mental health Flashcards
DE-ESCALATION
influences (2)
- individual characteristics
a. personality traits: competitiveness, narcissistic, low frustration tolerance
b. pre-anger state - environment
DE-ESCALATION
Identification and recognition
Originating domains: aspects of the ward that create potential issues or flash points
Flashpoint: times or situations where things could go wrong
Patient modifiers: things patients can do at the point of recognising a flashpoint
staff modifiers: things staff can do at the point of either originating domains and flashpoints to avoid progression to conflict
DE-ESCALATION
Nine strategies to enable staff modifiers
- clear mutual expectations
- soft words
- talk down
- bad news mitigation
- know each other
- mutual help meeting
- calm down methods
- reassurance
- discharge messages
DE-ESCALATION
Pattern of conflict
-> compliance
-> verbal resistance and gestures
-> passive resistance
-> active resistance
-> aggressive resistance
-> serious or aggravated resistance
DEESCALATION
Early Warning signs
- Prolonged eye contact
- darkening facial colour
- increased breathing scale
- kicking the ground
- standing tall
- head held back
- large movements
- erratic behaviour
DE-ESCALATION
Main elements of verbal communication for de-escalation
acronym: SHARE
Simplicity
Honesty
Authenticity
Rapport
Empathy
HEEADSSS
Home
Education & employment
Exercise & eating
Activity
Drugs, alcohol, tabacco use
Safety from risky behaviours
Sexuality
Suicide
Nursing role in mental health nursing
- complete comprehensive MSA
- participate in the MDT
- provide treatment options, health education, talk therapy
- working alongside whanāu
- school interface/observations
- community liaison, education and networking
- court liaison
- advocating for young people and their whanāu
mental health ASSESSMENT (screen, choice, comprehensive)
- presenting concern
- family history
- medical history
- social history
- developmental assessment
- cultural issues
- psychometric tools
- mental state assessments
- observation of interactions
- risk assessment
- alcohol and drug assessments
- forensic screening
- specialist assessments
Assessment process for child’s mental health
- up to 3 sessions with whanāu
- engagement focus
- cultural safety
- school liaison and observations
- MDT approach
- Therapy Formulation
- predisposing: what makes the person vulnerable
- precipitating: stressful events or substance leading to problem occuring at a time
- perpetuating: factors leading to problem persisting
- protective: factors that may reduce impact of problem
what is PRIMARY MENTAL HEALTH
Primary healthcare: providing “essential healthcare” which is universally accessible to individuals and families in the community and provided as close as possible where people live and work
Primary health:
- involves diagnosing and treating people with mental disorders
- putting strategies in place to prevent mental health deterioration
- healthcare workers apply psychosocial and behavioural science skills day-to-day to improve overall health outcomes in primary health care
What is CHRONIC MENTAL ILLNESS
a persistent mental or emotional disorder that seriously impairs their functioning relative to such primary aspects of daily living such as personal relations, living arrangements or employment
Nursing in in chronic mental health illness
- developing strategies for coping with emotional and behavioural manifestations of their disorder
- supporting during times of crisis
- encouraging during times of remission
- supporting the family to cope with the challenges of living with a person with the behavioural and emotional manifestations
Most common chronic mental illness (adult and child)
Adults:
- schizophrenia
- mood disorders
- delusional disorders
- delirium
- dementia
- amnestic and other cognitive disorders
Children:
- pervasive developmental disorders
- childhood schizophrenia
- conduct disorders
- mental retardation
mental health in primary care- tools
- Kessler Psychological Distress Scale 10 (K10)
- Patient Health Questionnaire (PHQ-9)
- Anxiety (GAD-7 and GAD-2)
- Alcohol and Substance Abuse (AUDIT)
Mental health in primary care
Assessment of suicide risk
- intent/definite plan
- lethality of likely means
- access to means
- presence of risk factors
- hopelessness
- psychological factors
- lack or absence of protective factors
Mental State Exam
Appearance
Behaviour
Speech
Thought (process, content)
Perception
Insight/Judgement
Mood
Affect
Memory
