Kohlenberg > Mental Health, Diversity, & Disparity Flashcards by Rhonda Mittenzwei

What proportion of Americans will meet the criteria for a DSM diagnosis of a mental disorder over their lifetime?

about half

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What is the 12 month prevalence for any mental health disorder?

26.2%

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how many people (%) with sx receive tx in a 12 month period?

41.1%

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T/F: depression is global

true

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T/F: mental health disorders increase risk for communicable & non-communicable diseases

true

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what is the #1 most disabling disorder worldwide measured in years lived w/ disability?

depression

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Regarding suicide, (blank) % of ppl are in low & middle income countries

86%

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(more/less) than half of ppl who commit suicide are btwn 15-44 yo

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in india, suicide was the leading cause of death among what age group?

10-19 yo

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which gender does suicide in India impact more?

women (75% of deaths)

only 24% of all deaths in boys

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how many suicides happen annually in Japan?

30,000

10 years running

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T/F: mental health awareness needs to be integrated into ALL aspects of health & social policy, health system planning, & delivery of primary & secondary general healthcare

TRUE

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T/F: Interpersonal therapy in Uganda is not effective

false

after 2 weeks only 6% of treated pts still had depression

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What is the Thinking Healthy Program?

in Pakistan
taught basic CBT for 2 days to female community health workers (Lady Health Workers) > integrate therapy into visits w/ pregnant women & new moms

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How is the Thinking Healthy Program framed to be socially acceptable in Pakistan?

as a way to help the baby

which is true because women’s mental health is crucial to baby’s development

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Did the Thinking Healthy Program impact infant growth indices?

nope

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what were the benefits for infants and mothers were in the Thinking Healthy Program?

less diarrhea
more likely to be immunized
moms more likely to use contraceptives (spacing)
both parents spent more time playing w/ baby

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T/F: minorities bear a greater burden from unmet mental health needs

true

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why are there healthcare disparities w/ minorities?

less access

lower quality of care

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what ethnic & socioeconomic class do clinicians usually represent?

white
middle-class
(cultures, values, beliefs, biases, stereotypes, misconceptions)

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what are the 4 major racial or ethnic minority groups?

african american
asian/pacific islander
hispanic american
native american

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what racial minority group makes up the largest percentage?

african american (12.8%)

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what racial minority group is PROJECTED to make up the largest percentage?

hispanic american (24% by 2050)

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which ethnic group experiences PTSD more than 2x the general population?

american indians

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African Americans are (under/over) represented in outpt settings & (under/over) represented in inpt settings

under in outpt | over in inpt

Is somatization higher or lower among african americans (compared to whites)?

higher | 15% vs 9%

suicide rates in african americans in what age group are increasing?

10-14 yo | BOYS

what percentage of psychiatrists are african american?

2% :(

what doctors are african americans more likely to see than a specialist?

ER | primary care MD

what is unique about african americans & psych meds?

may metabolize slower but are generally prescribed higher doses

T/F: asian americans consider expression of mental illness a personal weakness

true | so reporting is lower

asian american women have (higher/lower) rates of suicide than other women of comparable ages

higher

rates of substance use disorders are (higher/lower) among asian americans (esp women) than the US population

lower!

(more/less) Latino youth have pervasive feelings of sadness & hopelessness than whites

do Latinos or whites attempt suicide more?

Latino (10% vs 6%)

Hispanic youth are (more/less) likely than non-Hispanic ppl to use alcohol/illicit drugs

less

Native Americans use & abuse alcohol/drugs at (younger/older) ages & at (higher/lower) rates than all other ethnic groups

younger | higher

Suicide is the 2nd leading cause of death in native americans of which age group?

10-34 yo

what are the 6 protective factors for native americans?

``` strong ID w/ culture family connection w/ past traditional health practices adaptability wisdom of elders ```

what are the 5 challenges to health & well-being for native americans?

``` alcohol misuse enduring spirit (stubborn) clashes btwn cultural views of mental health long memories (wtf) trauma is communal ```

What are individuals w/ a strong tribal spiritual orientation HALF as likely to do?

report a suicide attempt

the fuck is ethnopsychopharmacology?

cultural & ethnic influences on responses to meds (genetic & cultural)

African Americans & Asians have high proportions of slow metabolizers of what 2 drusg?

TCAs | SSRIs

what proportion of US women will experience intimate partner violence?

1 in 4

what is the leading cause of injury to american women?

domestic violence

more than 3 women/day are murdered by who?

current or former intimate partners

what age group of women has the highest incidence of partner violence?

16-24 yo

pregnant & recently pregnant women are more likely to die of THIS than any other cause

homicide | "significant portion" by partners

T/F: men are not at risk of domestic violence

false | 28.5% report lifetime victimization

1 in 5 high school students reports being physically or sexually abused by WHO?

a partner

what is the ACE study?

adverse childhood experiences & how they influence health/leading causes of death

what are the 7 categories of adverse childhood experiences?

``` physical sexual emotional family w/ alc or drugs someone incarcerated someone depressed/mentally ill/institutionalized/suicidal mother treated violently ``` Google search adds 3 more: one or no parents physical neglect emotional neglect

how many adverse childhood experiences did over half of the ACE study participants have?

1 or more

1 in 16 ACE study participants had HOW MANY adverse childhood experiences?

did ppl w/ 4+ adverse childhood experiences have higher or lower risks for health problems?

HIGHER

what health probs are ACE sufferers more likely to have?

``` alcoholism drug abuse depression suicide attempt smoking poor self-rated health (50+) sex partners & STDs physical inactivity severe obesity hepatitis heart disease fractures occupational health & job performance ```

80% of attempted suicides can be contributed to what?

adverse childhood experiences

pushing, shoving, kicking, punching, slapping, choking, restraining, and refusing to help when sick/injured are examples of WHAT?

physical abuse

threats of harm, falsely accusing, blaming for everything, extreme jealousy, deprivation, criticism, and intimidating are all examples of WHAT?

emotional abuse

what 2 things define sexual abuse?

trying to force sexual performance against pt's will or when not fully conscious or when afraid to say no OR physically hurting the pt during sex or assaulting the pt's genitals

T/F: screening for domestic violence & abuse is not recommended

false | can provide benefits w/ minimal adverse effects

how stupid was this lecture on a scale of 1-10

1000000000000