Mental Health (and mental health problems)

We all hope for mental health: the capacity to enjoy life and cope with its challenges. Problems that affect this capacity are varied in type and severity. In some severe cases the term psychiatric illness, or mental illness, is used. Mental health problems can affect both children and adults. Changes in communication skills, social skills, and swallowing patterns (dysphagia) are features of mental health problems that speech and language therapists may be involved with.

There are many different causes for dementia but sufferers usually have linguistic deficits (e.g. difficulties with understanding, reasoning, talking and memory). With some other mental health problems (e.g. bipolar disorder, depression) there may be no loss of language skills, but people have reduced non-verbal communication, and altered social interaction skills.

A rare disorder of childhood is known as selective mutism (previously known as elective mutism). The children are able to speak but persistently fail to do so in specific situations over a long period. This affects progress in education and social skills. Speech therapists can provide intervention and support for children with selective mutism. Youngsters with a diagnosis of autism spectrum disorder may experience mental health problems (e.g. obsessive compulsive disorder - OCD, oppositional defiant disorder - ODD, anxiety, depression).

Some characteristics of mental health problems:

• Inappropriate social skills e.g. reduced interaction, or being extremely talkative.
• Reduced non-verbal skills e.g. reduced eye-contact, poor posture, reduced facial expression.

  Memory deficits, reduced orientation. (Found predominantly in those with dementia).

• Communication deficits affecting comprehension and expression (with inability to stick to topics of conversation).
• Swallowing deficits (dysphagia).

Speech and language therapists are often involved with multi-professional teams working in mental health settings. The client is always under the care of a psychiatrist and may have a Care Coordinator and/or social worker in the community.

The following may form part of therapy input for people with mental health problems:

• Informal communication assessments and writing guidelines for carers and/or other health professionals with strategies to enhance two-way conversation.
• Informal dysphagia assessments and writing swallowing guidelines (dysphagia management).
• Group therapy for adults: social skills groups targeting non-verbal skills (e.g. eye-contact/facial expressions), assertiveness, problem-solving, negotiation skills, 'small talk' and initiating conversations.
• Group therapy for older people with dementia: groups targeting maintenance of communication skills through reminiscence/validation therapy.

Some points you may wish to discuss with any therapist you contact:

• The package of care you are receiving from the NHS; the case history; speech and language input received in the past; specific communication deficits; aims of therapy.
• The therapist's specialist credentials in the area of mental health work. Experience is likely to have been gained in Cognitive-Behavioural Therapy, and may include counselling skills and specialist knowledge of dementia, bipolar disorder, depression, schizophrenia, anxiety attacks, panic attacks, and phobias. The therapist may have experience of running groups for those with mental health difficulties.
• If you are already involved in a special programme (e.g. counselling, Cognitive-Behavioural Therapy) you may wish to talk to the therapist about that.
• How much experience the therapist has with mental health work.
• Where the therapist sees people for assessment/therapy.
• How much the therapist charges for assessment and/or regular therapy.

Click here to search for Speech Therapists in your area with Mental Health as a specialty.