Basic Mental Illness

Question 1

Effective things nurses can do to help patients with mental illness?

Answer 1

See their patient, maintain safety, maintain therapeutic milieu, maintain therapeutic environment, show care, show empathy, have clinical competence, learn therapeutic communication skills, become self-aware

Question 2

Name some aspects of mental health?

Answer 2

Effective coping, happiness, control of behavior, appraisal of reality, effective in work, healthy self-concept, satisfying relationships

Question 3

Name some “good” mental health attributes?

Answer 3

Healthy self-concept and value, ability to play and laugh, ability to love and experience joy, capacity to deal with conflicting emotions, living without fear, guilt, anxiety. Ability to take responsibility for one’s actions, attaining self-defined spirituality, negotiate each developmental task

Question 4

What’s involved in thinking clearly?

Answer 4

Problem solving, using good judgment, reasoning logically, reaching insightful conclusions, being creative

Question 5

What’s involved in relating to others?

Answer 5

Forming close relationships. Having close, loving, adaptive relationships. Experiencing empathy toward others. Managing interpersonal conflict constructively.

Question 6

Psychiatry’s definition of mental health changes and reflects what?

Answer 6

Changes in cultural norms and society’s expectations. Values and professional biases. Individual differences and political climate. Psychology of women.

Question 7

Why does no one definition of mental exist that fits all?

Answer 7

All people have different backgrounds and cultures. Grow intellectually and emotionally at different rates. Make different decisions at different times. May or may not evaluate their behaviors. Have or have no spiritual beliefs. Grow within themselves.

Question 8

A collection of negative attitudes, beliefs, thoughts, and behaviors that influence the individual and general public. Attitudes towards individuals who are mentally ill have harmful effects on the individual and the family.

Answer 8

Stigma. Has been acknowledged to be a major barrier in mental health treatment and recovery over the the last 13-14 years.

Question 9

What psychosocial processes lead to stigmatization?

Answer 9

Stereotyping, labeling, separating, and status loss or discrimination in a context of lower imbalance, social isolation, and reduced opportunities.

Question 10

The DSM-5 includes information specifically related to culture in what three areas?

Answer 10

Discusses cultural variations for each clinical disorder
Describes culture-bound syndromes
Outline assists clinicians in evaluating and reporting the impact of an individual’s cultural context.

Question 11

What are examples of issues facing those with severe persistent mental illness (SPMI)?

Answer 11

Residual symptoms. Medication side effects, particularly extrapyramidal symptoms. Meds are expensive (>20k annually). Possible relapse, chronicity, and loss. Co-occuring medical illnesses. Unemployment and poverty. Housing instability. Social isolation and loneliness. Meds reduce libido. Treatments are inadequate. Substance abuse in 50%. Victimization occurs more than twice as often among mentally ill.

Question 12

What are some issues affecting society and the individual?

Answer 12

Baker act, out-pt commitment is designed to provide mandatory treatment. Criminal offenses and incarcerations may be the result of desperation, impaired judgment, etc. May not accept treatment or meet the requirements for involuntary treatment. Can become public nuisances, committing nonviolent crimes.

Question 13

What are examples of interventions for those with SPMI?

Answer 13

Rehabilitation vs recovery model. Evidence-based treatment approaches and services. Cognitive-behavioral therapy. Promotion of family support and partnerships. Social skills training. Supportive psychotherapy. Vocational rehabilitation.

Question 14

What is seeking treatment for mental health problems complicated by?

Answer 14

The nature of the mental illness is misunderstood. Psychosis impairs a person’s ability to recognize the need for care. The health care system is complicated to navigate. Apathy is present, no motivation to seek care. There may be no previous experience with mental illness.

Question 15

Inpatient care?

Answer 15

24 hr nursing care. Locked units for safety. Crisis care. Residential treatment programs. State acute care systems. Gen-hosp psychiatric units. Private psychiatric hospital acute care.

Question 16

Outpatient care?

Answer 16

Primary care providers. Patient-centered medical homes. Primary care medical homes. Community mental health centers. Psychiatric home care. Intensive outpatient programs.

Question 17

Just as social relationships are different from therapeutic relationships, basic communication is different from what, which is called what?

Answer 17

Professional, goal-directed, and scientifically based communication, which is called therapeutic communication.

Question 18

What is involved in the communication process?

Answer 18

Stimulus, sender, message (influenced by transmission quality), person(s) receiving the message, formulation of feedback, sender again

Question 19

What factors can impede accurate communication?

Answer 19

personal, environmental, societal, power differentials, stigma

Question 20

Explain verbal and nonverbal communication?

Answer 20

90% is nonverbal, consisting of body movement, touch, proximity and eye contact.
Also pacing, intonation, clarity, brevity, timing, relevance.
Verbal is only 10%, vocabulary

Question 21

What attending behaviors can be used? Aka behaviors that encourage talking.

Answer 21

Control vocal qualities (tone and speech rate). Face the person. SOILER. Use encouraging gestures. Track verbal contact; do not change the subject. Use open-ended vs close-ended questions.

Question 22

What’s included in active listening?

Answer 22

Observing the patient’s nonverbal behaviors. Listening and understand the verbal message, a person in social context, and listening for “false notes.” Providing feedback (be there psychologically, socially, and emotionally)

Question 23

What are examples of therapeutic communication techniques?

Answer 23

Use silence, accepting, giving recognition, offering self, offering general leads, giving broad openings, placing the events in time and sequence, making observations, encouraging description of perception, encouraging comparison, relating, reflecting, focusing

Question 24

More examples of therapeutic communication techniques?

Answer 24

Exploring, giving information, seeking clarification, presenting reality, voicing doubt, seeking consensual validation, verbalizing the implied, encouraging evaluation, attempting to translate into feelings, suggesting collaboration, summarizing, open-ended

Question 25

What are examples of non-therapeutic techniques?

Answer 25

Advice giving, minimizing feelings, being falsely reassuring, making value judgements, asking “why” questions, asking excessive questions, probing, giving approval/agreeing, disapproving/agreeing, changing the subject, platitudes and stereotypical comments

Question 26

What are sophisticate techniques?

Answer 26

Challenging or confrontation. Self disclosure.

Question 27

Four areas that may prove problematic when interpreting specific verbal and nonverbal messages of the patient include?

Answer 27

Communication styles, use of eye contact, perception of touch, and cultural filters

Question 28

What’s involved in a social relationship?

Answer 28

Purpose is friendship, socialization, enjoyment, accomplishing a task. Mutual needs are met. May Include giving advice. Interactions are spontaneous. Little evaluation of interaction occurs. There is no defined end.

Question 29

What’s involved in a therapeutic relationship?

Answer 29

Purpose is to enhance pt’s growth. Pt needs are addressed. Communication is therapeutic. Interactions are goal directed and planned. Includes periodic evaluation. There is a defined end.

Question 30

Role and relationship blurring. are often a result of unrecognized what?

Answer 30

Transference and countertransference

Question 31

Person unconsciously and inappropriately displaces emotional reactions that originated from significant figures in childhood onto another individual.

Answer 31

Transference

The patient will say “You remind me of ____”

Question 32

Tendency of the nurse to displace feelings related to people in their past onto a patient.

Answer 32

Countertransference

Question 33

What are the four phases of the nurse-pt relationship?

Answer 33

Pre-orientaiton, orientation, working, termination.
Termination involves summarizing and thanking the client (where to go for help, which agencies to contact, which specific resource persons are available.

Question 34

Common patient behaviors that are more challenging to deal with?

Answer 34

States they want to kill themselves. Asked nurse to keep a secret, a personal question. Makes a sexual advance. Cries. Leaves conversation abruptly. Says they do not want to talk. Gives the nurse a present. Another pt interrupts a one-on-one conversation.

Question 35

What are examples of nurse characteristics that enhance growth?

Answer 35

Genuineness, empathy, positive regard, consistency, pacing (pt sets the pace), listening, positive attitude, communication techniques, self-awareness.

Question 36

What are the phases of motivational interviewing? Aka the prochaska model of behavioral change

Answer 36

Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse