NUR 144 - Week 1 - Mental Health P1 Flashcards
What is the Community Mental Health Act (CMHA) of 1963?
- Deinstitutionalization
- Enhanced care within community: patients did not attend out-patient
- Unintentional effect: mental health facilities were shut down, incarceration of individuals with mental illnesses rose
Mandated that less patients be in psychiatric units (“not all of them need to be in in-patient; they can get their care from out-patient”)
Explain the term “Mental Health Disorders
Diagnostic term
- Categorized by group of clinical manifestations
Examples:
- Neurodevelopmental disorders
- Neurocognitive
- Schiphrenia
What is diathesis?
An individual’s genetic or biological predisposition for developing an illness
What is stress?
A change in a person’s environment, physical or psychological, which may precipitate clinical manifestations of a mental illness
What is impact?
Increased risk for developing a mental health disorder has been linked to a combination of predisposing factors (genetic, biological) and stressors (psychological or physical changes)
What are contributing factors to mental health disorders?
Life course - Exposure to physical, environmental and socioeconomic events at critical stages in life
Household - Income, access to resources, parental mental/physical health, social support; unemployment conditions
Community - Characteristics of the built and natural environment, neighborhood security
Local services - Local schools, social services, health-related services, family services
Community and global factors - R/t social determinants of mental health
What are the Social Determinants of Mental Health?
Environmental factors
Social or economic circumstances
Individual attributes or behaviors
Populations at Risk for Mental Illness
Underserved individuals
Incarcerated individuals
People experiencing houselessness
Nursing responsibilities in behavioral health care
- Providing education
- Orienting client and family
- Establishing a welcoming trauma-informed environment
- Selecting and advocating for activities
- Ensuring culturally sensitive care is provided
- Providing ongoing support and safety
- Trauma-informed approach to care
What is a Trauma-Informed Approach
Create a culture of empathy
Restraints/seclusion perceives as assault: Cultural considerations & previous experiences
Consider psychological and emotional risk
How to reduce disparities
Provide culturally sensitive client-centered care
- Increased workforce diversity
- Promote cultural and language competence
What is Milieu Therapy?
Therapeutic-Milieu-healing environment
Develop life and social skills
The environment is part of the treatment
- Organized and focused on healing
Milieu Therapy:
Components
Developing physical healing spaces: ensure safety & healing
Creating a healing culture: develop awareness and intention for healing with staff; ensure experiences for personal wholeness
Creating a therapeutic milieu
- Trauma-informed approach
- Encourage open expression of feelings
- Supportive when trying on new behaviors
What are the bioethical principles?
Autonomy - Right to make decision about one’s own care without undue interference
Nonmaleficence - to do no harm
Beneficence - doing good
Fidelity - Keeping promises to clients while displaying integrity
Veracity - Being truthful and authentic with clients
Justice - Ensures element of fairness influences nursing decisions & care
Confidentiality
Informed Consent
Burden of Treatment
Clients right to treatment
Types of Admission:
What are they?
Voluntary:
- Request of client; client recognizes need for care
Involuntary:
- Danger to self or others
- Unable to meet basic self-care needs
- Mental illness preventing recognition or need of care
Emergency:
- Temporary admission
- Subtype of involuntary admission
- Client imminent danger to self or others
- For evaluation of mental illness
Clients Rights to Privacy
Clients Right to Informed Consent
Must include:
- Description of the treatment
- Possible benefits from the treatment
- Possible risks involved in receiving the treatment
- Possible consequences of not receiving the treatment
- Alternative treatments
Client is UNABLE to provide, if:
- Deemed legally mentally incompetent
- Alternate decision-maker
Implied Consent:
What is it?
Occurs in emergency situation; if patient is unconscious and unable to provide informed consent
- Legal rep is unavailable
- Assumes client actions willing to treatment
Capacity and Competence:
What are they?
Torts:
Unintentional vs. Intentional
Documentation:
Legal Considerations
Restrainst and Seclusion:
Which types are there?
In which order do you apply the interventions?
