Chapter 23: Behavioral Health Emergencies

behavior

the way in which individuals interact with their environment

behavioral health emergency

a situation in which a person’s behavior poses a threat to themselves or others or prevents them from caring for themselves or functioning effectively in their community

mental illness

a chronic health condition involving changes in behavior, thinking, and/or emotion, which significantly interferes with the patient’s ability to function in daily life

altered mental status

a change in a way a person thinks and behaves that may signal disease in the central nervous system or elsewhere in the body

depression

a persistent mood of sadness, despair, and discouragement; may be a symptom of many different mental and physical disorders or may be a disorder on its own

Has at least 5 of these following symptoms for over a 2 week period:

• depressed mood

• greatly decreased interest or pleasure in activities they usually enjoy

• significant weight loss or gain

• insomnia or excessive sleeping

• motor agitation or slowing

• fatigue or loss of energy

• feelings of worthlessness or excessive/inappropriate guilt

• decreased ability to think, concentrate, or make decisions

• thoughts of suicide

psychiatric disorder

an illness with psychological or behavioral symptoms and/or impairment in functioning caused by social, psychological, genetic, physical, chemical, or biological disturbance

bipolar disorder

a type of mental illness characterized by alternating periods of depression and manic episodes

manic episode

a period of markedly elevated mood and increased activity and energy levels, often lasting a week or longer

May display the following behaviors:

• exaggerated feelings of self-importance

• little need for sleep/food

• talkativeness or racing thoughts

• distractibility

• increased activity

• increased impulsivity or reckless behavior

• delusions or hallucinations (in severe cases)

schizophrenia

a complex, difficult-to-identify mental disorder whose onset typically occurs during early adulthood. Symptoms typically become more prominent over time and include delusions, hallucinations, a lack of interest in pleasure, and erratic speech

Symptoms:

• hallucinations and delusions

• paranoia

• a lack of interest in everyday activities or relationships with others

• erratic, disorganized speech

• a flat or blunted affect

Posttraumatic stress disorder (PTSD)

a delayed reaction to a prior incident; often the result of one or more conditions concerning the incident, and may relate to an incident that involved physical harm or the threat of physical harm

patients may experience:

• nightmares, flashbacks, or intrusive thoughts that bring the same visceral response as when they initially encountered the stress

Dissociated PTSD

• when person attempts to escape from constant internal distress or a particularly disturbing event

• altered consciousness allows them to continue functioning under negative conditions

dementia

a slow, progressive decline in cognitive function that impairs memory function and leads to behavior change

delirium

an acute state of confusion, which occurs suddenly and may fluctuate over short periods. Rather than a disease itself, it is a sign of any number of underlying problems

substance use disorders (SUDs)

chronic, treatable medical conditions characterized by the uncontrolled use of substances such as alcohol, opioids, stimulants, or other drugs, despite harmful consequences

psychosis

a mental disorder characterized by the loss of contact with reality; may be evidenced by hallucinations and/or delusions; a symptom not an illness

Causes:

• use of mind altering substances

• genetics

• intense stress

• sleep deprivation

• use of certain medications

• traumatic brain injury

• other mental health conditions

hallucinations

false perceptions involving the senses of sight, sound, taste, smell, or touch

delusions

false beliefs that persist despite incontrovertible evidence to the contrary