MH EXAM 1 STUDY GUIDE
Lecture 1: Chapter 1: 2 questions /Chapter 4: 3 questions= Total 5
Mental Health definition and overview Ch 1 pg. 2- No single universal definition of mental health exists.
Generally, a person’s behavior can provide clues to his or her mental health. Mental health has many
components, and a wide variety of factors influence it. These factors interact; thus, a person’s mental health is
a dynamic, or ever-changing, state. Factors influencing a person’s mental health can be categorized as
individual, interpersonal, and social/cultural.
Deinstitutionalization Ch 1 pg. 4 - The movement toward treating those with mental illness in less restrictive
environments gained momentum in 1963 with the enactment of the Community Mental Health Centers
Construction Act. Deinstitutionalization, a deliberate shift from institutional care in state hospitals to
community facilities, began. Community mental health centers served smaller geographic catchment, or
service, areas that provided less restrictive treatment located closer to individuals’ homes, families, and
friends. These centers provided emergency care, inpatient care, outpatient services, partial hospitalization,
screening services, and education. Thus, deinstitutionalization accomplished the release of individuals from
long-term stays in state institutions, the decrease in admissions to hospitals, and the development of
community-based services as an alternative to hospital care.
Community Based Care, Ch 1 pg. 6 the community-based system did not accurately anticipate the extent of
the needs of people with severe and persistent mental illness. Many clients do not have the skills needed to
live independently in the community. Consequences of nontreatment are cited) as:
•Homelessness•Psychiatricboarding•Arrest•Incarceration•Victimization•Suicidality•Familial violence• Danger
to other. Despite the flaws in the system, community-based programs have positive aspects that make them
preferable for treating many people with mental illnesses. Clients can remain in their communities, maintain
contact with family and friends, and enjoy personal freedom that is not possible in an institution. People in
institutions often lose motivation and hope as well as functional daily living skills, such as shopping and
cooking. Therefore, treatment in the community is a trend that will continue.
Treatment settings Ch 4 pg. 62 inpatient units must provide rapid assessment, stabilization of symptoms, and
discharge planning, and they must accomplish goals quickly. A client-centered multidisciplinary approach to a
brief stay is essential. Clinicians help clients recognize symptoms, identify coping skills, and choose discharge
supports. When the client is safe and stable, the clinicians and the client identify long-term issues for the client
to pursue in outpatient therapy. Some inpatient units have a locked entrance door, requiring staff with keys to
let persons in or out of the unit.
Ch 4 pg. 64 Partial hospitalization- In day treatment programs, clients return home at night; evening programs
are just the reverse. The services that different PHPs offer vary, but most programs include groups for building
communication and social skills, solving problems, monitoring medications, and learning coping strategies and
skills for daily living. Individual sessions are available in some PHPs as are vocational assistance and
occupational and recreation therapies.
Evolving consumer household Ch 4 pg. 66- is a group living situation in which the residents make the
transition from a traditional group home to a residence where they fulfill their own responsibilities and
function without on-site supervision from paid staff. One of the problems with housing for people with mental
illness is that they may have to move many times, from one type of setting to another, as their independence
increases. This continual moving necessitates readjustment in each setting, making it difficult for clients to
, sustain their gains in independence. Because the evolving consumer household is a permanent living
arrangement, it eliminates the problem of relocation.
Clubhouse Model Ch 4 pg. 67 the clubhouse focus is on health, not illness. Taking prescribed drugs, for
example, is not a condition of participation in the clubhouse. Members, not staff, must ultimately make
decisions about treatment, such as whether or not they need hospital admission. Clubhouse staff supports
members, helps them obtain needed assistance, and, most of all, allows them to make the decisions that
ultimately affect all aspects of their lives. This approach to psychiatric rehabilitation is the cornerstone and the
strength of the clubhouse model. The clubhouse is based on the following four guaranteed rights of members:
•A place to come to• Meaningful work• Meaningful relationships• A place to return to (lifetime membership)
Mental Illness & Incarceration Ch 4 pg. 69 Criminalization of mental illness refers to the practice of arresting
and prosecuting mentally ill offenders, even for misdemeanors, at a rate four times that of the general
population in an effort to contain them in some type of institution where they might receive needed
treatment. However, if offenders with mental illness had obtained needed treatment, some might not have
engaged in criminal activity. Detecting mental illness among detainees of inmates can be problematic. Mental
health screening is often performed by law enforcement personnel, meaning it involves the use of a screening
tool that is brief and easy to administer, yet accurate. Tools that are readily available for use in mental health
screening include the Brief Jail Mental Health Screen and the Correctional Mental Health Screens (CMHS),
available for both men and women (CMHS-M and CMHS-W)
Active Military & Veterans Ch 4 pg. 70 Many times, veterans may be reluctant to seek treatment, or find that
treatment isn’t readily available. Dealing with the stigma or perceived stigma of mental illness can also be
problematic. Obsessive–compulsive disorder is moderately higher and more prevalent in veterans than the
general population and should be routinely screened by health care providers. Military sexual traumas are
more widespread and common than most would think (and can affect both male and female veterans). It is
associated with an even greater risk for PTSD, depression, anxiety, eating disorders, substance use, sleep
disorders, and suicide.
Lecture 2: Chapter 5: 5 questions/ Chapter 6: 6 questions /Chapter 8: 4 questions= TOTAL 15
Components of therapeutic relationships, Ch 5 pg. 76 1.The orientation phase is directed by the nurse and
involves engaging the client in treatment, providing explanations and information, and answering
questions.2.The identification phase begins when the client works interdependently with the nurse, expresses
feelings, and begins to feel stronger.3.In the exploitation phase, the client makes full use of the services
offered.4.In the resolution phase, the client no longer needs professional services and gives up dependent
behavior. The relationship ends.
Boundaries in nurse-client relationships, Ch 5 pg. 87 it is the nurse’s responsibility to define the boundaries
of the relationship clearly in the orientation phase and to ensure those boundaries are maintained throughout
the relationship. The nurse must act warmly and empathetically but must not try to be friends with the client
Transference Ch 3 pg. 43 /Ch 5 pg. 86- occurs when the client displaces onto the therapist attitudes and
feelings that the client originally experienced in other relationships. Transference patterns are automatic and
unconscious the therapeutic relationship. For example, an adolescent female client working with a nurse who
is about the same age as the teen’s parents might react to the nurse like she reacts to her parents. She might
experience intense feelings of rebellion or make sarcastic remarks; these reactions are actually based on her
experiences with her parents, not with the nurse Ch 3 pg. 43 Countertransference occurs when the therapist
displaces onto the client attitudes or feelings from his or her past. For example, a female nurse who has
Lecture 1: Chapter 1: 2 questions /Chapter 4: 3 questions= Total 5
Mental Health definition and overview Ch 1 pg. 2- No single universal definition of mental health exists.
Generally, a person’s behavior can provide clues to his or her mental health. Mental health has many
components, and a wide variety of factors influence it. These factors interact; thus, a person’s mental health is
a dynamic, or ever-changing, state. Factors influencing a person’s mental health can be categorized as
individual, interpersonal, and social/cultural.
Deinstitutionalization Ch 1 pg. 4 - The movement toward treating those with mental illness in less restrictive
environments gained momentum in 1963 with the enactment of the Community Mental Health Centers
Construction Act. Deinstitutionalization, a deliberate shift from institutional care in state hospitals to
community facilities, began. Community mental health centers served smaller geographic catchment, or
service, areas that provided less restrictive treatment located closer to individuals’ homes, families, and
friends. These centers provided emergency care, inpatient care, outpatient services, partial hospitalization,
screening services, and education. Thus, deinstitutionalization accomplished the release of individuals from
long-term stays in state institutions, the decrease in admissions to hospitals, and the development of
community-based services as an alternative to hospital care.
Community Based Care, Ch 1 pg. 6 the community-based system did not accurately anticipate the extent of
the needs of people with severe and persistent mental illness. Many clients do not have the skills needed to
live independently in the community. Consequences of nontreatment are cited) as:
•Homelessness•Psychiatricboarding•Arrest•Incarceration•Victimization•Suicidality•Familial violence• Danger
to other. Despite the flaws in the system, community-based programs have positive aspects that make them
preferable for treating many people with mental illnesses. Clients can remain in their communities, maintain
contact with family and friends, and enjoy personal freedom that is not possible in an institution. People in
institutions often lose motivation and hope as well as functional daily living skills, such as shopping and
cooking. Therefore, treatment in the community is a trend that will continue.
Treatment settings Ch 4 pg. 62 inpatient units must provide rapid assessment, stabilization of symptoms, and
discharge planning, and they must accomplish goals quickly. A client-centered multidisciplinary approach to a
brief stay is essential. Clinicians help clients recognize symptoms, identify coping skills, and choose discharge
supports. When the client is safe and stable, the clinicians and the client identify long-term issues for the client
to pursue in outpatient therapy. Some inpatient units have a locked entrance door, requiring staff with keys to
let persons in or out of the unit.
Ch 4 pg. 64 Partial hospitalization- In day treatment programs, clients return home at night; evening programs
are just the reverse. The services that different PHPs offer vary, but most programs include groups for building
communication and social skills, solving problems, monitoring medications, and learning coping strategies and
skills for daily living. Individual sessions are available in some PHPs as are vocational assistance and
occupational and recreation therapies.
Evolving consumer household Ch 4 pg. 66- is a group living situation in which the residents make the
transition from a traditional group home to a residence where they fulfill their own responsibilities and
function without on-site supervision from paid staff. One of the problems with housing for people with mental
illness is that they may have to move many times, from one type of setting to another, as their independence
increases. This continual moving necessitates readjustment in each setting, making it difficult for clients to
, sustain their gains in independence. Because the evolving consumer household is a permanent living
arrangement, it eliminates the problem of relocation.
Clubhouse Model Ch 4 pg. 67 the clubhouse focus is on health, not illness. Taking prescribed drugs, for
example, is not a condition of participation in the clubhouse. Members, not staff, must ultimately make
decisions about treatment, such as whether or not they need hospital admission. Clubhouse staff supports
members, helps them obtain needed assistance, and, most of all, allows them to make the decisions that
ultimately affect all aspects of their lives. This approach to psychiatric rehabilitation is the cornerstone and the
strength of the clubhouse model. The clubhouse is based on the following four guaranteed rights of members:
•A place to come to• Meaningful work• Meaningful relationships• A place to return to (lifetime membership)
Mental Illness & Incarceration Ch 4 pg. 69 Criminalization of mental illness refers to the practice of arresting
and prosecuting mentally ill offenders, even for misdemeanors, at a rate four times that of the general
population in an effort to contain them in some type of institution where they might receive needed
treatment. However, if offenders with mental illness had obtained needed treatment, some might not have
engaged in criminal activity. Detecting mental illness among detainees of inmates can be problematic. Mental
health screening is often performed by law enforcement personnel, meaning it involves the use of a screening
tool that is brief and easy to administer, yet accurate. Tools that are readily available for use in mental health
screening include the Brief Jail Mental Health Screen and the Correctional Mental Health Screens (CMHS),
available for both men and women (CMHS-M and CMHS-W)
Active Military & Veterans Ch 4 pg. 70 Many times, veterans may be reluctant to seek treatment, or find that
treatment isn’t readily available. Dealing with the stigma or perceived stigma of mental illness can also be
problematic. Obsessive–compulsive disorder is moderately higher and more prevalent in veterans than the
general population and should be routinely screened by health care providers. Military sexual traumas are
more widespread and common than most would think (and can affect both male and female veterans). It is
associated with an even greater risk for PTSD, depression, anxiety, eating disorders, substance use, sleep
disorders, and suicide.
Lecture 2: Chapter 5: 5 questions/ Chapter 6: 6 questions /Chapter 8: 4 questions= TOTAL 15
Components of therapeutic relationships, Ch 5 pg. 76 1.The orientation phase is directed by the nurse and
involves engaging the client in treatment, providing explanations and information, and answering
questions.2.The identification phase begins when the client works interdependently with the nurse, expresses
feelings, and begins to feel stronger.3.In the exploitation phase, the client makes full use of the services
offered.4.In the resolution phase, the client no longer needs professional services and gives up dependent
behavior. The relationship ends.
Boundaries in nurse-client relationships, Ch 5 pg. 87 it is the nurse’s responsibility to define the boundaries
of the relationship clearly in the orientation phase and to ensure those boundaries are maintained throughout
the relationship. The nurse must act warmly and empathetically but must not try to be friends with the client
Transference Ch 3 pg. 43 /Ch 5 pg. 86- occurs when the client displaces onto the therapist attitudes and
feelings that the client originally experienced in other relationships. Transference patterns are automatic and
unconscious the therapeutic relationship. For example, an adolescent female client working with a nurse who
is about the same age as the teen’s parents might react to the nurse like she reacts to her parents. She might
experience intense feelings of rebellion or make sarcastic remarks; these reactions are actually based on her
experiences with her parents, not with the nurse Ch 3 pg. 43 Countertransference occurs when the therapist
displaces onto the client attitudes or feelings from his or her past. For example, a female nurse who has
