Overview presentation for Community Mental Health Team Leaders Prepared by NS&CC MHDA 2011

Overview presentation for Community Mental
             Health Team Leaders
                 Prepared by NS&CC MHDA
                                      2011

(Acknowledgement: slides from a disaster response presentation by
Professor Beverly Raphael were adapted in this overview)

A public health issue

z State Emergency Service brochure, South Australia

Hot weather is dangerous

z High temperatures are a threat to health, especially
  in summer and extreme heatwave conditions.

z Heat can affect consumers on psychotropic
  medications
   – anticholinergic drugs impair sweating
   – neuroleptic drugs impair thermoregulation.

z Early recognition of heat stroke and prompt
  treatment reduces mortality

Summer “Heat” Social Behaviours

z Increased alcohol and drugs use – ‘water first’ preferable

z Heat and violent behaviours

z Motor vehicle accidents

z Vulnerable youth – risk behaviours

z Drownings

z Heat-related stress – “tipping point”

z “She’ll be right mate” attitudes

Signs and Symptoms of heat-related illness
Signs and symptoms of heat exhaustion
    – thirst, paleness and sweating
    – weakness and discomfort
    – rapid shallow breathing
    – muscle cramps
    – nausea and vomiting
    – dizziness or fainting
    – rapid heart rate

Prevention strategies
    – cool, non-alcoholic drinks
    – resting out of the heat
    – cool shower, bath or sponge bath
    – wearing lightweight clothing
        – watch for inappropriate clothing in hot weather

Signs and Symptoms of heat-related illness

z Signs and symptoms of heat stroke (medical emergency)
   – core body temperature > 40.5°C
   – confusion or disorientation
   – Red, hot, dry skin (no sweating)
   – rapid pulse
   – severe headache & dizziness & nausea
   – possible loss of consciousness
   – shallow, rapid breathing
z Management
  – Encourage rapid cooling & Ambulance
     NSW

Risks for mental health consumers in
extreme heat

z Particular risk for those maintained on antipsychotic medications:
  – Recurrent heat-related health problems associated with
    antipsychotic treatment
  – set point of temperature regulation centre could be elevated by
    antidopaminergic effects of anti-psychotics e.g. phenothiazines
    and thioxanthenes
  – Neuroleptics may impair hypothalamic thermal regulatory
    pathways
z Meta-analysis of risk from extreme heat:
  – increased risk with pre-existing psychiatric illness
  – Mortality: death rate tripled particularly if isolated, housebound
    (Bouchama et al Arch in Med 2007)

Suggested Mental Health Service Strategies
z Identify vulnerable consumers
z Encourage consumers to write self-care strategies in a wellness
  plan e.g. Use of fans, air conditioning, fluids, showers for
  prevention and treatment of heatstroke
z Work to implement the care plan to budget and purchase
  appropriate curtains and fans etc prior to summer. Check
  consumers have keys for locking windows to be able to open for
  a cool breeze.
z Contact charity organisations re curtains and fans if financial
  constraints for consumer
z Check clients have a plan for power failures (high grid load in
  summer)
  – E.g. for essential medical equipment such as CPAP.
z Consider partnership with NGO’s to provide support during
  summer

NS & CC MHDA resources
z Guideline: Hot weather preparation and actions for mental
  health Consumers [a guideline for staff to assist consumers
  during hot weather and heat wave conditions 2011]

z Brochure

z Promotion materials
   – Poster
   – caps
   – drink bottles
   – fridge magnets

guideline
   Interim
   Hot weather preparation and actions for Mental Health consumers

Document Number

Publication Date         July 2011
Intranet location/s

Summary                  Assisting consumers to better monitor and manage body temperature
                         during summer and heat waves.
Author Department        NSLHD & CCLHD MHDA

Contact (Details)        Liz Newton MHDA GSU, GroupWise

Endorsed By              Andrea Taylor, NSLHD & CCLHD MHDA Executive Sponsor
Sector/Service           All services (community& inpatient) within NSLHD & CCLHD MHDA

Audience                 All Staff of NSLHD & CCLHD MHDA
Date Created             July 2011
Review date              July 2014
Previous Reference No.   n/a

Related Policy/s

Key Words                Heatwave, summer, Consumers, medications
Status                   active
Attachments              Heat Wave Brochure and Flyer

Health promotion items

Caps
printed on the front with
‘HEATWAVE keep cool’

Fridge magnets with clip
to attach brochure to fridge

Simple fridge magnets

Rationales of some decisions

Logo was selected in a transparent style, as
it cost $70 set up fee per colour – cheaper to
use the colour of the product to colour the
centre of the sun than pay to have it
coloured.
Hats were chosen in light colours that
would be more dirt resistant than white or
natural.