Topic 1: Ch 1

health

a state of complete physical, mental, and social well being and not merely the absense of disease or infirmity

mental health

a state of well-being in which individuals reach their own potential, cope with the normal stresses of life, work productively, and contribute to the community; provides people with the capacity for rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem

prevailing culture, social values, cultural norms, social expectations, political climates, reimbursement criteria by third-party payer

what shapes society’s definition of mental illness

mental illness

all psychiatric disorders that have definable diagnoses that are manifested in significant dysfunctions that may be related to developmental, biological, os psychological disturbances in mental function

1. Individual attributes and behaviors:

   1. The way someone manages thoughts and feelings and navigates the everyday pressures of life; the ability to respond to social cues and participate in social activities

   2. biological/genetic factor: prenatal exposure to alcohol, oxygen deprivation at birth, family history

   3. resiliency

2. Social and economic circumstances: family, school, peer groups, career, job security, salary/benefits

3. environmental factors: access to healthcare and needs, social and economic policies, cultural beliefs

what are the contributing factors to mental health and wellbeing

resiliency

the ability and capacity for people to secure the resource they need to supports their well being; does not mean unaffected by stressors but rather effective at regulating their emotions and not focusing on negative, self-defeating thoughts

Brief Resilient Coping Scale

self-survey survey to measure resilience

• 4-13: low resilient copers

• 14-16: medium resilient copers

• 17-20 high resilient copers

Germ theory of disease

theory used in the late 1800s that explained mental illness in the same way other illnesses were being described; was abandoned quickly because causative factors for mental illness were not able to be identified

diathesis-stress model

the most accepted explanation for mental illness that says there is a biological predisposition and environmental stress/trauma factor to mental illness and says that most psychiatric disorders result form a combination of these

recovery

a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential; 10 guiding principles include

1. emerges from home

2. is person-driven

3. occurs through many pathways

4. is holistic

5. is supported by peers and allies

6. is supported through relationships and social networks

7. is culturally based and influenced

8. is supported by addressing trauma

9. involves individual, family, and community strengths and responsibilities

10. is based on respect

1990

what decade was the Decade of the Brain (designated by president Bush)

Decade of the Brain

advances and progress during this time included

• understanding the genetic basis of embryonic and fetal neural development

• mapping genes involved in neurological illnesses

• discovering that the brain uses a relatively small number of NTs but has a vast assortment of NT receptors

• uncovered the role of cytokines in disorders such as depression

• refined neuroimaging techniques

• computer modeling and lab research which led to computational neuroscience

Surgeon General’s Report on Mental Health

published in 1999 and was based on an extensive review of scientific literature in consultation with mental health providers and consumers

• mental health is fundamental to overall health

• there are effective treatments to mental health

Human Genome Project

a 13-year project that lasted from 1990-2003 that strengthened biological and genetic explanations for psychiatric conditions

New Freedom Commission on Mental Health

released recommendations for mental healthcare in America in 2003 and called for a streamlined system with less fragmentation in the delivery of care, advocating for early diagnosis and treatment, adoption of principles of recovery, and increased assistance in helping people find housing and work

1. Understand that mental health is essential to overall health

2. Mental health is consumer and family-driven

3. Disparities in mental health services are eliminated

4. Early mental health screening, assessment, and referral are common practices

5. Excellent mental health care is delivered, and research is accelerated

6. Technology is used to access mental healthcare and information

what were the 6 goals for a transformed mental health system in the US

Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series

released in 2005 and highlighted effective treatments for mental illness and addressed the huge gap between the best care and the worst, but focuses on issues such as coerced treatment, treating mental health separately from physical health problems, and lack of quality control; it encouraged healthcare workers to focus on safe, effective, patient-centered, timely, efficient, and equitable care

The Future of Nursing: Focus on Education

this 20211 report contented the old way of training nurses and called for highly educated nurses who are prepared to care for an aging and diverse population with an increasing incidence of chronic disease

1. patient centered care

2. teamwork and collaboration

3. evidence-based practice

4. quality improvement

5. safety

6. informatics

What are the 6 key QSEN competencies

Mental Health Parity Act (1996)

legislation that required insurers to provide mental health coverage to offer annual and lifetime benefits at the same level as other medical/surgical coverage

Patient Protection and Affordable Care Act (2010)

improved coverage for most Americans who are insured through a combination of expanded Medicaid eligibility and the creation of Health Insurance Exchanges

• allowed young adults to remain on their parents’ health plans until age 26

epidemiology of psychiatric-mental health

The quantitative study of the distribution of mental disorders in the human population

major depressive disorder

is the leading cause of disability worldwide and affects nearly twice as many women as men

comorbidity

The presence of two or more disorders that can occur at the same time or in a sequence

incidence

conveys information about the risk of contracting a disease; the number of new cases of mental disorders in a healthy population within a given period of time (usually annually)

prevalence

describes the total number of cases, new and existing, in a given population during a specific period of time, regardless of when they became ill

schizophrenia and bipolar disorder

what psychiatric disorders affect men and women equally

childhood and middle age

what age is the highest risk for generalized anxiety disorder

panic disorder

What psychiatric disorder typically develops in adolescence/early adulthood and 1/3 of people with this eventually develop agoraphobia

childhood or adolescence

when do symptoms of OCD and social phobia begin

PTSD

can develop at any time, high among veterans and first responders

young adulthood

when does agoraphobia typically begin

childhood

when do specific phobias usually start

men

antisocial personality disorder is most common in who

clinical epidemiology

a broad field that examines health and illness at the population level and includes:

• studies of natural history of an illness

• studies of diagnostic screening tests

• observational and experimental studies of interventions used to treat people with the illness or symptoms

DSM-5

identifies disorders based on specific criteria and is used in inpatient, outpatient, partial hospitalization, consultation-liaison, clinics, private practice, primary care, and community settings; also a tool for collecting statistics of the diagnosis of psychiatric disorders

Contains:

1. Neurodevelopmental

2. schizophrenia spectrum

3. bipolar and related

4. depressive

5. anxiety

6. OCD

7. trauma and stressor-related

8. dissociative

9. somatic symptom

10. feeding and eating

11. elimination

12. sleep wake

13. sexual dysfunctions

14. gender dysphoria

15. disruptive, impulse control, and conduct

16. substance-related and addictive

17. neurocognitive

18. personality

19. paraphilic

20. other

psychiatric mental health nursing

nursing speciality that is dedicated to promoting mental health through the assessment, diagnosis, and treatment of behavioral problems, mental disorders, and comorbid conditions across the lifespan; work with ALL ages and assist those in crisis, those with life problems, or those with long term illnesses; work with individuals, couples, families, and groups in hospitals, at home, in shelters, in clinics, in halfways houses, and many more

phenomena of concern

the human experiences and responses for psychiatric mental health nurses

Milieu therapy

provides, structures, and maintains a safe and therapeutic environment in collaboration with patients, families, and other healthcare clinicians

International Classification for Nursing Practice

the standardized nursing classification system that is used to form and communicate nursing diagnoses and patient problems