continuum of mental health and mental illness

some attributes of mental health

happiness, control of behavior, appraisal of reality, effective in work, healthy self-concept, satisfying relationships, effective coping

factors affecting mental health

genetics, spirituality, culture, community, personality, health beliefs, environment, economics

well-being

occasionall stress to mild distress, no impairment

emotional problems or concerns

mild to moderate distress, mild or temporary impairment

mental illness

marked distress, moderate to disabling or chronic impairment

dsm-5

current official guidebook used by the psychiatric community used for categorizing and diagnosing psychiatric mental health disorders in the united states

must exceed expected and culturally-defined responses to particular events, such as grief after the loss of a loved one

mental health disorders

clinically significant behavioral or psychological syndromes or patterns that are associated with distress and disability

nanda-i

provides common language for nursing

describes a nursing diagnosis as a clinical judgment about responses to health problems

stigma

a collection of attitudes, beliefs, thoughts, and behaviors that influence the individual and the general public

psychosocial processes that lead to stigmatization

stereotyping, labeling, separating, status loss or discrimination in the context of power imbalance, social isolation, reduced opportunities

inpatient psychiatric care

24 hour nursing care, locked units, crisis care, residential treatment programs, state acute care systems, general hospital psychiatric units, private psychiatric hospital care

outpatient psychiatric care

primary care providers, patient-centered medical homes, primary care medical homes, community mental health centers, psychiatric home care, intensive outpatient programs

psychiatric nursing assessment

perform a mental status examination

assess psychosocial status

identify mutual goals for treatment

formulate a plan of care that prioritizes the patient’s immediate condition and needs

document data in a retrievable format

gathering data

review of systems

laboratory data

mental status examination

psychosocial assessment

spiritual/religious assessment

cultural and social assessment

self-awareness assessment

conducting a mental status examination

the nurse observes physical behavior, verbal and nonverbal communications, appearance, speech, thought content and cognitive ability as well as observations centering on the presenting problems, current lifestyle, strength of resources such as family, friends, and education or work experiences

mental status examination

personal information, appearance, behavior, speech, affect and mood, thought, perceptual disturbances, cognition

psychosocial assessment

central or chief complaint

history of violent, suicidal, or self-mutiliating behaviors

alcohol or substance abuse

family psychiatric history

personal psychiatric treatment including medications and complementary therapies

current stressors and coping methods

quality of activities of daily living

personal background

social background including support system

weaknesses, strengths, and goals for treatment

racial, ethnic, and cultural beliefs and practices

spiritual beliefs or religious practices

outcomes

are variable and measurable, are a reflection of the patient’s actual state

goals

are measurable, indicate the patient’s desired behaviors, include a set time for achievement, are short and specific

interventions should be

safe, evidence-based, realistic, compatible with other therapies