Intro Flashcards
mental health
reach own potential, well being, work productively, contribute to community
Mental illness
Change in emotion, thinking, behavior that is distressing and causes problems with functioning
Aspects of mental wellness
Rational thought, self-esteem, resilience, self-care, productivity, emotional growth, spirituality, relationship satisfaction
psychological aspects of biopsychosocial functioning
Interactions, skills, creativity, emotional development
Resilience determines…
Severity and progression of mental illness
- essential to recovery
Resilience
ability to get resources to obtain own wellbeing
Continuum of wellbeing
Wellbeing–>mild to moderate emotional problems and concerns with some sx–>mental illness (altered thinking and behavior with mood alterations)
Inheritance theory
mental illness passed through genetics
Germ theory
Mental illness is contagious through contagious microbes
Septic foci theory
Mental illness spread through infection that begins in localized part of the body and spreads
- bleeding or surgery to cure
Moral degeneracy theory
poor character causes illness
Diathesis stress model
Biological predisposition plus environmental stress or trauma causes illness presentation
Lunacy act
1845, started asylums and pushed to institutionalization
early 1800s mental health understanding
symptoms are behavioral; sedation and restraint
- tx with lobotomy, insulin therapy, hydrotherapy, sedative cold pack, ECT
Mental Health act
1930; institutes now give medical care
1970
Mental health institutes become more hospitalized
1990s
Mental health care moved to community
When did mental and primary HC interweave?
late 2000s
Effect of deinstitutionalization
SMI moved to outpt/community, some integrated successfully with psychotropic drugs or did not know how to fxn, many ended in prison or homeless
Revolving door tx
60s, cycle of going in and out ED, limited comm support; changed admission criteria to shorter stays
NAMI
consumers with AMI advocate for tx and focus on awareness, education, research, integration
1999 Surgeon general report
mental health is real and early dx and tx is needed
Tim’s law
Aimed at stopping revolving door; for people do not do well in community
anosognosia
Don’t know you have a mental illness
2003 new freedom commission
linked mental health to overall health; screenings and more resources
Fayette county mental health court
Provides alternates to jail with classes, meds for AMI, tx recs
Mental health parity act
1996; advocate for same coverage for phys and mental health disorders
Affordable care act
Coverage for uninsured thru expanded Medicaid
Dual diagnosis
AMI and sub abuse dx
Recovery
Reach full potential and improve health
Sigma
Fear and misunderstanding of mental illness
Acute care
3-7d, stability and crisis intervention
Long term care
7+ days to stabilize pt
Partial hospitalization
daily for 6h/d, for pt who don’t need inpt but need monitoring
Day tx
less intense, 2-3x/w, group work on social skills and interpersonal often
Who gets inpatient psych care
Ind who can’t care for self or are at risk for SI or attempt, homicidal ideation
72h hold
Involuntary hold against when danger to self or others (weekends and holidays not included)
Pt restraint orders
Can’t be PRN or standing orders
- can be obtained ASAP after applying restraints
- begin with least restrictive
Order of sedation and restraint
- take to room to dec stimulation
- oral PRN meds
- Seclusion
- IM PRN meds
- restraint if dangerous
Duty to warn and protect 3rd party
Exemption from pt’s rights; pt says they will kill specific person or case of child and elder abuse
Therapeutic milieau
Safe, secure, and therapeutic environment for ppl
- reality orientation, real life training, interactions with peer/staff
Elements of therapeutic milieau
Secure containment (basic needs), support, validation (holistic health), structure, and involvement (promote efficacy)
