Mental Health Flashcards
The incidence of depression increases with ___, especially after the ______.
age, onset of puberty
Incidence of depression by gender among children
Equal
Incidence of depression by gender among youth
2:1 girls to boys
Symptoms of depression in children
- deny rather than admit
- vary with developmental age
- chronic head/tummy ache, crying for no reason
Symptoms of depression in youth (>12)
- irritability
- loss of interest in favourite activities
- frequent complaints of physical illness
- oppositional behaviour
- poor performance in school
- recurrent suicidal ideation of behaviour
Considerations of symptoms of depression in youth?
■ Some are typical youth behaviors; not always obvious indicators
■ Parents are not always aware due to how subtle
Depression in children can lead to
Suicide - 95% of those who attempt/contemplate suffer
Major Depressive Disorder in Adolescents Symptoms
- Depressed mood MOST of the time
- Loss of interest in favourite activities
- significant weight loss/gain
- insomnia
- fatigue
- low self-esteem
- decreased ability to concentrate
Depression in children can be effectively treated with a combination of _______ and ________.
psychotherapy and antidepressants
Considerations of depression treatment
■ Consideration of insurance for therapy
■ Psychiatrists have big wait lists
■ Usually end up in ED with crisis
Mild depression can usually be treated with
psychotherapy alone
More serious depression requires an
antidepressant medication
What is the leading cause of death among Canadian youth aged 15-19?
Suicide
Incidence of suicide attempts peaks in
Adolescence
For every completed suicide there are as many as __ attempts
20 attempts
The rate of suicide among Indigenous People is __X compared to Non-Indigenous youth.
5
Suicide is leading cause of death among _______ youth.
indigenous
Of all age groups, Indigenous aged ______ years are at the highest risk of completing suicide
15-29
__________ of suicidal behaviour in 10-14 year age group-1.9/100,000
Increase
Suicidal ideation reports as young as ____
6-9
Rate of suicide by _____ has doubled
firearms
50% of suicide attempters fail to receive:
follow-up mental health care
77%, of those who do receive follow-up, do not:
attend or fail to complete treatment
What is the strongest risk factor for suicide?
Previous suicide attempt is strongest predictor. People who have attempted suicide are 40 times more at risk of suicide
What gender is at greater risk for suicide?
Male gender: Males complete suicide 3X more than female.
Females more attempts.
Other risk factors for suicide besides previous attempt and gender
family history of attempts
parental mental health problems
gay/bisexual
4 social risk factors for suicide
- social isolation
- impaired parent/child relationship
- difficulties in school
- presence of stressful life event
How does social isolation increase risk for suicide
The absence (or perceived absence) of supportive resources may increase the risk of suicide.
Personal resources can sustain a person on times of great trouble
Personal Risk Factors for Suicide
Any history of mental illness
- Depression
- Bipolar disorder
- Substance use
- PTSD
- Panic attacks
- History of Anger management
4 Traits of Adolescence at Low Risk for Suicide
- responsive and intact family,
- good peer relations and social support
- hope for the future,
- a desire to resolve conflicts
4 Immediate Suicide Risk Factors
- agitation
- intoxication
- perception of recent stressful life event
- current plan
6 Traits of Adolescents at High Risk for Suicide
- have made previous attempts,
- exhibit a high degree of intent to commit suicide,
- show evidence of serious depression or other psychiatric illness,
- are abusing alcohol or other drugs,
- have low impulse control,
- have families who are unwilling to commit to counseling
4 Categories of Guiding Questions for Suicide Risk Assessment
- thoughts of suicide ideation
- intent
- plan
- resources
What should you question regarding thoughts of suicide ideation in risk assessment
frequency, intensity, and quality of thoughts
What should you question regarding intent in suicide risk assessment?
illicit reasons for living; how have they coped until this point
- “Have you ever thought of acting on your thoughts?”
- “Do you want to end your life?”
What should you question regarding plan in suicide risk assessment?
do they have access to the means?
What should you question regarding resources in suicide risk assessment?
clear instructions on the importance of communicating their thoughts with trusted adult
Warning signs for family/nurse for suicide
- self-destructive behaviour
- signs of increased anxiety/panic
- new/more involuntary restlessness
- extreme degree of elation/energy - suddenly seem okay
Nursing interventions for suicidal teen
- Listen, reassure and help the person to remember the things that have kept them alive so far
- Identify what and who needs to change
- Evaluate the client’s way of thinking about problems and generating solutions
- Suicide proof the environment
- Document your contact with the suicidal person
- Understand negative personal feelings
- Identify positive traits
- Reduce stressors
- Strengthen coping abilities
- Identify personal and community resources
True or false: if a child is at risk for suicide but does not want to tell their family, you must put the therapeutic relationship first and keep their secret
False - lots of gray area though; use critical thinking
True or false: a calorically focussed treatment plan is effective for treatment of eating disorders
False - psychological disorders not merely problems with food
Eating disorder behaviors are initiated as _____ and expressed through a wide range of patterns focused on _____, _____ and ______
coping strategies
food, body and weight.
body dissatisfaction and the desire to lose weight are the norm for ________ of young women.
70%
Eating disorders are a unique reaction to
a variety of external and internal conflicts, such as stress, anxiety, unhappiness and feeling like life is out of control.
The person suffering with Anorexia may be abnormally sensitive about:
being perceived as overweight.
8 Symptoms of Anorexia
o Dramatic weight loss
o Dresses in layers to hide weight loss or stay warm
o Preoccupied with weight, food, calories, fat grams, and dieting
o Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
o Makes frequent comments about feeling “fat” or overweight despite weight loss
o Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy
o Denies feeling hungry
o Develops food rituals
Usually individuals suffering from bulimia often will have ______, ______ and ______
low self-esteem, feelings of helplessness, and a fear of becoming overweight.
6 Symptoms of Bulimia
o Binge eating
o Recurrent inappropriate compensatory behavior to prevent weight gain (vomiting, use of laxatives)
o Excessive amount of tooth enamel erosion,
o A greater-than-normal number of filled cavities
o Calluses on the back of her hand.
o May not appear underweight
Nursing interventions for eating disorders focus on
Holistic Health
Why is treatment of an eating disorder difficult?
many of the clients with this problem believe there is nothing wrong with them.
True or false: eating disorder recovery is about eliminating the disorder
False
not necessarily about eliminating the eating disorder.
It is about living life differently so that the behaviors diminish over time and may eventually disappear.
What is the first step in eating disorder treatment?
acknowledging the difficulty of struggling day to day with the pain, secrecy, isolation and shame that are a big part of the disorder.
3 Treatment steps for eating disorders
- counselling
- antidepressant
- support groups
What is important to consider about the use of support groups for those with eating disorders
Can be counterproductive; sharing tricks in the trades – losing weight/hiding it better
