Psychiatric Mental Health Nursing Lecture Review

Flashcards covering key terms, definitions, historical context, treatment settings, patient rights, and legal aspects related to Psychiatric Mental Health Nursing, based on lecture notes for Chapters 1, 4, 6, & 32.

What is comorbidity?

Two co-occurring chronic illnesses, such as depression and anxiety or depression and diabetes.

What is deinstitutionalization?

Legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care, leading to many hospitals closing.

What is Mental Health Parity?

The requirement that insurance companies provide equal treatment coverage for psychiatric disorders as they do for physical health conditions.

Define the Diathesis-Stress Model.

The most accepted explanation for mental illness, asserting that most psychiatric disorders result from a combination of genetic vulnerability (diathesis) and negative environmental stressors (stress).

What is dual diagnosis?

Co-occurring mental illness and a substance use disorder, such as alcohol use disorder and bipolar disorder.

What is the difference between adherence and compliance in healthcare?

Adherence refers to following the plan of care and has replaced the term compliance to imply a more active, collaborative role of the patient.

What is revolving door treatment?

A pattern, starting in the 1960s with deinstitutionalization, where patients with mental illness have repeated admissions to psychiatric inpatient units, often returning to the ED for care due to lack of community services or independent living skills.

What is recovery in the context of mental health?

A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

What is resilience?

The ability and capacity to secure resources to support well-being, characterized by optimism, a sense of mastery, and competence, which is essential to recovery.

According to the World Health Organization (WHO), what is the definition of health?

Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

How does the World Health Organization (WHO) define mental health?

Mental health is a state of wellbeing in which everyone can realize their own potential, cope with stresses, work productively, and contribute to the community, encompassing emotional, cognitive, and social well-being.

What is the American Psychiatric Association's definition of mental illness?

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these) that are associated with distress and/or problems functioning in social, work, or family activities.

What are the three main categories of influences that contribute to mental health?

Biologic, Psychological, and Sociocultural influences.

What was the prevalence of any mental illness (AMI) among US adults in 2021?

57.8 million US adults (22.8%) had any mental illness.

Name one early 19th-century theory of mental illness.

Inheritance theory (transmitted through generations), Moral degeneracy theory (mentally ill by bad character), Germ theory ('insanity' is contagious), or Septic foci theory (infection can be removed by surgery).

What were some early treatments for mental illness in the 1800s-1900s?

Restraining devices (padded helmet, hand mittens, straight jacket), chemical restraints, surgery (lobotomy), insulin therapy, hydrotherapy, sedative cold wet packs, and electro-shock therapy.

What legislation initiated deinstitutionalization?

The Community Mental Health Act.

What social movement was formed by individuals with mental illness to advocate for their rights?

The Consumer Movement, which led to the formation of the National Alliance on Mental Illness (NAMI).

What are the main goals of the National Alliance on Mental Illness (NAMI)?

Communicating that mental illnesses are brain disorders, eliminating stigma and discrimination, advocating for people with mental illness, improving access to treatment services, and integrating mental illness into community life.

What were key findings of the 2003 New Freedom Commission on Mental Health?

It found US mental healthcare was in shambles, called for a streamlined system with less fragmented care, advocated for early diagnosis and treatment, adopted principles of recovery, and increased assistance with housing and employment.

What is the purpose of the Mental Health Parity Act of 1996?

It required insurance companies to provide equal treatment coverage for psychiatric disorders as for medical/surgical conditions.

What is 'stigma' in the context of mental health?

When someone sees you in a negative way because of a particular characteristic, attribute, or personal trait, often fueled by widespread fear and misunderstanding of mental illness.

What is the Diagnostic and Statistical Manual of Mental Disorders, 5th Ed. (DSM-5)?

The official medical guidelines of the American Psychiatric Association for diagnosing psychiatric disorders, based on specific criteria influenced by multiprofessional clinical field trials.

What are the two main levels of psychiatric nursing practice?

Basic Level (Psychiatric Mental Health Registered Nurse or PMH-RN) and Advanced Practice (Psychiatric Mental Health Advanced Practice Registered Nurse or PMH-APRN).

Name at least three members of an interdisciplinary team in mental health care.

Patient, Family/Significant others, RN, MD, CNS/APRN, Psychologist, SW/LCSW, Pharmacist, Recreational (Activity) Therapist, Certified Drug and Alcohol Counselor, Teacher (Child/Adolescent), Mental Health Associates.

What is acute care hospitalization in a psychiatric setting?

A highly structured setting that optimizes safety and addresses crisis intervention, with an average length of stay of 3-7 days.

What is a Partial Hospitalization Program (PHP)?

A program for those needing supervision but not inpatient hospitalization; it's a step between inpatient and fully independent home life, typically involving six hours of group therapy multiple days a week to keep patients safe, reduce readmissions, and assist in coping.

What are the admission criteria for inpatient psychiatric mental health care?

Danger to themselves (suicidal ideation and/or behaviors), danger to others (homicidal ideations), or individuals unable to care for basic needs and/or gross impairment of judgment, placing them at imminent risk due to inability to protect oneself.

What is voluntary admission to a psychiatric hospital?

When both the individual and the healthcare professionals agree with the need for treatment and hospitalization, and the individual signs a consent for treatment.

Describe involuntary admission or commitment.

When a healthcare professional feels admission is necessary, but the individual does not wish to be admitted. This can involve a 72-hour hold, after which a court petition may be sought if treatment is still deemed necessary.

List at least three rights of every hospitalized psychiatric patient.

The right to receive or refuse treatment, dignity, involvement in planning, protection from harm, legal counsel, communicate, confidentiality, or least restrictive means.

What does 'informed consent' mean regarding patient rights?

The patient is informed of risks, benefits, and alternatives of treatment, and must voluntarily accept the treatment.

Are orders for restraint or seclusion ever written as an 'as needed' or standing order?

No, orders for restraint or seclusion are never written as an as needed or as a standing order.

What are exceptions to patient confidentiality?

Duty to warn and protect third parties, and child and elder abuse reporting statutes.

What is a therapeutic milieu?

The surroundings and physical environment of the inpatient hospital unit, which provides a sense of security/safety, promotes social competence and self-worth through interactions, serves as a real-life training ground, and offers activities, unit rules, and group therapy.

Name one component of a therapeutic milieu.

Containment (provision of basic needs, safety, security), Support (encouragement, praise, positive feedback), Validation (respecting privacy, cultural needs, feelings), Structure (control and limitation of maladaptive behaviors, setting limits), or Involvement (promoting client self-efficacy).