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Mental health and mental illness (Varcarolis ch.1)

Terms in this set (52)

mental health
state of well-being in which individuals can:
- able to realize his or her own potential
- cope w/ normal stresses of life
- work productively
- make contribution to community
5 signs of mental health
- Happiness
- Control over behavior
- Accurate Appraisal of reality
- Effectiveness in work
- Healthy self-concept
psychiatry's definition of mental health
Evolves over time and is shaped by the prevailing culture and societal values. Reflects changes in cultural norms, society's expectations, and political climates.
mental illness
refers to all mental disorder with definable diagnoses.
mental health continuum
A conceptual line used to represent levels of mental health and mental illness that vary from person to person and vary for a particular person over time.
dysthymia
a condition characterized by mild, but chronic, depressive symptoms that last for at least 2 years
cyclothymia
Milder form of bipolar disorder
- mania bi-polar
&
- depression for 2 + yrs
DSM-5
diagnostic and statistical manual; written by the american psychiatric association. classifies 157 separate disorders
influences that impact individuals mental health
- available support system
- spirituality
- family influences
- developmental events
- personality traits and states
- demographic/geographic location
- negative influences
-psychosocial stressors
-poverty
-impaired/inadequate parenting
- cultural beliefs & values
- health practice/belief
- hormonal influences
- biological influences
- inherited factors
- environmental experiences
Culture
There is no standard measure for mental health, in part because it is culturally defined and is based on interpretations of effective functioning according to societal norms
ex: Japanese may consider suicide to be an act of honor
cultural bound syndrome
Disorder only common to a society
diathesis-stress model
Asserts that most psychiatric disorders result from a combination of genetic vulnerability and negative environmental stressors
10 guiding principles of recovery
- Self-directed
- Individual- and person-centered
- Empowering
- Holistic (whole life body/mind/spirit/community)
- Nonlinear (continual growth, occ setbacks, learning from experience)
- Strengths-based
- Peer-supported
- Respect
- Responsibility
- Hope
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.
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.
key areas of care promoted by QSEN
Patient-centered care
Teamwork and collaboration
Evidence-based practice
Quality improvement
Safety
Informatics
epidemiology
is quantitative study of the distribution of mental disorders in human population.
comorbid condition
a condition that occurs along with another disorder

Two disorders or conditions that occur or are diagnosed together. They co-occur.
incidence
The number of new cases of a disease within a given period of time
Prevalence
total number of cases (new & existing)
clinical epidemiology
a broad field that examines health and illness at the population level.

ex) study of diagnostic screening test
observation/experimental studies of interventions used to treat pell with illness
DSM-5
manual to diagnose and classify mental disorders
GENERALIZED ANXIETY DISORDER
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months): (Note: Only one item is required in children.)
1.Restlessness or feeling keyed up or on edge
2.Being easily fatigued.
3.Difficulty concentrating or mind going blank.
4.Irritability.
5.Muscle tension
6.Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
psychiatric mental health nursing
this specialty area in nursing and core mental health profession
- promotes mental health through the nursing process in the treatment of mental health problems and psychiatric disorders
basic level registered nurse
Any nurse with basic training (diploma, associate degree, baccalaureate degree) in nursing.
registered nurse-psychiatric mental health (RN-PMH)
basic level: work as staff nurse, case manager, home care nurse

2 yrs of full-time work: after certified exam = RN-BC
Psychiatric Nurse's Roles
- Counselor
- Patient Advocate
- Crisis Manager
- Promoter of Self Care
- Health Promoter & Maintainer
- Health teacher-to patient and family
- Assertiveness Trainer
- Milieu Manager
- Case Manager:
--- Planner and evaluator of care
--- Discharge planning
milieu
Environment or surroundings
APRN-PMH (advanced practice registered nurse-psychiatric mental health)
A nurse generalist who has obtained additional training to provide care as a clinical nurse specialist with advanced nursing expertise or as a nurse practitioner who
-diagnoses
- prescribes
- treats psychiatric disorders
phenomena of concern
The central interests of a particular discipline. In nursing they are commonly considered to be person, health, environment, and nursing.
cultural competence
An understanding of how a patient's cultural background shapes his beliefs, values, and expectations for therapy.
electronic health care
The provision of health care through methods which are not face-to-face but rather through an electronic medium.
DSM-5 Organized Structor (young to old disorders)
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. Paraphiliac Disorders
20. Other Disorders
Clinical descriptions of mental and behavior disorders are divided into 11 disease classifications
1. Organic—including symptomatic—mental disorders
2 .Mental and behavioral disorders due to psychoactive substance use
3. Schizophrenia, schizotypal, and delusional disorders
4. Mood (affective) disorders
5. Neurotic, stress-related, and somatoform disorders
6. Behavioral syndromes associated with physiological disturbances and physical factors
7. Disorders of adult personality and behavior
8. Mental retardation
9. Disorders of psychological development
10. Behavioral and emotional disorders with onset usually occurring in childhood and adolescence
11. Unspecified mental disorder
Key points to remember
• Mental health and illness are not either/or propositions but endpoints on a continuum.
• The study of epidemiology can help identify high-risk groups and behaviors. In turn, this can lead to a better understanding of the causes of some disorders. Prevalence rates help us identify the proportion of a population experiencing a specific mental disorder at a given time.
• Recognizing that mental disorders are biologically based with environmental mediation, it is easier to see how they can be classified as medical disorders.
• The DSM-5 provides criteria for psychiatric disorders and a basis for the development of comprehensive and appropriate interventions.

• Culture influences behavior, and symptoms may reflect a person's cultural patterns or beliefs. Symptoms must be understood in terms of a person's cultural background.
• Psychiatric mental health nurses work with a broad population of patients in diverse settings to promote optimal mental health.
• Standardized nursing classification systems (NANDA-I, NOC, NIC) are used to form and communicate patient problems, outcomes, and interventions specific to nursing care.
• Psychiatric mental health nurses function at a basic or advanced level of practice with clearly defined roles.
• Due to social, cultural, scientific, and political factors, the future holds many challenges and possibilities for the psychiatric mental health nurse
DSM-V & DSM IV-TR
- A WAY OF ORGANIZING INFORMATION:
---> to determine medical diagnosis
---> as multi axial system for diagnosis
---> contains axes I through V (1 - 5)
---> tool for data collection related to psych diagnosis

CLASSIFY DISORDERS NOT PEOPLE: We do not think in terms of "the bipolar in 257-A", but instead "the patient with bipolar disorder in 257-A".
DSM IV-TR
include 5 axis
Axis I = psychiatric diagnosis (major clinical disorders)
Axis II = personality disorders
Axis III = general medical conditions
Axis IV = environmental stressors
Axis V = Scale 0-100: Global Assessment of Function
Axis I (DSM IV-TR)
Major Psychiatric Diagnosis
- Bipolar Disorder
- Schizophrenia
- Generalized Anxiety Disorder
- Alcohol Dependence
- Major Depression
- Post-Traumatic Stress Disorder
Axis II (DSM IV-TR)
personality disorders OR
mental retardation

- Borderline Personality Disorder
- Antisocial Personality Disorder
- Schizotypal Personality Disorder
- Narcissistic Personality Disorder
- Obsessive-Compulsive Personality Disorder
- Must state "_______ Personality Disorder"
OR
- Mental Retardation
Axis III (DSM IV-TR)
general medical conditions
- Arthritis
- Head trauma, remote
- Colitis
- Hepatitis
- Diabetes
- Hypertension
Axis IV (DSM IV-TR)
environmental stressors
- Illness in the family
- financial problems
- Living alone
- Unemployment
- Homelessness
- Lack of transportation
- Recent arrest
Axis V (DSM IV-TR)
Number corresponding to the level at which the physician, NP, PA, Psychologist sees the patient functioning in daily life.
Scale goes from 1 to 100 with 100 being best possible functioning and 1 being worst possible functioning. Zero may be used to indicate insufficient data for dx.
If two numbers are seen, the first usually indicates current level of functioning; the second indicates best level of functioning within the past year. Ex: "35 / 60". or they may be labeled with a time frame. Ex: "Current 35; Past year 60"
DSM-V
- Now collapses Axis 1 - 3 into one axis or diagnostic statement.
- The Environmental stressors are now addressed using specific codes.
- One instrument for measuring those is the WHO Disability Assessment Schedule (WHODAS 2.0) (in the DSM folder-Canvas)
THIS SET IS OFTEN IN FOLDERS WITH...