mental health
successful performance of mental function, resulting in productive activities, fulfilling relationships, and the ability to adapt to change and cope with adversity
elements of mental health and balanced life
elements: self-governance, growth and self-realization, comfort/tolerance of the unknown, self-esteem, reality awareness/orientation, mastery of life situation, stress management
self-governance
acting independently, dependently, or interdependently as the need arises without permanently losing autonomy
growth and self-realization
being willing to move forward to maximize capabilities
comfort with the unknown
facing the uncertainty of life and the certainty of death with faith and hope
self-esteem
being aware of and accepting of personal abilities and limitations through lifelong self-reflection and feedback from others
reality awareness
distinguishing fact from fantasy and behaving accordingly
mastery of life situation
interacting competently, effectively and creatively with and influencing environmental contexts
stress management
experiencing congruent emotions in daily life and tolerating stress-provoking situations in an adaptive, creative, and flexible way knowing that any negative feelings are time limited
mental illness
clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with an increased risk of suffering death, pain, disability, or an important loss of freedom
elements of mental illness
elements: brain dysfunction, symptoms of distress and daily functioning are beyond the norm for situation and culture, genetics
unknown interactions among genetic predispositions, environmental influences, chemical alterations in brain
what causes mental illness? (3)
ICD 10
international disease classification system; refers to the WHO's classification of mental and behavioral disorders; became the international diagnostic standard
-ex. analysis of general health, monitoring of incidence/prevalence of diseases and other heal
DSM
groups disorders by symptom clusters and differentiates between normality and psychopathology based on the duration and severity of symptoms; 5 axis; used for billing, plans of care, prevent misdiagnosis, research tool
cost
stigma
revolving door
limited access
4 treatment issues in psychiatry
parity
designed to improve coverage for mental health care and close the gap bw physical and mental health care benefits
NAMI- national alliance for the mentally ill
self-help group for consumers of mental health services and their social supports
axis 1
axis- clinical disorders
-there can be several dx here
-ex. schizophrenia, bipolar, major depression, ADHD, autism, eating d/o
axis 2
axis- personality d/o and MR
-may be more than one on this axis
-types-paranoid, narcissistic, antisocial, borderline
axis 3
axis- general medical conditions
-may be multiples
axis 4
axis-psychosocial and environmental problems
-problems with: primary support group, r/t the social environment, educational, occupational, housing, economic problems, lack of access to HC, legal problems, other-war
axis 5
axis-GAF
overall function upon admit and in previous year; used for planning treatment, discharge; 1-100
basic level of practice: completed nursing program and passed the NCLEX
type of nurse practice
-promote/encourage the maintenance of health and prevention of disorders
-assess biopsychosocial functioning
-serve as case managers
-design therapeutic environments
-promote self-care activities (med and symptom mgmt)
-psychobiolog
advanced level of practice: received at least a masters degree
type of nurse practice
-deliver comprehensive primary mental health services
-teaching and screening
-performing preventive interventions and evaluating and managing care for people with mental illness
-teaching r/t prevention
-preventive strategies: teac
pseudoscience
term used for therapies and treatments that have no empirical or theoretical support
-based on assumptions
-lack of valid evidence
myths
complete inventions, often deeply rooted in cultural beliefs and difficult to dispel
-ex. self-esteem
quack
charlatan, a pretender to medical skill
-methods not scientifically accepted and involves fraudulent medical practices usually for money, ego gratification and power
-give false hope
-people are sincere at what they are doing
patterning
best-known quackery treatment
-aka doman-delcato technique
-has to do with MR and how a person fails to develop t/ proper phylogenetic stages
-treatment involves passive physical manipulation of limbs and body to impose the proper pattern on the CNS
-must
facilitated communication
methods that assist nonverbal people to type letters, words, phrases, or sentences with a typewriter, computer, keyboard or alphabet facsimile
attachment therapy
subjecting the client to physically confrontation and restraint to release repressed anger over abandonment
-repeated until child is exhausted and reduced to an infantile state then parents cradle, rock and bottle feed the child
patterning, FC, attachment therapy
examples of quackery
MPD, food additives
examples of junk science
MPD
-SRA was without merit
proliferation of interest in and publicity included the rise of talk shows featuring victims of sexual abuse, emergence of child advocacy mvt, and allegations of satanic ritual abuse of children
-these repressed memories subjected people to horrors to unc
food additives
nonnutritive sweeter that was said to cause various illnesses like MS, lupus, gulf war syndrome, chronic fatigue syndrome, brain tumors, AD, DM
competency
aware of surroundings, understand others, make decisions based on what they think is best and agree to treatment without coercion, able to give informed consent
-judge decides this
substituted consent
HCP obtaining informed consent from someone else like an appointed guardian or next of kin
privileged communication
professional have the legal privilege to withhold conversations with patients but provide this to physicians, attorneys, and clergy
child abuse
threats of suicide
allegations of sexual misconduct
what information must you breach confidentiality with a patient?
voluntary admission
admission where one is competent, has a 72 hr notice, can refuse treatment, who have admitted themselves and are a danger to themselves or others, willing for treatment but doesn't have the right to d/c at any time but can request it
emergency admission
admission where they are a harm to self/others, can have forced meds, not ECT or surgery, has the right to an attorney. right to come and go is restricted
involuntary admission
admission where the court submitted them, those who refuse treatment but are a danger to self and others, mentally ill
if defendant chooses to plead insanity, mental health professionals evaluate their mental condition at the time of the alleged crime. a person found not guilty by reason of insanity is admitted involuntary to a psychiatric unit
what is the insanity plea?
autonomy
right to make decisions for oneself-ethical principle
beneficence
principle of doing good, not harm (provide a safe environment)
paternalism
ethical principle: intent is to do good (put pt on suicide alert)
veracity
ethical principle: honesty and truthfulness in speech
fidelity
ethical principle: faithfulness to duties, obligations and promises (keeping a time when meeting with a client)
justice
ethical principle: equitableness of benefits, including the right to access care
biologic, psychological and sociocultural influences
what 3 factors influence mental health?
biologic influences
influence on mental health including:
-prenatal, perinatal and neonatal events
-physical health status
-nutrition
-history of injuries
-neuroanatomy
-physiology
psychological influences
influence on mental health including:
-interactions
-IQ
-self-concept
-skills
-creativity
-emotional developmental level
sociocultural influences
influence on mental health including:
-family stability
-ethnicity
-housing
-child-rearing patterns
-economic level
-religion
-values and beliefs
tautology
term: logical error in reasoning that explicates a person's behavior based on a diagnostic label
dual diagnosis
term: adults with mental illness also have a co-occuring substance abuse problem
culturally competent care
term: care that is acceptable to the client's cultural background, regardless of whether it is given by someone from the same or from a different ethnic or minority group as a client
medication adherence
term: clients are taking their drugs as prescribed
EBP
term: integration of research with clinical expertise
empirically supported treatments
term: treatments with at least 2 randomized controlled clinical trials that demonstrate their efficacy
empiricism
term: all knowledge and ideas derive from experience
junk science
term: faulty data collection and analysis to further a special agenda
respondeat superior
when nurses are found liable in malpractice cases, their employers are usually found liable under this legal theory. exception: acts of employees are intentional
assimilation
term: process of immigrants and minorities becoming more like the majority culture
ethnocentrism
belief that one's own cultural practices and values are correct or superior of others
prejudice, stereotyping, discrimination, stigmatization
what 4 problems can ethnocentrism lead to?
prejudice
negative preconceived opinions about other people or groups based on perception or emotion
stereotyping
beliefs that one member of a cultural group will display certain behaviors or hold certain attitudes (negative) simply bc they are a member of that cultural group
discrimination
differential treatment based on race, class, sex or other variables rather than on individual merit
stigmatization
attribution of negative characteristics or identity to one person or group, causing feelings of rejection, alienation, and ostracization (exclude) from society
cultural congruence
clients receive an overall message, conveyed both verbally and nonverbally, of personal and cultural validation
health literacy
degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
hispanic/latino
ethnicity:
family is 1st source of assistance in HC, men are head of the house and women are sacred, turn to priests for medical help,
-nurses be aware of catholic church, prayers, herbs, hot and cold, good and evil imbalances
black americans
ethnicity:
poor, religion is important, rituals, voodoo, respect elders bc wisdom, more likely to go to ED, family dr. or alternative practitioners, slow metabolizers, schizo more common,
native americans
ethnicity
traditional herbs, sweat lodge, follow plans that comply with family practices, suspicious of police and fear that children will be taken
-nurses need to evaluate historical trauma
asian and pacific islanders
ethnicity
yin and yang imbalance (ill), father important role, don't complain, herbal remedies, view therapists as authority figures, want personal relation first, slow metabolizers, believe health is harmony with nature, their body isn't theirs and must
middle east
ethnicity
privacy important, ramadan-fasting, conservative, dont eat pork or drink alcohol, rude to point or signal a person with a hand or use left hand to gesture, don't touch women in public, say prayers 5x/day, women with a veil-wont introduce, consci
eastern europeans
ethnicity
look white, prayer is private coping, culture shock, religion isn't a strong influence, education is a source of stress, remove shoes, superstitions and magical curing, remedies with vodka