exam i: ch4 - treatment settings Flashcards
inability to recognize need for care
anosognosia
what factors can complicate psychiatric care?
-misunderstanding mental illness
- apathy
- misdiagnosis
what was the first antipsychotic med and when was it discovered
thorazine (chlorpromazine) in the 1950s
which commission recommended more community-based care and when
carter’s commission on mental health in the 1980s
decision that deinstitutionalized - keeping people in psychiatric hospitals was “unjustified isolation” and created community care systems instead
olmstead decision in 1999
when was the affordable care act placed
2010
what is the current psychiatric care system
outpatient and inpatient settings along a continuum of care
serves the needs of the hard to engage, community living needs of people with serious persistent psychiatric symptoms
assertive community treatment (ACT)
what are some challenges with the success of tx?
- housing and stability
- income and source of income
- family/support
- substance abuse history
- physical well-being
people who use mental health services
consumers
explain the role of a mental health nurse
- Promote optimal mental and physical well being
- Prevention of mental and behavioral distress
- Promotion of social inclusion to the mentally and behaviorally challenged person
- Care for co-occurring mental health and substance use disorders
- Care for mental health and physical disorders
- Ensure a safe and therapeutic environment
Illness and medication management and education
element of tx environment; primary to all other aspects
safety
element of tx environment; physical environment, daily schedules + tx acitivities
structure
element of tx environment; specific expectations for behavior that exist in the environment
norms
element of tx environment; establishing boundaries and clarifying expectations of behavior in the millieu
limit-setting
element of tx environment; allowing increasing independent behaviors in a dependent environment
balance
what are the criteria for admission (4)
- suicidal/homicidal
- short term acute care/inability to care for self
- can be locked or unlocked
- voluntary or involuntary
psychiatric care plan that focuses on disability
social security disability insurance
psychiatric care plan that focuses on economic need
supplemental secruity income
Requires insurance to provide comparable coverage for mental health, substance use disorder, and physical health care so people can get the tx they need
parity
surrounds/environment, setting structures, emotional climate that is important to healing
- training ground for communication, coping skills
therapeutic millieu
what is the most frequent method of inpatient suicide
hanging
medical emergency where patient shows violence toward self or others (like a rapid for behavioral health)
- “code”
- escalates in predictable way
- can lead to seclusion, restraints, or medications
behavioral crisis
what are the 4 national patient safety goals in behavioral health
- ID pt with 2 identifiers
- use meds safely
- prev infection
- ID pt at risk for harming selves/others
