Mental Health Awareness
Education Summit
January 23, 2016
Faith Edgren & Roxane Rausch
MHICM RANGE
MHICM RANGE
• Mental Health Intensive Case Management (MHICM)
Rural Access Network for Growth Enhancement (RANGE)
• We are the only RANGE in Wisconsin
• Team of 4: Psychiatrist, RN and Social Workers
• Eligibility:
– Veteran
– Enrolled in VA Healthcare
– Reside 65 miles from Waupaca, WI
– Currently underserved
– Clinically Appropriate
MHICM RANGE
• Program Foundation: 10 Fundamental
Components of Recovery
• What we do:
– Weekly appointments
– Work together in partnership
– Focus on recovery
Veterans We Serve
Diagnosed with a Several Mental Illness
(SMI)
• Schizophrenia
• Schizoaffective
• Bi-Polar Disorder
• Major Depressive Disorder w/ Sever
Psychosis
Scope of Psychosis
Risk Factors
• Psychosis may affect persons of all types
regardless of age, gender, race, and/or
ethnicity
• Individual risk factors (dependent on the
diagnosis)
• Familial and genetic factors: many psychotic
disorders
• Impaired physical and/or mental health
Risk Factors continued…..
• Substance or alcohol abuse
• Stress intolerance
• Ineffective coping
Acute Psychosis
• Depends on internal factors such as loss, trauma,
pain and environment.
• In many cases, psychosis is reversible and there
are no residual effects
• Problems with daily activities
• Cognitive Dysfunction
• Impairment in personal, social, and/or
occupational function
• Risk for violence to self/and or others
Chronic Psychosis
• Dependent on internal factors
• High rates of recidivism, homelessness,
incarceration, joblessness, and long term
disability
• Danger to self and/or others
• Premature mortality
• Costly to family and society
Schizophrenia
• 1% of population has schizophrenia
• Most common psychotic disorder
• Increased risk of suicide
• Increased risk factor with positive family
history of schizophrenia
• First break-adolescence or young adulthood
• Neurotransmitter involved-Dopamine
Positive Symptoms of Schizophrenia
• Hallucinations
• Delusions
• Psychosis
• Illusions
• Agitation
• Hostility
• Bizarre Behaviors
• Association Disturbances
• Disorganized Speech
Negative Symptoms of Schizophrenia
• Alogia, Affective Blunting, Avolition ,
Anhedonia and Restricted emotion
• Social withdrawal
• Dependency
• Lack of ego boundaries
• Concrete thought processes
• Lack of self-care
• Sleep disturbance
The nurse working with a client who is newly diagnosed with
schizophrenia would include which of the following in the client's
teaching?
a. “Schizophrenia is curable if the correct medication and dosages
are achieved.”
b. “Schizophrenia has been found to be nonresponsive to
medications, and we will work mostly on helping you with daily
activities.”
c. “Schizophrenia is caused by pathology in the cerebellum, and
there are medications that are helpful in this area.”
d. “Schizophrenia is an illness that involves neurotransmitters,
most particularly the dopamine system.”
Treatment Helps Mindy Manage
Schizophrenia
• https://maketheconnection.net/conditions/schizo
phrenia?condition_id=8&story_id=517
• Mindy joined the Navy, but her enlistment was cut
short with the onset of schizophrenic symptoms.
After her military discharge, she began counseling
at VA. Her medical team helped her understand
her condition and find ways to manage her
symptoms. Consistent professional support
enables Mindy to find solutions for living well.
Schizoaffective
• Is a major psychiatric disorder similar to
schizophrenia
• Is a biological disorder which likely results
from an imbalance in brain chemicals
• Develops in about 1 in 200 people (.05%)
• Affects all aspects of daily living, including
work, social relationships and self-care
Positive Symptoms of Schizoaffective
• Hallucinations
• Delusions
• Thinking Disturbances
Negative Symptoms of Schizophrenia
• Affective Blunting
• Anhedonia (Decrease in ability to experience
pleasure)
• Apathy
• Poverty of Speech or Content of Speech
• Inattention
Bipolar Disorder
Type I
• Manic phase: (Required)
– Disturbed sleep pattern
– Sleep deprivation
– Imbalanced nutrition
– Hypothermia
– Deficient fluid volume
– Noncompliance
Type II
• Hypomanic:
– Inflated self-esteem
– Decreased need for sleep
– More talkative or pressured to keep talking
– Flight of ideas
– Increase in goal-directed activity
Type II cont’d
• Depressive phase:
– Disturbed sleep pattern
– Imbalanced nutrition
– Fatigue
– Self-care deficit
– Nausea
– Disturbed thought processes
– Sexual dysfunction
• -Self-injury
Signs and Symptoms
• Manic episode: an abnormally and persistently elevated,
expansive, or irritable mood for a duration of at least 1 week
• Three (or four if the mood is irritable) of seven additional
symptoms:
– Inflated self-esteem or grandiosity
– Decreased need for sleep
– Being more talkative or having pressured speech
– Flight of ideas or racing thoughts
– Distractibility
– Increase in goal-directed activity or psychomotor agitation
– Excessive involvement in pleasurable activities that have a
high potential for painful consequences
– https://www.youtube.com/watch?v=oUI5xS_IH24
Community Activity
• This is Sam….
Community Activity
Immediate
Family
Doctor Office Nurse
County Worker Spouse/Children
Veteran
Co-Worker Police Officer
Friend District Attorney
Hospital Judge
QUESTIONS ???
VA RESOURCES
• Madison VA System (608) 256-1901
William S. Middleton Memorial Veterans, 2500 Overlook
Terrace, Madison, WI 53705
• Milwaukee VA System (414) 384-2000
2500 Overlook Terrace
Clement J. Zablocki VA Medical Center
5000 W National Ave., Milwaukee, WI
• Tomah VA System (608) 372-3971
Tomah VA Medical Center
500 E. Veterans Street, Tomah, WI 54660
Community Resources
• SAMHSA: Substance Abuse and Mental Health
Services Administration - http://www.samhsa.gov/
• NIMH: National Institute of Mental Heath
https://www.nimh.nih.gov/index.shtml
• NAMIWisconsin: http://www.namiwisconsin.org/
• Make the Connections:
http://maketheconnection.net/
