what’s going on around here? news from the mental health front lines

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

But first, a word from our sponsor

Robin Steed, PhD, LOTRwww.robinsteed.pbworks.com

National Alliance on Mental IllnessNorthwest Louisiana Affiliate

www.naminwla.pbworks.com

www.nami.org

Agenda

Keeping All Students Safe Act

Stop Bullying Act

Changes in Mental Health Care in Louisiana

Motivational Interviewing

Stages of Change

KEEP OUR STUDENTS SAFE

Keep Our Students Safe Act

S.2020 in the Senate and H.R. 1381 in the House

Government Accountability Office study: teen hung himselfchild smothered to deathchildren with disabilities

Only 14 states currently restrict use of restraint (Louisiana is not one of them)

What the Act will do:Ban:

physical restraint unless an emergency restraints interfering with breathingchemical restraints

Parents to be notified on same day

What you can do:Email US legislators using NAMI's legislative

action center

Educate school officials, teachers and case workers!

STOP BULLYING

Keeping kids safe from bullyingChildren 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 Act

House Bill 407 Senate Bill 619

Fills the gaps in meeting federal regulations

Will specifically name at risk groups Identifies process for reportingDefines specific types of bullying

You can help!• Stopbullyinglouisiana.org

• http://www.stopbullyinglouisiana.org/petition

• To find out more, contact Stephanie

Patrick at spatrick@advocacyla.org or 1-800-960-7705, ext. 143.

CHANGES IN MENTAL HEALTH CARE IN LOUISIANA

Merger 2011● Office of Mental Health and Office of

Addictive Disease to create Office of Behavioral Health

OMH OAD OBH

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 INTERVIEWING

What for?

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

ambivalence

Concepts of MI• Readiness to change• Ambivalence• Resistance

Principles of MI

1.Express Empathy2.Roll with Resistance3.Support Self-efficacy4.Develop Discrepancy

Empathetic 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 StatementsClient: 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-motivatingClient: 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 Cons

Take meds

Don’t hear voices as muchI can live by myselfI can go to school

Side effectsCost moneyHave to remember

Don’t take meds

No side effectsA little more $

The voices make me feel like killing myself, Can’t take care of myself, Can’t remember anything

Client with MS

Consistent carePT and OT Positive supportCounseling

Scary, bad memoriesHusband madStress increases fatigueFamiliar home

Husband happyEasier

Depend on husband Stressful environmentMiss therapy

In pt.

Out pt.

Pros Cons

Brainstorm Approach1. 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 doArgueAssume expert roleTalk all the timeShould on your clientTell the client they have a problemPrescribe solutions (especially without

listening!)

STAGES OF CHANGE MODEL

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 stage

Mismatch between intervention and client’s readiness for change =

resistance

Transfer 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.

• www.robinsteed.pbworks. com