamilyand/oralossofinterestinactivities

previouslyenjoyed

Ifyouareexperiencinganyofthesymptomsofburnoutalready:

Takethetimeneededtoconsideryourownhealthneeds,andthentakestepsimmediatelytodosomethingaboutthem.Talkwithyourcaseworkeraboutwhatsupportsmaybeavailabletoyou,andusethem.Counseling,respite,extrainhomesupport–arejustsomeoftheoptionsthatmaybeavailabletoyou.Withthehelpofyoursupportworker,significantother,orsomeoneclosetoyou,comeupwithaplantoaddressthestress.Donotbeafraidtoreachouttoothersforyourownneeds.Thesymptomslistedaboveareyourbodyandmind’swayoftellingyouaboutyourownneedsand,ifignored,canleadonetoexperiencingtheirownmentalhealthcrisis.Remember,itcantakesometimefortheeffectsofburnouttodevelop,anditcantakejustaslongorlongertoremedytheconditionandreturntonormal.

Thekeyistorecognizeyourownneedsandtakethestepsneededtoproperlycareforyourself.Don’twaituntiltheeffectsofstressarestartingtotaketheirtollonyoubeforedoingsomethingaboutit.

TheRippleEffect:Family&Friends

Keepinmindthatwhenoneindividualinahouseholdisexperiencingmentalhealthconcerns,everyoneinthehouseislikelyexperiencingtherippleeffectsoftheillnesstosomedegree.Livingwithandworkingthroughamentalhealthissuecanbestressfulanddifficultnotonlyfortheindividualwiththeillness,butforeveryoneclosetothehimorher,includingextendedfamilyandfriends.Thisisnotsaidtoblame,shame,orguilttheindividualwhoisstrugglingbuttodrawattentiontothefactthatthoselivingwithorclosetoanindividualwithmentalhealthissueslikelyallshareinthestress.

Considerhowfamilyandfriendsareaffectedorimpactedbythestressesoflivingwithmentalillness.Justasoneneedstobeintentionalaboutself-care,itisalsocriticaltoconsidertheeffectsonthoseclosetothestrugglingchildanddiscusswaystomitigatetheeffects.Thiscouldincludefamilytalktimes,one-on-onediscussionsanddebriefing,individualorgroupcounseling,andmanyotherideasthatgiveindividualsopportunitytotalkaboutandprocesstheirexperiences.Justbyacknowledgingtherippleeffects,wearevalidatingthedifficultiesandchallengesfacedandrecognizingtheeffortsofthosesupportingthechildoryouthinneed.

Put YOUR Mask on First

Self-Care & De-stressing Considerthefollowingself-careideas:

• Self-careRule#1:Planforitbeforeyouneedit.Scheduleregulartime-outs,continuewithyournormalactivities,andcontinuetodothethingsyouenjoy.Thisisaboutyourhealth,andisnotselfish.Don’twaituntilyourstressbecomesoverwhelmingbeforeacting.

• Beproactiveaboutyourphysicalhealth:exercise,eathealthy,andgetenoughsleep.Thiswillnotonlyhelpwiththeenergyyouneed,butwillalsosupportand

strengthenyouremotionalwellbeing.

• Bepurposefulandintentionalaboutcreatingtimeandspaceforde-stressing.Don’tleaveittochanceorcircumstances.Taketheproverbialbubblebath!

• Taketimetopursuehobbiesandinterests,andmaintainfriendships.Don’tletcaregivingconsumeyourlife.

• Considercounselingortherapyforyourselfandspousetohelpyoucopewithyourfeelingsandalsotohelpyoukeepapulseonyourownwellnessthroughouttheprocess.Checkwithyourcaseworkertoseewhetherthecostforthismaybecoveredforyou.

• Giveyourselfpermissiontodisengage,beaway,andthinkofotherthings.Don’twastetimewithfeelingsofguiltorwonderingifyoushouldbetakingthetimetotakecareofyourself.Youneedtotakecareofyourselfifyouwanttobetheretotakecareofsomeoneelse.

• Taketimetoworkonyourotherrelationships.Talkaboutyourrelationshipwithyourpartneranddiscussideasforkeepingithealthy.Continuetodothingstogetherthatbothyouandyourpartnerenjoy.

• Userespitetogiveyourself,otherhouseholdmembers,andtheaffectedchildtimetode-stressandrecharge.

• Bringinoutsidehelpsuchasextendedfamily,home-careoryouthworkers,whenpossible.Buildastrongsupportteamanduseit.Oftenotherswanttobehelpfulbutdon’tknowhow.

• Communicateoften,witheveryone.

• Yourfeelingsaregenuineandlegitimate,donotavoidthem.Love,laugh,forgive,cry,it’sOK.

• Bookyourrespite,mini-vacationsorstay-cations,dates,daytrips,spaday,roadtrip,walks,aheadoftimeandfollowthrough.Planonhavingfunandthendo!

• Afterbookingyourowntimeoffandaway,considerhowthesamemaybehelpfulforthechildoryouththathasthementalhealthconcern.Amovieout,horsebackriding,bikeridingoradaytripmaybeatonicorpositivedistractionforthechildinquestion.Theseactivitiescanbewithyou,extendedfamily,orachildandyouthcareworker,dependingontheneedandthecircumstances.

• Considerwaysofusingextendedfamilyandorcommunityagencies/mentorstohelpsupportthechild.Buildingateamaroundthechildbyextensionhelpstheentirefamily.

Althoughtheworldisfullofsuffering,itisalsofulloftheovercomingofit.HelenKeller

The Path to Better Mental Health Starts Here Underlying Conditions May Cause or Aggravate Mental Health Concerns

Thereareanumberofissuesandgeneralhealthconditionswhichareknowntohavethepotentialofimpactingone’smentaland/oremotionalhealth.Caregiverscancheckfortheseissueswhilewaitingforamentalhealthconsultationand,ifapplicable,addressthemwhilewaiting.Checkingfortheseissuesbeforetheinitialmentalhealthappointmentwillprovideacoupleofbenefits;first,iftheyarepresentinthechild,addressingthemimmediatelymaycorrectoratleastalleviatethesymptomswhicharedisturbingthechild.Secondly,bycheckingfortheseissuesearly,evenwhilewaitingforamentalhealthconsultation,youaredoingsomething,andtakingstepstodosomethingcanbeencouragingforthechildandfamily.

Addressingthefollowingconcernsassoonaspossibleallowsyoutorulethemoutaspotentialunderlyingfactorsthatareaffectingthechild’swellbeing,andmaywellbethefirststepstowardthepathofhopeandhealing.

Sleep Mostofushavemissedsleepatsomepointinourlivesandcanattesttohoweasilythelackofsleepcanthrowusoffofourgame.Withprolongedsleepdisturbancestheabilitytofocusandpayattentioncansuffer,cognitiveabilitiesandperformancemaybeimpactedandwemayfindourselvesshorttempered,irritable,andoverlyemotional.

Howisthechildinyourcaresleeping?Ifheorsheishavingissuesgettingtosleeporstayingasleep,thisproblemalonemaybeenoughtocreateconditionswhichpresentasmentalhealthand/orbehaviouralissues.

DuringtheannualFosterParentConferenceinJasper,Alberta(2014),KeirKutney,abehaviouralspecialistfromtheRedDeerareawithmorethan26yearsofexperienceworkingwithchildrenwhohaveseverebehaviouralissues,notedthatmanybehavioural,emotional,and/orpsychologicalissuesexperiencedbychildrenincaremaybecausedbyorfurtheraggravatedbychronicsleepproblems.Whilesleepdisturbancesmaybetheresultofmanyfactorsingeneral,acombinationofpasttraumaticexperiences,placementanxietyandcurrentstresses,whicharenotuncommonforchildrenincare,oftendoresultinchronicsleepdisturbances.

TipsforImprovingYourChild'sSleep

• Routine

Itishardtooveremphasisethevalueofroutinewhenhelpingchildrenwhostrugglewithsleepissues.Bycreatingarepetitivebedtimedrill,wecreateatransitionscriptthatsignalsthemindandbodythatbedtimeiseminent,andallowsthemindtoquietitself.ForchildrenwithFASDorothercognitivedisabilities,developingastandardroutinealsohelpsthemnavigatetheoftenchallengingtransitionfromplaytimetobedtime.Aroutinecanincludeanythingthatworksforyouandthechildwhichcreatesquiettimeandrelaxation.Someideasincludewarmbaths,bedtimestories,pajamatime,quiettimeinbedreadingorlookingatbooks,oranythingelsethatprovidesapositive,repeatable,andcalmingmomentforthechild.

Manysleepexpertscautionagainstusingtelevisionorvideogamesuptoanhourbeforebed,foranumberofreasons;firstofall,thestimulatingeffectoftheseworkdirectlyagainstthegoalofquietingthemind.Secondly,thelightemittedfromtheseelectronicscanaffectthebody’sproductionofthenaturalhormonesthathelpussleep.Agoodsleeproutineshouldincludearelativelyconsistentwakingtimeaswell,asvaryingthewaketimebylargeamounts(likesleepinginlate)canworkdirectlyagainstthechild’seveningsleepcycle.Forachildwithsleepissues,thebedtimeroutineshouldstartatthesametimeandfollowthesamescripteverynight.

• Environment

Somepeopleseemtobeabletosleepanywhere,anytime,whileothersaremuchmoresensitivetotheirenvironmentandthestimulationwithinit.Unfortunately,childrenwithFASDorothercognitivedisabilitiessuchasthosecausedbychildhoodtrauma,bothofwhicharenotuncommonamongchildrenincare,oftenfindthemselvesinthegroupthathasmuchmoredifficultyachievingandmaintainingsleep.Considerthechild’senvironmentbasedontheirpersonalabilitytohabituateto(orblockout)environmentalstimulation;

theamountoflight,thenoiseandactivitylevelinandneartheirbedroom,androomtemperatureareeasyplacestostart,butathoroughreviewoftheirenvironmentshouldalsoincludeareviewofthedistractionswithinthechild’sroomsuchastoysanddécor,thetypeoforweightofthebedding,andeventhetypeofclothingthechildsleepsin.Allofthesearepotentialareasthatcanbeadjustedtomatchthechild’sabilitytohabituatetoorblockoutdistractingstimuli.

Notallchildrenrespondthesamewayundersimilarcircumstances.Forinstance,somemaypreferacompletelyquietroom,whileothersprefersomebackgroundnoise;somemaypreferlightbeddingthattheycankickedoff,whileotherspreferaheavyblanket.Adjustthetemperature,ambientlight,andnoiseoractivitynearthechild’sbedroomaccordingly.

• Diet

Itiswidelysuggestedthatchildrennotbegivenfoodordrinkthatcontainscaffeineuptosixhoursbeforebedtime.Avoidingfoodswithlargeamountsofsugaraswellaslargemealsclosetobedtimecanalsohelpyouavoidconditionswhichmayaffectthechild’sabilitytoenterhisorhernaturalsleepcycle.

• SleepAids

Childrenwhochronicallystrugglewithsleepdisturbancesmaybenefitfromusingsleepaidssuchamelatoninorevenmildoverthecounterorprescriptionsleepmedications.Ifyouhaveexploredallthelessinvasiveoptionsandthechildstillstruggleswithsleepissues,youmaywanttotalkwiththechild’sdoctorandcaseworkertodecideifheorshewouldbenefitfromasleepaid.

TheBottomLine

Whilegettingenoughsleepiscriticaltogoodmentalandemotionalhealth,sleepproblemscaneasilybeoverlookedorconsideredlessimportantwhenafamilyisstrugglingwithsymptomsandbehavioursthatarenegativelyimpactingachild’slife.Ifthechildishavingongoingsleepproblems–eitherfallingorstayingasleep,orisexperiencingsleepdisturbancessuchasregularnightmares,addressingtheseassoonaspossiblemaywellputthechildontothepathofmentalwellness.Talktoyourchild'shealthcareproviderandcaseworkerifyourattemptstoaddresssleepdon’tworkandyouneedadditionalhelp.

FromtheWeb

Therearemanyresourcesavailableontheinternettohelpyouunderstandandaddresssleepissues.Thefollowinglinkscangetyoustartedonfindingsolutionsforchronicsleepissues.

https://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=abh0127

http://keltymentalhealth.ca/healthy-living/sleep

Part1:http://lovinadoptin.com/2014/08/29/why-adopted-and-foster-children-have-sleep-issues-part-1/Part2:http://lovinadoptin.com/2014/09/05/how-to-help-your-adoptedfoster-child-sleep-part-2/

Underlying Medical Conditions

In some cases underlyingmedical conditions, such as Hypo or hyper-thyroidconditions, hypoglycemia, Iron deficiencies, low levels of Vitamin D, andhormoneissues,maycauseorcontributetomentalhealthconcerns.

It is important to see one’s primary care physician as soon as concernsarisetoruleoutpotentialunderlyinghealthconcerns,obtainabloodworkbaseline,andcompleteathoroughmedicalassessment.

Knowing Your Professional Team Therearemanyprofessionalswhomayplayaroleinachild’swellnessjourney.Listedbelowaresomeofthemorecommonprofessionalsalongwithadescriptionoftheirexpertiseandservicesprovided.

RoleDescription Requ

Referrals

Prescribes

ications

Family/Prim

CareDoctor

Thefamilyorprimarycaredoctorwillworkwithyoutoassessyourchildinitiallyandhelpplanacourseofaction.Heorshecanalsobebeneficialinhelpingyouselectotherteammemberstosupportthechildandhelpmonitorprogress.Someserviceproviders,likepsychiatrists,canonlybeaccessedthroughareferralfromaprimarycaredoctor.

Afamilydoctorcanrunteststoruleoutmedicalfactorssuchashypoorhyper-thyroid,vitaminDdeficiencies,hypoglycemia,hormoneimbalances,lowiron,etc.,asthesemaycausesymptomswhichappeartobementalhealthconcernsoraddtotheseverityofdepression,anxiety,irritability,andinsomnia.

NO YES

Pediatric

Afterbecomingamedicaldoctor,pediatricianstrainforatleastfourmoreyearsinthespecializedcareofchildren.Manypediatricianstraininaspecificareaofchildandyouthhealth,calledsubspecialists.Someexamplesarepediatricsurgeons,neonatologists(caringforsicknewbornsorprematurebabies),anddevelopmentalpediatricians.

Adevelopmentalpediatricianisapediatricianwhohasreceivedadditionaltraininginchilddevelopmentandbehavior.Typically,aspecializedpediatricianacceptspatientsthroughreferrals.

YES YES

Psychiatrist AccordingtotheCMHA(2014)apsychiatristisamedicaldoctorwithaspecialtyinthe

diagnosisandtreatmentofmentalillnesses.Theycanprescribemedicationandusecounsellingtosupportrecovery.Youusuallyneedareferralfromyourfamilydoctortoseeapsychiatrist.Psychiatrists’feesarecoveredbyprovincialandterritorialhealthplans.

YES YES

Psycho

logist

Psychologistsaretrainedtoassess,diagnoseandtreatmentalhealthproblemsanddisorders.Theyholdamastersordoctoraldegreeinpsychologyandoneormorespecialtyareaorareaslikeclinicalpsychologyorclinicalneuropsychology.Theirexpertiseincludespsychologicaltestingandassessmentofemotionalandcognitivefunctions,thediagnosisofemotionalandcognitivedisorders,andtheuseofevidence-basedpsychologicaltreatmentsandpsychotherapies(CMHA,2014).

Whenapsychologistisemployedbyapublicinstitutionlikeahospital,school,orcorrectionalfacility,theirservicesarecoveredbythepublichealthsystem.Whenapsychologistpracticesinthecommunity,however,theirservicesaretypicallynotcoveredbypublichealthinsuranceplans.

rs TheCMHA(2014)notesthatregisteredorcertifiedcounsellors(suchasaRegistered

ProfessionalCounsellororRegisteredClinicalCounsellor)aretrainedtoassessmentalhealthproblemsandusedifferentcounsellingand/orothertherapeuticmethods.Thisoftenincludesteachingdifferentskillstohelpimprovewell-being.Counsellorsarenotmedicaldoctorsandcan’tprescribemedications.

Knowing Your Professional Team

RoleDescription Requ

Referrals

Prescribes

ications

SocialW

orker Asocialworkerisahelpingprofessionalwhofocusesonboththeindividualandhisor

herenvironment.Socialworkersperforminterventionsthroughresearch,policy,communityorganizing,directpractice,andteaching.Asocialworkercanhelporganizeasupportteamforyourchild,facilitateteammeetings,andprovidepersonalsupporttoindividualsandfamilies.

YouthMen

ThetermYouthMentorcanbeusedtodescribeawiderangeofprofessionalswhosupportchildrenwhoarestrugglingwithvariousissues,includingbehaviouralandmentalhealthconcerns.Dependingontheagencythroughwhichtheyouthmentoriscontracted,theindividualmayhaveminimaltraininggainedthroughworkexperience,butmorelikelywillhaveadiplomaordegreeinChildandYouthCare,Psychology,NursingorSocialWork.Youthmentorstypicallyworkaspartofateambycarryingouttherapeuticactivitiesassociatedwithatreatmentplanwithintheindividual’shomeandsocialenvironments.

Pharmacist

PharmacistsrepresentoneofthemostaccessiblepointsofhealthcareinAlberta.Forthoselivingwithmentalillness,thisaccesstohighlyknowledgeableprofessionalsinourhealthcaresystemofferstremendousbenefit.Itispartofpharmacist’sregulardutiesistoansweryourquestions,andtheyareanexcellentsourceofinformationregardingmedications,alternatives,risksandsideeffects,interactionpotentialandmuchmore.Itisstronglyrecommendedthatoneusesthesamepharmacistthroughouttreatmenttoavoidreceivingtoomanymedications,ormedicationsthatcontradictorcauseareactionwhentakentogether.

AlbertahasrecentlyexpandedtheroleofthepharmacistbycreatingtheClinicalPharmacistposition,whosepurposeisnottodispensemedications,buttogiveadviceandsupporttopatientsandaddtothemedicationinformationpatientsreceiveatthepharmacycounter.

PsychiatristorPsychologist;WhichOne?

Theanswertothisquestiondependsonthecircumstances;itmaybebothanditmaybeneither,dependingonthementalhealthissuesofthechild.WhenDr.Abel(2011),aPsychologistandAuthor,wasaskedwhichshewouldreferapersonalfriendto,heranswerwas,“IfIwereadvisingafriendorfamilymemberonwhethertoseeapsychotherapistorapsychiatrist;Imightrecommendbothinsomeinstances.However,byandlargeifthepersonsuffersfromBi-PolarDisorder,ADHD,orSchizophreniaIwouldrecommendapsychiatrist.IftheyaresufferingfromGeneralizedAnxietyDisorder(GAD),Post-TraumaticStressDisorder,SocialAnxiety,PanicDisorder,Agoraphobia,SimplePhobia,Insomnia,orDepressionwithoutcyclesofManiaIwouldrecommendatherapistwhospecializesinthefield.”Thefirststepistoseeone’sfamilydoctorwhowillhelpdeterminewhethereitherofthesespecialistscanbenefityourchildandsupporttheirtreatment.

Useful Links and Phone Support

AlbertaMentalHealthHelpline1-877-303-2642

KidsHelpPhone1-800-668-6868

24hourdistresslineEdmonton780-482-4357/780-342-7777(MobileResponseTeam)

24hourdistresslineinCalgary403-266-1605/403-266-HELP(4357)403-266-4357

HealthLinkAlbertaTollFree1-866-408-LINK(5465)

CanadianMentalHealth24HourPhoneSupportforIndividualsExperiencingaCrisis.1-888-787-2880

Phone211:FreeinformationandreferralsystemforthousandsofcommunityandsocialservicesinAlberta.Availabledayornightbydialing211.TextConnect:1-587-333-2724Textconnect:MondaytoFriday,from5pm–10pmandSaturdayandSundayfrom12pm–10pmIfyoufeelmorecomfortabletypingthantalking,thenyoucangetintouchwithusthisway.(AprogramoftheDistressCentre)

Internet Links

Â Children’sMentalHealthLearningSeriesTheChildren’sMentalHealthLearningSeriesprovidescaregivers,familiesandprofessionalswithhelpfulinformationtoincreaseknowledgeandhelpsupportchildrenandyouthwithmentalhealthconcerns.http://humanservices.alberta.ca/family-community/cmh-learning-series.html

Â AlbertaMentalHealth&WellnessMainwebportaltoAlberta’smentalhealthserviceshttp://www.albertahealthservices.ca/mentalhealth.asp

Â AlbertaHealthServiceshttp://www.albertahealthservices.ca/

Â Edmontonregionmentalhealthservicedirectoryhttp://www.albertahealthservices.ca/services.asp?pid=service&rid=7484

Â EdmontonCommunityMentalHealthClinichttp://www.albertahealthservices.ca/services.asp?pid=service&rid=1001410

Â MedicineHatregionsupportandservicesdirectoryincludingcrisislinehttp://ser.cmha.ca/files/2012/03/WhenYouNeedHelp-MedicineHat.pdf

Internet Links

Â AddictionandmentalhealthinformationandservicesLinkstoinformationandresourcesonmentalhealth,substancesandaddictiontohelpimprovethehealthandmentalwell-beingofAlbertans.http://www.health.alberta.ca/health-info/addiction-mental-helth.html

Â ParentLinkCentresThreenewParentLinkCentreswilljoinanetworkof50otherCentrestoprovideparentsandcaregiverswithfreeresourcesandsupporttodevelopnurturingenvironmentstosupportearlychildhooddevelopment.http://humanservices.alberta.ca/family-community/15576.html

Â ParentlinkAlbertadirectoryhttp://humanservices.alberta.ca/family-community/plc-regional-map.html

Â AlbertaMentalHealthPatientAdvocateOfficeTheMentalHealthPatientAdvocateislegislatedtoprotectpatientrightsandinvestigatecomplaints.ThePatientAdvocateisnotpartofaprovincialhealthauthority,hospital,clinicortreatmentteam.https://www.mhpa.ab.ca/Contact/Pages/default.aspx

Â TriplePTakestheguessworkoutofparentingTheAlbertagovernmentistakingtheguessworkoutofparenting,supportingparentsandcaregiverswiththeTripleP–PositiveParentingProgram.TriplePgivesparentssimpletipstohelpmanagethebigandsmallproblemsoffamilylife.http://www.triplep-parenting.net/alb-en/home/

Â CASACaregiverVillageAwealthofinformation,supportandtoolsthatcoversabroadrangeofissuesincludingmentalhealthconcerns,parenting,anddevelopmentaldisabilitiessuchasFASD.Selectanareaofconcernandyourchild’sagetofindinformationandresourcesthatcanhelpyoucareforyourchild.www.caregivervillage.ca/index.php/webapp

Â (CAMESA)guidelinesTheCanadianAllianceforMonitoringEffectivenessandSafetyofAntipsychoticsinChildren(CAMESA)guidelinesprovideparentsanddoctorswithinformationaboutthesideeffectsofantipsychoticdrugsinchildren.http://camesaguideline.org/about-the-guidelines

Â PsychotherapiesForChildrenAndAdolescentsAbriefdescriptionofthemorecommontypesofpsychotherapyforfamiliesandchildrenandhowtheymaybenefityou.http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Psychotherapies_For_Children_And_Adolescents_86.aspx

Â KeltyMentalHealthAwiderangeofonlineresourcestosupportfamiliesastheysupportindividualsthroughavarietyofissues,includingmentalhealth,parentinganddevelopmentaldisabilities.http://keltymentalhealth.ca/resources?tid3[]=44

Internet Links

Â NationalAllianceonMentalIllnessFactSheetLibraryNAMI'sfactsheetsareclear,conciseinformationonmentalhealthtopics.Afewwaysyoumightwanttousethemarebysharingthemwithalovedone,bringingthemtoanappointment,orhandingthemoutathealthfairs.http://www.nami.org/Learn-More/Fact-Sheet-Library

Â CalgaryRegionHullServiceshelpschildren,adults,andfamilieswhoexperiencesignificantmentalhealth,behaviouralanddevelopmentalchallenges,usingtheirexpertisetohelpmovethemtosuccess,andactivelyconfrontthebarrierstowellnessinourwholecommunitywww.hullservices.ca

Â DistressCenterDistressCentreensureseveryonehasaplacetoturntoinatimeofcrisisbyproviding24hourcrisissupport,professionalcounsellingand211referrals-allatnocost.http://www.distresscentre.com/

Â Help-4-MeMentalhealthsupportforchildrenandyouthhttp://www.help4me.ca/

Â YouthSmartTools,informationandResourcesforyouthhttp://www.youthsmart.ca/

Â ConnecTeen(Calgary)AconfidentialpeersupportserviceforyouthinCalgaryandarea,aprogramofDistressCentre.CalgaryHelpLine403.264.8336|TEXT:587.333.2724http://calgaryconnecteen.com/

Preparing for the Mental Health Consultation Child’s Personal HistoryPlacementhistory

Anyknownhistoryofneglectorabuse

Familyoforiginhealth/mentalhealthhistory

History of Symptoms

Currentsymptoms,challengesand/orproblematicbehaviours

Firstsymptoms:whatwerethey,whendidtheystart,howhavetheychanged

Knowntriggerswhichmayleadtoorescalatesymptoms

of2PreparingfortheMentalHealthConsultation

KnownHealth/MentalHealth&CognitiveFunctionIssuesIncludingcurrentandpasthealthandmentalhealthissues,knownorsuspectedcognitivefunctionissues(i.e.FASD,ADHD,RAD,Bipolar,etc.)

Current Medications & Treatments

Includeallprescribedmedications,herbalandhomeopathicremedies

Current Strategies

Whatstrategieshaveyouusedtohelpwiththesymptoms,whathasbeenhelpfulandwhathasnotbeenhelpful

Hopes, Desires, & Expectations of Treatment

Other(informationyoubelievemaybeusefulorrelevantduringthementalhealthconsultation)

PreparingfortheMentalHealthConsultation

Question to Ask During a Mental Health Consultation AbouttheIllnessWhatisthecauseofthisillness?

Whatdoweneedtoknowaboutthecondition?

Howdoweachievethebestresultsforthiscondition:psychotherapy,medication,oracombinationofboth?

WherecanIgetmoreinformation?

AbouttheTreatmentPlanIsthegoaloftreatmenttocurethisconditionormanageit?Howlongmighttreatmentlast?

Arethereanymedicaltestsorotherassessmentswhichneedtobedonebeforemychildbeginstreatment?

Howoftenwillprogressbecheckedandbywhom?Whenisthenextappointment?

Whodowecontactincaseofanemergency(regularbusinesshoursandafterhours/weekends)

Whatpotentialbehaviouralchangesshouldwebepreparedfor?

AbouttheMedicationsWhyareyouprescribingthismedicationtothechild?

Howwillthemedicationhelpthechild?

Question to Ask During a Mental Health Consultation Page1of4QuestiontoAskDuringaMentalHealthConsultation

AbouttheMedications(cont.)

Aretherealternativestousingthismedication?

Whatisthenameofthemedication?Aretherebenefitstotakingthebrandnameversusagenericequivalent?

Howlongwillmychildneedtotakethismedication?

Whatchangesshouldweexpecttosee?Howlongbeforeweexpecttoseechangesand/orimprovement?

Whataretherisksandsideeffectsassociatedwiththismedication?

WhatdoIdoifsideeffectsdevelop?

Howlongdoyouexpectthechildwillneedthemedication,andhowwillthedecisionbemadetostopusingit?

Willapsychiatristbemonitoringmychild'sresponsetothemedication?

Isthismedicationaddictive?Canitbeabused?

Whatifwemissadose?

Arethereothermedications,foods,oractivitieswhichmychildshouldavoidwhiletakingthismedication?

Arethereadverseinteractionsbetweenthismedicationandotherprescription,over-the-counter,orherbalmedications?

Doesmychild'sschoolnurseneedtobeinformedaboutthismedication?

Question to Ask During a Mental Health Consultation Page2of4QuestiontoAskDuringaMentalHealthConsultation

AboutSupportingtheChild

Whatcanthefamilydotosupportthechildduringtreatment?

Whatadviceorstrategieswouldyourecommendfordealingwithchallengingbehavioursandsymptoms?

Arethereanycommunityresourcesthatwouldbenefitthechildand/orfamilyduringtreatment?

Whatelsedoweneedtoknowthathasn’tbeencoveredyet?

Question to Ask During a Mental Health Consultation

of4QuestiontoAskDuringaMentalHealthConsultation

NOTES:

Monitoring Symptoms and Side Effects

of4QuestiontoAskDuringaMentalHealthConsultation

Thefollowingpagescontainformsthatmaybeusedtotrackboththesymptomsandsideeffectsthatachildmightexperiencewhenbeingtreatedwithpsychotropicmedications.

IMPORTANT:Usethisformalongwithoneofthemedicationmonitoringformsbelow,foundonpages26-29.

Remember:ifyoudochoosetousetheseoranyothertrackingforms,tostarttrackingBEFOREachildbeginsusingmedicationsifpossible,sothatasolidbaselinecanbeestablishedpriortotreatment.Thiswillhelpidentifypositiveornegativechangesinsymptomsandinpossiblesideeffects.

Itisstronglyrecommendedthatyouconsultwiththechild’sprimarycarephysicianbeforebeginninganypsychotropicmedicationstodetermine:

Â Whetherthereareunderlyingmedicalconditionswhichmaybecausingorcontributingtothementalhealthissue,orwhichmaycauseanadversereactionifmedicationsareusedintreatment

Â Completeamedicalassessmentthatestablishesphysicalbaselinestohelpmonitorforpotentialchangesastreatmentprogresses

Â Checkwiththechild’sprimarycarephysiciantoensurethatwhicheverformsyouchoosetouse(tomonitorandtracksymptomsandsideeffects)arecapturingtheinformationthatyouandthechild’sdoctorneed

Physical/MedicalBaseline&Tracking

Baseline1

Weeks3

Weeks4

Weeks5

Weeks6

Weeks8

Weeks10

Weeks12

WeeksBloodpressure

Heartrate

Respiration

Height

Weight

Waist(circumference)

Bloodwork:

Formoreinformationabouttherisksandpossiblesideeffectsofantipsychoticmedications,youcanvisitCAMESA,whichisdedicatedtohelpingparentsanddoctorsmanagethesideeffectsofsecondgenerationantipsychoticsinchildren.http://camesaguideline.org/about-the-guidelines

Medication Monitoring Form: Anxiety and Depression

Anxiety&DepressionThefollowingformisdesignedtohelpyoutrackchanges,positiveand/ornegative,whileon

medications.AlwaysconsultwithyourPhysicianpriortouse,andfollowtheirdirections.

of1Physical/MedicalBaseline&Tracking

Ratesymptomsusingascaleof0to3asperthefollowing:

0=NotPresent 1=Little 2=Moderate 3=Severeand/orFrequent

NOTE:1. ItisimportanttocompleteaBASELINEevaluationforbothsymptomsandsideeffectsBEFOREtreatmentbeginsto

provideacomparison.

2. Extraspacesareprovidedbelowforspecificsymptomswhichmaynotberepresented

Baseline

2Weeks

3Weeks

4Weeks

5Weeks

6Weeks

8Weeks

10Weeks

12Weeks

Date Dose

Symptoms Baseline1

Weeks3

Weeks4

Weeks5

Weeks6

Weeks8

Weeks10

Weeks12

Anxiety Panicattacks Feelingoverlyworried Compulsivehabits Unusualachesandpains Avoidancebehaviours Obsessivethoughts Worriedaboutsocialsituations Restlessorjittery Other:

Depression Irritablemood Sadorlowmood Feelingthingsarehopeless Guiltyfeelings(likeyouletyourself/othersdown) Littleinterestorpleasureinthingsyoutypicallyenjoy Movingorspeakingslowly Difficultyconcentratingorfocusingonatask Anyself-harmor“betteroffdead”thoughts Poorappetite(lessthan2regularmeals/day) Overeating(morethan3largemeals/day) Notabletocompletetasks(school/home) Sleepingtoomuch(12+hrs/day) Difficultyfallingorstayingasleep Other:

Side Effects Monitoring Form: Anxiety and Depression Anxiety&Depression

Thefollowingformisdesignedtohelpyoutrackchanges,positiveand/ornegative,whileon

of2SideEffectsMonitoringForm:Anxiety&Depression

Ratesideeffectsusingascaleof0to3asperthefollowing:

provideacomparison.

4. Extraspacesareprovidedbelowforspecificsideeffectswhichmaynotberepresented

SIDEEFFECTS Baseline1

Weeks3

Weeks4

Weeks5

Weeks6

Weeks8

Weeks10

Weeks12

WeeksWeightgain Weightloss Stomachache Appetiteincrease Appetitedecrease Indigestion Nausea Diarrhea Constipation Urinaryproblems Drymouth Sweating Musclespasms Twitching Can’tsleep Tired/sleepy Apathy,unmotivated Agitation Anxiety Shakiness Heartracing Sexualchanges Rash Innerrestlessness Headaches Dizzy Vividdreams Visualchanges Other:

Medication Monitoring Form: AntipsychoticsAntipsychotics

of2 SideEffectsMonitoringForm:Anxiety&Depression

Ratesymptomsusingascaleof0to3asperthefollowing:

provideacomparison.

6. Extraspacesareprovidedbelowforspecificsymptomswhichmaynotberepresented

Baseline

2Weeks

3Weeks

4Weeks

5Weeks

6Weeks

8Weeks

10Weeks

12Weeks

Date Dose

Symptoms Baseline1

Weeks3

Weeks4

Weeks5

Weeks6

Weeks8

Weeks10

Weeks12

WeeksAggression Lowmood Anxiety Hallucinations Delusions Feelingoverlyexcitedorhappy Disruptivebehaviours Troublefallingorstayingasleep Hyperactivity Disorganizedthoughts Tics(uncontrolledmotormovementsorvocalizations) Other:

Side Effects Monitoring Form: Antipsychotics Antipsychotics

of2SideEffectsMonitoringForm:Antipsychotics

Ratesideeffectsusingascaleof0to3asperthefollowing:

provideacomparison.

8. Extraspacesareprovidedbelowforspecificsideeffectswhichmaynotberepresented

SIDEEFFECTS Baseline1

Weeks3

Weeks4

Weeks5

Weeks6

Weeks8

Weeks10

Weeks12

WeeksUrinaryproblems Weightgain Weightloss Racingheartbeat Skinrash Musclespasms Stiffmuscles Increasedappetite Appetiteloss Headaches Feelingdrowsy Feelingnauseatedand/orvomiting Feelingdizzyorlightheaded Feelingagitated Drymouth Constipation Blurredvision Disruptionwithsexualfunctioning Disruptionwithmenstrualcycleor Diarrhea Other:

of2 SideEffectsMonitoringForm:Antipsychotics

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