Behavioral Health (DERS) Instructor Guide Flashcards
Facilitation Guidance:
START RECORDING!
Housekeeping issues…
Instructor will:
**Welcome participants to class
**Ask if they are in the correct class (Behavioral Health Services Overview)…Target Audience:
**Cover housekeeping issues
Does everyone have their PG (Participant Guide)
G DE5600 PGR.pdf (enter link into chat, SAY to download to your desktop)…can also use Kami to open your downloaded PG so you can take NOTES and ANNOTATE to help you learn the material. Go to your WAFFLE icon, scroll down to MORE FROM GOOGLE WORKSPACE MARKETPLACE, type KAMI in the search bar, INSTALL, REFRESH page, then right click on your PG and open with KAMI.
**Discuss the schedule for the class today (e.g. Breaks, leaving momentarily, announcing when returning from Breaks, etc.)
*Morning 15-minute BREAK & Afternoon 15-minute BREAK…if you need to briefly step away at any time, please type BRB in the chat, and BACK when you return…we need to make sure everyone is accounted for to get credit for attendance
*Lunch is 1 hour (typically from 12p-1p)…please type BACK when you return from lunch so you are sure to get credit for attendance
*There IS an Assessment at the end of today’s course, Attendance will be added to the Roster at the END of the class, which needs to be done BEFORE you can access the assessment
*At ANY time, please feel free to ask questions in the Chat, our Producer (______) will monitor the Chat.
**Ask & respond to any questions:
Does ANYONE have any questions before we start? …
Introductions/Ice Breaker:
Voluntold (a word having its origins in military slang) -
When you ‘volunteer’ someone else for something, in this case, to go next
- Give a little background of myself:
A. Started with DERS/OPD a few months ago; Previously a Special Education Teacher at a private/non-profit school for students with severe developmental, intellectual, & behavioral disabilities in NJ (13 yrs), was a Teacher of adult male inmates for the NJDOC in ABE/GED prep (9 yrs).
B. PRESENT Google Slide (Voluntold - Class Introductions/Ice Breaker)
3 INTERESTING FACTS:- Been a licensed Cosmetologist/Hairstylist since 1988
- I traveled/drove across the country from NJ to AZ by myself 1 year ago to relocate to start a new chapter in my life, being closer to my only sibling/sister
- I tried out for Survivor twice
I Voluntold (Terri) to tell us about her (________________)
Share PG (in Kami) and explain a bit…
Table of Contents:
*Equal Opportunity
Employer/Program
*Course Goal/Description
*Course Objectives
Course Description/Goal:
By the end of the course, staff members should be able to APPLY Psychiatric Rehabilitation Principles, ISA (Interagency Service Agreement), and Collaborative Protocols…WITH EVERY CASE.
Course Objectives:
As a result of taking this course, the participant should:
1Recognize the definition and principles of Psychiatric Rehabilitation
2Identify the LANGUAGE guidelines
3Recognize the key components from the ISA (Interagency Service Agreement)
4Recognize the key elements from the Collaborative Protocols
5. *Identify the BHS Libera components
ASK: Does everyone understand the 5 course Objectives?
Brief History of the 4 Major Eras of Psychiatric Care in the United States:
Deinstitutionalization –
Which started in 1960 is the process of replacing long-stay psychiatric hospitals with fewer isolated community mental health services. This was done by: first reducing the population size of mental institutions (releasing patients and shortening stays), and second reforming mental hospitals’ institutional processes to reduce maladaptive behaviors.
Community Mental Health Centers -
From Community Mental Health Act of 1963 providers of comprehensive mental health
services, offering inpatient, outpatient, home-based, school, and community-based programs to individuals and families.
Psychosocial Rehabilitation -
Stems from deinstitutionalization of 1960s and 1970s is the process of restoring the community
functioning and well-being of an individual who is considered to have a psychiatric disability.
Consumer Recovery Movement –
A diverse association of individuals who currently access mental health services, or who are survivors of interventions by psychiatry, or who are ex-patients of mental health services.
Which stems from the civil rights
movement of the late 1960s and early 1970s and personal histories of psychiatric abuse experienced by some ex-patients.
CLASS ACTIVITY (15 minutes)
*Use Kahoot!
kahoot.it
Login: OPDDERS
PW: DES-OPD-DERS7!
Kahoot!
BHS - Mental Health in the USA Timeline QUIZ (15 Questions)
Mostly EDUCATED GUESSING, but we’ll review the actual TIMELINE for Mental Health in the US after our Kahoot! Quiz :)
APPENDIX - PG pg A1 (43)
Timeline of Mental Health Legislation & Significant Events
ASK FOR VOLUNTEERS TO READ ALOUD
1773 - Williamsburg, VA…the first patient is admitted to the PUBLIC HOSPITAL for PERSONS of INSANE and DISORDERED MINDS
1841 - Dorothea Dix (Boston schoolteacher) visits the EAST CAMBRIDGE JAIL…first sees HORRIBLE living conditions of the mentally ill. She believed they could be CURED, and lobbies lawmakers and courts for better treatment until her death in 1887. PSYCHIATRIC HOSPITALS (110) were established by 1880 due to her efforts.
1887 - Nellie Bly - on assignment for the New York World, she feigns LUNACY in order to be admitted to the WOMEN’S LUNATIC ASYLUM on New York’s Blackwell Island. Her expose, “TEN DAYS IN A MAD-HOUSE,” detailing the appalling living conditions of the asylum, leads to a GRAND JURY investigation and needed reforms at the institution.
1907 - Indiana is the FIRST of more than 30 states to ENACT a compulsory STERILIZATION law, allowing the state to “prevent procreation of confirmed criminals, idiots, imbeciles, and rapists.” By 1940, 18,552 mentally ill people are surgically sterilized.
1936 - The FIRST prefrontal lobotomy was performed (by Dr. Walter Freeman and his colleague James Watt). By the late 1950s, an estimated 50,000 lobotomies are performed in the United States.
1938 - ELECTROSHOCK THERAPY was introduced as a treatment for people with schizophrenia and other chronic mental illnesses (Italian neurologist Ugo Cerletti).
1954 - Thorazine, marketed by Smith-Kline and Frenc, CHLORPROMAZINE, is the FIRST anti-psychotic drug approved by the FDA. It quickly becomes a staple in asylums.
1962 - Bestseller ‘One Flew Over the Cuckoo’s Nest, a novel by Ken Kesey, is published. Based on his experience working as a Nurse’s Aid in the psychiatric wing of Menlo Park Veteran’s Hospital in California.
1963 - President John F. Kennedy signs the COMMUNITY MENTAL HEALTH ACT to provide Federal funding for the construction of community-based preventative care and treatment facilities. Between the Vietnam War and an economic crisis, the program was never adequately funded.
1965 - With the passage of MEDICAID, states are incentivized to move patients OUT of state mental hospitals and INTO nursing homes and general hospitals because the program excludes coverage for people in “institutions for mental diseases.”
1980 - President Jimmy Carter signs the MENTAL HEALTH SYSTEMS ACTS, which aims to restructure the Community Mental-Health-Center Program and improve services for people with chronic mental illness.
1981 - Under President Ronald Reagan, the Omnibus Budget Reconciliation Act REPEALS Carter’s community health legislation and establishes block grants for the states, ENDING the Federal government’s roles in providing services to the mentally ill. Federal mental-health spending decreases by 30%.
2004 - Studies suggest approximately 16% of prison and jail inmates are seriously mentally ill (roughly 320,000 people). This year, there are about 100,000 psychiatric beds in public and private hospitals. That means there are MORE THAN 3x as many seriously mentally ill people in jails and prisons than in hospitals.
***ASK:
Where do you think we were in 2010? …
HOW MANY PSYCHIATRIC BEDS do you think there were in 2010 per 100,000 people?
2010 - There are 43,000 psychiatric beds in the United States, or about 14 beds per 100,000 people - the SAME ratio as in 1850!
***ASK:
Where do you think we were as of 2016? which was only 6 years ago…
HOW MANY PSYCHIATRIC BEDS do you think there were in 2016 per 100,000 people?
2016 - From their historic peak in 1955 (558,922 state hospital psychiatric beds), the number of state hospital beds in the United States had plummeted almost 97% by 2016 (37,679 state hospital psychiatric beds). Even when private hospitals are included, the number of psychiatric beds per 100,000 people in the United States ranks the nation 29th among the 34 countries in the Organization for Economic Cooperation and Development.
Without access to hospital care, acutely ill individuals deteriorate, families and caregivers buckle under stress, ERs fill with acutely ill patients waiting for a bed to open and police and fire responders find themselves increasingly diverted to mental health calls. By 2014, 10x more people with serious mental illness were in prisons and jails than in state mental hospitals, a circumstance widely attributed to the shortage of beds to provide timely treatment.
A minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. Like every state, ARIZONA fails to meet this minimum standard.
> Beds in 2016 - 302
Beds in 2010 - 260
Beds lost or gained - 42
Census of forensic patients - 143
% of all beds occupied by forensic patients - 47.4
State ranking in beds per capita - 48
MENTAL HEALTH RECOVERY
