Foundations of Psychiatric Mental Health Nursing

Mental Health

-Complex and challenging to define universally

-A dynamic, ever-changing state influenced by various factors

-Exists on a continuum

-Influencing factors: Individual, Interpersonal, Social/Cultural

-Mental health encompasses emotional and psychological well-being, whereas mental illness involves diagnosable conditions impacting daily functioning

Mental Illness

-Bases of disorders affecting: Mood- how we feel, Behavior- How we act, and Thinking (Cognitive)- How we think

-Mental disorders often cause significant distress and/or impaired functioning in these areas:

Mood: Depression/Bipolar

Behavior: Oppositional Defiance Disorder

Thinking: Attention Deficit Disorder

-All disorders will have some effect on all 3 categories

Mental Illness Exists on a Continuum

-Ranges from mild symptoms that may not impair daily functioning to severe symptoms that significantly disrupt life

-Ex: Anxiety may range from occasional worry to debilitating panic attacks

-Recognizing the continuum helps to reduce stigma and promotes understanding that everyone may experience symptoms at some point

Understanding the Causes of Mental Illness

-Mental illness arises from an interplay of factors: Biological, Social, Individual

-These factors often overlap, contributing to the development or worsening of symptoms

Biological Causes

-Factors include genetics, neurochemistry and cognitive function play a role in predisposing individuals to mental illness

Key Contributors:

-Genetics and family history

-Neurochemical imbalances (serotonin, dopamine)

-Anatomical differences

-Physical health conditions (thyroid disorders, chronic illnesses)

-Biological factors may predispose individuals to mental illness but do not act in isolation

Social causes

-Social factors can have an influence on the onset and progression of mental illness

Key Contributors:

-Stigma of illness

-Discrimination

-Cultural beliefs

-Inadequate social support

-History of trauma or abuse

-Unstable living environments or socioeconomic stressors

Individual Causes

-Characteristics of an individual and can lead to vulnerability or protective factors to mental illness

-Cognitive factors: catastrophizing, all or nothing thinking

-Emotional Factors: Difficulty managing intense emotions

-Behavioral and Social skills: Limited or maladaptive coping strategies

DSM-5

-Provides a standardized classification system for mental health diagnoses

-Identifies all factors that relate to a patient’s conditions

-Purpose: standardize nomenclature, language; Identify defining characteristics or symptoms

-Organized into sections detailing diagnostic criteria, usage guidance, and tools for research and assessment offering a comprehensive framework for mental health professionals

-3 main sections: Introduction- explains the use of the DSM, Diagnostic criteria- details for specific disorders, Emerging measures and models- tools for further research and assessment

Limitations of the DSM

-Faces criticisms of cultural bias, over-diagnosis, and reliance on subjective reporting, highlighting areas for future improvement in mental health care

-Overdiagnosis or pathologizing normal behavior

-Cultural bias in some criteria

-Reliance on subjective reporting

-Gender bias

-Future directions: A more dimensional and inclusive approach to diagnosis

Research Domain Criteria (RDoC)