Conditions and Care

This is an opportunity to remind yourself about the mental health issues you might encounter in the workplace.

The following list is adapted from the Ministry of Health’s Mental Health webpage.

Depression

With depression, your mood is persistently low, and you experience a loss of enjoyment in activities that you normally enjoy. This continues for a sustained period – weeks or months. Depression can range from mild to severe and can often be triggered by stressful changes in your life.

To read more about depression and how it differs from simply being sad, click on the link to access the following webpage from depression.org.nz.

Anxiety disorder

We all feel worried or anxious sometimes – it is a natural response to a stressful situation such as a job interview. When these feelings of anxiety become extreme and negatively impact our day-to-day lives, it can be classified as an anxiety disorder.

The most common type is generalised anxiety disorder (GAD). As the name suggests, the tangata with GAD will feel anxious about various everyday situations.

Click on the link to access the Mental Health Foundation’s webpage on anxiety to read about GAD.

Bipolar disorder

Bipolar disorder is characterised by a change in people's moods, where they experience periods of both mania (elevated mood) and depression. In the manic state, the tangata might engage in risk-taking behaviour and suffer from insomnia. During the depressive phase, the tangata may feel sad and unable to find enjoyment in usual activities.

Click on the link to access the Healthify web page on bipolar disorder.

Eating disorders

There are a range of disorders based around food. Examples include:

• Anorexia nervosa: where people drastically reduce their food intake, leading to dramatic weight loss.
• Bulimia nervosa: where people eat a large amount of food and then attempt to compensate by vomiting, taking laxatives or exercising excessively.
• Binge-eating disorder: characterised by periods of extreme overeating (binging).
• Avoidant/restrictive food intake disorder (ARFID): characterised by a refusal to eat a full range of foods, potentially leading to malnutrition.

Ref: Adapted from EDANZ Eating Disorders Explained

Click on the link to display the EDANZ page on different eating disorders. Click on the links to read about the disorders listed.

Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is where someone has obsessive thoughts that make them anxious and lead to compulsive behaviour. Compulsive behaviours can include washing hands frequently or constantly checking that the switches are turned off, or doors are locked.

Click on the link to display the Mental Health Foundation web page on obsessive compulsive disorder.

Panic disorder

Repeated panic attacks characterise panic disorder. These are sudden episodes of intense anxiety and physical symptoms you would have if you were in physical danger. Symptoms include nausea, dizziness, and shortness of breath, and these attacks can be disabling.

Click on the link to display the Mental Health Foundation web page on panic disorder.

Post-traumatic stress disorder 

If someone has been through a traumatic event, this can cause ongoing problems with Post-Traumatic Stress Disorder (PTSD). Symptoms last at least a month and can continue for years. PTSD can result in nightmares and flashbacks.

Click on the link to display the Mental Health Foundation’s page on post-traumatic stress disorder (PTSD).

Schizophrenia

Schizophrenia is characterised by episodes of psychosis where the person loses touch with reality. Psychotic episodes may include hallucinations and delusions, where the person hears voices or sees things that others cannot see. It can majorly impact the person’s ability to work or maintain relationships.

Click on the link to display Healthify’s page on schizophrenia.

Stress

Stress is your body’s physical reaction to a perceived threat. Some stress is necessary in our lives, as it motivates us to achieve. However, sustained high-stress levels can impact our ability to manage our day-to-day lives. It can cause physical symptoms such as headaches and stomach pain. It can also affect your sleep and make you moody and irritable. If untreated, it can contribute to the development of heart disease, high blood pressure and mental health issues such as anxiety.

Click on the link to display Healthify’s page on stress.

Remind yourself about the types of addiction you may encounter. This can include substance and/or behavioural addictions.

Substance addiction

The tangata may be addicted to one or more of the following substances:

• alcohol
• illegal drugs
• prescription drugs
• tobacco
• caffeine
• inhalants such as aerosol sprays

Not everyone who takes these substances has an addiction. The continuum of use of a substance describes the levels of use.

Behavioural addiction

The tangata may be addicted to one or more of the following:

• gambling
• work
• exercise
• eating certain foods or too much food
• viewing social media or other websites
• video gaming
• using smartphones
• shopping
• sex/pornography
• getting plastic surgery

Like substance addiction, behavioural addiction affects the reward centre of the brain, and the impact on the addict and their whānau can be very similar.

Common addictive substances

The website of the New Zealand Drug Foundation – Te Puna Whakaiti Pāmamae Kai Whakapiri describes the main addictive substances.

Click on the link to access the Drugs A-Z web page and review the details.

Gambling disorders

For many New Zealanders, buying a Lotto ticket, playing the occasional pokies game or having a day out at the races is harmless entertainment. However, for some people, gambling becomes addictive. A gambling addiction can cause harm, including:

• financial harm
• relationship problems
• problems with work or study
• mental health issues such as anxiety and depression
• negatively impacting friends and whānau; every gambler affects between 5 and 10 other people

Ref: Healthify: Gambling overview.

Harmful gambling disproportionately impacts the following:

• Māori
• Pacific people
• Asian communities
• young people
• individuals with limited incomes

Ref: Ministry of Health: Gambling harm

Impacts of addiction

Drugs are chemicals that affect the body and brain. Different drugs can have different effects. Some effects of drugs include health issues that are long-lasting or permanent. Effects of drug addiction may include:

• increased strain on the liver puts the person at risk of significant liver damage or liver failure.
• increased strain on the heart.
• lung disease.
• sleep problems.
• increased risk of accidents.
• seizures, stroke, mental confusion and brain damage.
• problems with memory, attention and decision-making.
• overdose – where a dangerous amount or a dangerous mixture of drugs is taken. This can lead to serious ill effects or death.

Physical addiction

Physical addiction to a substance can occur when repeated use of a drug changes the way the brain feels pleasure. The addicting drug causes physical changes to some nerve cells (neurons) in the brain. Neurons use chemicals called neurotransmitters to communicate. These changes can remain long after a person stops using the drug.

Eventually, drugs can change how the brain works and interfere with a person’s ability to make choices, leading to intense cravings and compulsive drug use.

Withdrawal

When people stop using a drug they are addicted to, they are likely to suffer withdrawal. This is because the body is used to and may even depend on the drug. When the drug is no longer taken, side effects can occur. Side effects will vary depending on the substance and the duration and severity of the addiction but can include:

• tremors
• nausea
• headaches, body pain
• sweating
• confusion
• insomnia
• anxiety, agitation, irritability
• extreme cravings for the substance

You are expected to apply a person-centred approach when working with tangata with mental health or addiction issues. 

What is person-centred care?

Person-centred care is a highly effective, evidence-based approach. It places the person receiving care and support at the centre of all the planning and decision-making activities that surround them.

Person-centred support means thinking about how to individualise and focus on specific needs and requirements, as well as meeting the interests, preferences and desires of the person in the most effective way possible. Person-centred support requires high-level communication skills from workers so that they can provide information, offer services, ask questions and give advice and guidance appropriately.

Person-centred approaches are widely used in the New Zealand healthcare sector. It can be seen as a 'toolbox' of ways to listen and gather information enabling patients to share health decisions and inform a care plan.

Principles of patient-centred care include:

• respect
• emotional support
• physical comfort
• information and communication
• continuity and transition
• care coordination
• involvement of family and carers
• access to care

Ref: Patient and Person-centred Care, 2022

Person-centered techniques

• Consider the person, not the illness or issue.
• Use communication skills to identify the tangata’s needs and preferences and share information.
• Tailor care to meet the needs of the individual.
• Include whānau and other people important to the tangata in care and decision-making.
• Encourage the tangata to make decisions about their own care, and respect those decisions.
• Ensure personal plans are read and kept updated.
• Work closely with the multi-disciplinary team.
• Be adaptable in your approach.