Mental Health Stats Flashcards

1
Q

Proportion of adults with mental illness

A

1/5 43.8 million in US

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2
Q

Proportion of adults with serious mental illness

A

1/25 10million in US

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3
Q

Prevalence of mental illness by sex, race, age

A

Females, 21.2%
14.3 male

18-25 21.7%,
26-49 20.9%

29.5 mixed race 2 or more
28.3 American Indian, Alaskan native
19.3 white
18.6 black
16% hispanic
13.9 Asian
14.3% Native Hawaiian/Pacific Islander

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4
Q

Kids 13-18 with mental illness

A

20%
11% mood disorder
10% behavior
8% anxiety

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5
Q

Percent with depression

A

6.9%

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6
Q

%with anxiety

A

18.1%

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7
Q

%with bipolar

A

2.6%

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8
Q

% schizophrenia

A

1.1%

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9
Q

% of homeless with mental health probs,

% in state prisons

A

26%

24% with recent hx

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10
Q

Lost earning in US Per year

A

-193 billion

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11
Q

Suicide is the ________ th leading cause of death

A

10th…. 90% of suicides hav under lying mental illness
3rd for ages 10-14
2nd cause for ages 15-34

2x homicide rate! 44,193 vs 17,793

50x greater in schizophrenia compared to gen pop

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12
Q

How many have addiction and another Mental Illness

A

10.2 million

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13
Q

likelihood of mental illness in the LGBT community

A

2x more likely as straight individuals

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14
Q

percent of transgender being denied mental health care because bias

A

11%

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15
Q

suicide in LGBT and questioning community compared to straight youth

A

2-3X more likely

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16
Q

percent of those with mental illness who got help in the past year
(total pop, younger, and by race compared to whites)

A

60% total in US
only 50% if 8-15 y.o.
AA and Hispanics get 1/2 as much compared to whites, asians only a 1/3 compared to whites

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17
Q

Who uses more mental health services compared to others?

by race, by sex

A
women almost always more than men, except in Alaskan Natives and American Indian. (16%m: 15%w)
White: 11:23
Black:7:10
Asian: 4:5
Hispanic: 6:9
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18
Q

Top 8 issues multicultural communities face

A
Less access to care
Less likely to receive treatment
Poorer quality of care
Higher levels of stigma
Culturally INsensitive health care system
Racism, bias, homophobia, discrimination in Tx setting
Language barriers
Lower rates of Health Insurance
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19
Q

Who is NAMI and what do they do

A

National Alliance on Mental Illness

They insure Mental Health is treated equally to physical illness in insurance plans.

and secure $ for research to protect access

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20
Q

what is unique about biopsychosocial model

A

holistic, focuses on health and illness, focuses on what can be changed to make health better, multifactorial

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21
Q

Match: Biology, Psychology, Social Context

to the following…
Gender, Education, Attitudes, Family background, Personality, Genetic vulnerability, stress reactivity, cultural traditions, immune function, coping skills, trauma, neurochemistry, disability, learning/memory, social support, economic status

A
Bio:Gender
Immune function
stress reactivity
Genetic vulnerability
neurochem
disability
Psycho: Attitudes,
Personality
Coping skills
trauma
Learning/Memory
Social: Education
Family background
cultural traditions
Social Supports
economic status
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22
Q

Purpose of Psych interview

A
Establish a relationship
Assess risk
DDX and Mgt. plan
Negotiate & Start Tx
Document
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23
Q

Difference between content and process, and goal of attending to both

A

content: what is being said
Process: the way/how and sometimes the why
Goal: to understand pt beyond their diagnosis to improve delivery of quality care

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24
Q

3 interview techniques for Psych Interview

A

Normalization: reduce shame/stigma/judgemt

continuation: acknowledge/engage pt
redirection: guide and focus pt

25
Q

Top 12 tips for Psych Interview Techniques (part 1)

List step 1-4

A

1) Establish rapport with empathy statements, direct feeling questions, reflective listening statements
2) allow pt to talk w/o interruption for 3-4 min.
3) Determine Pt’s cc
4) Develop DDx

26
Q

Top 12 tips for Psych Interview Techniques (part 2)

List steps 5-8

A

5) Use Open and closed questions
6) Focused questions to clarify DDx
7) Follow up on vague questions
8) May not try reasoning initially

27
Q

Top 12 tips for Psych Interview Techniques (part 3)

9-12

A

9) Gradually move to tougher questions (drugs, sex, criminal behavior)
10) ALWAYS ask about suicidal and homicidal ideations
11) Provide adequate time for pt to ask ?s
12) Convey confidence/hope and acknowledge you will do your very best to provide care and address their concern.

28
Q

Three phases of interview

A

Opening: ID self, and describe the purpose, and timing. Then learn why they are there
Body/Middle: balance clinical needs with pt’s needs
Closing: Thank pt, and allow them to ask final questions. Discuss assessment, negotiate tx/ follow up.

29
Q

Psychiatric Encounter Notes

A
Pt ID, CC, source, reliability
HPI, and psych ROS
Past Psych Hx
Fam Hx
Social Development Hx
Focused Medical Hx (PMH)
MSE
General Physical/ Neuro exam,
WHODAS/4P
Diagnostic Impression/ DDx
Tx/ Management Plan
30
Q

What is included in ID?

A

name, age, gender, Marital status, occupational status

31
Q

how do you document cc

A

1) Open-ended questions, “What brings you here?”
2) Use patient’s own words cuz they provide window to mental status.
3) Duration of complaint

32
Q

how do you document HPI

A
Symptoms new/recurrent
Onset, 
Duration 
Timing, intensity, context, 
Modifying factors, 
Associated symptoms.  
Comorbid risks,(ETOH/Drugs), 
Impact/incapacitation of symptoms Tx/effectiveness/compliance
Suicidal/ homocidal ideations

SOD TIC MAC ITS = MODIST CACTI’S= STICCADO MITS

33
Q

ROS includes

A

Mood: Depression, Mania, Mixed/Other

34
Q

Depression ROS includes…

A

Sleep, interest, guilt, energy, concentration, appetite, psychomotor agitation/slowing (SIGECAPS) + sadness, tearfulness, sexual function,

35
Q

Mania ROS includes

A

Impulsivity, grandiosity, recklessness, excessive energy, decreased need for sleep, increased spending beyond means, talkativeness, racing thoughts, hypersexuality
IGR ESS TRH= GER SHIRTS= SHR TIGERS

36
Q

Anxiety ROS

A
general anxiety symptoms, 
panic disorder symptoms,
O-C symptoms
PTSD
Social anxiety
Simple phobias
37
Q

General Anxiety Symptoms

A

where, when, who how long, how frequent

38
Q

Panic disorder symptoms

A

how long until peak, somatic: racing ehart, sweating, SOB, trouble swallowing, sense of doom, fear of recurrence, agoraphobia

39
Q

OCD symptoms

A

checking, cleaning, organizing, rituals, hang-ups, obsessive thinking, counting, rational or irrational beliefs

40
Q

PTSD

A

nightmares, flashbacks, startle response, avoidance

41
Q

simple phobias

A

heights, planes, spiders

42
Q

Psychosis includes:

A

Hallucinations: auditory, visual, olfactory, tactile,
Delusions: TV, radio, thought broadcasting, mind control, referential thinking
Pt’s Perceptions: spiritual or cultural context of symptoms, reality testing

43
Q

Other

A

ADHD, eating disorder, personality disorder, substance/ addiction, somatization (no longer in DSM5)

44
Q

Past Psych Hx Goal

A

Get info re: all psychiatric illness, course, symptoms, tx

45
Q

Past Psych Hx includes

A

age of 1st diagnosis,
# of hospitalizations/ episodes
Course of previous episodes in chronological order (duration, symptoms, severity, hospitalization, tx)
Hx of violence
Past homicidal or suicidal ideations/attempts

46
Q

Fam Hx:

A

Age, occupation of parents, siblings, kids
Fam Hx of mental illness, course, tx, outcome
Alcohol/drug/ criminal hx, severe depression, suicide, etc.
Social, cultural, educational background

47
Q

Social Development Hx Goal

A

Establish pt’s dev’al / social hx through life

48
Q

What’s included in social hx

A

Personal hx: demographics
birth place, childhood area
developmental/ social adjustments
sexual hx/ development/abuse

Plus ask about childhood, adolescence, adulthood

49
Q

Childhood questions for social hx include

A

Childhood: behavioral concerns (temper tantrums, phobias, cruelty concerns)

50
Q

Adolence questions for social hx include

A

Adolescence: family, peer, authority relationships, school performance, drugs, legal, disciplinary

51
Q

Adult social hx includes

A

Education, occupation, marital and fam relationships, military hx, religious and cultural attitudes, financial situation, current living/ social situation, habits, support system, legal issues

52
Q

Medical Hx

A

(focused) Current medical illness, chronic disease, meds,
Allergies, hospitalizations, surgeries, injuries
Hx of neuro disorders (seizure, HA, trauma, CNS disorders)
(illness, or drugs may impact tx options)

53
Q

Safety during interview

A

1) distraction minimized,
2) 4-6 ft from pt and unobstructed exit,
3) someone within earshot for help,
4) wary of pt with hx of violence
5) watch for indicators of potential violence in voice/ rising temp/pitch, threats, insults,
6) watch for agitation, clenched fists

if sense danger, announce you’re leaving, then do so.

54
Q

what is WHODAS 2.0

A

world health organization disability assessment schedule, version 2.0 to track change through time
Cognition, mobility, self-care, getting along, life activities, Participation
Rates 1=none 5= extreme disability

55
Q

4 P’s Model

A

Predisposing Factors: why me
Precipitating factors: why now
Perpetuating factors: why still today
Protective factors: what’s my “ace in the hole,” strengths, support

56
Q

WHODAS 2.0 scoring

A

Gen. disability score 85: 2.36 mild
Subscale: life activities 14: 3.5 moderate
Subscale: particiation in Society 28- 3.5

57
Q

4 Ps for biological

A

Predisposing: genetics
Precipitating: alcohol
Perpetuating factors: addiction
Protective: access to care

58
Q

4 Ps for Psychological

A

History of violent childhood
Stress of break up
Perpetuating thought of unworthiness
Wants to get better, seeking CBT

59
Q

4 Ps for Social

A

vulnerable population
Coming out to family/ community
Social bias and phobias of community
Supportive friends and mentors, employment