Test #3 Mental Health

-sx often mistaken for normal developmental behaviour

-lack of access to specialized care

-stigma, denial by caregivers

why is mental health disorder in children is underdiagnosed?

attention-deficit/hyperactivity disorder (ADHD)

most diagnosed mental health disorder in childhood?

-inattention

-hyperactivity

-impulsivity

3 behaviours that characterize ADHD

-predominantly inattentive

-predominantly hyperactive-impulsive

-combined

3 types of ADHD

inattentive: easily distracted, forgetful, difficulty following instructions, avoid tasks sustaining effort

hyperactive: fidget/squirms, talks excessively, runs/climbs inappropriately, interrupts/intrudes others

sx of predominantly inattentive vs hyperactive ADHD

oppositional defiant disorder

pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness lasting at least 6 months

-aggression towards people or animals

-destruction of property

-deceit, theft

-serious violation of rules

characteristics of conduct disorder

antisocial personality disorder

1/3 of teens with conduct disorder develop which personality disorder?

-childhood-onset: male, physically aggressive

-adolescent-onset: environmental factors, less aggressive

2 subtypes of conduct disorder

motor and vocal tics

tourette disorder is characterized by:

enuresis

involuntary urination, especially at night (bedwetting)

-difficulty with social interaction

-restricted/repetitive behaviours

-normal to above average intelligence

characteristics of asperger disorder (part of autism spectrum disorder)

boys

is autistic disorder more common in boys or girls?

-impaired social interaction

-delayed or absent speech

-repetitive behaviours

-resistance to change

characteristics of autistic disorder

stimulants

-side effects: low appetite, headaches, stomach aches, sleep problems; tolerance in adderall

-education: take meds in morning and with food, avoid caffeine and cough meds

type of medication used to treat ADHD

appetite suppression or decreased appetite

most frequent side effect of stimulants

-psychiatrist, psychologist

-nurse

-social workers

-occupational therapists

-educators

members included in multidisciplinary team

improve communication, problem-solving, emotional support within family

goals of family therapy

play therapy

therapeutic approach that uses play to help children express feelings, process experiences, and resolve problems

-massage with aromatherapy

-biofeedback

-melatonin, omega-3 fatty acids

alternative therapies for children

-establish trust

-provide structured environment

-educate family

-encourage expression of feelings

-promote self-esteem

nursing interventions for childhood/adolescent disorders

-set clear expectations

-use positive reinforcement

-provide structure and routine

-break tasks into manageable steps

-communicate regularly between home and school

guidelines for parents/teachers of children with ADHD

men (due to more lethal means used)

are suicide rates higher among men or women?

higher among women

do men or women have higher rates of self-harm?

-indigenous youth

-LGBTQ+

-mental/chronic illness, substance abuse

-elderly

-survivors of abuse/trauma

high-risk populations for suicide

-previous attempts

-mental illness (depression, bipolar), substance abuse

-family hx

-social isolation

-major life change/losses

risk factors for suicide

-high stress

-easy access to lethal means

-stigma around seeking help

-pressure, burnout

why are health care professional at higher risk for suicide?

-mental illness

-escape from pain (emotional or physical)

-feeling like a burden, hopelessness

-trauma, abuse

-financial, relationship problems

reasons for suicide

-thinking about hurting/killing yourself? what has stopped you from acting on it?

-plan? if so what? access to carry plan?

-have you tried hurting yourself before? hearing voices telling you to do so?

-how long have you been feelings this way?

-support systems?

-recent major loss or change?

questions to ask when assessing a potentially suicidal pt

-ensure safety and remove harmful objects

-therapeutic relationship

-ongoing risk assessments, safety plan

-encourage expression of feelings

-connect pt to resources and support systems

nursing interventions for suicidal pts

crisis care card

small card with emergency contact information, crisis resources, personalized coping strategies that pt can use in crisis moments

-expressing hope

-reconnecting with others

-engaging in future planning

-following safety plan

-verbalizing decreased suicidal thoughts

signs a suicidal pt is improving

-physical: hitting, slapping, burning

-emotional: verbal insults, threats, humiliation

-sexual: unwanted sexual contact, no consent

-social: excluding fro family/friends

-economic: little access to assets, how money is spent

types of abuse and examples

-physical: lack of food, clothing, shelter

-emotional: lack of affection, attention

-medical: not providing necessary healthcare

-educational: not ensuring school attendance

-abandonment: leaving child unsupervised in unsafe situations

types of neglect and examples

-children, women (pregnant), elderly

-people with disabilities

-marginalized populations

who is at higher risk for IPV?

-brain injury, developmental delay

-blindness

-death

dangers of shaken baby syndrome

neglect

most frequently reported type of child maltreatment

factitious disorder by proxy (munchausen by proxy)

caregiver deliberately causes or fabricates illness in another (often a child) to gain attentions or sympathy

-repeated aggressive behaviour involving power balance

-can be physical, verbal, relational, cyberbullying

what does bullying include?

women

who is more likely to be a victim of IPV?

-tension-building: minor incidents and emotional abuse; victim may try to please abuser

-serious battering incident: physical violence; victim seriously injured

-honeymoon: abuser apologizes and promises change, may show affections and remorse

3 phases of spousal abuse cycle

-fear of retaliation or being institutionalized

-dependence on abuser

-shame or self-blame

-cognitive impairment

why is elder abuse under-reported?

family members or caregivers

who is most likely to inflict elder abuse?

abdomen

-miscarriage, premature labour, fetal injury, placental previa

where are pregnant women more likely to be hit?

yes, it can be equally or more damaging over time

is emotional abuse as damaging as physical abuse?

stalking

repeated unwanted attention or contact that causes fear; may also be accompanied by property damage and assault

women

who is more likely to be a victim of stalking?

cyberstalking

using digital platforms to harass, intimidate, threaten

-fear, hope, isolation

-learned hopelessness

-traumatic bonding

-emotional, financial dependency

-guilt/shame, severe depression

-children

reasons victims stay or return to abusers

-bruising, bleeding

-depression, withdrawal from friends and social activities

-frequent bladder infection

-physical abnormalities

criteria for suspecting abuse

-ensure immediate safety

-document findings carefully

-develop safety plan

-respect autonomy and choices, provide nonjudgemental support

-refer to community resources

nursing interventions for victims of abuse