Foundational Concepts, Safety, & EBP.

Diathesis-stress model theory

illness develops from a biological predisposition (diathesis) combined with stress

Main Social Determinants of Health?

• socioeconomic status

• environmental factors

• individual attributes/behaviors

MH Parity and Addiction Equity Act (2008)

Law that requires insurance benefits for MH and substance use conditions to be equal for those for medical care

Implicit vs Explicit Bias

I - stereotypes that affect our decisions in an unconscious manner

E - attitudes/beliefs we have about a person/group on a conscious level

Institutional Stigma

systemic policies of organizations that limit opportunities for people with mental illness.

Milieu Therapy

promoting a healing environment, organized and focused on healing social skills and life.

Developing vs Creating Mileiu?

Developing: physical environment, ensure safety and healing

Creating: psychosocial environment, developing awareness for healing, applying collaborative therapy, experiences.

What are the exceptions to confidentiality and privacy?

• danger to self

• duty to warn

• evidence of abuse or client report of abuse

What things must informed consent include?

• description of tx

• possible benefits of tx

• possible risk from tx

• consequences of no tx

• alternative tx options

Unintentional vs Intentional TORTS:

U: negligence & malpractice

I: Assault, battery, and false imprisonment

What must the nurse do while the client is in restraints?

• reassure safety

- ongoing integumentary assessment

- care of basic needs

- ROM

- medication management

- evaluate response to interventions & readiness for release

What options does the patient have to refuse treatment?

- cost
- lack of understanding
- second opinion
- serious mental illness

What are some social factors that affect mental health?

- socioeconomic status
- food security
- living conditions
- family
- health
- employment status

Who would be at risk for a negative impact on mental health?

- lower income
- compromised living conditions
- food insecurity
- lack of family
- no sense of belonging
- unemployment
- health and doscrimination

How would a serious mental illness (SMI) potentially impact a client?

- co-occurring comorbid illness
- shorter life expectancy
- limited healthcare access
- reduced quality of life & lifestyle habits
- stigma

How is stigma a problem with mental health?

Self Stigma:

- low self-esteem, hope, emotional regulation, reduction in tx compliance
Professional Stigma:
- negative thoughts/fear of client
- reduced quality of client care

What are some issues living with a SMI?

- Unemployment, housing
- impacts family
- Tx issues: adherence & relapse prevention

What is TORTS?

a civil wrong that is committed against a person