Psych Nursing: Foundational Concepts of Mental Health Nursing

Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR)

The diagnostic guide used by mental health providers. The manual contains the description, manifestations, and any additional criteria needed to diagnose a mental health disorder (nurses use to guide interventions)

Mental Health

A condition of well-being in which an individual can positively function in their daily life and is able to cope with stressors as they appear

Mental Illness

According to the American Psychological Association, mental illness is described as "any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these."

Bias

Stereotyping, prejudice, or even discrimination against a group of people that in comparison to another group is unfair

The National Mental Health Act 1946

Established the National Institute of Mental Health

Mental Retardation Facilities and Community Mental Health Centers Construction Act 1963

federal support for community mental health centers

What does the Mental Health Continuum represent?

A range of mental health functioning from adaptive to maladaptive.

What are the two ends of the Mental Health Continuum spectrum?

Adaptive (wellness, health coping) and maladaptive (illness, unhealthy coping).

What factors influence the Mental Health Continuum?

Behaviors, emotions, cognition, and physical adaptation.

SDOMH

Social determinants of mental health (biological, social psychological, environmental, genetic, behavioral)

Adverse Childhood Experiences (ACEs)

Traumatic or negative events such as physical or emotional abuse and neglect, sexual abuse, and a dysfunctional homelife that increase the risk for depression, anxiety, behavior, and substance use disorders

Public Stigma

When there is a negative attitude toward those who have a mental illness; this can be expressed in discriminatory attitudes or actions

Self-Stigma

When an individual adopts a negative view or internalized shame regarding their condition

Institutional Stigma

When governmental policies or organizations limit opportunities for those with mental illness; this can be both intentional and unintentional

Sterotype

A generalized belief about a group of people

Prejudice

A preconceived belief about an individual not based on facts

Discrimination

unjustifiable negative behavior toward a group and its members

Implicit Bias

When the bias occurs outside of one's conscious awareness

Explicit Bias

Intentionally displaying behaviors of discrimination toward someone

Nursing Scope and Standards of Practice and the Code of Ethics guide what?

ethical decision-making and establish professional standards they must uphold

Cultural Humility

The practice of trying to appreciate and respect another individual's culture and the role it plays in the individual's life and health practices

Mental Status Examination

Assessment of cognitive and emotional functioning.

Mood Behavior

A client's mood provides information about the emotion that the client is feeling

Affect Behavior

A client's affect is an objective expression of mood (a flat affect or a lack of facial expression)

How to assess immediate memory?

Ask the client to repeat a series of numbers or a list of objects

How to assess recent memory?

Ask the client to recall recent events (visitors from the current day) or the purpose of the current mental health appointment or admission

How to assess remote memory?

Ask the client to state a fact from their past that is verifiable (their birth date or their mother's maiden name).

How to assess clients ability to calculate?

"Can the client count backward from 100 in serials of 7?"

How to assess clients ability to abstractly think?

Can the client explain the similarities between two objects? ("How are cars and trains similar?")

How to assess the client's judgement

Based on the client's answer to a hypothetical question - how would they answer the question, "What would you do if there were a fire in your room?" The client should provide a logical response.

How to assess a clients quality of their language?

Client's speech and responses should be meaningful, articulate, and appropriate.

How do nurses use the DSM-5-TR?

- establish diagnostic criteria for individual mental health disorders

- assists nurses in planning care for clients who have mental health disorders

- indicates expected data collection findings of mental health disorders

Primary Prevention of Mental Illness

promotes health and emphasizes efforts on preventing mental health problems from occurring (like community education)

Secondary Prevention of Mental Illness

focuses on early detection of mental illness - like screening older adults in the community for depression

Tertiary Prevention of Mental Illness

focuses on rehabilitation and prevention of further problems - like leading a support group

Partial Hospitalization Programs

intense short-term treatment for clients who are well enough to go home every night and who have a responsible person at home to provide support and a safe environment

Assertive Community Treatment (ACT)

reduce recurrences of hospitalizations and provides crisis intervention, assistance with independent living, and information regarding resources for necessary support services.

Community Mental Health Centers

Facilities that provides educational groups, medication dispensing programs, and individual/family counseling programs

Psychosocial Rehabilitation Programs

Provide a structured range of programs for clients in a mental health setting - like residential services and day programs for older adults

Home-based services

Types of assistance provided to people in their own homes for psychiatric treatment with special client criteria to be considered

Home-based services criteria

- Must be homebound

- Have a psychiatric diagnosis

- Need the skills of the mental health nurse

- Have a plan of care developed by the health care provider