Depression: A Training for Community Health Workers in Iowa - PowerPoint PPT Presentation

Depression: A Training for Community Health Workers in Iowa December 11, 2017 Presented by Iowa Chronic Care Consortium and Molly Lee, DVM, MPH

1. Explain what depression is (and what it is not), including its symptoms, causes, and common co-morbidities, and how it is diagnosed and by whom. Learning 2. Describe the impact of depression and the importance of understanding depression, Objectives and be able to apply this to your community and patients or clients. 3. Identify barriers to treatment of depression and tools to overcome these barriers. 2

 Common  Serious  Illness  Feel, think, act What is  Sadness Depression?  Loss of interest  Emotional  Physical  Interferes with daily life 3

 Many types, with different  Symptoms  Severity  Duration  CHWs can help with describing, Forms of logging symptoms Depression  Knowing the specific diagnosis helps with treatment  Most common types  Major Depression  Persistent Depressive Disorder 4

 Simple  Situational depression Postpartum depression Manic Depression  Grief Bipolar Disorder What Alcoholism Schizophrenia Situational Depression Dysthymia Psychosis  Other disorders Depression SAD  Overlap is NOT  Triggers  Coexisting conditions  Misdiagnosis 5

 Feeling sad, empty, hopeless  Decreased interest in activities  Weight changes  Changes in sleep Symptoms of  Restlessness and agitation Depression  Tiredness  Worthlessness, guilt, low self-esteem  Indecisiveness, difficulty concentrating  Thoughts of death or suicide 6

In children In teens  Performing poorly  Tardiness, absence, in school poor performance in Symptoms of school and  Frequent nightmares extracurricular Depression  Frequent activities (cont’d) disobediences,  Neglected aggression or appearances temper tantrums  Self-harm  Withdrawl from friends, family 7

 Biological  Genetics/family history  Gender  Race  Age What Causes  Brain changes Depression?  Other medical conditions Image: Mayo Foundation 8

 Environmental/Social  Violence  Abuse  Neglect  Poverty  Stress What Causes  Lack of social Depression? support  Loneliness  Substance abuse, smoking  Cultural views, stigma 9

 Psychological  Behavioral Shutdown What Causes Depression? 10

 Chronic health conditions  Hormone disorders  Heart disease  Chronic pain  Stroke Common  COPD Co-morbidities  Drug or alcohol abuse  Note difficulties with treatment adherence 11

 Primary Care Provider  Physicians, Nurse Practitioners, Physician’s Assistant  May refer to Primary Care Provider psychiatrist The  Clinical Psychologists, Community Healthcare Counselor/ Clinical Social Workers Health Psychologist Therapist Worker  Behavioral Team interventions Psychiatrist  Counselor/Therapist  ER Physician  Community Health Worker Image: M. Lee 12

 Screening tests  Beck Depression Inventory (BDI)  Hamilton Rating Scale for Depression (HAM-D or HRSD)  Inventory of Depressive Symptomatology (IDS or QIDS) Diagnosing  Patient Health Questionnaire (PHQ-9) Depression  Pre-screening tests  PHQ-2  Screening, Brief Intervention and Referral to Treatment (SBIRT) for substance abuse  DSM-5 13

 Medication  Antidepressants  Anti-anxiety meds  Mood stabilizers Treating  Antipsychotic meds Depression  Co-occurring condition treatment  Psychotherapy (“talk therapy”) 14

 Environmental Supports Treating  Self-care Depression  Social support  Alternative care 15

 Reduced life span Impacts of  Lost productivity/work days  Increased risk of suicide Depression 16 Image: Mental Health America

 Family system Impacts of Depression (Cont’d) Image: World Health Organization 17

 Medication  Compliance, side effects  Access to care  Transportation  Finances Barriers to  Environment Overcoming  Stigma Depression  Discomfort from healthcare team  Depression  Relapses 18

 Combination of supportive CHWs- Follow treatments up and  Identifying and overcoming obstacles Monitoring  ID when additional Response to care is needed Treatment  Motivation and Image: World Health Organization support 19

 Providers  Insurance  Transportation CHWs- Finding  Self-care tools Image: World Health Organization Resources to  Other tools Assist in  Peer-to-peer Recovery support programs  Organizations  Online resources  Helplines 20

Stories of Depression 21

Stories of Depression www.friendshipbenchzimbabwe.org 22

 Depression is  Depression is not  Impacts  Symptoms  Importance of  Causes understanding Review  Common  Barriers co-morbidities  Tools to overcome  Diagnosis  Providers 23

 Describing symptoms  Keeping appointments Review-  Providers Role of the  Community support, self-care activities CHW  Non-judgmental listening  Involvement with family systems 24

 Questions?  For more information, contact us at the Iowa Chronic Care Consortium Thank You!  Deb Kazmerzak: 515.554.3788 25