10.1 Caring for Patients with Mental Illness and Substance Use Disorders

Question 1

Mental Health Illness

Answer 1

• Clients with mental health illness dies 25 years earlier than the general population with 60% of those coming from preventable or treatable causes.

Question 2

Diagnostic Overshadowing

Answer 2

• Phenomenon where physical symptoms are attributed to their mental illness
• Clients with mental illness who go to general healthcare are at risk for lack of treatment or appropriate referrals
• This is due to lack of knowledge of symptom detection, stigmatization, and lack of awareness about counseling and referral services

Question 3

Depression is a Risk Factor For

Answer 3

• Cardiovascular disease
• Metabolic syndrome
• Diabetes
• Dementia
• Asthma
• Arthritis
• Hyperlipidemia

Question 4

Screening for Mental Illness

Answer 4

• Used to identify symptoms that require further assessment/intervention

Priorities
- Trauma
- Suicide Risk
- Substance abuse disorders

Question 5

Trauma

Answer 5

• Essential psychosocial issue that should be screened for upon arrival to any healthcare setting

Violence and trauma are high risk for
- Injury
- Unhealthy coping mechanisms
- Arthritis, IBS, Chronic Pain

Childhood trauma can cause
- Cognitive change
- Psychosocial change
- Social change
- Neurobiological change

Question 6

Trauma Informed Care

Answer 6

• Care that assesses and demonstrates sensitivity to impact of trauma on current behavior and relationships.
• Nurses need to understand that there is a risk of retraumatizing a patient if there is lack of awareness

Question 7

Common groups who may not be forthcoming of suicide

Answer 7

• Military with PTSD
• Older adults with depression
• Trauma victims
• Medical professionals
• Law enforcement officials (high rates of substance abuse and alcohol)

Question 8

Preventing Suicide

Answer 8

• Screening
• Trust and collaborative relationship

Risk Factors
- Depression
- Substance abuse
- Chronic pain

Question 9

Non-Suicidal Self-Injury Behavior

Answer 9

• Non lethal repetitive act to reduce distress rather than end ones own life
• Patients with psychiatric co-morbidities should be referred to a specialized mental-healthcare services.
• These patients are at higher risk for suicide

ALERT
- Patients who do this due to command hallucinations NEED IMMEDIATE MEDICAL ATTENTION

Question 10

Substance Abuse Disorders

Answer 10

• Methamphetamine withdrawal has a higher chance of suicide
• Many patients deny substance abuse disorders due to fear of legal consequences.
• Substance abuse during pregnancy can have legal consequences.
• Establish trust, clear communication, and tell patients why information is being collected.

Question 11

SBIRT (Used for Substance Abuse Disorders)

Answer 11

S - Screening
(Quickly assess severity of substance use and identify level of treatment)

BI - Brief Intervention
(Focus on increasing awareness of substance use and motivation towards behavior change)

RT - Referral to Treatment
(Identify those who need more extensive treatment and provide them with access to specialty care)

Question 12

Referrals

Answer 12

• Listen to the patient
• Empower their decision making
• Establish collaborative partnership
• Those at risk of hurting themselves or unaware of their significant symptoms need to be referred to a “restrictive environment” (even against their will)

Question 13

Stigmatization

Answer 13

• Devaluing a person because of a particular characteristic or illness.
• Creates a barrier to effective treatment in healthcare settings.

Question 14

Social Distancing

Answer 14

• Aspect of stigma
• Avoid people with mental health or addiction issues.