Mental Health and Mental Illness

What are the three main areas a mentally healthy individual must function in?

Social, occupational, and academic responsibilities.

What does it mean to carry out social roles?

Function in society, get from point A to point B, maintain employment or schooling, and engage in social functions.

What does “adaptive and appropriate” behavior mean in mental health?

Meeting needs without hurting oneself or others.

What role do interpersonal relationships play in mental health?

They should be satisfying and healthy, including relationships with partners, children, colleagues, and friends.

Is mental health binary?

No, it exists on a spectrum with many gray areas.

Do people stay in one spot on the mental health spectrum?

No, individuals shift throughout their lives depending on circumstances.

Where are most patients in the hospital setting on the spectrum?

In the acute suffering phase.

What role can nurses play for patients who are suffering?

Be a beacon of hope and support during their distress.

What are the four stages of the mental health spectrum?

Suffering → Struggling → Surviving → Thriving.

What characterizes the “struggling” stage?

Some coping but difficulty managing life demands.

What characterizes the “surviving” stage?

Able to function and meet responsibilities, but just “getting by.”

What characterizes the “thriving” stage?

Engaged, adaptive, connected, and experiencing growth.

Why is being “stuck” in suffering or struggling concerning?

It indicates difficulty moving back toward balance and better mental health.

How is mental health connected to Maslow’s hierarchy of needs?

Mental health depends on lower-level needs (physiological and safety) being met before higher-level growth.

Why is it ineffective to focus on self-esteem or self-actualization in a patient in crisis?

Because basic needs like safety, food, shelter, or sobriety may not be met yet.

What is the order of prioritization for Maslow’s needs in behavioral health?

Imminent threat → physiological needs → safety needs → love and belonging → self-esteem → self-actualization.

What does “imminent threat wins every time” mean?

Life-threatening issues (e.g., airway/breathing/circulation problems, active suicidality, imminent harm) take priority over all other needs.

 In the hospital setting, which two needs are often the starting focus?

Physiological needs and safety needs.

How is mental illness defined?

Disorders that affect mood, behavior, and thinking.

What two criteria must be met for a behavior to be considered mental illness?

It must be incomprehensible to a mentally healthy individual and culturally relative.

 Example: A stranger slaps you with a green onion. Why could this be considered mental illness?

It’s bizarre behavior, incomprehensible outside of cultural context.

Why would slapping someone with a green onion as part of a ritual not be considered mental illness?

Because it is culturally bound and understood within that culture/religion.

What is the purpose of the DSM-5-TR?

To determine whether someone meets the diagnostic criteria for a psychiatric disorder.

What are some limitations of the DSM-5-TR?

Written by a single group, imperfect, stigmatized, and some disorders are not neatly defined.

Why is the DSM-5-TR still important?

It’s refined over time and remains the gold standard for psychiatric diagnosis.

Who usually recognizes someone’s mental illness first: family or outsiders?

Outsiders. Families often excuse symptoms as quirks or “just how they are.”

Why do families often not recognize mental illness in their own members?

They adapt to or normalize unusual behaviors within the household.

Which groups are more likely to seek mental health treatment?

Jewish individuals, women, and those with higher financial/social standing.

Which groups are less likely to seek help?

Catholics, Protestants, men, and people with lower socioeconomic status.

Why are people with higher social or financial standing more likely to access care?

Their basic needs (food, shelter, safety) are already met, allowing focus on higher-level needs.

Why might someone struggling to feed their family deprioritize mental health care?

Basic survival needs come first, making mental health treatment lower priority.

How does distance from mainstream society affect stigma?

The greater the distance, the more negative the response.

Example: Why is society more understanding of a celebrity disclosing depression?

Because they present in an admired, “acceptable” way (attractive, successful).

How are people who are visibly ill or symptomatic often treated?

With less compassion and more stigma, especially if they show symptoms publicly or at work.

What framework do nurses use throughout their careers to prioritize needs?

Maslow’s Hierarchy of Needs.

Which needs always take priority in treatment?

Physiological needs.

What is the nurse’s goal in treating mental illness with Maslow’s hierarchy?

To help patients move upward (safety → belonging → esteem → self-actualization).

What happens if a patient falls back in the hierarchy?

Treatment must start again at the unmet need level.

What does SAMHSA stand for?

Substance Abuse and Mental Health Services Administration.

What is SAMHSA’s role in behavioral health?

It promotes public health approaches to mental health, including the Recovery Model.

What is the focus of the Recovery Model?

Supporting people to live healthy, meaningful lives, even with ongoing mental illness.

Why does the Recovery Model move away from the idea of “cure”?

Because many individuals live productive lives with conditions in remission or ongoing management.

How does the Recovery Model go beyond symptom control?

It emphasizes overall quality of life, not just medical management.

What is the foundation of the Recovery Model?

Hope.

What does “person-driven” mean in the Recovery Model?

Patients define recovery for themselves and set their own goals.

Why is recovery considered holistic?

It involves not just pharmacology, but also social, cultural, spiritual, and relational dimensions.

What is peer support, and why is it important?

People with lived experience (e.g., depression, PTSD, addiction) help others with similar struggles. It provides empathy and credibility.

How are mental health symptoms viewed in the Recovery Model?

As exaggerated or unchecked versions of normal human thoughts and behaviors.

How does the Recovery Model address culture?

It acknowledges cultural context and the role of community in recovery.

What does trauma-informed care emphasize?

Shifting the perspective from “What’s wrong with you?” to “What happened to you?”

Why should providers avoid rescuing behavior in recovery?

Because the goal is empowerment and responsibility, not dependency.

What is unconditional positive regard in the Recovery Model?

 Belief that every person deserves dignity and respect simply for being human.

Why is hope critical in recovery?

Mental illness is not a death sentence; people can still live meaningful lives.

When is inpatient care used?

As a last resort when someone is a danger to themselves or others.

Why is inpatient care considered the least ideal setting?

It is expensive and often restricts basic rights.

What are the main goals of inpatient care?

Rapid assessment, stabilization, starting medications, and discharge planning/education.

Why are repeat admissions common after inpatient care?

Patients may lack clear next steps or ongoing support after discharge.

What is milieu therapy?

A structured, therapeutic environment that promotes growth and learning through patient interactions.

How do patients benefit from milieu therapy?

They learn social skills, handle interactions, and role-model adaptive behaviors for each other.

What is partial hospitalization (PHP)?

Intensive daytime treatment with patients returning home at night.

What makes PHP cost-effective?

It avoids overnight stays while providing structured care.

What is required for patients in PHP?

Safety contracts (e.g., “I will not hurt myself or drink until I return”).

What are residential settings?

Structured environments that can be transitional (like halfway houses) or long-term housing.

What is the goal of residential care?

Provide support and structure while preparing individuals for independent living.

What is the clubhouse model?

An intentional community for people with persistent psychiatric disabilities.

What kinds of support does a clubhouse provide?

Shared meals, job placement help, and community building.

What is ACT? (Assertive Community Treatment)

A team-based program where providers meet patients in the community.

Who benefits most from ACT?

Patients with transportation issues or poor medication adherence.

What services does ACT provide?

Check-ins and administration of long-acting medications.

What is telepsychiatry?

Mental health care delivered remotely through technology.

Who benefits most from telepsychiatry?

Rural patients or those with transportation difficulties.

Why is telepsychiatry valued?

It’s cost-effective and increases access to care.

Why must basic needs be met first in treatment?

Without them, higher-level mental health work cannot be successful.

How is recovery best described?

Dynamic and multifaceted, involving medical, social, cultural, and personal aspects.