Chapter 12: Caring For Patients With Mentak Illness And Substance Use Disorders In General Practice Settings Flashcards
Intro: The client with mental illness…
Has historically been misunderstood, misdiagnosed, and mistreated.
We overlook people. Mental illness is not screened for in every setting.
The need for education of healthcare providers
Clients with significant mental illness die 25 years earlier than the general population
60% of those deaths are related to preventable or treatable causes
Diagnostic overshadowing
The phenomenon in which a person’s physical symptoms are attributed to their mental illness
Depression is a risk factor for…
Cardiovascular disease, metabolic syndromes, diabetes, dementia, asthma, arthritis, and hyperlipidemia.
Screening
The use of screening tools is better than clinical judgment alone in the diagnosis of mental illness.
Horowitz and associates tool for suicide screening in general practice
Start with 2 questions:
- In the past month have you had thoughts about suicide?
- Have you ever made a suicide attempt?
- Yes to either prompts this question:
- Are you having thoughts of suicide right now?
A good nurse manager…
Keeps in touch with nurses
Equips their staff with reliable and user-friendly tools
Screening priorities. Those who are high risk:
Trauma, suicide risk, substance use disorders
Trauma
Screen everyone
Most individuals affected by violence are women and children
It is ok to ask about trauma! You won’t re-traumatize them.
Trauma is linked to many physical and mental problems and early death
Trauma informed care
Nurses should recognize the risk of traumatizing patients if there is a lack of sensitivity to the impact of that trauma.
Risk for suicide
Certain groups of people like military personnel with with PTSD, older adults with depression, trauma victims should be specifically screened.
A brief screening…
… Is not enough prevent suicide in some individuals
Adapt to each patient and follow up! Do’t just “click a box”
Risk for suicide: Nonsuicidal self-injuring behavior (NSSIB)
Typically a non lethal, repetitive act used to reduce distress rather than end one’s life.
Substance use disorders: Facts about USA
Opioid addiction can lead to overdose, and rates of opioid abuse reached epidemic levels in the U.S.
Methamphetamine use has also increased significantly. Withdrawal of this is associated with increased risk for suicide.
Screening, brief intervention, and referral to treatment (SBIRT)
It quickly asses the severity of substance use and identifies the appropriate level of TX
Brief intervention: increase insight and awareness. Motivation onward change.
Referral to TX provides hose identified as needing more extensive treatment with access to specialty care.
