Chapter 11 Community Mental Health

Mental Health

--- emotional and social well-being, including one's psychological resources for dealing with day to day problems in life

Mental Illness

-- a collective term for all diagnosable mental disorders

Mental disorders

--- health conditions characterized by alterations in thinking, mood, or behavior associated with distress and or impaired functioning

Major depression disorder (DEPRESSION)

-- an affective disorder characterized by a dysphoric mood, usually depression, or loss of interest or pleasure in almost all usual activities or pastimes

Introduction

-- Mental illness is the leading cause of disability in North America and Europe

-- 26% of American adults have a mental or addictive disorder during a given year

-- 6% of adults in the United States have a serious mental illness

--- Needs of people with mental illnesses are diverse

--- 1/2 of people with mental illness have more than one disorder

Good Mental Health

Adults with good mental health are able to:

--- Function under adversity

--- Change or adapt to changes around them

--- Maintain control over their tension and anxiety

--- Find more satisfaction in giving than receiving

--- Show consideration for others

----- Curb hate and guilt

--- Love others

Stress

--- Fight or flight reaction

-- diseases of adaptation

-- Psychophysiological disorders

--- Avoiding stressful situations preferable to managing stress

--- Stress management

--- Community support

Classification of Mental Disorders

--- Classification of mental disorders arbitrary because based on descriptions of behavioral signs and symptoms rather clinical measurements

--- Diagnostic and Statistical Manual of Mental Disorders

Cultural Competence

--- service--provider's degree of compatibility with the specific culture of the population served, like, proficiency in languages other than English, familiarity with cultural idioms of distress or body language, folk beliefs, and expectations regarding treatment, procedures, and likely outcomes

General adaptation syndrome ( GAS)

--- The complex physiological responses resulting from exposures to stressors

Fight or flight reaction

--- an alarm reaction that prepares one physiologically for sudden action

Diseases of adaptation

--- diseases resulting from chronic exposure to excess levels of stressors that produce a general adaptation syndrome response

Moral treatment

--- a nineteenth-century treatment in which people were removed from the everyday life stressors of their home environments and given "ASYLUM" in a rural setting, including rest, exercise, fresh air, and amusements

Electroconvulsive therapy ( ECT)

--- a method of treatment for mental disorders involving the administration of electric currents, to induce a coma or convulsions

Lobotomy

-- surgical severance of nerve fibers of the brain by incision

National Institute of Mental Health ( NIMH)

--- The nation's leading mental health research agency, housed in the National "Institutes of Health

Deinstitutionalization

--- the process of discharging, on a large scale, patients from state mental hosiptals to less restrictive

Chlorpromazine

--- the first and most famous antipsychotic drug, introduced in 1954 under the name Thorazine

Neuroleptic drugs

--- pharmaceuticals that reduce nervous activity; another term for antipsychotic drugs

Chemical straitjacket

--- a drug that subdues a mental patient's behavior

Tardive dyskinesia

--- irreversible, involuntary, and abnormal movement of the tongue, mouth, arms, legs, which can result from long--term use or certain antipsychotic drugs

Mental Retardation Facilities and Community Mental Health Centers Act

--- a law that made the federal government responsible for assisting in the funding of mental health facilities and services

Community mental health center ( CMHC)

--- A fully staffed center originally funded by the federal government that provides comprehensive mental health services to local populations

Transinstitutionalization

--- transferring patients from one type of public institution to another, usually as result of policy change

Bipolar Disorder

--- an affective disorder or characterized by distinct periods of elevated mood alternating with periods of depression

Legal leverage

--- a court ordered mandate to force a patient to accept treatment, which may involve service providers taking control the patient's disability income and/or suspending the patient's eligibility for subsidzed housing

Mental health courts

--- use judges who have special training and can use nonadversarial procedures to mandate and rehabilitation if the individual is found guility rather than incarcration

Psychopharmacological therapy

--- treatment for mental illness that involves medications

Psychotherapy

--- a treatment that involves verbal communication between the patient and a trained clinician

Cognitive --- behavioral therapy

--- treatment based on learning theory in which a patient learns adaptive skills through rewards and satisfaction

Recovery

--- outcome sought by most people with mental illness; includes increased independence, effective coping, supportive relationships, community participation, and sometimes gainful employment

Psychiatric rehabilitation

-- intensive, individualized services encompassing treatment, rehabilitation, and support, delivered by a team of providers over an indefinite period to individuals with severe mental disorders to help them maintain stable lives in the community

evidence - based practices

-- ways of delivering services to people using scientific evidence that shows that the services are effective

Self-help groups

-- concerned members of the community who are united by a shared interest, concern, or deficit not shared by other members of the community ( AA)

National Alliance on Mental Illness ( NAMI)

-- a national self-help group that supports the belief that major mental illnesses are brain diseases that are of genetic origin and biological in nature and are dignosable and treatable with medication

Parity

--- the concept of equality in health care coverage for people with mental illnesses or injuries

Affordable Care Act

--- a law passed in 2010 requiring individuals whose income is less than 133% of the federal poverty line to be eligible for Medicaid with all plans covering mental and substance use disorders at partity with medical-surgical benefits