smoking in people with poor mental health is much higher than in the general population. Smoking is particularly frequent in people with psychosis. It is possible that tobacco is used as a type of self- medication by some people with poor mental health to improve mood and cognitive functioning. Although tobacco contains a vast number of different chemicals, its addictive effects are known to be caused by the stimulant drug nicotine (258). Youth MHFA considerations for addictive behaviours and substance misuse Revisit the Youth MHFA action plan in full. Severe effects from substance misuse If the young person is using alcohol or other drugs, it is possible they will experience acute effects from intoxication, poisoning, withdrawal, overdose, overheating or dehydration. It is important to act quickly to avoid significant physical and mental consequences, both short-term and long-term. See the crisis approach in the Severe effects from substance misuse . Don’t assume that behaviours are a phase. If you suspect that a young person is engaging in harmful gaming, gambling, or substance use, it is important to get them help because there can be significant negative consequences. Consider the young person’s readiness to talk. Be aware that the young person may deny, or might not recognise, that their harmful behaviour is problematic and that trying to force the young person to admit they are experiencing poor mental health may cause conflict. They may also go through cycles of awareness and denial. Stigma and discrimination can be major barriers to seeking help. Understand that the person will have their own perception of their harmful behaviours –ask if their habits and their consequences are getting in the way of the life they want to live. Create an honest and open space where they feel safe sharing without feeling that they might be in trouble (259).
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