Psychology Transes 1 (FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING)

Mental health

State of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability.

Mental health

Affects how a person makes choices and how we handle stress.

Mental health

This also affects how we interact with each other.

INDIVIDUAL

INTERPERSONAL

SOCIAL/CULTURAL

FACTORS AFFECTING MENTAL HEALTH:

INDIVIDUAL

FACTORS AFFECTING MENTAL HEALTH: • Physical

• Personal freedom/ choices

• Sense of belonging

• Stress management (how a person copes)

• Physical

• Personal freedom/ choices

• Sense of belonging

• Stress management (how a person copes)

FACTORS AFFECTING MENTAL HEALTH: INDIVIDUAL

INTERPERSONAL

FACTORS AFFECTING MENTAL HEALTH:

• Effective communication

• How you balance connection and separateness

• Building relationship

• Effective communication

• How you balance connection and separateness

• Building relationship

FACTORS AFFECTING MENTAL HEALTH: INTERPERSONAL

SOCIAL/CULTURAL

FACTORS AFFECTING MENTAL HEALTH: Positive outlook in life

Positive outlook in life

FACTORS AFFECTING MENTAL HEALTH: SOCIAL/CULTURAL

MENTAL ILLNESS

It includes disorders that affect mood, behavior, and thinking, such as depression, schizophrenia, anxiety disorders, and addictive disorders.

Mental disorders

Often cause significant distress or impaired functioning or both.

Hallucination

Delusion

COMMON EXAMPLES OF MENTAL ILLNESS:

Hallucination

COMMON EXAMPLES OF MENTAL ILLNESS: False perception of reality that involves your senses.

Delusion

COMMON EXAMPLES OF MENTAL ILLNESS: False perception of reality in an event or object.

Tactile Hallucination

Gustatory Hallucination

Visual Hallucination

Olfactory Hallucination

Types of Hallucination:

Tactile Hallucination

Types of Hallucination: Involves sense of touch.

Gustatory Hallucination

Types of Hallucination: Involves sense of taste

Visual Hallucination

Types of Hallucination: Involves sense of sight.

Olfactory Hallucination

Types of Hallucination: Involves sense of smell.

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM-

It has three purpose which is the following:

1. To provide a standardized nomenclature and language for all mental health professionals.

2. To present defining characteristics or symptoms that differentiate specific diagnoses.

3. To assist in identifying the underlying causes of disorders.

ANCIENT TIMES

Believed that any sickness indicated displeasure of the gods and in fact, was a punishment for sins and wrongdoing.

ANCIENT TIMES

Those with mental disorders were viewed as either or demonic, depending on their behavior.

ARISTOTLE (382-322 BC)

Attempted to relate mental disorder to physical disorders

ARISTOTLE (382-322 BC)

Developed his theory that the amounts of blood, water, and yellow and black bile in the body controlled the emotions. These four substances, or humors, corresponded with happiness, calmness, anger, and sadness.

CHRISTIAN TIMES (1-1000 AD)

Primitive beliefs and superstitions were strong.

CHRISTIAN TIMES (1-1000 AD)

All diseases were again blamed on demons, and the mentally ill were viewed as possessed.

CHRISTIAN TIMES (1-1000 AD)

Priests performed exorcisms to rid sufferers of evil spirits. When that failed, they used more severe and brutal measures, such as incarceration in dungeons, flogging, and starving.

RENAISANCE (1300-1600)

In England, people with mental illness were distinguished from criminals.

RENAISANCE (1300-1600)

Those considered harmless were allowed to wander the countryside or live in rural communities, but the more "dangerous lunatics" were thrown in prison, chained, and starved.

1547

The Hospital of St. Mary Bethlehem was officially declared a hospital for the insane, the first of its kind.

Hospital of St. Mary of Bethlehem

Officially declared a hospital for the insane, the first of its kind.

Hospital of St. Mary of Bethlehem

Visitors at the institution were charged a fee for the privilege of viewing and ridiculing the inmates, who were seen as less than human animals.

1775

WHEN: visitors at the institution were charged a fee for the privilege of viewing and ridiculing the inmates, who were seen as less than human animals

1547

During this same period in the colonies (later the United States), the mentally ill were considered evil or possessed and were punished.

1547

Witch hunts were conducted, and offenders were burned at the stake.

1790's

A period of enlightenment concerning persons with mental illness began.

Philippe Pinel in France and William Tuke in England

Formulated the concept of asylum

Asylum

Safe refuge or haven offering protection at institutions where people had been whipped, beaten, and starved because they were mentally ill.

DOROTHEA DIX (1802-1887)

Began a crusade to reform the treatment of mental illness after a visit to Tuke's institution in England.

DOROTHEA DIX (1802-1887)

Believed that society was obligated to those who were mentally ill, she advocated adequate shelter, nutritious food, and warm clothing.

DOROTHEA DIX

She was instrumental in opening 32 state hospitals that offered asylum to the suffering.

After 100 years

WHEN: the establishment of the first asylum, state hospitals were in trouble. Attendants were accused of abusing the residents, the rural locations of hospitals were viewed as isolating patients from their families and homes, and the phrase insane asylum took on negative connotation.

Sigmund Freud (1856-1939)

Emil Krepelin (1856-1926)

Eugen Bleuler (1857-1939)

The period of scientific study and treatment of mental disorders began with who?

Sigmund Freud (1856-1939)

Who challenged society to view human beings objectively?

Emil Krepelin (1856-1926)

Who began classifying mental disorders according to their symptoms?

Eugen Bleuler (1857-1939)

Who coined the term schizophrenia?

1950

A great leap in the treatment of mental illness began when?

Psychotropic drugs

Drugs used to treat mental illness

Chlorpromazine (Thorazine)

An antipsychotic drug, and lithium, an antimanic agent were the first drugs to be developed

Psychotropic drugs

Reduced agitation, psychotic thinking, and depression

1963 March on Washington

The movement toward treating those with mental illness in less restrictive environments gained momentum, when?

Community Mental Health Centers Construction Act.

The movement toward treating those with mental illness in less restrictive environments gained momentum in 1963 with the enactment of what?

Deinstitutionalization

A deliberate shift from institutional care in state hospitals to community facilities, began.

Federal legislation

Passed to provide an income for disabled persons: supplemental security income (SSI) and Social Security disability income (SSDI).

Supplemental security income (SSI)

Social Security disability income (SSDI)

Federal legislation was passed to provide an income for disabled persons:

Supplemental security income (SSI)

Social Security disability income (SSDI)

This allowed people with severe and persistent mental illness to be more independent financially and to not rely on family for money

18 to 25 age group

Age that has the highest prevalence of mental illness as well as the lowest percent of people receiving treatment.

15 million adults

4 million children and adolescents.

How many people is affected by mental illness or serious emotional disturbances that impair daily activities

Revolving door effect.

Although deinstitutionalization reduced the number of public hospital beds by 80%, the number of admissions to those beds correspondingly increased by 90%. S

Community support service programs

Developed to meet the needs of persons with mental illness outside the walls of an institution.

Community support service programs

These programs focus on rehabilitation, vocational needs, education, and socialization as well as on management of symptoms and medication.

Managed care

A concept designed to purposely control the balance between the quality of care provided and the cost of that care

Managed care

People receive are based on need rather than on request.

early 1970s

When did Managed care began

Managed care

Began in the early 1970s in the form of health maintenance organizations, which were successful in some areas with healthier populations of people.

1990s

When did new form of managed care was developed by utilization review firms or managed care organizations to control the expenditure of insurance funds by requiring providers to seek approval before delivery of care.

Case management

Management of care on a case-by-case basis, represented an effort to provide necessary services while containing cost.

Psychiatric care

Costly because of long-term nature of the disorders.

Linda Richards

Graduated from the New England Hospital for Women and Children in Boston

Linda Richards

She went on to improve nursing care in psychiatric hospitals and organized educational programs in state mental hospitals in Illinois.

Linda Richards

The first American psychiatric nurse

Linda Richards

She believed that "the mentally sick should be at least as well cared for as the physically sick"

1873

WHEN: Linda Richards

1882

WHEN: The care was primarily custodial and focused on nutrition, hygiene, and activity.

1882

WHEN: The first training of nurses to work with persons with mental illness was in__ at McLean Hospital in Belmont, Massachusetts.

McLean Hospital in Belmont, Massachusetts.

WHERE: The first training of nurses to work with persons with mental illness was in 1882 at __

1920

WHEN: The first psychiatric nursing textbook was published

Nursing Mental Diseases by Harriet Bailey

WHAT: The first psychiatric nursing textbook that was published

Johns Hopkins

The first school of nursing to include a course in psychiatric nursing in its curriculum

1913

WHEN: Johns Hopkins was the first school of nursing to include a course in psychiatric nursing in its curriculum.

WHEN: the National League for Nursing, that accredits nursing programs, required schools to include an experience in psychiatric nursing.

HILDEGARD PEPLAU

Published Interpersonal Relations in Nursing in 1952 and Interpersonal Techniques: The Crux of Psychiatric Nursing in 1962

HILDEGARD PEPLAU

She described the therapeutic nurse client relationship with its phases and tasks and wrote extensively about anxiety.

HILDEGARD PEPLAU

The interpersonal dimension that was crucial to her beliefs forms the foundations of practice today.

Interpersonal Relations in Nursing in 1952

Interpersonal Techniques: The Crux of Psychiatric Nursing in 1962

What did HILDEGARD PEPLAU published?

Nursing Therapy

Mellow's 1968 work

Nursing Therapy

Described Mellow's approach of focusing on clients' psychosocial needs and strengths.

JUNE MELLOW

Contended that the nurse as a therapist is particularly suited to working with those with severe mental illness in the context of daily activities, focusing on the here and now to meet each person's psychosocial needs.

JUNE MELLOW

Who published Nursing Therapy, described her approach of focusing on clients' psychosocial needs and strengths.

AMERICAN NURSES ASSOCIATION (ANA)

Develops standards of care, which are revised as needed

Standards of care

Authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable.

AMERICAN PSYCHIATRIC NURSES ASSOCIATION (APNA)

Has standards of practice and standards of professional performance. These also outline the areas of practice and phenomena of concern for today's psychiatric-mental health nurse.

13

HOW MANY: The phenomena of concern describe the __ areas of concern that mental health nurses focus on when caring for clients.

Self-awareness

The process by which the nurse gains recognition of his or her own feelings, beliefs, and attitudes

• Keep a diary or journal that focuses on experiences and related feelings.

• Talk with someone you trust about your experiences and feelings.

• Engage in formal clinical supervision.

• Seek alternative points of view.

• Do not be critical of yourself (or others) for having certain values or beliefs.

POINTS TO CONSIDER WHEN WORKING ON SELF-AWARENESS

1. What if I say the wrong thing?

2. What will I be doing?

3. What if no one will talk to me?

4. Am I prying when I ask personal questions?

5. How will I handle bizarre or inappropriate behavior?

6. What happens if a client asks me for a date or displays sexually aggressive or inappropriate behavior?

7. Is my physical safety in jeopardy?

8. What if I encounter someone I know being

9. treated on the unit?

10. What if I recognize that I share similar problems

11. or backgrounds with clients?

STUDENT CONCERNS