2. Mental Health & Mental Illness

Question 1

TRUE/FALSE

1. Mental health and mental illness are difficult to define precisely.
2. People who can carry out their roles in society and whose behavior is appropriate and adaptive are viewed as healthy.
3. People with emotional wellbeing or mental “healthiness” do not function comfortably in society and are not satisfied with their achievements.

Answer 1

1. True
2. True
3. False

Question 2

….it is the successful performance of mental function, resulting in productive activities, fulfilling relationships & the ability to adapt to change and cope with adversity.

Answer 2

Mental health

Question 3

Mental health provides:

Answer 3

• the capacity for rational thinking
• Communication
• Learning
• Emotional growth
• Resilience
• Self-esteem

Question 4

Elements of Mental health:

Answer 4

1. Self-governance: acting independently, dependently, or interdependently as the need arises without permanently losing autonomy
2. Progress toward growth or self-realization: being willing to move forward to maximize capabilities.
3. Tolerance of the unknown: facing the uncertainty of life and the certainty of death with faith and hope.
4. Self-esteem: being aware and accepting of personal abilities and limitations through lifelong self-reflection and feedback from others.
5. Reality orientation: distinguishing fact from fantasy and behaving accordingly.
6. Mastery of environment: interacting competently, effectively, and creatively with and influencing environmental contexts.
7. Stress management: experiencing congruent emotions in daily life and tolerating stress-provoking situations in an adaptive, creative, and flexible way, knowing that any negative feelings are time limited.

Question 5

• Prenatal, perinatal, and neonatal events
• Physical health status
• Nutrition
• History of injuries
• Neuroanatomy
• Physiology

Answer 5

Biologic Influences of Mental health

Question 6

• Interactions
• Intelligence quotient
• Self-concept
• Skills
• Creativity
• Emotional
  developmental level

Answer 6

Psychological Influences of Mental health

Question 7

Family stability
- Ethnicity
- Housing
- Child-rearing patterns
- Economic level
- Religion
- Values and beliefs

Answer 7

Sociocultural Influences of Mental health

Question 8

The American Psychiatric Association (APA, 2000) defines a mental disorder as:

Answer 8

“A clinically significant behavioral or
psychological syndrome or pattern that occurs in an individual and is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom”.

Question 9

General criteria to diagnose mental disorders include:

Answer 9

• Dissatisfaction with one’s characteristics, abilities, and accomplishments.
• Ineffective or unsatisfying relationships.
• Dissatisfaction with one’s place in the world.
• Ineffective coping with life events & lack of personal growth.

Question 10

Factors contributing to mental illness can also be viewed within:

Answer 10

1. Individual factors:
   - Biologic makeup
   - Intolerable or unrealistic worries or fears.
   - Inability to distinguish reality from fantasy.
   - Intolerance of life’s uncertainties.
   - A sense of disharmony in life.
   - A loss of meaning in one’s life.
2. Interpersonal factors:
   - Ineffective communication,
   - Excessive dependency on or withdrawal from relationships.
   - No sense of belonging.
   - Inadequate social support.
   - Loss of emotional control.
3. Social/cultural factors
   - Lack of resources
   - Violence
   - Homelessness
   - Poverty
   - An unwarranted negative view of the world.
   - Discrimination such as stigma, racism, classism, ageism, and sexism.

Question 11

This term….refers to 2 aspects of nursing that interact and overlap.

Answer 11

Psychiatric–mental health nursing

1. Psychiatric nursing: focuses on the care and rehabilitation of people with identifiable mental illnesses or disorders.
2. Mental health nursing: focuses on well and at-risk populations to prevent mental illness or provide immediate treatment for those with early signs of a disorder.

Question 12

Psychiatric–Mental Health Nursing: Scope and Standards of Practice describes psychiatric–mental health nursing as committed to promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders.

Answer 12

(American Nurses Association [ANA],
American Psychiatric Nurses Association [APNA],
International Society of Psychiatric–Mental Health Nurses [ISPN], 2007).

Question 13

• She improved nursing care in psychiatric hospitals and organized educational programs in state mental hospitals in Illinois.

-……she is called the first American psychiatric nurse.

Answer 13

Linda Richards

Question 14

STANDARDS OF PROFESSIONAL PERFORMANCE

Answer 14

• Standard 7. Quality of Practice: The psychiatric–mental health registered nurse systematically enhances the quality and effectiveness of nursing practice.
• Standard 8. Education: The psychiatric–mental health registered nurse attains knowledge and competency that reflect current nursing practice.
• Standard 9. Professional Practice Evaluation: The psychiatric–mental health registered nurse evaluates one’s own practice in relation to the professional practice standards and guidelines, relevant statues, rules, and regulations.
• Standard 10. Collegiality: The psychiatric–mental health registered nurse interacts with and contributes to the professional development of peers and colleagues.
• Standard 11. Collaboration The psychiatric–mental health registered nurse collaborates with patients, family, and others in the conduct of nursing practice.
• Standard 12. Ethics: The psychiatric–mental health registered nurse integrates ethical provisions in all areas of practice.
• Standard 13. Research The psychiatric–mental health registered nurse integrates research findings into practice.
• Standard 14. Resource Utilization: The psychiatric–mental health registered nurse considers factors related to safety, effectiveness, cost, and impact on practice in the planning and delivery of nursing services.
• Standard 15. Leadership: The psychiatric–mental health registered nurse provides leadership in the professional practice setting and the profession.

Question 15

PSYCHIATRIC–MENTAL HEALTH NURSING: SCOPE AND STANDARDS OF PRACTICE

Answer 15

• Standard 1. Assessment: The psychiatric–mental health registered nurse collects comprehensive health data that is pertinent to the patient’s health of situation.
• Standard 2. Diagnosis: The psychiatric–mental health registered nurse analyzes the assessment data to determine diagnoses of problems, including level of risk.
• Standard 3. Outcomes Identification: The psychiatric–mental health registered nurse identifies expected outcomes for a plan individualized to the patient or the situation.
• Standard 4. Planning: The psychiatric–mental health registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.
• Standard 6. Evaluation: The psychiatric–mental health registered nurse evaluates progress toward attainment of expected outcomes.

Question 16

Psychiatric–mental health nursing is built on certain principles or beliefs about people and the care they deserve:

Answer 16

• Every person is worthy of dignity and respect.
• Every person has the potential to change and grow.
• All people share basic human needs.
• All behavior is meaningful and can be understood from the person’s perspective.
• People have the right to participate in decisions affecting their health and treatment.
• Through the therapeutic use of self, via therapeutic relationships and communication, nurses help people adapt, change, and grow.

Question 17

• …..these are authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable.
• In 1973, the division of psychiatric and mental health practice of the American Nurses Association (ANA) developed…..which it revised in 1982, 1994, 2000, and 2007.

Answer 17

Standards of Care

Question 18

• Her 1968 work, Nursing Therapy: described her approach of focusing on clients’ psychosocial needs and strengths.
• She contended that the nurse as therapist is particularly suited to working with those with severe mental illness in the context of daily activities, focusing on the here and now to meet each person’s psychosocial needs (1986).

Answer 18

Mellow

Question 19

• In 1952, she published Interpersonal Relations in Nursing and Interpersonal Techniques: The Crux of Psychiatric Nursing in 1962.
• She described the therapeutic nurse–client relationship with its phases and tasks and wrote extensively about anxiety.

Answer 19

Peplau

Question 20

PSYCHIATRIC–MENTAL HEALTH NURSING - SCOPE AND STANDARDS OF PRACTICE Standard 5:

Answer 20

• Standard 5. Implementation: The psychiatric–mental health registered nurse implements the identified plan.
• Standard 5A. Coordination of Care: The psychiatric–mental health registered nurse coordinates care delivery.
• Standard 5B. Health Teaching and Health Promotion: The psychiatric–mental health registered nurse employs strategies to promote health and a safe environment.
• Standard 5C. Milieu Therapy: The psychiatric–mental health registered nurse provides, structures, and maintains a safe and therapeutic environment in collaboration with patients, families, and other health-care clinicians.
• Standard 5D. Pharmacological, Biological, and Integrative Therapies: The psychiatric–mental health registered nurse incorporates knowledge of pharmacological, biologic, and complementary interventions with applied clinical skills to restore the patient’s health and prevent further disability.
• Standard 5E. Prescriptive Authority and Treatment: The psychiatric–mental health advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations.
• Standard 5F. Psychotherapy: The psychiatric–mental health advanced practice registered nurse conducts individual, couple, group, and family psychotherapy using evidence-based psychotherapeutic frameworks and nurse–patient therapeutic relationships.
• Standard 5G. Consultation: The psychiatric–mental health advanced practice registered nurse provides consultation to influence the identified plan, enhance the abilities of other clinicians to provide services for patients, and effect change.

(Note: Standards 5D–G are advanced practice interventions and may be performed only by the psychiatric–mental health advanced practice registered nurse.)