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PathwaystoMentalHealth:MakingEveryStepCount
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
PathwaystoMentalHealth:MakingEveryStepCount
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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.
100%
Thisisthepercentageofpeoplewhobenefitfrompositivesupportduringamentalhealthcrisis.Staypositive.Thosewhosupportindividualswithmentalhealthissuescanhelpbyseeingpasttheoccasionallychallengingbehaviourstothegenuinepersonthatcanbecomeburiedbeneaththeillness.Becommittedtobelievingintheindividual’spersonalstrengths,positivecharactertraits,futurerecovery,andlifegoals,rememberingtheabundanceoflife’slittlegiftsthat,inspiteofstruggles,seemtosprinklethroughvirtuallyeveryone’slife.
43%
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!
PathwaystoMentalHealth:MakingEveryStepCount
4
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
PathwaystoMentalHealth:MakingEveryStepCount
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5
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.“
PathwaystoMentalHealth:MakingEveryStepCount
6
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
VS
PathwaystoMentalHealth:MakingEveryStepCount
7
Whenactionsinterpretedas“BadBehaviours” Whenactionsinterpretedas“Symptoms”
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.
Whenactionsinterpretedas“BadBehaviours” Whenactionsinterpretedas“Symptoms”
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.
VS
VS
PathwaystoMentalHealth:MakingEveryStepCount
ASupport&RecoveryTeamMightInclude:
 Thepersonwholiveswiththementalhealthcondition
 Thedoctorwhodiagnosesthecondition
 Atherapist/socialworker/counselor/psychologist/psychiatrist
 Familymembers,friends,neighbors
 Teachers,schoolnurse,youthleaders/mentors
8
#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.
PathwaystoMentalHealth:MakingEveryStepCount
9
#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
PathwaystoMentalHealth:MakingEveryStepCount
Careforyourselftohavethestrengthto
careforothers
10
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
PathwaystoMentalHealth:MakingEveryStepCount
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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
PathwaystoMentalHealth:MakingEveryStepCount
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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;
PathwaystoMentalHealth:MakingEveryStepCount
13
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.
PathwaystoMentalHealth:MakingEveryStepCount
Knowing Your Professional Team Therearemanyprofessionalswhomayplayaroleinachild’swellnessjourney.Listedbelowaresomeofthemorecommonprofessionalsalongwithadescriptionoftheirexpertiseandservicesprovided.
RoleDescription Requ
ires
Referrals
Prescribes
Med
ications
Family/Prim
ary
CareDoctor
Thefamilyorprimarycaredoctorwillworkwithyoutoassessyourchildinitiallyandhelpplanacourseofaction.Heorshecanalsobebeneficialinhelpingyouselectotherteammemberstosupportthechildandhelpmonitorprogress.Someserviceproviders,likepsychiatrists,canonlybeaccessedthroughareferralfromaprimarycaredoctor.
Afamilydoctorcanrunteststoruleoutmedicalfactorssuchashypoorhyper-thyroid,vitaminDdeficiencies,hypoglycemia,hormoneimbalances,lowiron,etc.,asthesemaycausesymptomswhichappeartobementalhealthconcernsoraddtotheseverityofdepression,anxiety,irritability,andinsomnia.
NO YES
Pediatric
ian
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.
NO NO
Coun
sello
rs TheCMHA(2014)notesthatregisteredorcertifiedcounsellors(suchasaRegistered
ProfessionalCounsellororRegisteredClinicalCounsellor)aretrainedtoassessmentalhealthproblemsandusedifferentcounsellingand/orothertherapeuticmethods.Thisoftenincludesteachingdifferentskillstohelpimprovewell-being.Counsellorsarenotmedicaldoctorsandcan’tprescribemedications.
NO NO
14
PathwaystoMentalHealth:MakingEveryStepCount
15
Knowing Your Professional Team
RoleDescription Requ
ires
Referrals
Prescribes
Med
ications
SocialW
orker Asocialworkerisahelpingprofessionalwhofocusesonboththeindividualandhisor
herenvironment.Socialworkersperforminterventionsthroughresearch,policy,communityorganizing,directpractice,andteaching.Asocialworkercanhelporganizeasupportteamforyourchild,facilitateteammeetings,andprovidepersonalsupporttoindividualsandfamilies.
NO NO
YouthMen
tors
ThetermYouthMentorcanbeusedtodescribeawiderangeofprofessionalswhosupportchildrenwhoarestrugglingwithvariousissues,includingbehaviouralandmentalhealthconcerns.Dependingontheagencythroughwhichtheyouthmentoriscontracted,theindividualmayhaveminimaltraininggainedthroughworkexperience,butmorelikelywillhaveadiplomaordegreeinChildandYouthCare,Psychology,NursingorSocialWork.Youthmentorstypicallyworkaspartofateambycarryingouttherapeuticactivitiesassociatedwithatreatmentplanwithintheindividual’shomeandsocialenvironments.
NO NO
Pharmacist
PharmacistsrepresentoneofthemostaccessiblepointsofhealthcareinAlberta.Forthoselivingwithmentalillness,thisaccesstohighlyknowledgeableprofessionalsinourhealthcaresystemofferstremendousbenefit.Itispartofpharmacist’sregulardutiesistoansweryourquestions,andtheyareanexcellentsourceofinformationregardingmedications,alternatives,risksandsideeffects,interactionpotentialandmuchmore.Itisstronglyrecommendedthatoneusesthesamepharmacistthroughouttreatmenttoavoidreceivingtoomanymedications,ormedicationsthatcontradictorcauseareactionwhentakentogether.
AlbertahasrecentlyexpandedtheroleofthepharmacistbycreatingtheClinicalPharmacistposition,whosepurposeisnottodispensemedications,buttogiveadviceandsupporttopatientsandaddtothemedicationinformationpatientsreceiveatthepharmacycounter.
NO NO
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.
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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
 Children’sMentalHealthLearningSeriesTheChildren’sMentalHealthLearningSeriesprovidescaregivers,familiesandprofessionalswithhelpfulinformationtoincreaseknowledgeandhelpsupportchildrenandyouthwithmentalhealthconcerns.http://humanservices.alberta.ca/family-community/cmh-learning-series.html
 AlbertaMentalHealth&WellnessMainwebportaltoAlberta’smentalhealthserviceshttp://www.albertahealthservices.ca/mentalhealth.asp
 AlbertaHealthServiceshttp://www.albertahealthservices.ca/
 Edmontonregionmentalhealthservicedirectoryhttp://www.albertahealthservices.ca/services.asp?pid=service&rid=7484
 EdmontonCommunityMentalHealthClinichttp://www.albertahealthservices.ca/services.asp?pid=service&rid=1001410
 MedicineHatregionsupportandservicesdirectoryincludingcrisislinehttp://ser.cmha.ca/files/2012/03/WhenYouNeedHelp-MedicineHat.pdf
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Internet Links
 AddictionandmentalhealthinformationandservicesLinkstoinformationandresourcesonmentalhealth,substancesandaddictiontohelpimprovethehealthandmentalwell-beingofAlbertans.http://www.health.alberta.ca/health-info/addiction-mental-helth.html
 ParentLinkCentresThreenewParentLinkCentreswilljoinanetworkof50otherCentrestoprovideparentsandcaregiverswithfreeresourcesandsupporttodevelopnurturingenvironmentstosupportearlychildhooddevelopment.http://humanservices.alberta.ca/family-community/15576.html
 ParentlinkAlbertadirectoryhttp://humanservices.alberta.ca/family-community/plc-regional-map.html
 AlbertaMentalHealthPatientAdvocateOfficeTheMentalHealthPatientAdvocateislegislatedtoprotectpatientrightsandinvestigatecomplaints.ThePatientAdvocateisnotpartofaprovincialhealthauthority,hospital,clinicortreatmentteam.https://www.mhpa.ab.ca/Contact/Pages/default.aspx
 TriplePTakestheguessworkoutofparentingTheAlbertagovernmentistakingtheguessworkoutofparenting,supportingparentsandcaregiverswiththeTripleP–PositiveParentingProgram.TriplePgivesparentssimpletipstohelpmanagethebigandsmallproblemsoffamilylife.http://www.triplep-parenting.net/alb-en/home/
 CASACaregiverVillageAwealthofinformation,supportandtoolsthatcoversabroadrangeofissuesincludingmentalhealthconcerns,parenting,anddevelopmentaldisabilitiessuchasFASD.Selectanareaofconcernandyourchild’sagetofindinformationandresourcesthatcanhelpyoucareforyourchild.www.caregivervillage.ca/index.php/webapp
 (CAMESA)guidelinesTheCanadianAllianceforMonitoringEffectivenessandSafetyofAntipsychoticsinChildren(CAMESA)guidelinesprovideparentsanddoctorswithinformationaboutthesideeffectsofantipsychoticdrugsinchildren.http://camesaguideline.org/about-the-guidelines
 PsychotherapiesForChildrenAndAdolescentsAbriefdescriptionofthemorecommontypesofpsychotherapyforfamiliesandchildrenandhowtheymaybenefityou.http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Psychotherapies_For_Children_And_Adolescents_86.aspx
 KeltyMentalHealthAwiderangeofonlineresourcestosupportfamiliesastheysupportindividualsthroughavarietyofissues,includingmentalhealth,parentinganddevelopmentaldisabilities.http://keltymentalhealth.ca/resources?tid3[]=44
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Internet Links
 NationalAllianceonMentalIllnessFactSheetLibraryNAMI'sfactsheetsareclear,conciseinformationonmentalhealthtopics.Afewwaysyoumightwanttousethemarebysharingthemwithalovedone,bringingthemtoanappointment,orhandingthemoutathealthfairs.http://www.nami.org/Learn-More/Fact-Sheet-Library
 CalgaryRegionHullServiceshelpschildren,adults,andfamilieswhoexperiencesignificantmentalhealth,behaviouralanddevelopmentalchallenges,usingtheirexpertisetohelpmovethemtosuccess,andactivelyconfrontthebarrierstowellnessinourwholecommunitywww.hullservices.ca
 DistressCenterDistressCentreensureseveryonehasaplacetoturntoinatimeofcrisisbyproviding24hourcrisissupport,professionalcounsellingand211referrals-allatnocost.http://www.distresscentre.com/
 Help-4-MeMentalhealthsupportforchildrenandyouthhttp://www.help4me.ca/
 YouthSmartTools,informationandResourcesforyouthhttp://www.youthsmart.ca/
 ConnecTeen(Calgary)AconfidentialpeersupportserviceforyouthinCalgaryandarea,aprogramofDistressCentre.CalgaryHelpLine403.264.8336|TEXT:587.333.2724http://calgaryconnecteen.com/
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Preparing for the Mental Health Consultation Child’s Personal HistoryPlacementhistory
Anyknownhistoryofneglectorabuse
Familyoforiginhealth/mentalhealthhistory
Other
History of Symptoms
Currentsymptoms,challengesand/orproblematicbehaviours
Firstsymptoms:whatwerethey,whendidtheystart,howhavetheychanged
Knowntriggerswhichmayleadtoorescalatesymptoms
Page1of2PreparingfortheMentalHealthConsultation
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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)
Page2of2
PreparingfortheMentalHealthConsultation
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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
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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
PathwaystoMentalHealth:MakingEveryStepCount
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AboutSupportingtheChild
Whatcanthefamilydotosupportthechildduringtreatment?
Whatadviceorstrategieswouldyourecommendfordealingwithchallengingbehavioursandsymptoms?
Arethereanycommunityresourcesthatwouldbenefitthechildand/orfamilyduringtreatment?
Whatelsedoweneedtoknowthathasn’tbeencoveredyet?
Question to Ask During a Mental Health Consultation
Page3of4QuestiontoAskDuringaMentalHealthConsultation
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NOTES:
Monitoring Symptoms and Side Effects
Page4of4QuestiontoAskDuringaMentalHealthConsultation
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Thefollowingpagescontainformsthatmaybeusedtotrackboththesymptomsandsideeffectsthatachildmightexperiencewhenbeingtreatedwithpsychotropicmedications.
IMPORTANT:Usethisformalongwithoneofthemedicationmonitoringformsbelow,foundonpages26-29.
Remember:ifyoudochoosetousetheseoranyothertrackingforms,tostarttrackingBEFOREachildbeginsusingmedicationsifpossible,sothatasolidbaselinecanbeestablishedpriortotreatment.Thiswillhelpidentifypositiveornegativechangesinsymptomsandinpossiblesideeffects.
Itisstronglyrecommendedthatyouconsultwiththechild’sprimarycarephysicianbeforebeginninganypsychotropicmedicationstodetermine:
 Whetherthereareunderlyingmedicalconditionswhichmaybecausingorcontributingtothementalhealthissue,orwhichmaycauseanadversereactionifmedicationsareusedintreatment
 Completeamedicalassessmentthatestablishesphysicalbaselinestohelpmonitorforpotentialchangesastreatmentprogresses
 Checkwiththechild’sprimarycarephysiciantoensurethatwhicheverformsyouchoosetouse(tomonitorandtracksymptomsandsideeffects)arecapturingtheinformationthatyouandthechild’sdoctorneed
Physical/MedicalBaseline&Tracking
Baseline1
Week2
Weeks3
Weeks4
Weeks5
Weeks6
Weeks8
Weeks10
Weeks12
WeeksBloodpressure
Heartrate
Respiration
Height
Weight
Waist(circumference)
BMI
Bloodwork:
Formoreinformationabouttherisksandpossiblesideeffectsofantipsychoticmedications,youcanvisitCAMESA,whichisdedicatedtohelpingparentsanddoctorsmanagethesideeffectsofsecondgenerationantipsychoticsinchildren.http://camesaguideline.org/about-the-guidelines
Medication Monitoring Form: Anxiety and Depression
Anxiety&DepressionThefollowingformisdesignedtohelpyoutrackchanges,positiveand/ornegative,whileon
medications.AlwaysconsultwithyourPhysicianpriortouse,andfollowtheirdirections.
Page1of1Physical/MedicalBaseline&Tracking
PathwaystoMentalHealth:MakingEveryStepCount
26
Ratesymptomsusingascaleof0to3asperthefollowing:
0=NotPresent 1=Little 2=Moderate 3=Severeand/orFrequent
NOTE:1. ItisimportanttocompleteaBASELINEevaluationforbothsymptomsandsideeffectsBEFOREtreatmentbeginsto
provideacomparison.
2. Extraspacesareprovidedbelowforspecificsymptomswhichmaynotberepresented
Baseline
1Week
2Weeks
3Weeks
4Weeks
5Weeks
6Weeks
8Weeks
10Weeks
12Weeks
Date Dose
Symptoms Baseline1
Week2
Weeks3
Weeks4
Weeks5
Weeks6
Weeks8
Weeks10
Weeks12
Weeks
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
medications.AlwaysconsultwithyourPhysicianpriortouse,andfollowtheirdirections.
Page1of2SideEffectsMonitoringForm:Anxiety&Depression
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Ratesideeffectsusingascaleof0to3asperthefollowing:
0=NotPresent 1=Little 2=Moderate 3=Severeand/orFrequent
NOTE:3. ItisimportanttocompleteaBASELINEevaluationforbothsymptomsandsideeffectsBEFOREtreatmentbeginsto
provideacomparison.
4. Extraspacesareprovidedbelowforspecificsideeffectswhichmaynotberepresented
SIDEEFFECTS Baseline1
Week2
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
Thefollowingformisdesignedtohelpyoutrackchanges,positiveand/ornegative,whileon
medications.AlwaysconsultwithyourPhysicianpriortouse,andfollowtheirdirections.
Page2of2 SideEffectsMonitoringForm:Anxiety&Depression
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Ratesymptomsusingascaleof0to3asperthefollowing:
0=NotPresent 1=Little 2=Moderate 3=Severeand/orFrequent
NOTE:5. ItisimportanttocompleteaBASELINEevaluationforbothsymptomsandsideeffectsBEFOREtreatmentbeginsto
provideacomparison.
6. Extraspacesareprovidedbelowforspecificsymptomswhichmaynotberepresented
Baseline
1Week
2Weeks
3Weeks
4Weeks
5Weeks
6Weeks
8Weeks
10Weeks
12Weeks
Date Dose
Symptoms Baseline1
Week2
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
Thefollowingformisdesignedtohelpyoutrackchanges,positiveand/ornegative,whileon
medications.AlwaysconsultwithyourPhysicianpriortouse,andfollowtheirdirections.
Page1of2SideEffectsMonitoringForm:Antipsychotics
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29
Ratesideeffectsusingascaleof0to3asperthefollowing:
0=NotPresent 1=Little 2=Moderate 3=Severeand/orFrequent
NOTE:7. ItisimportanttocompleteaBASELINEevaluationforbothsymptomsandsideeffectsBEFOREtreatmentbeginsto
provideacomparison.
8. Extraspacesareprovidedbelowforspecificsideeffectswhichmaynotberepresented
SIDEEFFECTS Baseline1
Week2
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:
Page2of2 SideEffectsMonitoringForm:Antipsychotics