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Change For The Better
One useful way at looking at areas of peoples’ lives that are presenting difficulties is to make use of the change theory. If you’re working with someone with mental health problems, who also has a problem with cannabis use, then working with this person to bring about change can be difficult, unless we understand some of the factors pushing the person into these behaviours. First of all, why do we need to worry? Well there’s the law aspect, and the QCS policy on illegal drug use is very clear on care home responsibilities here. There’s also the impact on someone’s mental health. Here the facts are a little less clear. There’s a lot of controversy around the use of cannabis – particularly whether it causes mental health problems.
Knowing the arguments
Its worthwhile care staff knowing what the arguments are. These are outlined in the article by Smit et al. Cannabis use and the risk of later schizophrenia: A review an article in Addiction May 2004.
- The first one is that if you’ve got a major mental illness like schizophrenia with hallucinations you might think cannabis is a good way of stopping the symptoms - a crude sort of self-medication-so rather than cannabis causing schizophrenia, it’s the schizophrenia that leads to the cannabis use.
- Maybe if you take cannabis you take other more powerful illegal drugs, and those may be the cause of mental health problems.
- Not everyone who takes cannabis will get schizophrenia, but for people who may be susceptible, cannabis might just be the final trigger. The Royal College of Psychiatrist publishes a cannabis fact-sheet with evidence that young people, say at around the age of 15, who use cannabis have an higher than average risk of developing schizophrenia.
- It can be a cause of schizophrenia – regular drug use appears to double the risk of developing a psychotic episode.
- There may be number of factors at work – so that it becomes difficult to separate out the cannabis from the illness.
Push and Pull
If we’re looking to help someone, change theory can be a useful start point. Look at some of the thinking on this developed by psychologist Kurt Lewin. If you wanted to change something in your life, a way of doing it is to list the push and pull factors. The push factors are those that are pushing you to do it. Those might be about peer pressure from friends, or the effects of the drug that someone enjoys. The pull factors are the ones we want to use to pull the person away from cannabis use. Getting into trouble with the police is one, and the potential harmful effects on someone who may be vulnerable to major mental health problems may be another. If the strength of the pull factors outweighs the push factors, our chances of getting a change are much improved!
David Beckingham – QCS Expert Mental Health Contributor