Chapter 6 - Mental Health Assessment Flashcards
What is the leading cause of disability worldwide?
depression
The suicide rate in indigenous communities is ___ higher than the rest of the population
2x (first nations) 6-11x (inuit)
How does the DSM-5 define PTSD?
a trauma related disorder where symptoms begin or worsen after the event
What do individual responses to trauma depend on?
1) nature of the trauma
2) characteristics of the individual
3) the environment of the individual
What is considered a positive screen for the Primary Care PTSD Screen?
-indicating you have had a traumatic experience
-answering yes to at least 3/5 of the following questions
Mental Health (positive) Definition
capacity to feel, think, express emotions and behave in ways that enhance ability to manage challenges and adapt
Mental Disorder Definition
the medical term for mental illness that is defined and diagnosed according to DSM-5
Concurrent Disorder Definition
co-occurrence of a mental health disorder and a problematic substance use disorder
40-__% of people with mental illness develop a substance use disorder at some point
60%
What are the 6 Dimensions of Recovery-Oriented Practice?
- Creating culture and language of hope
- Recovery is personal (unique)
- Recovery occurs in the context of ones life (encourage connection to family, friends, culture, spirit)
- Respond to the diverse needs of everyone
- Working with FNMI
- Recovery is about transforming services and systems
Stigma Definition
an attribute associated with difference that is deemed less desirable by one person in relation to another
Elements of Stigma
-labelling
-stereotyping
-“othering’’ us vs. them
-discrimination
-power dynamics that affect ones ability to access resources
What is important for the nurse to assess about themselves before conducting a mental health assessment?
the factors in their own life that may impact the nurse-patient relationship AND their own understanding of mental health and wellness
Relational practice is ________, _________, and reflexive
respectful, nonjudgemental
What must the nurse understand about the patient?
-mental health and wellness
-illness beliefs and experiences
-challenges with daily living
-strengths and resources
What combined elements help gather information during a mental health assessment?
-observation
-interview
-examination
-physical assessment
-collaboration
When should you observe the patient?
-at different times of day
-in different situations
-with various people
What is the purpose of interviewing?
-building rapport
-clarify perceptions and meaning
-gather factual knowledge
Mental Health Interview Components
-complete health history
-source of info
-ID
-reason for seeking care
-past health
-family health history
-developmental considerations
-present health (allergies, meds, etc.)
Mental Health Observation Components
-mood
-appearance
-behaviour
-cognitive function (AOx4)
-thought
Mental Health Physical Assessment
-ADLs
-nutrition patters
-sleep patterns
-activity/mobility
-elimination
-relationships
-self-esteem
-culture
-spirituality
-coping and stress management
-smoking
-alcohol
-drug use
-home environment
What is the distinguishing component of the mental status assessment?
mental status examination (included in physical assessment)
Mental Status Examination: Appearance
general presentation to others
Mental Status Examination: Behaviour
-mood and affect
-speech ability
Mental Status Examination: Cognition
-consciousness (aware of thoughts, feelings, emotions)
-orientation
-memory
-attention and concentration
-comprehension and abstract reasoning (deeper meaning beyond literal)
Immediate Memory
on the spot recall
Recent Memory
day-to-day events
Remote Memory
years of experiences
Mental Status Examination: Thinking
-perception (awareness of objects via 5 senses)
-content (thoughts, ideas, beliefs)
-process (the way someone thinks)
-insight (awareness to reality)
-judgement (ability to be logical)
When is it necessary to perform a mental health assessment?
-family members concerned about memory or social interactions
-Brain lesions (trauma, tumour, stroke)
-Aphasia
-Symptoms of mental illness are evident
What can affect interpretation and should be noted?
-health problems like alcoholism or renal disease
-medications that can cause confusion or depressing
-normal education and behaviour
-responses that indicate stress, sleep habits, substance use
What questions should you begin a mental health assessment with? WHY?
-Identification (name, dob, gender, relationship status, education, employment, etc.)
-These are usually nonthreatening questions
What are notable childhood trauma elements?
-head trauma
-abuse/neglect
-chronic illness
-birth trauma
-obstetrical history
What to inquire in family history?
-age and current health of close relatives
-if a death is reported ask when, how, and the effect on the patient
-illnesses that run in the family
How long does the Mini Cog take to complete?
3 mins
What does the Mini Cog consist of?
-3 item recall test
-clock drawing test
