CHS Semester 2 Exam

How does mental illness impact life expectancy?

Reduces life expectancy comparably to smoking due to health risks.

Define mental illness.

Diagnosable disorders involving altered thinking, mood, or behavior causing distress or impaired functioning.

What is comorbidity?

Presence of two or more mental disorders simultaneously (e.g., depression + anxiety).

What distinguishes normal emotions from pathological symptoms?

Pathological symptoms are prolonged, intense, and disrupt daily functioning.

What role does stress play in mental disorders?

Chronic stress interacts with genetics/environment to trigger or worsen disorders (e.g., PTSD, depression).

Why are youths/college students vulnerable to mental health challenges?

High stress, identity development, and often lack access to community resources.

How does lack of cultural competence harm mental health care?

Leads to misdiagnosis (e.g., misinterpreting cultural expressions of distress as pathology).

Name four characteristics of good mental health.

Emotional maturity, Stress management, Positive relationships, Self-regulation/adaptability.

What is self-regulation?

Ability to manage emotions/behaviors adaptively (e.g., calming oneself during stress).

What is emotional maturity?

Includes self-awareness, empathy, and constructive coping with setbacks.

What are the three stages of the General Adaptation Syndrome (GAS)?

Alarm (fight-or-flight), Resistance (adaptation), Exhaustion (depletion, illness risk).

What physical risks arise from chronic stress?

Heart disease, weakened immunity, and unhealthy behaviors (smoking, alcohol use).

Describe U.S. mental health care before WWII.

Patients institutionalized in poorhouses/almshouses with harsh, neglectful conditions.

Who pioneered moral treatment, and what did it involve?

Pinel and Tuke; emphasized humane care (rest, fresh air, dignity).

What did Dorothea Dix achieve?

Lobbied for public mental hospitals, leading to 32 state hospitals in the 19th century.

Why was lobotomy discontinued?

Caused severe side effects (personality changes, cognitive decline) and poor outcomes.

What drove deinstitutionalization in the 1950s?

High cost of hospitals, Legal reforms (patient rights), New antipsychotics (e.g., chlorpromazine).

What replaced state hospitals after deinstitutionalization?

Community Mental Health Centers (CMHCs) offering outpatient, emergency, and day treatment.

What did the National Mental Health Act (1946) establish?

Created the National Institute of Mental Health (NIMH) to fund research and improve care.

What was the Community Mental Health Centers Act (1963)?

Funded local CMHCs to replace state hospitals, aiming for accessible community-based care.

What does the Mental Health Parity and Addiction Act (2008) require?

Insurance plans to cover mental health/substance use disorders equally to physical illnesses.

How did the Affordable Care Act (2010) impact mental health?

Expanded insurance coverage, mandated mental health services, and integrated care systems.

What is ECT, and when is it used?

Electroconvulsive Therapy—electrically induced seizures for severe depression (when drugs fail).

What is tardive dyskinesia?

Neurological side effect of long-term antipsychotics (e.g., chlorpromazine), causing involuntary movements.

What was chlorpromazine (Thorazine)?

First widely used antipsychotic (1954) to manage psychosis (e.g., schizophrenia).

How do mental disorders rank globally in terms of disability?

Among top causes of years lost due to disability (YLD).

Stigma

Societal prejudice causing shame, discrimination, and reluctance to seek help.

Cultural context in DSM-5 diagnosis

To avoid misdiagnosing culturally specific behaviors (e.g., grief rituals vs. depression).

Bipolar disorder

Episodes cycling between depressive lows and manic highs.

PTSD

Anxiety disorder from trauma exposure (e.g., war, assault), causing flashbacks and hypervigilance.

CMHCs

Local, accessible services: inpatient, outpatient, emergency care, and consultation.

Causes of mental disorders

Biopsychosocial factors: genetics, environment (e.g., trauma), and social stressors.

Medical care in the U.S. (Colonial era to 19th century)

Mostly by family/neighbors; physicians trained via apprenticeships; hospitals served as welfare institutions.

Healthcare changes in the Late 19th century

Shift from home care to hospitals/office care; hospitals staffed by trained professionals.

Decline of communicable diseases in the 20th century

Public health advances (sanitation, vaccines) and rise of chronic diseases (e.g., heart disease).

Employer-based insurance post-WWII

Wage controls led employers to offer health benefits as a tax-free incentive.

Hill-Burton Act (1946)

Funded hospital construction/expansion to meet post-WWII demand.

Major programs introduced in the 1960s

Medicare (for seniors) and Medicaid (for low-income populations).

HMO Act (1973)

Promoted integrated insurance and care delivery through Health Maintenance Organizations (HMOs).

Healthcare focus in the 1980s

Deregulation and market competition to reduce costs.

Affordable Care Act (ACA, 2010)

Expanded insurance coverage via marketplaces, mandated essential benefits, and faced political challenges.

Primary care

First-contact care (80% of needs), includes prevention/routine treatment (e.g., family doctors, NPs).

Secondary care

Specialized care via referral (e.g., cardiologist for heart issues).

Tertiary care

Highly specialized treatment (e.g., organ transplants, cancer therapy) at academic/specialty hospitals.

Restorative care

Rehabilitation/recovery post-treatment (e.g., physical therapy after surgery).

Long-term care

Support for chronic illness/disability (nursing homes, home health aides).

End-of-life practice

Hospice care for patients expected to live <6 months, focused on comfort/support.

Deductible

Amount paid out-of-pocket by insured before insurance coverage begins.

Co-insurance

Percentage of costs paid by insured after meeting deductible (e.g., 20% of bill).

Copayment

Fixed fee paid at time of service (e.g., $30 for a doctor's visit).

Fixed indemnity

Insurer pays a set amount per service, regardless of actual cost.

Pre-existing condition

Illness present before insurance enrollment, which may affect coverage/costs.

Self-insured company

Employer pays employee health claims directly instead of buying external insurance.

Medicare

Federal insurance for those 65+ or with disabilities (Parts A-D cover hospital, medical, drugs).

Medicaid

Joint federal-state program for low-income individuals/families.

CHIP

Children's Health Insurance Program for families above Medicaid limits but unable to afford private insurance.

Medicare Part D

Prescription drug coverage for Medicare enrollees.

HIPAA

Health Insurance Portability and Accountability Act (1996); ensures coverage continuity between jobs and protects patient privacy.

HMO

Requires in-network providers and referrals for specialists.

PPO

Allows out-of-network care without referrals (higher cost).

EPO

Exclusive Provider Organization—middle cost, no referrals but must use in-network providers.

POS plan

Point of Service—mix of HMO/PPO; requires PCP referrals but allows out-of-network care at higher cost.

nonallopathic provider

Practitioner of nontraditional care (e.g., chiropractor).

integrative medicine

Combines mainstream therapies with CAM (e.g., acupuncture + chemotherapy).

triangle of health care

Balancing cost containment, access, and quality.

capitation

Payment method where providers receive a fixed fee per patient, regardless of services used.

fee-for-service

Payment after service is rendered; criticized for incentivizing unnecessary procedures.

staff model HMO

HMO that employs its own providers (e.g., Kaiser Permanente).

The Joint Commission

Accredits healthcare facilities to ensure quality/safety standards.

closed-panel HMO

Contracts exclusively with private physicians for services.

open-panel HMO

Contracts with private-practice physicians to deliver care in their own offices.

managed care organizations (MCOs)

Systems that control costs via provider networks and service guidelines (e.g., HMOs, PPOs).

environmental health

Study of how environmental conditions (air, water, food, waste) affect human health and well-being.

environmental hazards

Factors in the environment that increase risk of injury, disease, or death (e.g., pollution, radiation).

primary pollutants

Directly emitted from sources (e.g., carbon monoxide from cars).

secondary pollutants

Formed when primary pollutants react with sunlight/other chemicals (e.g., ozone).

photochemical smog

Brown haze from pollutants (e.g., car exhaust) reacting with sunlight.

industrial smog

Gray haze from burning coal (contains sulfur dioxide and particulates).

ozone (O₃)

Causes lung damage and aggravates asthma; most harmful air pollutant.

thermal inversion

Warm air traps cool, polluted air near the ground, worsening air quality.

Clean Air Act (CAA)

Federal law (1963, amended 1970, 1990) setting air quality standards (NAAQS) for 6 pollutants.

Air Quality Index (AQI)

Scale (0-500) reporting daily air quality: 0-50 (Green): Safe. >100 (Orange/Red): Unhealthy for sensitive groups.

asbestos

Inhaled mineral fibers cause lung cancer (e.g., from old insulation).

biogenic pollutants

Mold, pollen, or bacteria triggering allergies/asthma.

combustion by-products

Carbon monoxide (CO) from stoves/heaters; lethal in high doses.

VOCs

Volatile organic compounds in paints/cleaners; cause headaches, cancer (e.g., formaldehyde in plywood).

radon

Radioactive gas from soil; #1 cause of lung cancer in nonsmokers (21,000 deaths/year).

sick building syndrome

Illness from poor indoor air quality due to low ventilation.

point source pollution

Pollution from a single identifiable source (e.g., factory pipe).

nonpoint source pollution

Runoff from farms/streets (harder to control than point sources).

Runoff

Runoff from farms/streets (harder to control than point sources).

Endocrine-disrupting chemicals (EDCs)

Chemicals (e.g., atrazine) interfering with hormone systems.

Safe Drinking Water Act (SDWA)

Sets Maximum Contaminant Levels (MCLs) for 87 water pollutants.

Food safety regulation agency

FDA (USDA handles meat/dairy).

Municipal solid waste (MSW)

Everyday trash (4.4 lbs/person/day).

Resource Conservation and Recovery Act (RCRA)

"Cradle-to-grave" regulation via the Resource Conservation and Recovery Act.

Superfund (CERCLA)

Law funding cleanup of abandoned hazardous sites (1,706 on National Priority List).

Ionizing radiation

Radiation damaging cells (e.g., UV, X-rays).

Brownfields

Contaminated land requiring cleanup for reuse.

Carrying capacity

Maximum population an environment can sustainably support.