Chapter 1 Mental Health and Mental Illness

Chapter 1 Mental Health and Mental Illness Mental Health and Mental Illness 1. Mental health ability to realize his or her own potential, cope with normal stresses, work productively, and contribute to the community 2. ABC’s of Psychiatric Nursing a. Appearance, behavior, communication 3. Attributes of mental health a. Rational thinking b. Coping c. Resiliency d. Self-control e. Self-awareness f. Developmentally on task g. Spirituality h. Happiness and joy i. Self-care j. Positive self-concept k. Learning/productivity l. Communication m. Meaningful relationships 4. Mental illness psychiatric disorders that have definable diagnoses a. Three alternations – Developmental, biological, or psychological b. Culturally defined Mental Health Continuum Continuum of mental health and mental illness 5. Mental health continuum (spectrum) a. Mental health & well-being i. Occasional stress to mild distress (no impairment) b. Emotional problems or concerns i. Mild to moderate distress (mild or temporary impairment) 1. Ex. insomnia, lack of concentration, loss of appetite c. Mental illness i. Marked distress (moderate to disabling chronic impairment) 1. Ex. altered thinking, mood, and behavior 2. Depression, anxiety, schizophrenia Risk and Protective Factors 6. Contributing factors to mental health a. Individual attributes and behaviors i. Inborn (biological or genetic factors) 1. Substance abuse during pregnancy ii. Learned characteristics 1. Behaviors not taught during childhood 2. Abuse and neglect iii. Resilience ability to secure the resources needed to support well-being 1. Effective at regulating emotions 2. Being able to rise above and prosper from setbacks 3. Role of resilience in the prevention of and recovery from mental illness and consider resilience in response to stress b. Social and economic circumstances i. Family is the primary effect on confidence and coping skills or instilling anxiety and feelings of inadequacy ii. Socioeconomic status (food, clothing, and shelter) iii. Educational advancement (career, security, and economic benefits) c. Environmental factors i. Political climate 1. Basic needs and commodities (healthcare, water, safety services) 2. Social policies (global, national, state, and local government) ii. Cultural considerations 1. Beliefs, attitudes, and practices 2. No standard measure for mental health because it is culturally defined 3. Acceptable vs unacceptable to a particular culture a. Ex. Japanese culture considers suicide an act of honor b. Middle Eastern “suicide bombers” considered holy warriors c. Western culture considers attempting or completing suicide mentally ill 4. How culture influences the view of mental illnesses and behaviors associated with them 7. Stigma the belief that psychiatric disorders are under personal control 8. Nature versus nurture a. Diathesis-stress model diathesis represents biological predisposition (genetic factor) and stress represents environmental stress or trauma i. Most accepted explanation for mental illness b. Nature-plus-nurture – most psychiatric disorders result from a combination of genetic vulnerability and negative environmental stressors c. Nature/nurture origins of psychiatric disorders 9. Recovery process of change improving health and wellness, living a self-directed life, and striving to reach full potential a. Hope b. Self-determination and self-direction (person driven) c. Many pathways d. Holistic e. Support, relationships and social network f. Individual, family, and community strengths, responsibilities, and resources g. Culturally based and influenced h. Supported by addressing trauma i. Respect 10. Social influences a. National Alliance on Mental Health (NAMI) b. Decade of the Brain (1990) c. Human Genome Project d. Social influences of mental healthcare in the United States…?? Page 7 Epidemiology of Mental Health 11. Comorbid condition simultaneous existence of two or more disorders (one mental one medical) 12. Epidemiology quantitative study of the distribution of mental disorder in human population a. Helps identify high-risk groups and risk factors associated with onset, duration, and recurrence b. Incidence risk of contracting a disease c. Prevalence total number of cases d. Clinical epidemiology examines health and illness at the population level i. Studies the natural history, diagnostic screening tests, and intervention e. Frequency in which psychological symptoms appear together with physical illness i. Ex. depression is a risk factor for death in people with cardiovascular disease f. How epidemiological studies improve medical and nursing care 13. Classification of mental disorders – Diagnostic and Statistical Manual, Fifth Edition (DSM-5) dominant method of categorizing and diagnosing mental illnesses a. Describes criteria for 157 disorders; classifies disorders (ex. schizophrenia spectrum, depressive, anxiety, obsessive-compulsive, feeding and eating, personality disorders b. How DSM-5 is used for diagnosing psychiatric conditions Psychiatric-Mental Health Nurse (PMHN) 14. Psychiatric-mental health nursing promoting mental health through assessment, treatment of human responses, bedside nursing, nursing process and care plan, communication with the team, advocate, Milieu therapy (manage the environment) a. Advance practice psychiatric nurse conducts therapy and prescribes medication b. Describe the specialty of psychiatric-mental health nursing 15. Phenomena of concern human experiences and responses 16. Nursing Outcomes Classification (NOC) and Nursing interventions of Classification (NIC) a. Nursing Diagnosis – diagnosis and treatment of human responses to actual or potential mental health problems b. A well-defined nursing diagnosis provides the framework for identifying appropriate NIC for dealing with patient’s reaction to the disorder c. DSM-5 – diagnoses a psychiatric disorder d. DSM-5 medical diagnosis versus nursing diagnosis 17. Future issues for PMH nurses a. Educational challenges i. Patients have shorter hospital stays, nurses need to be prepared to educate patients during discharge, so they can manage their illness at home b. Aging population i. Increase need for nurses in inpatient settings, home services, retirement communities, assisted living facilities c. Cultural diversity i. Cultural competence adjust practice to meet patients’ cultural beliefs, practices, needs, and preferences d. Science and technology i. Human Genome Project discovered genetic markers implicated in psychiatric illnesses; identifies high-risk patients ii. Electronic healthcare e. Future challenges and opportunities for mental healthcare in the United States Advocacy and Legislation Involvement 18. Nurse advocate through direct care and indirect action a. Direct care i. Reporting abuse or neglect ii. Upholding patient confidentiality iii. Supporting patient’s right to make decisions regarding treatment b. Indirect care i. Being active in mental health groups (ex. NAMI) and state and local mental health associations ii. Reviewing legislation affected healthcare to identity potential detrimental effects on the mentally ill; contribute to political voice c. Direct and indirect advocacy opportunities for PMHN