Presentation at Missions Interlink ConNEXTions 2013 by:
Dr Katherine Thompson
Mental Health Social Worker
BA, BAppSci(Hons), PhD(PsychMed), BTheol, BSW
164a Warrandyte Rd
North Ringwood Vic 3134
0402 343 029
katherinethompson@guitech.com.au
Mental Health First Aid for
Missionaries and the Need to Focus
on Prevention
Dr Katherine Thompson
That was then and this is now…
•
•
•
•
•
Globalisation
Internet, email, mobile phones, etc.
Transport changes
Normalisation of cross cultural work
Health focus on prevention and intervention
Social Readjustment Rating Scale
• The Stress Scale – a scientific scale used to
assess the stress load we carry over the past
12-month period
» "The Social Readjustment Rating Scale", Thomas H.
Holmes and Richard H. Rahe, Journal of Psychosomatic
Research, Volume 11, Issue 2, August 1967, Pages 213218.
Life
LifeEvent
Event
1 Death of spouse
1 Death of spouse
2 Divorce
2 Divorce
3 Marital separation
3 Marital separation
4 Jail term
4 Jail term
5 Death of close family member
5 Death of close family member
6 Personal injury or illness
6 Personal injury or illness
7 Marriage
7 Marriage
8 Fired at work
8 Fired at work
9 Marital reconciliation
9 Marital reconciliation
10 Retirement
10 Retirement
11 Change in health of family member
11 Change in health of family member
12 Pregnancy
12 Pregnancy
13 Sex difficulties
13 Sex difficulties
14 Gain of new family member
14 Gain of new family member
15 Business readjustment
15 Business readjustment
16 Change in financial state
16 Change in financial state
17 Death of close friend
17 Death of close friend
18 Change to a different line of work
18 Change to a different line of work
19 Change in number of arguments with spouse
19 Change in number of arguments with spouse
20 A large mortgage or loan
20 A large mortgage or loan
Value
Value
100
100
73
73
65
65
63
63
63
63
53
53
50
50
47
47
45
45
45
45
44
44
40
40
39
39
39
39
39
39
38
38
37
37
36
36
35
35
31
31
Check if
Check if
this
this
applies
applies




0
21
21
22
22
23
23
24
24
25
25
26
26
27
27
28
28
29
29
30
30
31
31
32
32
33
33
34
34
35
35
36
36
37
37
38
38
39
39
40
40
41
41
42
42
43
43
Foreclosure of mortgage or loan
Foreclosure of mortgage or loan
Change in responsibilities at work
Change in responsibilities at work
Son or daughter leaving home
Son or daughter leaving home
Trouble with in-laws
Trouble with in-laws
Outstanding personal achievement
Outstanding personal achievement
Spouse begins or stops work
Spouse begins or stops work
Begin or end school/college
Begin or end school/college
Change in living conditions
Change in living conditions
Revision of personal habits
Revision of personal habits
Trouble with boss
Trouble with boss
Change in work hours or conditions
Change in work hours or conditions
Change in residence
Change in residence
Change in school/college
Change in school/college
Change in recreation
Change in recreation
Change in church activities
Change in church activities
Change in social activities
Change in social activities
A moderate loan or mortgage
A moderate loan or mortgage
Change in sleeping habits
Change in sleeping habits
Change in number of family get-togethers
Change in number of family get-togethers
Change in eating habits
Change in eating habits
Vacation
Vacation
Christmas
Christmas
Minor violations of the law
Minor violations of the law
Your Total
Your Total
30
30
29
29
29
29
29
29
28
28
26
26
26
26
25
25
24
24
23
23
20
20
20
20
20
20
19
19
19
19
18
18
17
17
16
16
15
15
15
15
13
13
12
12
11
11












394
• If you fill out the Stress Scale according to
common experiences faced by people going to
work cross-culturally it generally adds to + 300
score
• This indicates the person has a high or very
high risk of becoming ill in the near future.
What happens when we change
cultures?
• Eco-maps are a method of plotting how well
someone is functioning socially,
how much support they have,
and how many resources they have.
• A healthy life that supports good mental
health will have a broad range of activities and
people within this map.
Eco-map
Church
Gardening
Work 2
Neighbours
Close
Friends
Mother
Pilates
Pets
Ian’s
work
Work 1
Katherine
Ian
Other
Family
Jack
People
in my
neighbourhood
Jack’s
School
Other
Hobbies
Mentors
Other
Friends
Draw
-ing
• Cross-cultural Work Exposes Staff to a higher
risk of mental illness because it takes away
their normal protective factors,
and exposes them to high stress.
Mental Illness in Australia
Total People
National Survey of
Mental Health and
Wellbeing 2007
aged 16-85 years
16 015 300
100%
Any lifetime mental
disorder
No lifetime mental
disorder
7 286 600
8 728 700
45%
55%
Any 12-month mental
disorder
No 12-month mental
disorder
3 197 800
4 088 800
20%
25%
http://www.abs.gov.au/ausstats/abs@.n
sf/Latestproducts/4326.0Main%20Featur
es32007?opendocument&tabname=Sum
mary&prodno=4326.0&issue=2007&nu
m=&view=
Any 12-month
mental disorder
20%
Anxiety
disorders
Affective
disorders
Substance Use
disorders
14.4%
6.2%
5.1%
High Prevalence Disorders
1. Anxiety Disorders
2. Affective Disorders
3. Substance Use Disorders
K10
For all questions, please fill in the appropriate response.
In the past 4 weeks:
1
About how often did you feel tired out for
no good reason?
2
About how often did you feel nervous?
3
About how often did you feel so nervous
that nothing could calm you down?
4
About how often did you feel hopeless?
5
About how often did you feel restless or
fidgety?
6
About how often did you feel so restless
you could not sit still?
7
About how often did you feel depressed?
8
About how often did you feel that
everything was an effort?
9
About how often did you feel so sad that
nothing could cheer you up?
10
About how often did you feel worthless?
None of
the time
A little of
the time
Some of
the time
Most of
the time
All of
the time
• K10 Scores:
•
•
•
•
score under 20 are likely to be well
score 20-24 are likely to have a mild mental disorder
score 25-29 are likely to have moderate mental disorder
score 30 and over are likely to have a severe mental disorder
• 13% of the adult population will score 20 and
over
» For further information on the K10 please refer to
www.crufad.org or
» Andrews, G Slade, T. Interpreting scores on the Kessler
Psychological Distress Scale (K10). Australian and New
Zealand Journal of Public Health: 2001; 25:6: 494-497.
Anxiety Disorders
• Types:
– Panic disorder
– Agoraphobia
– Social phobia
– Generalised anxiety disorder
– Obsessive compulsive disorder
– Post-traumatic stress disorder
• Anxiety is based on the body’s normal stress
response
• When we are under threat we either “fight” or
“flight”
• Anxiety is a problem when it causes us to
avoid things and starts to impact how we live
our life
Affective Disorders
• Types:
– Major Depression
– Dysthymia
– Bipolar Affective Disorder
• Symptoms of Depression (+ 2 weeks duration):
–
–
–
–
–
–
–
–
–
Unusually sad mood
Loss of enjoyment
Lack of energy
Feeling worthless and guilty
Thinking about death
Difficulty making decisions
Moving slowly or becoming agitated
Sleep difficulties
Loss appetite or eating too much
Healthy Relationships
Spiritual Satisfaction
Depression
Compression
What happens when people have
existing mental illness?
• Insight/Acceptance of illness
• Medication
• History of the illness and personal
management
Prevention is better than cure
Self-Care
• Sleep:
– Routine
– Constant amount
– Constant time
– No naps
– Strategies for dealing
with insomnia
• Exercise:
– Burns off stress
– Improves mood
– Assists with sleep
• Foster Creativity:
– Reading
– Craft
– Gardening
– Cooking
• Social connection:
– Thoughts and feelings
– Hospitality
– Connectedness
– Meaning
– Belonging
• Relaxation:
– Prayer
– Meditation
– Silence
– Stretching
– Relaxation exercises
• Luke 4.42
– At daybreak he departed and went into a deserted
place. And the crowds were looking for him…
• Luke 5.15-16
– But now more than ever the word about Jesus
spread abroad; many crowds would gather to hear
him and to be cured of their diseases. But he
would withdraw to deserted places and pray.
Are there any people who should not
be allowed to work cross culturally?
• Families with children who have:
– Autism Spectrum Disorders or other disabilities?
• Families with adolescents who have:
– Eating disorders, anxiety, depression, self-harm?
• Adults with Personality Disorders:
– Borderline Personality Disorder
– Dependent Personality