Practical Training for
Carers
Mental Health Awareness
Workbook
Participant Name……………………………….…..…….
Mental Health Awareness
Workbook
Sensitive Content
Mental Health Awareness is extremely important as mental health issues are increasingly
common. You will hear shortly that one in five Australians will experience mental health
issues in their lives. It is very likely that at least 20% of the people in this room currently are
or in the future will experience a mental health issue.
With these statistics it is very likely that most, if not all of you have been touched by mental
illness, if not personally then through family or friends.
The information you will be provided with today has been put together with much thought
and consideration to the duty of care of our participants.
All mental health awareness trainings, discussions etc. should include suicide therefore this
topic is also raised. We have dealt with this with great sensitivity whilst ensuring you are
provided with key information.
We must iterate and will continue to reiterate throughout the workshop : This training is a
mental health awareness training only. Once completing this training you will not be an
expert in mental health and you will not be able to diagnose mental health issues in people.
You will however be able to recognise signs and symptoms, and know where to get help for
some of the common mental illnesses.
Notes:
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Contents
MYTH OR FACT ACTIVITY .......................................................................................... 4
ACTIVITY: WHAT DOES MENTAL HEALTH MEAN TO YOU?................................ 5
DEFINITION OF MENTAL HEALTH ............................................................................. 6
DEFINITION OF MENTAL HEALTH ............................................................................. 7
CAUSE OF MENTAL ILLNESS .................................................................................... 8
FACTS ABOUT MENTAL ILLNESS............................................................................. 9
MENTAL ILLNESS INFORMATION ........................................................................... 11
SUICIDE AWARENESS .............................................................................................. 26
SOCIAL INCLUSION ................................................................................................... 28
CASE STUDIES ........................................................................................................... 29
POSITIVE MENTAL HEALTH - 10 TIPS .................................................................... 31
RESOURCES ............................................................................................................... 33
For Further Information ............................................................................................. 34
REFERENCES ............................................................................................................. 37
GLOSSARY OF TERMS ............................................................................................. 41
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MYTH OR FACT ACTIVITY
Read the statements below and then circle whether you think the
statement is a myth or a fact.
Mental illness is not very common and does not affect average
people
Myth
Fact
People with mental illnesses are dangerous.
Myth
Fact
People with mental illnesses are more likely to be the victims of
violence and crime than the perpetrators of violence and crime.
Myth
Fact
Only weak people experience from mental illnesses. They are
failures because mental illnesses can be willed away.
Myth
Fact
2% of our population will experience a mental health illness at
some point in their lives
Myth
Fact
Depression and other illnesses, such as anxiety disorders, do not
affect children or adolescents. Any problems they have are just a
part of growing up.
Myth
Fact
Most people with a mental illness are receiving treatment.
Myth
Fact
Mental illness is more like a weakness than a real illness.
Myth
Fact
Mental illnesses are as real as other diseases like diabetes or
cancer. Some mental illnesses are inherited, just as some physical
illnesses are.
Myth
Fact
People with mental illnesses can never be normal.
Myth
Fact
Mental illness is contagious.
Myth
Fact
People with mental illness never get better.
Myth
Fact
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ACTIVITY: WHAT DOES MENTAL HEALTH MEAN TO YOU?
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DEFINITION OF MENTAL HEALTH
A mental illness is a diagnosable illness that significantly interferes with the sufferers
cognitive, emotional and/or social abilities.
In general terms a mentally ill person experiences significant changes in their thinking,
feelings and/or behaviour and these changes are severe enough that the person’s
functioning is adversely affected causing distress to them and/or others. A healthy person on
the other hand can be described as having good mental functioning, general mental
wellbeing and/or not experiencing any problems in thinking, feeling and/or behaving (1).
A mental disorder has an identifiable group of symptoms and/or behaviours that interfere
with their capacity to function day-to-day and that cause them distress (2; 3).
Anxiety disorders are characterised by exaggerated responses of our normal and adaptive
reactions to fearful or stressful events. Tension, distress and nervousness are common
features (2; 3).
Mood or affective disorders on the other hand are characterised by mood disturbances
and/or changes in a person’s affect (affect being the experience of feeling and/or emotions,
for example, someone with a flat or blunt affect could be displaying a mental health
symptom) (2).
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DEFINITION OF MENTAL HEALTH
Mental health has been described as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ according to The World Health
Organisation (4; 5). They further note ‘mental health is a state of well-being in which the
individual realises his or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his or her community’ (4; 5).
‘A person’s mental health is affected by individual factors and experiences, social interaction,
societal structures, resources and cultural values. It is influenced by: experiences in
everyday life, in families and schools, on streets and at work’ (6).
The Northern Ireland Association for mental health note the key elements experienced by a
person with positive mental health. Positive mental health as opposed to the absence of
mental health issues:

Emotional well-being

Life satisfaction

Optimism/hope

Self-esteem

Resilience/coping

Social integration

Spirituality (4)
So put in extremely simple terms being mentally healthy is a combination of physical,
emotional and social wellbeing (7). It’s important to remember however that mental health
may be seen on a continuum of good mental health to mental disorder and finally mental
illness and most people will move up and down that continuum to a degree though not all will
experience a mental disorder and less still a mental illness (8).
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CAUSE OF MENTAL ILLNESS
Biological Factors:
Chemical
imbalance in brain,
Genetics,
Brain injury,
Chronic illness,
Medication
Events in
Childhood:
Violence and
abuse
Emotional neglect
Death of parent
Mental
Illness
Psychological
Factors:
Poor Self-esteem
Negative thinking
Social factors:
Family conflict
Poverty
Unemployment
Poor housing
Having a baby
Infertility
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FACTS ABOUT MENTAL ILLNESS
One in five Australians will suffer a mental health problem in any given year. Assuming there
are 20 attendees today, 4 of you have, are or will experience a mental health problem at
some point in your lives (2). 14.4% of Australians will suffer from an anxiety disorder in any
given year while 6.2% of Australians will suffer from a mood or affective disorder in any
given year (8).
According to the ABS in 2007 the annual cost of mental illness in Australia was estimated to
be $20 billion. This included the costs of lost productivity and labour force participation.
Prevalence rates at this time also noted that 45% of Australians aged between 16 and 85
years had experienced a mental health disorder at some point in their lives; this equated to
73 million people!
Type of condition
Males
Females
Any anxiety disorder
10.8%
17.9%
Any mood disorder
5.3%
7.1%
Any substance abuse disorder
7.0%
3.3%
Any common mental disorder
17.6%
22.3%
Source: ABS, 2007 National Survey of Mental Health and Wellbeing
Mental health and illness are determined by multiple and interacting social, psychological
and biological factors (4). Mental health problems have very high rates of prevalence; they
are often of long duration and have adverse effects on many areas of peoples’ lives
including educational performance, employment, income, personal relationships and social
participation. No other health condition matches mental illness in the combined extent of
prevalence, persistence and breadth of impact. Mental health problems often begin early in
life and cause disability when those affected would normally be at their most productive,
unlike most physical illnesses (4). Mental health problems have very high rates of
prevalence, are often long in duration and in some cases are lifelong problems. The cost is
comparatively high as adverse effects influence sufferers in many life areas including
educational performance, employment, income, personal relationships and social
participation (1). Mental health often adversely affects physical health with sufferers
experiencing higher rates of premature mortality from coronary heart disease, stroke,
diabetes, infections and respiratory disease (4).
In 2009 11% of the burden of disease worldwide was cited as being mental and behavioural
disorders which required disability-adjusted life and was expected to rise to 15% by 2020.
Depression was the fourth largest contributor to the disease burden in 1990 and is predicted
to be second only, behind ischaemic heart disease by 2020 (1; 7). It is generally accepted
that everyone should play a part in taking the required action to create an environment that
promotes the mental health and well-being of individuals, families, organisations and
communities (4).
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Research has confirmed that a combination of factors influences a person’s mental health; a
combination of genetics, brain chemistry and environmental factors generally need to be
present to induce a mental health disorder. Stressful life events can ‘trigger’ a genetic
predisposition to the development of mental health concern in an otherwise mentally healthy
person. People from any religion, culture, economic background and nationality may be
affected. There is also a very strong link between the quality of one’s mental and physical
health. In 2003 WHO noted 35% to 45% of absenteeism from work was due to mental health
problems (5). (10)
As most illnesses have a genetic component, mental illnesses included, if a family member
suffers from a mental health problem there is a higher risk that other family members may
suffer the same problem.
If they brain’s neurotransmitters (chemicals) are out of balance symptoms of a mental illness
may develop. The purpose of drugs to treat mental illnesses is usually to try and correct this
imbalance.
Stressful life events may also trigger mental health problems for example, grief and loss, a
traumatic accident or being a victim of violence.
The use of illegal substances and alcohol has also been proven to lead to mental health
problems in many cases. For example, there is a very strong link between psychosis and the
use of marijuana and amphetamines (10).
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MENTAL ILLNESS INFORMATION
Common Anxiety Disorders
Disorder
Males
Females
Generalised Anxiety Disorder (GAD)
2%
4%
Panic Disorder
2%
3%
Agoraphobia
2%
4%
Obsessive-compulsive Disorder (OCD)
2%
2%
Social Phobia
4%
6%
Post-Traumatic Stress Disorder
(PTSD)
5%
8%
Source: ABS, 2007 National Survey of Mental Health and Wellbeing
Generalised Anxiety Disorder (GAD)
This is the most common anxiety disorder.
People whose temperaments lend themselves being worriers seem to more susceptible to
this disorder. Sufferers typically experience excessive and uncontrollable worry
disproportionate to the activating event often expecting a disaster to occur i.e. they simply
worry about things that may go wrong or that they may not cope. These events are often
simple day-to-day concerns and their excessive worrying culminates in daily worry, fear and
dread. This behaviour must have been recurrent on most days for at least 6 months for a
diagnosis to be considered. Roughly 5% of the Australian population will suffer from GAD
during their lifetime (17; 18; 8; 3). In very simple terms, sufferer’s brains simply do not switch
off.
Mood Symptoms


Feeling worried or scared
Being irritable or being in a
constant bad mood

Feeling uneasy and on edge
Thinking Symptoms



Worried or a constant feeling that something bad is about to happen
Always wanting to be good, being very well-behaved, eg never upsetting others
(though not necessarily at home)
Being pessimistic and easily able to identify what may go wrong in any given
situation
Behaviour Symptoms

Often asking many unnecessary questions and requiring constant reassurance
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




Being a loner, or hanging out with a small group of people (who are often younger or
older)
Being a perfectionist, taking a long time to complete tasks because you try to get it
absolutely correct
Being argumentative (but not usually aggressive), especially if trying to avoid a
feared situation
Not answering questions and rarely volunteering comments or information at training
or work
Getting upset when a mistake is made or if there is a change of routine
Physical Symptoms
 Dry mouth and/or difficulty
swallowing
 Nightmares
 Difficulty getting to and staying
asleep
 Difficulty concentrating
 Muscle tension and headaches
 Rapid heart rate and breathing
 Sweating
 Trembling, light headedness, dizzy
spells



Diarrhoea
Flare-up of another health problem
or illness (eg dermatitis, asthma,
irritable bowel syndrome; stomach
aches)
Sexual problems, such as not
having any sexual feelings or being
interested in sex (10; 3)
Causes of GAD may include:




Genetics, or a history of anxiety within your family
Biochemical - an imbalance of the chemicals in the brain that regulate feelings
and physical reactions can alter your thoughts, emotions or behaviour, and result
in anxiety
A stressful event or chain of events such as a family break-up, abuse, ongoing
bullying at school, sexual abuse, a death, a relationship break up, family conflict
Personality style - Certain personality types are more at risk of anxiety than
others (10)
Panic Disorder
People who suffer panic attacks often report that they felt as though they were going to die –
in fact many of the symptoms of a panic attack mimic that of a heart attack. Panic attacks
are characterised by sudden periods or intense fear and/or extreme anxiety and are
experienced when the parasympathetic portion of the autonomic nervous system is triggered
even though there is no sign of danger (10; 8).
Panic attacks tend to happen without warning and can last from a few minutes to half an
hour. It usually takes a while for the sufferer to feel better. Once a panic attack has been
experienced the sufferer tends to worry about having another one and in response may
begin avoiding situations and/or activities they think may trigger another attack. Examples
include the avoidance of shopping centres, the use of public transport, flying in aeroplanes,
taking lifts and even being left alone (10).
In some cases, depression, anxiety and/or obsessive compulsive disorder may be comorbid
with panic attacks.
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Symptoms







A feeling of imminent doom,
danger or death
Sweating
Feeling short of breath, like you
can't get enough air
Pounding heart
Chest pains
Feeling unsteady
Feeling like you're choking or
suffocating







Dry mouth
Hot or cold flushes
Tingling
Feeling faint
Trembling and dizziness
Nausea or diarrhoea
Feeling like you're losing
control or you can't escape (10)
Agoraphobia
There is a strong link between Panic Disorder and Agoraphobia which is characterised by a
fear of having Panic Attacks in public places; as people who have suffered Panic Attacks
may avoid placing themselves in situations where previous Panic Attacks have occurred.
About half of the documented anxiety cases are those of Agoraphobia which is a fear of
public places (19; 8).
Sufferers fear embarrassment, that they will make a fool of themselves if they suffer a Panic
Attack in public, they worry they will not be able to get away or that no one may be able to
help them should an attack occur so they avoid these places and situations. Common
places/situations avoided are crowds, enclosed spaces, shopping centres and driving (19;
8).
Symptoms









Anxiety that a panic attack will occur when in a situation from which escape is not
possible, difficult or embarrassing
Fear others will notice a panic attack causing humiliation and embarrassment
Fear that during the panic attack their heart might stop, they won’t be able to
breathe, that they might die
Avoidance of environments and/or situations that may trigger anxiety
Require reassurance from others that they will be okay/are not alone (eg may
need a friend to go to the shopping centre with them)
Escaping a stressful place or situation and returning home immediately
Comforter – some may not leave home without their tablets; others may require
an alcoholic drink before leaving ome
Fear that they can’t cope without others
Fear that they are going crazy
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Causes
As with many mental health issues a number of factors contribute to the development of
Agoraphobia including genetics therefore Agoraphobia may well run in some families.
15 to 25% of children who have a least one parent with Agoraphobia will inherit the
personality type of the agoraphobic and develop the illness themselves. Environmental
influences include children who grow up with parents who are:



Overly critical and perfectionistic
Overprotective
Present an overly cautious view of the world (20)
Obsessive-Compulsive Disorder (OCD)
Of all anxiety disorders OCD is the least common however it is a very incapacitating
disorder. Adolescence is the time it generally appears and may continue for the sufferer’s
lifetime (8). As with all mental health disorders OCD does not discriminate between cultures,
sexes, classes, backgrounds or intelligence; approximately 2.3 % of Australians experience
OCD (10). Some sufferers may turn to drug and/or alcohol abuse in order to escape or numb
their overwhelming obsessions, compulsions and feelings as they have difficulty enjoying the
things they normally would.
OCD typically has two elements: Obsessions and compulsions both of which are
accompanied by feelings of anxiety (10) (8) (19). Obsessions are recurrent, unwanted and
inappropriate thoughts that make you feel anxious while compulsions are repetitive
behaviours, rituals and mental acts the sufferer feels driven to perform in response to an
obsession with a view to reducing or eliminating the anxiety caused by the obsession. Levels
of stress seem to affect the intensity and frequency of OCD behaviours ie the obsessions
and compulsions seem to become more intense and frequent during times of stress.
Sufferers may be well aware that their thoughts are irrational however their obsessions and
compulsions are difficult to resist. Therefore sufferers are often compelled to complete their
rituals for fear that failure to do so will cause something bad to happen (10).
Obsessive thoughts include:







Fear of contamination and/or dirt
Symmetry of objects and spaces
Exactness
Safety and fear of illness
Intrusive sexual thoghts/impulses
Aggressive impulses – hurting themselves or others
Religious and/or moral issues/preoccupation (10; 8).
Compulsive behaviours include:







Washing
Checking
Repeating
Ordering
Counting
Hoarding
Repeatedly touching (8)
Emotions felt may include:
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



Stress or anxiety
Annoyance and frustration
Low or depressed
A sense of shame (and a wish to hide their OCD from others)
Causes
Again, it’s thought a combination of factors influence the development of OCD. Research
suggests chemical, structural and functional abnormalities in the brain along with genetic
and hereditary factors combined with life stresses and personality traits are all involved. (10)
(8) (19).
Social Phobia
Social Phobia or Social Anxiety Disorder is quite common. (10).
Social Phobia is the fear of being embarrassed, humiliated and judged in social situations
and when talking to other people expecting others to think badly of them. It is much more
than simple shyness. Being around other people may be so difficult and social situations so
scary that sufferers may end being isolated from family and friends as well as people in
general. (10). (8)
Sufferers may well suffer the physical symptoms associated with anxiety and also be scared
of social interactions. It’s not uncommon for those with social phobia to avoid social
situations (10). (8)
Symptoms








Palpitations
Trembling
Sweating
Tense and/or twitching
muscles
Dry throat
Blushing
Dizziness
Sinking feeling in stomach




Overwhelming feeling of
wanting to escape
Feel self-conscious like you
have failed
Avoidance of the feared
situation
Increased likelihood of abusing
alcohol and other drugs (10).
Severe emotional distress may be experienced when:






Being introduced to others
Being teased or criticised
Being the centre of attention
Being observed while doing
something
Meeting or talking to people in
authority
Most social encounters





Making small talk
Speaking in a group
Eating and drinking in public
Meeting or talking to members
of the opposite sex
Using the telephone (10).
Causes
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It is believed genetics and/or a familial history of social phobia, combined with personality
style, particularly negative thinking style probably lead to Social Phobia. It also seems Social
Phobia often develops in shy children as they move into adolescence (10) (8).
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Post-Traumatic Stress Disorder (PTSD)
PTSD involves bursts of anxiety that happen after a person experiences a major emotional
shock following a stressful event. It is usually triggered by seeing or experiencing an event
that the person perceives as so threatening it may result in serious injury or death. Sufferers
experience recurring memories and thoughts, even reliving of the traumatic event which may
be triggered by similar images on the television, words or smells associated with the event
(8). Recurrent dreams of and flashbacks to the event are common. The perception of
traumatic is a personal experience and not all people respond in the same way; if the
person’s response involves intense fear, helplessness and/or horror to the event PTSD is
much more likely (8). (3). It is when the following symptoms continue, do not abate and
begin to interfere with everyday life that it’s likely PTSD has developed. (10).
Sufferers will often employ avoidance behaviours to help them cope or block out the
traumatic memories, flashbacks and intrusive thoughts. Common behavioural strategies
include avoidance of things associated with the event, emotional numbing, reduced interest
in others and the outside world (8)
Intrusive memories
The flashbacks, nightmares or daydreams experienced can be extremely vivid and sufferers
sometimes feel as though the trauma is happening again – ie they relive the trauma.
Avoidance
The avoidance PTSD experience is often much more intense than that of people who do not
suffer PTSD. Sufferers can be so traumatised that they become numb and virtually shut
down, withdraw from life and experience great difficulty connecting with other people.
Heightened arousal
Many sufferers feel jumpy and on edge and some constantly look for signs of danger in
order to avoid another traumatic event occurring. (10)
Examples of Trauma
 Accident
 Sexual assault
 Violence
 Natural disaster eg bushfires, floods and cyclones
 War
 Torture (10)
Symptoms









Inability to get the incident out of their mind
Bad sleep patterns
Irritability – with self and the world at large
Difficulty concentrating
Inappropriate behaviours to try and block out the memories ie drug/alcohol abuse
Increased business to avoid dealing with the issue/s
Struggle with university, school or work.
Difficulty connecting with others
Feelings of depression, panic or anxiety (10)
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Affective/Mood Disorders
Affective or Mood Disorders are characterised by mood disturbances or changes in affect.
Common affective disorders include Depression, Dysthymia and Bipolar. Depressed moods,
loss of self-confidence and self-esteem, reduced energy are common symptoms. Bipolar is
slightly different in that sufferers may swing between extreme depressive moods which can
be so severe suicide may be considered and/or attempted and manic episodes where
sufferers may need less sleep, experience increased activity and/or restlessness and
reckless behaviour. 6.2% of Australians aged between 16 and 85 years experienced
affective disorders in 2006/2007 (12).
Disorder
Males
Females
Depression
3.1%
5.1%
Dysthymia
1.0%
1.5%
Bipolar
1.8%
1.7%
Source: 2007 National Survey of Mental Health and Wellbeing (2)
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Depressed mood or depression
4.1% of Australians will suffer from a major depressive disorder in any given year and the
average age of onset is 25 years (8). Around 160,000 Australian youth live with depression
and this is the most common mental health problem for young people. Approximately 1 in 5
people will experience depression by the time they reach adulthood (21). (8). (10) Those
who experience depression and remain untreated are at higher risk of death by suicide (21)
Unlike the low or sad moods most of us experience at times in our lives and sometimes
incorrectly label as depression, depression is an illness that is much more severe, it lasts
longer than two weeks and interferes with other areas of life for example, work, study,
relationships (10). Depression is often comorbid with anxiety and/or substance abuse
disorders (8). (21)
Depression is actually descriptive of emotions being depressed, lowered and/or or kept
down. Depressed people often stop enjoying life and lose interest in things they used to like
doing (21). People with depression often find it hard to cope fro from day to day (21).
Common symptoms include:
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Feeling sad or moody
(including mood swings)
Feeling hopeless or helpless
Feeling numb or empty
Feeling anxious
Feeling guilty and blaming
yourself
Feeling irritable
Unable to feel good or enjoy
things that you do normally.
(10) (8)
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Being overly self-critical
Being pessimistic and believing
you can't cope and that things
are out of your control
Difficulty making decisions and
thinking clearly
Blaming yourself
Forgetting things
Worrying
Poor concentrating and
memory
Thinking others see you
negatively
Thinking about suicide or
ending your life (10) (8)
Lack of motivation and energy
Crying a lot/for no reason
Losing interest in activities you
usually enjoy
Not caring what you look like
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Withdrawing from your friends and
family or being overly dependent
on them
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Increased use of alcohol or
other drugs
Losing your temper more than
usual. (10) (8)
Loss of appetite or over-eating;
weight loss or gain
Changes in sleep patterns difficulty getting to sleep,
waking up in the middle of the
night, sleeping for longer or
chronic fatigue
Headaches or stomach aches
Feeling physically sick
Constipation
Irregular menstrual cycles
Unexplained aches and pains
Lack of interest in sex (10) (8)
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Causes
A combination of causes is again thought to lead to depression and they are different for
everyone. Genetics mean there is a hereditary predisposition for some to developing
depression while environmentally depression may sometimes occur as a response to
something while for other people depression develops for no apparent reason. Some
triggers within these areas are thought to be:
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A family history of mental illness or depression
A stressful event or chain of events
Having a baby (10; 21)
Being abused or bullied
Feeling that you are doing badly at work or school
Having bad experiences with your family (especially when you were young)
Family arguments, separation, divorce
Poor self esteem
Not getting on with friends or family
Inability to cope
Stress
Lack of adequate support
Debt
Putting yourself down
Feeling lonely (21)
Depression can be broken down into three broad types each with their own symptoms and
likely causes:



Non-melancholic depression or clinical depression
Melancholic depression
Psychotic depression
Non-melancholic depression
This type of depression is the most common type of depression affecting one in four females
and one in six males over their lifetime.
Symptoms can include:



Causes
A depressed mood for more than two weeks
Loss of pleasure, interest and productivity in most things, including social
activities, relationships and work, school or university
Constant low mood over the course of the day (10)
This type of depression is usually caused by psychological rather than biological factors. A
stressful or series of stressful events can usually be pinpointed as the cause and once they
have been resolved or removed the depression may go away, particularly if combined with
therapy to help learn and develop appropriate coping strategies. Personality types may
influence recovery (10)
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Melancholic depression
Around 1-2% of Australians suffer from this type of depression making it fairly uncommon. It
may be part of a bipolar disorder which we will look at shortly (10)
Symptoms include
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







Feeling hopeless or helpless
Losing interest in activities they usually enjoy
Lacking energy
Changes in sleeping and/or eating patterns
Crying a lot or feeling agitated
High use of alcohol or other drugs
Short tempered
Withdrawing
Headaches and/or stomach aches
Feeling empty
Anxiety (10)
Causes:
The cause of this type of depression is mainly biological and it is more severe than nonmelancholic depression.
Psychotic depression (10)
Psychotic depression is the least common form of depression however it is also the most
severe form. Medication is required to control the symptoms; it will not ‘go away’ on its own
The crucial symptoms are:



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More severely depressed mood than other types of depression
Hallucinations, eg hearing voices
Delusions, eg extreme or false beliefs of guilt, shame, poverty or illness
More severe psychomotor disturbances eg reduced ability to think and respond
(10)
Dysthymia
Those with dysthymic depression experience low moods most days and for the majority of
the day. It is however a chronic condition; diagnosis requires the symptoms be present for at
least 2 years (22). Around 5% of the population will suffer from Dysthymia (23)
Dysthymic depression does not have as many physical symptoms nor is it as severe as
major depression however sufferers tend to have more disturbing emotional symptoms like
gloominess and dark thoughts. Those suffering dysthymia may be at increased risk of
suicide and left untreated it may morph into a major depression; it’s suggested that all those
who suffer from dysthymic depression will experience at least one episode of major
depression in their lifetime (22; 23). (13) (24)
Symptoms include:
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Social withdrawal
Excessive crying
Low self esteem
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
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Low energy or fatigue
Feelings of helplessness
Too little/too much sleep
A pessimistic attitude to everything
Anger and temper outbursts
Poor appetite or over eating
Neglecting personal appearance and/or hygiene
Difficulty concentrating and/or making decisions
Constant short term memory problems (22) (23)
Causes
Dysthymia tends to run in families indicating a genetic/hereditary link. It may be comorbid
with anxiety, drug and/or alcohol abuse (23)
Bipolar disorder (8) (3) (10)
Symptoms:
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Elevated mood
Inhibitions
Energy
Racing thoughts
Many ideas
Little need for sleep
Rapid speech
Difficulty focussing
Frustration and irritability
Only around 2% of Australians will suffer from Bipolar Disorder. Bipolar Disorder was once
called manic depression. This mental illness is typified by extreme mood swings. At least
one episode of mania which can be classified as mild, moderate or severe will also be
experienced along with episodes of depression. The depressive episode/s may become
major depressive episode/s leaving the person feeling great despair and in some cases
suicidal. Generally periods of normal mood are experienced in between the manic, psychotic
and depressive episodes. These periods of normal mood may be experienced for extended
durations. To be classified an ‘episode’ symptoms should last a minimum of one week.
Bipolar means 2 poles hence the typical extremes in polarity ie extremely high moods and
extremely low moods. Bipolar Disorder can be categorised into Bipolar I and Bipolar II.
Bipolar I is just as common in men as in women however Bipolar II is twice as common in
women than in men.
Manic symptoms are typified by an elevated mood which is exhibited by the person having
plenty of energy, racing thoughts, full of ideas, little need for sleep, rapid speech, trouble
focusing on tasks, frustration and irritability and lack of inhibitions which may result in risks
being taken that wouldn’t normally.
During the manic phase the person tends to be optimistic, excessively happy and experience
exaggerated feelings of wellbeing. Their mind is overactive and their need for sleep is
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significantly reduced. Although they have abundant energy they lack concentration which
may result in their work and/or study suffering. It is not uncommon for them to lose touch
with reality and experience episodes of psychosis.
Psychosis involves the person hallucinating i.e. seeing or hearing something that is not there
and/or having delusions e.g. the person may believe they have superpowers.
Bipolar I people experience one or more manic episodes and often one or more major
depressive episodes. The depressive episodes can last for several weeks to several months
whilst alternating with intense symptoms of mania that can last just as long. Periods of
‘normal’ mental health may occur during these extremes. Seasonal changes may affect
symptoms as could stress life situations.
Bipolar II symptomology is the same as Bipolar I except the manic episodes tend not to be
as extreme. These less extreme manic episodes were once referred to as hypomanic
episodes.
Causes
There are a number of factors which may influence the development of Bipolar Disorder.
Hereditary factors are likely to play a large role; of the 2% of people who experience Bipolar
Disorder, 10% of those will have at least one parent with Bipolar Disorder.
A number of environment factors may also trigger symptoms such as changes in jobs, living
arrangements, family and relationship problems, having suffered from physical and/or
emotional abuse or trauma including verbal and sexual abuse, grief due to the death or loss
or someone and/or other major life transitions such as having a baby.
Physical health matters may also trigger symptoms eg pregnancy/childbirth, hormone
problems eg hyper/hypothyroidism, brain conditions eg Huntington’s Disease, Autoimmune
problems eg HIV and cancer.
Schizophrenia
What is Schizophrenia?
Schizophrenia is an illness, a medical condition. It affects the normal functioning of the brain,
interfering with a person’s ability to think, feel and act. Some do recover completely, and,
with time, most find that their symptoms improve. However, for many, it is a prolonged illness
which can involve years of distressing symptoms and disability.
People affected by schizophrenia have one ‘personality,’ just like everyone else. It is a myth
and totally untrue that those affected have a so-called ‘split personality’.
What are the symptoms?
If not receiving treatment, people with schizophrenia experience persistent symptoms of
what is called psychosis. These include:
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
Confused thinking
When acutely ill, people with psychotic symptoms experience disordered
thinking. The everyday thoughts that let us live our daily lives become
confused and don’t join up properly.

Delusions
A delusion is a false belief held by a person which is not held by others of the
same cultural background.

Hallucinations
The person sees, hears, feels, smells or tastes something that is not actually
there. The hallucination is often of disembodied voices which no one else
can hear.
Other associated symptoms are low motivation and changed feelings.
What causes Schizophrenia?
The causes of schizophrenia are not fully understood. They are likely to be a combination of
hereditary and other factors. It is probable that some people are born with a predisposition to
develop this kind of illness, and that certain things — for example, stress or use of drugs
such as marijuana, LSD or speed — can trigger their first episode.
How many people develop Schizophrenia?
About one in a hundred people will develop schizophrenia at some time in their lives. Most of
these will be first affected in their late teens and early twenties.
How is Schizophrenia treated?
Treatment can do much to reduce and even eliminate the symptoms. Treatment should
generally include a combination of medication and community support. Both are usually
essential for the best outcome.

Medication
Certain medications assist the brain to restore its usual chemical balance.
This then helps reduce or get rid of some of the symptoms.

Community support programs
This support should include information; accommodation; help with finding
suitable work; training and education; psychosocial rehabilitation and mutual
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support groups. Understanding and acceptance by the community is also
very important.
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SUICIDE AWARENESS
Death by suicide is the major cause of premature death among people with mental illness
and up to one in 10 people affected by mental illness die by suicide themselves. Studies
indicate 3.2% of Australians have tried to die by suicide at some time in their lives. It is
thought that around 87% of people who die by suicide suffer from mental health illnesses.
These people usually feel extremely isolated and alone and believe no one can help them or
be able to understand their pain.
Statistics indicate around 2,000 Australians die by suicide each year: Depression is likely to
be a major cause in many cases. Many people who have died by suicide have experienced
depression or bipolar disorder. For every person who dies from suicide, at least another 30
people try to die by suicide. (13)
Medical intervention, counselling, appropriate social support and time will prevent many who
have considered dying by suicide by following through on these ideas and/or plans. Many of
these people will go on to live full and productive lives.
Warning Signs
Warning signs a person may be thinking of dying be suicide include:
 Threatening to hurt or kill themselves
 Withdrawing from family and friends
 Feel trapped and like they have no way out
 Dramatic changes in mood
 Feel worthless, hopeless and/or that life is not worth living
 Saying they have no reason for living or have no purpose in life
 Talking or writing about death, dying or suicide
 Giving away possessions, putting their affairs in order and/or saying goodbye to
family and friends
 Talks and/or writes about death, dying or suicide
 Increased alcohol or drug use
 Experiences regular panic attacks
 Experiences delusions and/or hallucinations
 Gives away personal possessions
 Participates in dangerous, life-threatening activities (21)
 Changed eating and/or sleeping habits
 An overwhelming sense of shame or guilt
 A dramatic change in personality or appearance, or irrational or bizarre behaviour
 A lack of interest in the future
Sometimes warning signs are so mild or well hidden they will only be recognised in
hindsight, even by trained, mental health experts.
People who have decided to die by suicide may become quite calm following a period of
distress once they have made the decision to die this way.
Warning signs should always be taken seriously; if you are concerned ask the person if they
are considering suicide and if they have any plans. This won’t put any ideas or plans in their
head – they are already there however it may well encourage them to talk about their
feelings.
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External referrals can include:
Telephone help lines

Lifeline - 13 11 14
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Suicide Call Back Service - 1300 659 467

SANE Australia - 1800 18 SANE (7263)

Kids Helpline (for children aged under 18) - 1800 55 1800
Professionals

General Practitioners

Psychologists

Psychiatrists

Social workers
Mental health crisis team
Causes
Suicide is usually the result of a number of complex factors, however sometimes one or two
things can move the person from thought to action. Living can become very painful for some
people at times and problems seem insurmountable. Many people think about suicide at
times but have no intention of acting on those thoughts. For some people however thoughts
of suicide can seem like logical solutions to problems which are appear hopeless.
The following are some situations which may cause a person to feel hopeless:
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
Relationship break-up
Family problems
Major loss and grief
Abuse – sexual, physical, mental
Addiction problems
Mental illness- Mental illnesses such as depression changes the way people
think, causing them to take quite a pessimistic view of the world which is why
they find it very difficult if not impossible to identify ways to improve their
situation/s (21)
 Education/work problems
 Unemployment
 Feeling alienated, like they don’t fit in anywhere
Other contributing factors may include:
Depression – many people who die by suicide have experienced depression which
could be the result of another mental illness
Psychosis – some people who die by suicide become confused as a result hallucinations
that are symptomatic of their mental health illness/es and/or because they are trying
to escape from their symptoms
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SOCIAL INCLUSION
People with mental illnesses who have experienced recovery or positive mental health have
often developed good resilience, optimism, self-advocacy, creativity, tolerance of differences
and compassion for others. Conversely due to the mental illness and the general
community’s lack of mental health awareness these same people experience isolation,
loneliness, stigma, discrimination, low self-esteem, anxiety and stress.
Practicing social inclusion rather than perpetuating stigma
Notes:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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CASE STUDIES
Case Study One: JESSICA
Jessica is a 28 year-old married female. She has a very demanding, high stress job as a
second year medical resident in a large hospital. Jessica has always been a high achiever.
She graduated with top honors in both college and medical school. She has very high
standards for herself and can be very self-critical when she fails to meet them. Lately, she
has struggled with significant feelings of worthlessness and shame due to her inability to
perform as well as she always has in the past.
For the past few weeks Jessica has felt unusually fatigued and found it increasingly difficult
to concentrate at work. Her coworkers have noticed that she is often irritable and
withdrawn, which is quite different from her typically upbeat and friendly disposition. She
has called in sick on several occasions, which is completely unlike her. On those days she
stays in bed all day, watching TV or sleeping.
At home, Jessica’s husband has noticed changes as well. She’s shown little interest in sex
and has had difficulties falling asleep at night. Her insomnia has been keeping him awake
as she tosses and turns for an hour or two after they go to bed. He’s overheard her having
frequent tearful phone conversations with her closest friend, which have him worried.
When he tries to get her to open up about what’s bothering her, she pushes him away with
an abrupt “everything’s fine”.
Although she hasn’t ever considered suicide, Jessica has found herself increasingly
dissatisfied with her life. She’s been having frequent thoughts of wishing she was dead.
She gets frustrated with herself because she feels like she has every reason to be happy,
yet can’t seem to shake the sense of doom and gloom that has been clouding each day as
of late.
1. What symptoms is Jessica displaying?
2.
What might Jessica be thinking/feeling in regards to seeking help for her symptoms?
3. What steps could Jessica take to get help?
Case Study Two: KRISTEN
Kristen is a 38 year-old divorced mother of two teenagers. She has had a successful, wellpaying career for the past several years in upper-level management. Even though she has
worked for the same, thriving company for over 6 years, she’s found herself worrying
constantly about losing her job and being unable to provide for her children. This worry has
been troubling her for the past 8 months. Despite her best efforts, she hasn’t been able to
shake the negative thoughts.
Ever since the worry started, Kristen has found herself feeling restless, tired, and tense. She
often paces in her office when she’s there alone. She’s had several embarrassing moments
in meetings where she has lost track of what she was trying to say. When she goes to bed at
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night, it’s as if her brain won’t shut off. She finds herself mentally rehearsing all the worsecase scenarios regarding losing her job, including ending up homeless.
1. What symptoms is Kristen displaying?
2.
What might Kristen be thinking/feeling in regards to seeking help for her symptoms?
3. What steps could Kristen take to get help?
Case Study Three: MARTIN
Martin is a 21 year-old business major at a large university. Over the past few weeks his
family and friends have noticed increasingly bizarre behaviors. On many occasions they’ve
overheard him whispering in an agitated voice, even though there is no one nearby. Lately,
he has refused to answer or make calls on his cell phone, claiming that if he does it will
activate a deadly chip that was implanted in his brain by evil aliens.
His parents have tried to get him to go with them to a psychiatrist for an evaluation, but he
refuses. He has accused them on several occasions of conspiring with the aliens to have
him killed so they can remove his brain and put it inside one of their own. He has stopped
attended classes altogether. He is now so far behind in his coursework that he will fail if
something doesn’t change very soon.
Although Martin occasionally has a few beers with his friends, he’s never been known to
abuse alcohol or use drugs. He does, however, have an estranged aunt who has been in
and out of psychiatric hospitals over the years due to erratic and bizarre behavior.
1. What symptoms is Martin displaying?
2. What might Martin be thinking/feeling in regards to seeking help for her
symptoms, when he isn’t experiencing the symptoms?
3. What steps could Martin (or his family) take to get help?
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POSITIVE MENTAL HEALTH - 10 TIPS
1. Connect with Others. Develop and maintain strong relationships with people around
you who will support and enrich your life. The quality of our personal relationships
has a great effect on our wellbeing. Putting time and effort into building strong
relationships can bring great rewards.
2. Take Time to Enjoy. Set aside time for activities, hobbies and projects you enjoy.
Let yourself be spontaneous and creative when the urge takes you. Do a crossword;
take a walk in your local park; read a book; sew a quilt; draw pictures with your kids;
play with your pets – whatever takes your fancy.
3. Participate and Share Interests. Join a club or group of people who share your
interests. Being part of a group of people with a common interest provides a sense of
belonging and is good for your mental health. Join a sports club; a band; an evening
walking group; a dance class; a theatre or choir group; a book or car club.
4. Contribute to Your Community. Volunteer your time for a cause or issue that you
care about. Help out a neighbour, work in a community garden or do something nice
for a friend. There are many great ways to contribute that can help you feel good
about yourself and your place in the world. An effort to improve the lives of others is
sure to improve your life too.
5. Take Care of Yourself. Be active and eat well – these help maintain a healthy body.
Physical and mental health are closely linked; it’s easier to feel good about life if your
body feels good. You don’t have to go to the gym to exercise – gardening,
vacuuming, dancing and bushwalking all count. Combine physical activity with a
balanced diet to nourish your body and mind and keep you feeling good, inside and
out.
6. Challenge Yourself. Learn a new skill or take on a challenge to meet a goal. You
could take on something different at work; commit to a fitness goal or learn to cook a
new recipe. Learning improves your mental fitness, while striving to meet your own
goals builds skills and confidence and gives you a sense of progress and
achievement.
7. Deal with Stress. Be aware of what triggers your stress and how you react. You may
be able to avoid some of the triggers and learn to prepare for or manage others.
Stress is a part of life and affects people in different ways. It only becomes a problem
when it makes you feel uncomfortable or distressed. A balanced lifestyle can help
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you manage stress better. If you have trouble winding down, you may find that
relaxation breathing, yoga or meditation can help.
8. Rest and Refresh. Get plenty of sleep. Go to bed at a regular time each day and
practice good habits to get better sleep. Sleep restores both your mind and body.
However, feelings of fatigue can still set in if you feel constantly rushed and
overwhelmed when you are awake. Allow yourself some unfocussed time each day
to refresh; for example, let your mind wander, daydream or simply watch the clouds
go by for a while. It’s OK to add ‘do nothing’ to your to-do list!
9. Notice the Here and Now. Take a moment to notice each of your senses each day.
Simply ‘be’ in the moment – feel the sun and wind on your face and notice the air you
are breathing. It’s easy to be caught up thinking about the past or planning for the
future instead of experiencing the present. Practising mindfulness, by focusing your
attention on being in the moment, is a good way to do this. Making a conscious effort
to be aware of your inner and outer world is important for your mental health.
10. Ask for Help. This can be as simple as asking a friend to babysit while you have
some time out or speaking to your doctor (GP) about where to find a counsellor or
community mental health service. The perfect, worry-free life does not exist.
Everyone’s life journey has bumpy bits and the people around you can help. If you
don’t get the help you need first off, keep asking until you do.
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RESOURCES
National crisis lines and online services
Lifeline
13 11 14 - 24/7 telephone crisis support, as well as online one-one-one crisis support (8pmMidnight AEST)
Suicide Call Back Service
1300 659 467 - 24/7 professional telephone crisis support for people at risk of suicide, carers
and bereaved, as well as online resources and information
Kids Helpline
1800 55 1800 - 24/7 telephone counselling for young people 5–25 years, as well as online
and email counselling (check website for hours)
National Hope Line (Salvation Army)
1300 467 354 - 24/7 telephone counselling for people bereaved by suicide, as well as online
resources and information
ReachOut.com
Online crisis and mental health information for young people 14-25 years
headspace
Online support for 12-25 year olds, including mental health, drug and alcohol issues
National Sexual Assault, Family and Domestic Violence Counselling Line
1800 RESPECT (737 7328) - 24/7 confidential telephone counselling about domestic
violence
Helplines
SANE Australia
1800 18 SANE (7263) - Telephone mental illness advice and referrals, weekdays 9am–5pm
AEST, as well as online resources and information
beyondblue
1300 22 4636 - Info line for depression, anxiety and related disorders, as well as online
resources and information
Black Dog Institute
Clinical and research expertise and community education about depression and bipolar
disorder
Professional support


Make an appointment with your local doctor
Contact the Employee Assistance Program (EAP) to speak to a counsellor
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


Find a GP with an interest in mental health issues through beyondblue
Find a psychologist by postcode through the Australian Psychological Society
Visit your local headspace centre if you are 12-25 years old
Non-English language support
Translating Interpreting Services (TIS) National
Telephone and on-site interpreting service for people who don’t speak English and for
people supporting them: 131 450
Mental Health in Multicultural Australia
Translated mental health resources and information
SANE Australia
Translated mental health fact sheets and podcasts
For Further Information
beyondblue
beyondblue is a national depression initiative, working to reduce the impact of depression
and anxiety in Australia. It provides online information on depression, anxiety and related
disorders, as well as available treatments and where to get help. You can also call the
beyondblue info line on 1300 22 4636 (local call cost from a landline), or email
infoline@beyondblue. org. au.
The Black Dog Institute
The Black Dog Institute is a not-for-profit organisation offering specialist expertise in a range
of disorders, including depression and bipolar disorder. The Institute aims to improve the
lives of those affected by these disorders - and in turn - the lives of their families and friends.
It provides high quality clinical services for those with a mood disorder; undertakes research;
and provides education and training to health professionals, communities, workplaces and
schools. You can also use the Institute’s online self-assessment tool and resources.
Lifeline
Lifeline provides 24/7 crisis support for all Australians. For telephone crisis support call
Lifeline on 13 11 14. Its online crisis support chat service is also available 7 days a week
from 8pm - midnight. Lifeline also has a range of online self-help tool kits and fact sheets
covering issues such as mental illness, depression, suicide prevention, anxiety and more.
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Mental Health First Aid Australia
MHFA Australia is a national non-profit training and research program that provides high
quality evidence based mental health first aid education open to all members of the
community. Its 12-14 hour courses are presented by accredited Instructors across Australia
and in 16 other countries, and teach how to use mental health first aid strategies to assist
individuals with mental health problems. MHFA courses include Standard, Youth, Aboriginal
and Torres Strait Islander and Vietnamese.
Mindframe
The Mindframe National Media Initiative provides comprehensive national guidance on
responsible, accurate and sensitive portrayals of mental illness and suicide through the
mass media. Funded by the Australian Government and advised through media industry
engagement, Mindframe delivers evidence-based education, training and resources for
media professionals, universities and sectors working with the media on issues relating to
mental illness and suicide.
ReachOut.com
ReachOut. com is Australia’s leading online youth mental health service. It’s the perfect
place to start if you’re not sure where to look. It’s got information, stories and discussions on
everything from finding your motivation, to getting through really tough times. With a mobilefriendly site and forums, you can access help, info and support no matter where you are.
The Salvation Army
The Salvation Army’s Hope for Life Program aims to raise awareness about the impact of
suicide in Australia and to educate and empower the general community to provide
appropriate responses to people who have been bereaved by suicide. Its training courses
are designed to equip people in local communities with the skills, knowledge and confidence
to be there for people, to provide them with a listening ear, to give practical support and
assistance and to give them a sense of comfort and hope.
SANE Australia
SANE Australia is a national charity working towards a better life for people affected by
mental illness, through campaigning, education and research. The SANE Helpline and
Helpline Online also provide advice, information and referral for people concerned about
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mental illness and suicide prevention. Call 1800 18 SANE (7263) for advice and information.
Suicide Prevention Australia
Suicide Prevention Australia is the national peak body for the suicide prevention sector in
Australia. It promotes collaboration, coordination and partnerships in suicide prevention,
intervention and postvention. Its mission is to make suicide prevention everybody’s
business.
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REFERENCES
1. International society for the psychological treatments of the schizophrenias and other psychoses.
International society for the psychological treatments of the schizophrenias and other psychoses.
[Online] [Cited: 1 February 2012.] http://ispsuk.org/?p=312.
2. ABS. National Survey of Mental Health and Wellbeing: Summary of Results, 2007. Australian
Bureau of Statistics. [Online] 2008. [Cited: 1 February 2012.]
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ment.
3. Beyond Blue. [Online] [Cited: 1 February 2012.] http://www.beyondblue.org.au.
4. WHO. Promoting mental health - summary report. France : World Health Organisation, 2004.
5. Investing in Mental Health pdf. World Health Organisation. [Online] 2003. [Cited: 5 February
2012.] www.who.int/mental_health.
6. Lynne Friedli, Michale Parsonage. Pdf. Community Health Exchange. [Online] [Cited: 6 February
2012.]
http://www.chex.org.uk/media/resources/mental_health/Mental%20Health%20Promotion%20%20Building%20an%20Economic%20Case.pdf.
7. Pathways, rehabilitation and support services ltd. [Online] [Cited: 1 February 2012.]
http://www.pathways.org.au/index.php?option=com_content&view=article&id=36:mental%20healt
h&catid=7&Itemid=25.
8. Kitchener BA, Jorm AF, Kelly CM. Mental health first aid manual 2edn. Melbourne : Orygen Youth
Health Research Centre, 2010.
9. ABS Australian Social Trends 4102.0 2009 - Mental Health pdf. Australian Bureau of Statistics .
[Online] 2009. [Cited: 7 February 2012.]
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/$File/41020_Mentalhealth.pdf.
10. Reachout Australia. [Online] [Cited: 6 February 2012.] http://au.reachout.com/.
11. 7. [Online] http://www.nald.ca/library/research/famlithea/cover.htm.
12. ABS. 2009-10 Year Book Australia. Canberra : Australian Bureau of Statistics, 2010. Vol. Number
91, ABS Catalogue No. 1301.0.
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.
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14. Neimark, MD. The Fight or Flight Response. Mind/Body Education Center. [Online] [Cited: 5 July
2011.] http://www.thebodysoulconnection.com/EducationCenter/fight.html.
15. What is Stress. Understanding and Dealing with Stress. [Online] [Cited: 7 February 2012.]
http://www.mtstcil.org/skills-definition-1.html.
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http://library.thinkquest.org/C0123421/index.htm.
17. WebMD Medical Reference. Medicine Net.com. [Online] February 2009. [Cited: 3 February 2012.]
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http://www.mja.com.au.
19. Fact File: Anxiety Disorders. ABC Health and Wellbeing. [Online] 7 June 2005. [Cited: 3 February
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20. End anxiety for ever. [Online] [Cited: 6 February 2012.]
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21. Youth Beyond Blue. [Online] [Cited: 2 February 2012.]
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23. Medline Plus. National Institute of Health. [Online] 2010. [Cited: 8 February 2012.]
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http://www.ncbi.nlm.nih.gov/pubmedhealth.
25. Mental illness: myth versus fact. Mental Health Foundaton of Australia (Victoria). [Online] [Cited:
7 February 2012.] http://www.mentalhealthvic.org.au/index.php?id=112.
26. Mental Health and Wellbeing: Profile of Adults, Australia, 1997. Australian Bureau of Statistics.
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28. Zarcadoolas, Pleasant, & Greer. [Online] http://www.en.wikipedia.org/wiki/health_literacy.
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ocument&tabname=Summary&prodno=4233.0&issue=2006&num=&view=)..
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31. [Online] http://www.health.gov/communication/literacy/quickguide/factsbasic.htm.
32. Quickgude. [Online] http://www.health.gov/communication/literacy/quickguide/factsbasic.htm.
33. 1. [Online] http://www.health.gov/communication/literacy/quickguide/factsbasic.htm.
34. 2. [Online] Zarcadoolas, Pleasant, & Greer, 2006 at http://en.wikipedia.org/wiki/health_literacy).
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and Human Services, 2000.
36. 4. [Online]
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ocument&tabname=Summary&prodno=4233.0&issue=2006&num=&view=.
37. 5. [Online] http://heapro.oxfordjournals.org/content/24/3/285.full.
38. 5. [Online] http://en.wikipedia.org/wiki/health_literacy.
39. 6. [Online] World health Organization, 1998.
40. 7. [Online] http://www.healthliteracy.com/article.asp?PageID=3791.
41. 8. [Online] http://www.patientsorganizations.org/healthliteracy .
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43. 9. [Online] http://definitionofwellness.com/dictionary/health-literacy.html.
44. Weiss, BD (MD). 13. Health literacy and patitent safety: help patients understand, 2nd edn. s.l. :
American Medical Association Foundation and American Medical Association, 2007.
45. The Body Soul Connection. [Online] [Cited: 10 July 2011.]
http://www.thebodysoulconnection.com/EducationCenter/fight/html.
46. Dionne-Coster, S Sauve, L Shively, J. Family Literacy and Health. Canada : Centre for Family
Literacy, 2007.
47. Library think quest. [Online] [Cited: 6 July 2011.]
http://library.thinkquest.org/CO123421/index.htm.
48. Druss, B (MD, MPH) Reisinger Walker (MAT, MPH) E. Mental Diosrders and medical
comorbidity. Robert Wood Johnson Foundation. [Online] February 2011. [Cited: 7 February 2012.]
http://www.rwjf.org/files/research/021011.policysynthesis.mentalhealth.report.pdf.
49. ABS. Mental Health and Wellbeing: Profile of Adults, Australia - 1997. Canberra : Australian
Bureau of Statistics, 1998. Vol. ABS Catalogue No. 4326.0, ISBN 0 642 25726 4.
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50. Statistics, Australia Bureau of. 2009-10 Year Book Australia. Canberra : Australian Bureau of
Statistics, 2010. Vol. Number 91, ABS Catalogue No. 1301.0.
beyondblue Directory of Medical and Allied Health Practitioners in Mental Health
http://www.beyondblue.org.au/index.aspx?link_id=107.1007
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GLOSSARY OF TERMS
A
ADD or ADHD: Attention-deficit / hyperactivity disorders which occur in 3-5% of school-age
children; these disorders are characterised by inattention and hyperactivity or impulsivity and
affect academic performance, behaviour and social functioning.
Adverse life event: a stressful or difficult event in a person's life, which may increase the
risk of mental health problems or illness, e.g. separation or divorce, job loss, death of a
friend or family member.
Affective Disorders: a group of disorders including Depression which have a negative
impact upon a person's mood or 'affect'.
Agoraphobia: fear of being in situations from which it may be difficult or embarrassing to get
away if the person experiences a panic attack, or fear that help may not be available if
needed, e.g. in a crowded shopping centre, on public transport etc.
Anorexia nervosa: self-induced weight loss (or failure to grow) due to starvation, exercise
and purging; there is an intense fear of becoming fat even when severely underweight,
resulting in a preoccupation about body weight, eating and food.
Anxiety: a set of physical, mental and behavioural changes experienced in response to
danger or a threat, when the brain sends signals to the body to prepare for 'fight or flight' –
this causes an increase in heart rate and breathing as well as other physiological changes.
Anxiety disorder: a group of illnesses characterised by intense feelings of anxiety, often
without cause or out of proportion to the threat posed by the situation; these feelings result in
considerable discomfort and tension and make the person unable to function effectively in
the feared situation. Examples include various types of phobia, obsessive-compulsive
disorder and post-traumatic stress disorder.
Asperger’s Syndrome: a disorder thought to be related to autism, featuring difficulties with
social interaction and communication, as well as restricted interests. Unlike typical autism, it
is not associated with delays in language or cognitive development or with significant
intellectual impairment.
Attention-deficit / hyperactivity disorder (ADHD): a disorder seen in 3-5% of school-age
children, characterised by inattention and hyperactivity or impulsivity; it affects academic
performance, behaviour and social functioning.
Autism / Autism Spectrum Disorders: disorders of development that involve difficulties
with communication and social interaction, limited interests or activities and repetitive
behaviour. There is normally impaired or delayed development of language and cognitive
skills, as well as intellectual impairment.
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B
Bereavement: the grief and sadness experienced after a significant loss, such as the death
of a loved one, relationship breakdown, loss of home or security, etc.
Bipolar mood disorder: a disorder which involves recurrent episodes of depressed moods
and extremely elevated moods or mania, in which the person is in a state of elation and
overactivity; previously called manic depressive disorder.
Bulimia nervosa: also called Bulimia; an eating disorder characterised by restrictive eating
patterns, binge-eating of calorie-rich foods and attempts to compensate by self-induced
vomiting, laxative abuse, or compulsive exercise.
Bullying: repeated attacks on a person (verbal, physical, social or psychological) which
cause distress at the time and also cause longer-term distress because of the possibility of
future attacks.
C
Child abuse: a pattern of inappropriate treatment of a child, which may include physical or
sexual abuse, emotional abuse, or neglect of the child’s care.
Clinical Depression: a mental illness characterised by feelings of extreme sadness or
hopelessness, as well as other emotional and physical symptoms. See also Depression.
Compulsion: a repetitive behaviour or ritual that a person is driven to perform, in order to
control their anxiety about an obsessive thought or worry. For example, a person who is
obsessively worried about contamination or infection may feel compelled to wash their hands
excessively. See also Obsessive Compulsive Disorder.
Conduct disorder: recurrent behaviour over at least 6-12 months showing no regard for
social norms or the rights of others; may include aggression toward people or animals,
property damage, violation of rules, deceitfulness or theft.
Critical incident plan: a plan which outlines in advance how an organisation, such as a
school, should respond in the event of a disaster or emergency, such as a natural disaster,
bomb threat, suicide, or medical emergency.
D
Delusions: beliefs or thoughts which are bizarre and are different from most people in that
person's culture, e.g. a person believing without cause that they are being persecuted or
plotted against, that their thoughts are being broadcast aloud, or that they are someone else,
such as a famous person or religious figure.
Depression: feelings of sadness and grief experienced by everyone at some time, such as
a response to a negative event or situation. Severe or persistent negative feelings may
indicate a mental illness – this can also be called Depression or may be differentiated by
terms such as Clinical Depression, Depressive Illness or Mood Disorder. In these illnesses,
people may also experience: anxiety, guilt, changes in sleep and eating patterns,
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hopelessness, loss of energy, headaches and physical pains, poor concentration, suicidal
thoughts or behaviour.
Drugs: substances which have an effect on the human body, the use of which may be legal
or illegal. Drugs may include over-the-counter medications, prescription medications,
cigarettes, alcohol, heroin, cocaine, marijuana, etc. See also Substance Use and Substance
Abuse.
E
Early intervention: in mental health, this term means picking up the early signs of a mental
health problem or disorder and providing support at an early stage before the situation
worsens, e.g. a teacher referring a troubled student to the school counsellor.
Eating disorders: a group of illnesses characterised by disturbed eating patterns and a
preoccupation with body weight. Anorexia nervosa and Bulimia nervosa are eating disorders,
but there are also other forms.
Emotional abuse: a pattern of abuse in which the person's sense of self and emotional
security is undermined, e.g. by verbal abuse, threats of maltreatment and severe
punishment, rejecting the person and with-holding affection, creating a climate of fear, or
keeping the person socially isolated. This can occur in adult relationships, as well as in adultchild relationships. See also Child Abuse.
G
GRIP framework: a framework which can guide teachers in how to respond to a troubled
young person: Gather Respond, Involve, and Promote. Refer to Risk and Resilience: A
Teacher’s Guide to Mental Health.
H
Hallucinations: sensing or feeling something which is not there, even though it seems real,
eg hearing voices, seeing people or things which aren't there, feeling or smelling something
that is not real.
Health: a state of physical, emotional, social and spiritual wellbeing, which is more than
simply the absence of an illness.
Health promoting schools: schools which make a commitment to creating and maintaining
an environment that will promote the health of those in the school community. This is best
achieved by working across three domains: (1) curriculum, teaching and learning (2) school
ethos and environment and (3) partnerships with the community and services.
Help-seeking behaviour: a willingness and ability to seek personal and/or professional
support when facing physical or mental health problems, or personal difficulties.
I
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Incidence: the number of newly identified cases of a condition or event in a given time
period, usually in a year. Often expressed as a figure per 100,000 population.
Indicated intervention: in mental health, this means a specific program or response that is
designed to help people who are showing early signs of a mental health problem or disorder.
M
Mania / manic episode: a state of elation and overactivity, in which a person may feel
invincible, have increased energy and reduced need for sleep, rapid thinking and speech,
lack of inhibitions, grandiose plans and beliefs; if challenged they are likely to lack insight
into their behaviour and may become irritable. See also Bipolar Mood Disorder.
Manic depression: a term previously used for Bipolar Mood Disorder. A disorder which
involves recurrent episodes of: depressed moods, extremely elevated moods or mania, in
which the person is in a state of elation and overactivity.
Mental health: the capacity of people to have positive and appropriate thoughts, feelings,
behaviour and relationships with others. Mentally healthy people interact with one another
and their environment in ways that promote subjective wellbeing, achievement of goals, and
optimal use of their abilities.
Mental health problem: negative or altered thoughts, feelings or behaviour, but not to the
extent seen in mental illness. Mental health problems include transient or moderate feelings
of sadness, worry or stress, perhaps in response to change or difficult situations.
Mental health promotion: a program or a systematic approach which will enhance people's
mental health, e.g. by reducing or preventing risk factors (such as addressing school
bullying) or promoting protective factors (such as building resilience and connections with
others).
Mental illness / disorder: a recognised illness with a distinct set of symptoms affecting a
person's thoughts, feelings or behaviour. Diagnosis usually requires a combination of
symptoms, of a certain severity, which must be present over a minimum time period.
N
Nervous breakdown: a term used by some people when a person becomes unable to
function socially, or at school or work, because of a mental health problem or disorder.
Non-psychotic illnesses: mental illnesses which do not generally include psychotic
symptoms, such as phobias, anxiety disorders, depression, eating disorders, obsessive
compulsive disorder. However some of these disorders can be associated with psychotic
symptoms in certain cases.
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O
Obsessions: repetitive, unwanted thoughts or impulses which are disruptive to a person's
life. See also Compulsion and Obsessive Compulsive Disorder.
Obsessive Compulsive disorder: a disorder in which a person experiences obsessions
and compulsions to a degree which causes disruption to their everyday life. For example, an
obsession about contamination or infection may cause a person to adopt the compulsive
ritual of washing their hands excessively after contact with others.
Oppositional defiant disorder: a recurrent pattern of defiant, disobedient and hostile
behaviour toward authority figures over at least 6 months; a child with this disorder
frequently loses his or her temper, argues with parents or teachers, refuses to follow rules
and may deliberately annoy others.
P
Panic attack: a feeling of panic, with associated physical symptoms, which often starts
suddenly or for no apparent reason, and is not associated with a particular event or situation:
symptoms include shortness of breath, chest pain, dizziness, feeling faint, shaking, dry
mouth, pounding heart, tingling, sweating, an urge to flee, nausea, blurred vision, difficulty
gathering thoughts.
Panic disorder: people with this disorder experience more than one panic attack, which is
not associated with a particular event or situation, and then become worried about having
another attack.
Personality Disorder: a pattern of thoughts, feelings and behaviour (such as paranoid or
antisocial behaviour) that is different from or more extreme than other people in that person's
culture and causes distress or poor functioning.
Phobia: intense fears about particular objects or situations, such as a fear of spiders or
heights, to a degree which causes distress and interferes with the person's life.
Postnatal depression: a disorder affecting about 10-12% of new mothers in which they
experience sadness, anxiety, guilt, changes in appetite and sleep patterns; symptoms are
more severe and long-lasting than those experienced by the majority of new mothers.
Post traumatic stress disorder: recurrent feelings of terror, frightening dreams or
flashbacks which result from a previous traumatic event (such as war, torture, accident or
violence), causing disruption in the person's current life.
Prevalence: the proportion of the population or sub-group who experience a given disorder
or condition, often expressed as a percentage – eg 10-12% of new mothers experience
postnatal depression.
Psychiatrist: a doctor who has undertaken additional training to become a specialist in
mental illness and can prescribe medications as well as providing or referring people to other
forms of treatment and support, eg counselling.
Psychologist: a professional trained in assessing people's behaviour and abilities, who can
offer advice in regard to certain situations; a clinical psychologist specialises in mental health
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problems and illness, rather than other aspects of people's behaviour. A psychologist does
not prescribe medication but can provide a range of other therapies.
Psychosis / psychotic episode: a period of mental illness in which a person loses touch
with reality and may experience delusions, hallucinations, mood changes, disorganised
thoughts and other symptoms; can occur in several types of mental illness such as
Schizophrenia or Bipolar Mood Disorder.
R
Resilience: a person's ability to bounce back after experiencing difficult events or situations,
which helps to protect them from developing a mental health problem or illness. It can be
promoted by fostering a sense of caring and connection with others, by believing in a person
and offering support to help people reach their goals, and by ensuring that a person has
opportunities for contribution and participation.
Risk factor: a factor associated with a higher risk for developing a particular illness, eg high
cholesterol is a risk factor for heart disease. Some risk factors increase the chance of
developing a mental health problem or illness, such as having a parent with a mental illness,
being bullied or abused, or experiencing a stressful life event.
Risk taking behaviour: a pattern of behaviour in which a person is attracted to dangerous
and sometimes illegal activities: violence, excessive alcohol or drug use, unsafe sexual
practices, hanging from moving trains or vehicles, etc.
S
Same-sex attraction: being sexually attracted to a person of the same gender; may be
used to encompass terms such as gay, lesbian or bisexual.
Schizophrenia: a mental illness in which symptoms include confused thoughts, speech and
behaviour, delusions and hallucinations. It usually has its first onset in adolescence or early
adulthood. People with schizophrenia do not have a 'split personality.'
Selective intervention: in mental health, this means a specific program or response
designed to help people who have a risk of developing a mental health problem or disorder,
eg a program working with people who have experienced bullying.
Self-harm: a deliberate action someone takes to physically harm themselves, such as by
cutting, burning, or taking harmful substances; it is seen in some forms of mental illness and
increases the chance of suicidal behaviour.
Sexual abuse: occurs when a person is forced by another to engage in unwanted and/or
underage sexual activity. It may be in the form of non-contact sexual abuse (e.g. being
forced to watch sex or pornography), contact abuse (e.g. being forced to touch the genitals)
or intercourse (rape).
Social and emotional wellbeing: being able to function well socially and feel well
emotionally; an alternative term for 'mental health' and the preferred term for some people,
including many Indigenous communities.
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Social phobia: a disorder in which people fear that everything they do will be judged in a
negative way, so they limit what they do in front of others and may withdraw from social
contact.
Socio-economic problems: a broad term to describe the inter-related social and financial
problems that exist in some communities or families; socio-economic problems (such as
poverty, unemployment, family discord or child abuse) increase the risk of mental health
problems or disorders.
Split personality: a description sometimes used wrongly in association with the term
schizophrenia. People with schizophrenia do not have a 'split personality'.
Stigma: a negative association or preconception, which causes discrimination against a
person or group; e.g. negative stereotypes and misconceptions cause discrimination against
those with a mental illness, making it harder for them to seek help and support.
Stress: a term used to describe negative feelings of anxiety or depression a person may
experience when they are overly busy or have a number of negative events or situations in
their lives; severe or prolonged stress may increase the risk of a mental health problem or
disorder.
Substance abuse / dependence / disorder: the recurrent use of drugs or alcohol to the
extent that a person's social functioning and behaviour are affected, and they may be unable
to meet their obligations at school or work or in the home.
Substance use or drug use: the deliberate, non-medical use of a drug by a person, to alter
their own feelings or behaviour. This term may be applied to prescription drugs, cigarettes,
alcohol or illicit drugs.
Suicidal behaviour: a collective term for behaviours such as suicide and attempted suicide,
in which a person harms themselves in a deliberate attempt to end their own life.
Suicidal thoughts / ideation: thinking about suicide or planning an act of suicide, this may
or may not lead to a suicide attempt.
Suicide: a conscious and deliberate act by a person, with the intent of ending his or her own
life; in attempted suicide there is an intent to end one's own life but the attempt is not fatal.
U
Universal intervention: a program or approach that promotes the mental health and
wellbeing of everyone in the group or community, rather than just a particular individual or
group, e.g. a whole school program to prevent bullying or to promote resilience.
W
Warning sign: a sign which others might notice that indicates a person may actually have a
mental health problem or illness, or be thinking about suicide; this is different from a risk
factor, which increases the chances of the illness or suicidal behaviour occurring.
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Y
Youth suicide: Suicide among young people. The Australian Bureau of Statistics releases
information in year groups for those aged 15 to 24 - this is often termed youth suicide, but
rates are lower in school-aged young people than in those aged 19 to 24.
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