Ch. 1-Foundations of Community Mental Health and Illness Flashcards
asylum
institution for care of mentally ill
assertive community training (ACT)
way of delivering comprehensive and effective services to people with severe mental illness that includes support services
community
group of people who share common characteristics
community mental health
development and delivery of programs for a defined group of people to promote, protect, and treat mental health and its problems
culture
set of learned behaviors, beliefs, attitudes, values, and ideals characteristic of a particular society or population
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV)
standard manual used for diagnosis of mental disorders in the United States
“Bible of Mental Health”
disability-adjusted life year
DALY
measure that expresses years of life lost to premature death and disability
electroconvulsive therapy
ECT
electroshock treatment in which seizures are electrically induced for therapeutic effect; usually used to treat severe major depression unresponsive to other treatment
lobotomy
surgical technique that involves making an incision in the frontal lobe, severing several nerve tracts
mental disorders
characterized by alterations in thinking, mood, or behavior
-behavioral or psychiatric symptoms that describe the illness
mental health
successful performance of mental function, resulting in productivity, relationships, and ability to adapt and cope
-springboard of thinking and communication skills, learning, emotional growth, resilience, and self esteem
mental health problems
signs and symptoms are not intense or long enough to meet criteria for mental disorder
mental illness
umbrella term for all mental disorders
psychopathology
study of the origin, development, and manifestations of mental or behavioral disorders
public health
prevention of disease and promotion of health by government agencies that is concerned with health of community as a whole
seasonal affective disorder
SAD
winter depression, mood disorder in which people with normal health have depressive symptoms during certain times of the year
somatic
derives from greek word some-the body
conditions in which alterations in non-mental functions are dominant
What percentage of those 18+ are affected by mental illness?
26.2% yearly, or 1/4 americans
What contributes to stigmas?
fear of being judged, silence on the issue, and feeling ashamed
disorder
change in thinking, mood, or behavior with distress or impaired function
bereavement
grieving and letting go
-if it lasts longer than 2 months it can lead to a disorder
What did René Descartes say about mental illness?
he said the mind and the body are completely separate (religion and physical)
We need to distinguish between mind and _______ health.
somatic
Mental illness was originally believed to be related to what?
the moon
- believed to be caused by a baby born during a full moon or sleeping in the light of a full moon
- called “lunatics” and many were tortured
When and where was the first asylum built?
1751 in Pennsylvania because there were too many to care for in the home
-ignited beginning of 4 movements because the conditions were harsh
Moral Treatment Movement
- 1800 to 1850
- introduced by William Tuke, saying people needed asylum away from home and everyday situations to heal
- Dorothea Hix and Horace Mann agreed on somatic and psychosocial treatment
- building private and public asylums defined period
- used for untreatable chronic patients
- moral meant “return of person to reason by application of psychologically oriented therapy”
Mental Hygiene Movement
- 1890 to 1920
- Adolf Meyer and Clifford Beers
- mental illness can be cured if treated early
- developed lobotomy and electroconvulsive therapy
- newspapers revealed deteriorating conditions
Community Mental Health Movement
- 1955 to 1970
- Joint Commission on Mental Health and Illness report of 1961
- led to Mental Retardation Facilities and Community Mental Health Centers Act in 1963 under JFK
- reformers said long term stay was harmful, led to decreased hospital stay length and the discharge of many
- Medicare and Medicaid offered benefits (encouraged psychiatric units, paid for rehab, etc)
- not successful with deinstitutionalized chronic patients
- community did not welcome discharged patients
Community Support Movement
(1975-present)
- realization and criticism contributed to this
- acute treatment and prevention and helping chronic patients
- support systems to address welfare needs
- Assertive Community Training delivered services to those that did not respond well
- advocacy, housing assistance, and financial assistance came from ACT
- current system: lack of insurance, barriers, stigma
What did the public think of mentally ill individuals in the 90s?
38% thought depression was a health problem, but the majority of people still thought of them as dangerous
What percentage of people said they thought depression was a health problem in the 2000s?
72%
What percentage of people said they were comfortable around someone with diabetes or cancer?
94%
What percentage of people said they were comfortable around someone that is depressed, or that has bipolar disorder or schizophrenia?
63%; 45%
What will help with overall stigma reduction?
advocacy programs, research, educating the public
locality
geographic locations and type
-ex) small town, urban area
relational community
defined by interpersonal relationships and not location
-ex) nurses, sexual orientation, ethnic groups, gender
6 Elements of Community
membership-sense of belonging
common symbol systems-similar rituals, language, ceremonies
shared values and norms
mutual influence-members influence group and vice versa
shared needs and commitment to meeting them
shared emotional connection
5 Levels of Communities
Individuals-smallest level
-research focused on relationship between person and environment
Microsystems
-communities the person directly interacts with and influences
Organizations
-large systems made of smaller units
Locality
-geographic locations, they positively or negatively impact culture
Macrosystems-largest
-populations categorized by factors like gender, race, ethnicity
3 Main Factors that affect Mental Health
social, physical, and cultural issues
risk factors
negatively affect mental health
protective factors
positively affect mental health
social and cultural issues
numerous, complex, and related
-socioeconomic status, availability of service, crime rates
community stressors
crime, noise, traffic, litter, crowding
-can lead to depression, violence, and substance abuse
What is “Broken Windows: The Police and Neighborhood Safety?”
theory by James Wilson and George Kelling stating that physical factors can contribute to problems if left unattended (like broken windows, litter, etc)
Psychiatric disorders are ___ percent of all health related disability.
24%
How many people 18+ have a diagnosable psychiatric disorder?
22.1%
_________ is the leading cause of disability for ages ______.
mental disorders; 15-44
What is the leading cause of preventable death?
suicide
Mental illness is the ____ leading cause of disability and premature death.
second
What percentage of years in your life would you lose to disability or death from cardiovascular conditions?
18.4%
undefined burden
economic and social burden
negatively impacts victim’s role in community and incurs costs
hidden burden
associated with stigma and violations of rights
research does what to improve the wellbeing of victims of mental illness?
alleviates suffering and reduces financial burden
-because research caused advances in preventing, diagnosis, and treating
what did congress declare 1990s and why?
the decade of the brain
there was an increase in mental health problems
The Decade of the Brain
Human Genome Project added to knowledge about problems and causes
-improved meds and dosing, diagnosis, and prevention
public health model
- attends to health of entire population
- focus on epidemiological surveillance, health promotion, prevention, and access to services
- expanded to include interest and concerns about prevention and health promotion
What is the annual cost estimate of mental illness?
$318 billion total
-$100 billion directly (treatment) and the rest indirectly (lost productivity due to disability or death)
How much of the indirect annual cost of mental illness is due to lost wages alone?
60.8%
Why study community mental health?
- problems are widespread
- problems are disabling
- research paved way for identification and treatment
- prevention efforts are effective
- problems are costly
CDC definition of mental health
state of well being where the person realizes abilities, copes with normal stressors, and works productively
How many adults are in an optimal state of mental health?
17%
Which mental illness is the most common?
depression
emotional well-being
perceived life satisfaction, happiness, cheerfulness, peacefulness
-how they “emote”
psychological well being
self acceptance, control of environment, having a purpose, personal growth
social well-being
potential self worth, acceptance, usefulness, sense of community
indicators for mental illness represent 3 domains:
emotional, psychological, and social
social determinants of mental health
adequate housing, safe neighborhoods, quality education, stable job and wages
symptoms of major depression
2 weeks or more feeling:
sad, uninterested in things there was a previous interest, psychomotor retardation or agitation (staying in bed all day or not staying put), increased or decreased appetite
obstacles to reform
stigma-community didn’t welcome
housing services not available, couldn’t work
What were the two medications for psychosis and depression developed during the Community Mental Health movement?
Thorazine and Lithium
How many people today suffer without treatment?
2.2 million
