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Psych Ch. 1 Mental health and mental illness

Terms in this set (62)

The WHO defines mental health as:
a state of well-being in which each individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community.
Mental health according to the U.S. Department of Health and Human Services, 1999
Mental health provides people with the capacity for rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem
Some attributes of mental health: figure
Psychiatry's definition of mental health evolves over time. It is a definition shaped by:
the prevailing culture and societal values, and it reflects changes in cultural norms, society's expectations, political climates, and even reimbursement criteria by third-party payers.
Mental illness glossary definition
A clinically significant behavioral or psychological syndrome marked by the patient's distress or disability or the risk of suffering disability or loss of freedom.
Mental health glossary definition
A state of well-being in which each individual is able to realize his or her own potential, cope with the normal stresses of life, work productively and fruitfully, and make a contribution to the community.
Mental _________ refers to all mental disorders with definable diagnoses. These disorders are manifested in significant dysfunction that may be related to developmental, biological or psychological disturbances in mental functioning.
Mental illness. It is not until we experience marked distress or suffer from impairment or inability to function in our everyday lives that the line is crossed into mental illness.
Name a mental illness where cognition is impaired
Alzheimer's disease
Name a mental illness where emotions are affected
major depression
Name a mental illness where behavioral alterations may be apparent
schizophrenia
Behavior that deviates from socially accepted norms does not indicate a mental illness unless:
there is significant disturbance in mental functioning.
Mental health and mental illness can be conceptualized as points along a mental health ________.
continuum
_____-_____ is characterized by adequate to high-level functioning in response to routine stress and resultant anxiety or distress.
Well-being
Mental health- mental illness continuum visual
What does DSM-5 mean?
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition. This is a manual that classifies 157 separate disorders, states that there is evidence suggesting that the symptoms and causes of a number of disorders are influenced by cultural and ethnic factors.
List characteristics of mental health
Resilience--adaptable, able to get resources to support well-being, learn from experience, do not fall victim to negative, self-defeating thoughts (identify problems/challenges, accept things can't be changed, focused on what can be overcome)
culture--look at culture's ideas of acceptable and unacceptable behavior
Currently, the ________-_________ model—in which diathesis represents biological predisposition and stress represents environmental stress or trauma—is the most accepted explanation for mental illness.
diathesis-stress model (a nature plus nurture argument)
In 1979, people with mental illnesses and their families formed a nationwide advocacy group:
National Alliance on Mental Illness (NAMI)
The consumer movement also promoted the notion of ________, a new and an old idea in mental health. On one hand, it represents a concept that has been around a long time: that some people—even those with the most serious illnesses, such as schizophrenia—recover.
recovery
Recovery
people are able to live, work, learn, and participate fully in their communities
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) (2011), recovery is defined as:
"a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential." The focus is on the consumer and what he or she can do.
From the vignette: 10 guiding principles of recovery
Self-directed: Consumers lead, control, exercise choice over, and determine their own path of recovery.

Individual- and person-centered: Recovery is based on unique strengths and resiliencies, as well as needs, preferences, experiences (including past trauma), and cultural backgrounds.

Empowering: Consumers have the authority to choose from a range of options, participate in all decisions that will affect their lives, and be educated and supported in so doing.

Holistic: Recovery encompasses an individual's whole life, including mind, body, spirit, and community.

Nonlinear: Recovery is based on continual growth, occasional setbacks, and learning from experience.

Strengths-based: Recovery is focused on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals.

Peer-supported: Consumers encourage and engage each other in recovery and provide a sense of belonging, supportive relationships, valued roles, and community.

Respect: Community, systems, and societal acceptance and appreciation of consumers—including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery.

Responsibility: Consumers have a personal responsibility for their own self-care and recovery, for understanding and giving meaning to their experiences, and for identifying coping strategies and healing processes to promote their own wellness.

Hope: Recovery provides the essential motivating message of a better future: that people can and do overcome the barriers and obstacles that confront them. Hope is the catalyst of the recovery process.
In 1990, President George H.W. Bush designated the last decade of the 1900s as the Decade of the _____.
Brain
The two most important messages from the first Surgeon General's report on the topic of mental health in 1999:
(1) mental health is fundamental to overall health, and
(2) there are effective treatments for mental health
6 GOALS FOR A TRANSFORMED MENTAL HEALTH SYSTEM IN THE UNITED STATES
Goal 1

Americans understand that mental health is essential to overall health.

Goal 2

Mental health care is consumer- and family-driven.

Goal 3

Disparities in mental health services are eliminated.

Goal 4

Early mental health screening, assessment, and referral to services are common practice.

Goal 5

Excellent mental health care is delivered, and research is accelerated.

Goal 6

Technology is used to access mental health care and information.
List 2 examples of disorders that affect men and women equally
schizophrenia and bipolar disorder
Disorders that affect women more than men
major depressive disorder, , PTSD
Disorders that begin in childhood or adolescence
OCD, , panic disorder, social phobia, agoraphobia (Symptoms include fear and avoidance of places and situations that might cause feelings of panic, entrapment, helplessness, or embarrassment), specific phobia,
Disorder more common in men
any personality disorder, especially antisocial personality disorder
How is the DSM-5 organized?
In a developmental hierachy. Starts with infancy, childhood, adolescence, for example.
A look at the order of disorders in the DSM-5:
1.Neurodevelopmental Disorders
2.Schizophrenia Spectrum Disorders
3.Bipolar and Related Disorders
4.Depressive Disorders
5.Anxiety Disorders
6.Obsessive-Compulsive Disorders
7.Trauma and Stressor-Related Disorders
8.Dissociative Disorders
9.Somatic Symptom Disorders
10.Feeding and Eating Disorders
11.Elimination Disorders
12.Sleep-Wake Disorders
13.Sexual Dysfunctions
14.Gender Dysphoria
15.Disruptive, Impulse Control, and Conduct Disorders
16.Substance Related and Addictive Disorders
17.Neurocognitive Disorders
18.Personality Disorders
19.Paraphilic Disorders
20.Other Disorders
List off some mental health nursing interventions
coordination of carecommuity screenings
parenting classess
stress management
milieu therapy
medication
commuincate with other members of the health care team
Mental health and illness are not either/or propositions but endpoints on a ___________.
continuum
Examples of Standardized nursing classification systems are used to form and communicate patient problems, outcomes, and interventions specific to nursing care.
NANDA-I, NOC, NIC
Which statement about mental illness is true?
a.Mental illness is a matter of individual nonconformity with societal norms.
b.Mental illness is present when individual irrational and illogical behavior occurs.
c.Mental illness changes with culture, time in history, political systems, and the groups defining it.
d.Mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.
C
A nursing student new to psychiatric mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:
a.Nursing Interventions Classification (NIC)
b.Nursing Outcomes Classification (NOC)
c.NANDA-I nursing diagnoses
d.DSM-5
D
Epidemiological studies contribute to improvements in care for individuals with mental disorders by:
a.Providing information about effective nursing techniques.
b.Identifying risk factors that contribute to the development of a disorder.
c.Identifying who in the general population will develop a specific disorder.
d.Identifying which individuals will respond favorably to a specific treatment.
C
Which statement best describes a major difference between a DSM-5 diagnosis and a nursing diagnosis?
a.There is no functional difference between the two; both serve to identify a human deviance.
b.The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis takes culture into account.
c.The DSM-5 is associated with present symptoms, whereas a nursing diagnosis considers past, present, and potential responses to actual mental health problems.
d.The DSM-5 diagnosis impacts the choice of medical treatment, whereas the nursing diagnosis offers a framework for identifying multidisciplinary interventions.
C
The intervention that can be practiced by an advanced practice registered nurse in psychiatric mental health but cannot be practiced by a basic level registered nurse is:
a.Advocacy
b.Psychotherapy
c.Coordination of care
d.Community-based care
B
The quantitative study of the distribution of mental disorders in human populations is called
mortality.
prevalence.
epidemiology.
clinical epidemiology.
epidemiology.
________ refers to the proportion of a population with a mental disorder at a given time.
prevalence
Which statement best describes the DSM-5?
It is a medical psychiatric assessment system.
It is a compendium of treatment modalities.
It offers a complete list of nursing diagnoses.
It suggests common interventions for mental disorders.
It is a medical psychiatric assessment system.
Current information suggests that the most disabling mental disorders are the result of
biological influences.
psychological trauma.
learned ways of behaving.
faulty patterns of early nurturance.
biological influences.
List biologically influenced illnesses
schizophrenia, bipolar disorder, major depression, obsessive-compulsive and panic disorders, posttraumatic stress disorder, and autism.
A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "What does that title mean?" The nurse responds best by answering:
"Don't be afraid; it means I'm here to help, not hurt, you."
"Psychiatric mental health nurses care for people with mental illnesses."
"We have the specialized skills needed to care for those with mental illnesses."
"The nurses who work in mental health facilities have that title."
"We have the specialized skills needed to care for those with mental illnesses."
Which statement about diagnosis of a mental disorder is true?
The symptoms of each disorder are common among all cultures.
Culture may cause variations in symptoms for each clinical disorder.
All mental disorders listed in the DSM-5 are seen in all other cultures.
Psychiatric diagnoses are listed in separately from other physical disorders in a five axes system.
Culture may cause variations in symptoms for each clinical disorder.
The prevalence rate over a 12-month period for major depressive disorder is
lower than the prevalence rate for panic disorders.
greater than the prevalence rate for psychotic disorders.
equal to the prevalence rate for psychotic disorders.
greater than the prevalence rate for generalized anxiety.
greater than the prevalence rate for generalized anxiety.
These severe mental illnesses are recognized across cultures:
antisocial and borderline personality disorders.
schizophrenia and bipolar disorder.
bulimia and anorexia nervosa.
amok and social phobia.
schizophrenia and bipolar disorder.
Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)?
experimental
descriptive
clinical
analytic
clinical
A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking?
Control over behavior
Appraisal of reality
Effectiveness in work
Healthy self-concept
Appraisal of reality
A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous behavior, and has a history of school truancy but reports that her parents are just old- fashioned and don't understand her. The assessment data supports that the client
is displaying deviant behavior.
cannot accurately appraise reality.
is seriously and persistently mentally ill.
should be considered for group home placement.
is displaying deviant behavior.
The nurse planning care for a mentally ill client bases interventions on the concept that the client
has areas of strength on which to build.
has right that must be respected.
comes with experiences that contribute to their problem.
share fears that are similar to those of all mentally healthy individuals.
as areas of strength on which to build
In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to
ask the client whether he views himself as being depressed.
identify his culture's view regarding suicide.
explain to him that suicide is often regarded as a desperate act.
assess the client for other examples of depressive behaviors.
identify his culture's view regarding suicide.
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports that he is
demonstrating symptoms of bipolar disorder.
socially deviant.
egocentric.
not demonstrating any definitive signs of mental illness.
not demonstrating any definitive signs of mental illness.
A nursing diagnosis for a client with a psychiatric disorder serves the purpose of
justifying the use of certain psychotropic medication.
providing data essential for insurance reimbursement.
providing a framework for selecting appropriate interventions.
completing the medical diagnostic statement.
providing a framework for selecting appropriate interventions.
Which of the following best demonstrates parity related to mental health care?
The client is admitted for a 72-hour mental hygiene evaluation.
Advance practice nurse can be certified as psychiatric nurse specialist.
A client's mental health coverage is equal to his medical/surgical coverage.
A client who has attempted suicide is hospitalized for a mental health evaluation.
A client's mental health coverage is equal to his medical/surgical coverage.
The mental health status of a particular client can best be assessed by considering
the degree of conformity of the individual to society's norms.
the degree to which an individual is logical and rational.
placement on a continuum from health to illness.
the rate of intellectual and emotional growth.
placement on a continuum from health to illness.
According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by:
cultural and ethnic factors.
occupation and status.
birth order.
sexual preference.
cultural and ethnic factors.
One characteristic of mental health that allows people to adapt to tragedies, trauma, and loss is:
dependence.
resilience.
pessimism.
altruism.
resilience.
You are caring for Kiley, a 29-year-old female patient who is being admitted following a suicide attempt. Which of the following illustrates the concept of patient advocacy?
"Dr. Raye, I notice you ordered Prozac for Kiley. She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed."
"Dr. Raye, during her admissions interview Kiley stated that she has had three other suicide attempts in the past."
"Kiley, can you tell me more about your depression and your suicide attempt?"
"Kiley, I will take you on a tour of the unit and orient you to the rules."
Dr. Raye, I notice you ordered Prozac for Kiley. She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed."
You have graduated with your BSN degree and have taken your first job on a psychiatric unit after becoming a licensed Registered Nurse. You are providing teaching to Mason, a newly admitted patient on the psychiatric unit, regarding his daily schedule. Which of the following would not be an appropriate teaching statement?
"You will participate in unit activities and groups daily."
"You will be given a schedule daily of the groups we would like you to attend."
"You will attend a psychotherapy group that I lead."
"You will see your provider daily in a one-to-one session."
"You will attend a psychotherapy group that I lead."
A nurse who is active in local consumer mental health groups and in local and state mental health associations and who keeps aware of state and national legislation affecting mental illness treatment may positively affect the climate for treatment by:
becoming active in politics leading to a potential political career.
reducing the stigma of mental illness and advocating for equality in treatment.
encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons.
advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions.
reducing the stigma of mental illness and advocating for equality in treatment.
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