Exam 3.1 Flashcards
Mental illness
Leading cause of disability in north America and Europe, refers collectively to all diagnosable mental disorders
Mental health
State of successful performance of mental function
Mental disorders
Health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning
Causes of mental disorders
Poor prenatal care, stress, trauma, disease, nutrition deficiency, maladaptive family functioning
Stress
Psychological and physiological response to stressors
General Adaptation Syndrome (GAS)
Normal level of resistance vs. stages of alarm, resistance, and exhaustion
Avoiding stressful situations is preferable to
Managing stress
Mental health is
one of the most pervasive health problems in the US
Mental health care in colonial America
care by families or private caretakers
Mental health care in the 18th century
institutionalization first appeared, care in undifferentiated poorhouses or almshouses alongside people with non-mental disorder diagnosis
Mental health care in early 19th century
first efforts to separate people based on type of disability
The Moral treatment era
began in 1972, belief that environmental changes could affect the mind and alter behavior, people removed from everyday life and stressors of home, given asylum in country environment, initially deemed successful, overcrowding
State hospitals
built but deterioration of services occured as chronic nature of mental illness was discovered, long term or lifetime stays were the norm, capacities quickly reached, personalized care lost, restraints more practical, staff turnover high, 1940 population nearly half a million, many elderly, budget cuts led to crowding and subsistence care, lobotomies practiced
Dorothea Dix
advocated for public hospitals providing decent care for indigents with mental illness
Electroconvulsive Therapy (ECT)
introduced in 1939, still used today
National Mental Health Act of 1946
established National Institute of Mental Health, foster and aid research of neuropsychiatric disorders, provide training and award fellowships and grants for work in mental health, aid states in prevention, diagnosis, and treatment of neuropsychiatric disorders
Deinstitutionalization
discharging of tens of thousands of patients from state hospitals and the resettling and maintaining of those persons in less restrictive community settings, began in early 1950s, not preplanned policy, propelled by economics, idealism, legal considerations, and discovery of antipsychotic drugs
Mental Retardation Facilities and Community Mental Health Centers Act
funding to establish fully staffed, fulltime community mental health centers across US, core services: outpatient services, 24 hour emergency care, day treatment or partial hospitalization, screenings
Mental health care concerns in America today
significant improvements in treatment and supports for people with serious mental illness
Challenges of mental health care today
continued absence of a comprehensive, coordinated system, deinstitutionalization, homelessness
Deinstitutionalization equals
trans-insitiutionalization to prisons, jails and nursing homes
Serious mental illness and homelessness
2.1 million Americans a year, about half have substance abuse disorders, major depression and other co-occuring mental illness, need safe, affordable housing, successful interventions require provision of housing that individuals choose and want to live in, and needed services
The new asylums
jails and prisons
Prevalence of serious mental illness in jails
15% of state and federal inmates, 24% in local jails
Challenges of treatment in US prisons
overcrowding, lake of adequate space to offer treatment, lack of qualified treatment personnel, lack of timely access to services, more likely to commit crime if untreated once released back into community
Primary prevention of mental health problems
reduces the incidence of mental illness and related problems, high quality early education to economically disadvantaged preschool children and support to their families
Secondary prevention of mental health problems
reduces the prevalence but not incidence of mental illness, cognitive skills training to reduce prevalence of PTSD, employee assistance programs
Tertiary treatment of mental health problems
reduce symptoms, improve personal and social functioning, develop and strengthen coping skills, promote behaviors that improve life
Psychotherapy
Tx through verbal communication to resolve issues and problems, family, couple, individual, psychodynamic and supportive therapy, patient learns skills to modify thinking and behavior
Psychopharmacology
treatment with medications
Psychiatric rehabilitation
intensive individualized services encompassing treatment, rehab, and support delivered by a team of providers over an indefinite period to individuals with severe mental disorders to help them maintain stable lives in the community
Recovery from mental issues
progress toward financial and residential independence, managing symptoms effectively, satisfaction with life, basic personhood, mental and physical well-being, supportive relationships, opportunities to spend time productively, self-determination
Mental health care system in US
faces challenges, multiple services needed, but some unavailable in some locations, stigmatization of individuals and their family members, decentralized and fragmented (avoids bureaucracy), few resources for rural and low-income counties, lack of adherence to treatment, drop out rates
Medicaid for mental health
pays more than half of government funded mental health care
Mental Health Parity and Addiction Act of 2008
requires that if health care coverage includes mental health or substance abuse disorders, there must be parity with physical disorders in any limitations or restrictions
ACA and mental health
expands eligibility for medicaid whose income is less than 133% of poverty, medicaid required to cover mental health and substance abuse disorder services at parity with medical-surgical benefits, shifts huge new costs to states already struggling, does nothing to expand the number of practitioners
There are nearly 500,000
mentally ill being held in jails and prisons throughout America
Failure in society
no safety net for all the persons no longer being treated by mental health agencies, now in prisons instead of state mental hospitals
Prison population
at risk in institutions and when they leave
16% of prisoners
have been diagnosed with mental illness
In Ohio, mentally ill inmates
separated from general population and housed in mental health units where treated
More deaths, illnesses, and disabilities attributed to
Abuse of alcohol, tobacco, and other drugs than any other preventable disease
Drug
Substance other than food or vitamins that, when taken in small quantities, alter one’s physical, mental, or emotional state
Psychoactive drugs
Alter sensory perceptions, mood, thought processes, or behavior
Drug misuse
Inappropriate use of prescription or nonprescription drugs
Drug abuse
Taking of a drug for a non-medically approved purpose, continued use of a legal drug with the knowledge that it is hazardous, underage use
Drug dependence
When one believes that a particular drug is necessary for normal functioning
Dosage
The amount of a drug that is administered
Segregation
probably the worst thing that can happen to mentally ill inmates
Isolation
increases the risk of becoming mentally ill, makes mentally ill worse
