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Mental Health in APS Practice

Instructor Led- Skill Building (Virtual or In-Person)

We create experiences that transform the heart, mind, and practice.

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About the Academy & APSWI

The Academy is a project of San Diego State School of Social Work. Serving over 20,000 health and human services professionals annually, the Academy’s mission is to provide exceptional workforce development and learning experiences for the transformation of individuals, organizations and communities.

APSWI, or Adult Protective Services Workforce Innovations, is a training program of the Academy that provides innovative workforce development to APS professionals and their partners.

ACADEMY PROGRAMS

San Diego State University

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Welcome and Housekeeping

Facilitator Introduction

Housekeeping:

Respect everyone’s opinions and time
Raise hand
Confidentiality

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Learning Objectives, Guidelines, & Outline

Blended learning: builds upon the eLearning

Course Goal:

Familiarize yourself with mental health conditions to develop appropriate intervention skills and be able to effectively communicate with mental health partners

Learning Objectives:

Describe the common symptoms and behaviors of the five broad categories of mental health disorders and how they may impact APS casework
Identify personal and cultural experiences which influence working with clients with mental health conditions.
Explain ways to adapt the interview and case planning process to better accommodate a client experiencing symptoms of a mental health condition.
Identify and practice elements of a suicide risk assessment.

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Terminology

'Mental condition’- general term used to describe a condition that affects a person's thinking, feeling, behavior, or mood. These conditions deeply impact day-to-day living and may affect the ability to relate to others.

'Mental disorder’-used when referring to a specific mental health diagnosis to reflect the DSM 5-TR.

Be mindful and make effort to use person-centered, recovery oriented and trauma-informed language.

Acceptance that there are people with lived experiences with mental health conditions in training today.

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Icebreaker and Introductions

Answer the following questions:

What is one example of a TV show, movie, or book that portrays a character with a mental health condition?

Based on your current knowledge of mental health conditions, do you think the condition was accurately portrayed?

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Mental Health Disorders Review

Anxiety Disorders *
Mood Disorders
Personality Disorders *
Psychotic Disorders
Trauma and Stress Related Disorders *

Each group will be assigned a common mental health disorder from the * categories.

You have 10 min. to review/research your assigned mental health disorder and prepare a 5 min. presentation.

Use credible resources only
Presentation style is up to you

Include a summary of the disorder including common symptoms and behaviors and how these could impact APS casework.

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Depression Discussion

~8.4% of adults in US has experienced at least 1 major depressive episode
Impact of the COVID-19 pandemic

I Had a Black Dog, His Name Was Depression video

What signs and symptoms did you see?
How is major depression different from grief/sadness or feeling blue?
How can the symptoms of major depression interfere with APS casework?

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Schizophrenia Discussion

One of the top leading causes of disability worldwide

What are delusions?

Persecutory
Grandiose
Erotomanic

What are hallucinations?

Auditory
Visual
Olfactory and gustatory
Tactile

What are some negative symptoms?

How can this impact APS casework?

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Schizophrenia Simulation Exercise

CONTENT WARNING

4 roles (if applicable)

Client *
Social Worker *
Voice
Observer

Switch roles every 3 min to allow everyone various experiences

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Activity Debrief

Application to real-life case work

Seem distracted or disconnected
May be seen in other disorders: PTSD, depression, bipolar, postoperative delirium

How can we adapt our interviews to be more effective?

Allow plenty of time
Check-in for clarity and understanding
Go slowly, write down questions, reschedule
Repeat as necessary

Never presume experiencing symptoms = lack of intellect or ability to communicate

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Stigma and Stereotypes

Influence of stereotypes and stigmas
What are some common stereotypes you have encountered (could be in media examples shared earlier)?

Common stereotypes of people with mental health conditions:

Are more violent
Aren’t trying hard enough to ‘get better’

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Personal Experiences with Mental Health

Share only to the level you’re comfortable with.

Use “I” or in “my experience”.

What were you told about mental health conditions in any of your cultural identities, families (given or chosen), or communities?

Have your views about mental health conditions changed over time?

What can we do to help minimize stereotypes or stigma?

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Caroline’s Intake

Age 65, Widow, African-American, Retired
Has been diagnosed with breast cancer six months ago
RP unable to contact client for f/u
Spouse died 12 months ago
Client retired from bank when spouse died

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Home Visit

At 11 AM, you make an unannounced visit to Caroline’s home which is an upper middle-class neighborhood. The garden is overgrown. As you drive up, you notice a woman, watering the lawn next door.

You knock several times at the door and call out, asking to be let in. After two minutes, a woman’s voice calls out from behind the door, “Whatever it is, I’m not interested. Go away.”

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At the Door Activity

Decide what is the best next step and why:

Leave immediately, leaving your card in the door, plan on coming back the next day.
Call the mental health crisis assessment team in your area.
Call the police to assist getting in the door.
Knock on the door and try again.
Go over to the neighbor and enlist her help in getting in to see Caroline.

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�The Interview�

Handout #4

In groups, decide what is best next move and why:

Tell Caroline you know about the breast cancer diagnosis and explore her treatment options with her.
Get consent to speak with Mrs. DeLa Cruz, conclude the interview, and then interview Mrs. DeLa Cruz for additional information.
Assess Caroline for depression and possible suicide risk.
Refer Caroline to community resources for bereavement counseling and conclude the interview.
Recommend Caroline go see her doctor to find out why she has no energy and conclude the interview.

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SAFE-T Form

CONTENT WARNING

IDENTIFY RISK FACTORS

IDENTIFY PROTECTIVE FACTORS

CONDUCT SUICIDE INQUIRY

DETERMINE RISK LEVEL/INTERVENTION

DOCUMENT

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Caroline’s Level of Risk

What are some of Caroline’s protective factors?
What are some risk factors which may lead you to believe she could be suicidal?

Assessing Caroline for Suicide Risk:

Individually, write down some questions that would help assess Caroline’s suicide risk. These will be used in a role-play/demonstration.

Address additional risk or protective factors, intent, plan and/or means to carry out plan

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Demonstration Scenario 1

Everyone will ask their questions.

Listen to the answers from Caroline.

Once activity is complete, use SAFE-T Form to assess Caroline’s level of risk

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Demonstration Debrief

Is Caroline’s risk for suicide low, moderate or high?

Is it okay to directly ask Caroline if she is considering suicide?

What resources would you consider including in your service plan?

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Demonstration Scenario 2

Everyone will ask their questions.

Listen to the answers from Caroline.

Once activity is complete, use SAFE-T Form to assess Caroline’s level of risk

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