Test 2 Review Flashcards
What is the Mental Health Systems Act of 1980?
a law that protects the mentally ill from abuse and mistreatment
Laws are made to do what?
protect the needs of society and protect patients and care quality
What is the right to least restrictive treatment?
the right to be cared for without infringing on freedom unless necessary
ex) for example being put in outpatient treatment vs. inpatient treatment
- if they are deemed danger to self or others, that is when their rights are infringed
voluntary hospitalization
person admits themselves, requires insight into their illness
involuntary hospitalization
committed to an institution without consent
- length of stay determined by state
- if they are a danger to self or others, needs treatment, or can’t provide basic needs for themselves
restraints
any bonds on extremities to keep the person from harming themselves or other people
ex) 4 point restraints or straitjacket
How is a restraint ordered?
by a physician except under an emergency, then an immediate order is given
Are medications considered a restraint?
yes, because they “medicate” the person so they are numb to everything
seclusion
type of restraint that involves being placed in a room alone with nothing. room may be padded if considered a threat
competency
legal assessment if a person is able to make reasonable decisions
-foundation of legal rights with mental illness
Why is competency in dementia different?
a person isn’t just deemed incompetent, their cognitive ability fails over time so someone HAS to make decisions for them
incompetence
determined by court, inability to make judgments and be responsible for decisions
right to informed consent
physician fully explains everything about the procedure, and the client can agree or refuse if deemed competent. if incompetent, the guardian can make decision
right to refuse treatment
a competent person can refuse treatment as long as they are not committed and can refuse medication with voluntary or involuntary treatment. if incompetent the guardian can make that decision, and one can be appointed if the patient doesn’t have one
right to confidentiality
admission is confidential and on a need-to-know basis because stigma could affect employment or professional standing
right to keep items
they can keep their possessions but they are kept in a lockbox and they can have them upon discharge
code of ethics
standards that apply for professionals and their licensure
ethics
“moral compass”-determining right from wrong
- individual based
- protects confidentiality, accountability, veracity, and advocacy
duty of veracity
telling the truth and keeping promises
ex) end of life care-family doesn’t want patient to know they are dying, but nurse knows it’s not ethical to deceive the patient
duty of confidentiality
privacy is a basic human right and helps maintain dignity
-stigma can increase if info is shared
duty of advocacy and caring
advocacy-speaking in support of the patient
caring-involving yourself with others related to concern about how other people experience their world
accountability
being held responsible for the patient, oneself, and the agency
HIPAA
Healthcare Information Portability and Accountability Act
-first national set of standards to protect patient privacy
PHI
personal health information
-information that is individually identifiable
rules
certain actions should or should not be
ex) hitting a patient
principles
more abstract, foundation of rules
ex) empathy, etc.
5 moral principles
autonomy, justice, beneficence, nonmaleficence, fidelity
beneficence
the care benefits the patient; it does good and prevents harm
autonomy
freedom of choice
nonmaleficence
avoidance of harm/hurt
-not providing ineffective or harmful treatment
fidelity
integrity by staying committed and keeping promises
justice
fairness and equality
moral issues are usually:
heavily contested issues such as abortion and gay marriage
involuntary admission process in AR
- 72 hour hold ordered by physician if person deemed danger
- 7 day admission decided by court
- court initiated to keep patient up to 45 days, usually admitted to state facility in Little Rock
National Institute of Mental Health (NIMH)
gives grants to local provider agencies (community mental health centers) to provide care to the community
parity
“fairness”
mental health care is not given the same stature as other health care
de facto mental health service system
public and private sectors that have a variety of caregivers that work in diverse, independent, and coordinated facilities
public sector
services directly operated by government agencies and services financed with government resources
private sector
services directly operated by private agencies and services financed with private resources (ex-employer provided insurance)
4 major components/sectors of the de facto mental health services system
- specialty mental health sector
- general medical/primary care sector
- human services sector
- voluntary support network sector
specialty mental health sector
mental health professionals trained specifically to treat people with mental disorders
-most care provided in outpatient settings or private or public clinics
general medical/primary care sector
healthcare professionals in a variety of facilities
-identified as the initial point of contact for adults with mental disorders
human services sector
social services, school counseling, residential rehab, etc
voluntary support network sector
self help and social support groups
ex) AA
where are the bulk of services provided?
community mental health services (CMHS)
how is mental health care not customer oriented?
it is often underfunded and therefore treatment is more based on the amount of funding available. it is just now moving toward individual treatment plans
how is housing a barrier to mental health care?
often not enough housing or income, and community is unwelcoming (NIMBY-not in my backyard)
how is custody of children a barrier to mental health care?
in some states they require children to be under government care, which results in a dilemma for parents that have to debate whether to give up their child
how are disparities a barrier to mental health care?
there is not enough minority care and staffing, and some places are geographically remote
how is staffing shortage a barrier to mental health?
there is a shortage of prepared staff such as psychiatrists, psychologists, social workers, and RNs
how is lack of early intervention a barrier to mental health care?
it increases the negative course of the disease and long term disability. more people will end up in the criminal justice system instead of treatment where they will be undertreated
how is lag between research and application a barrier to mental health care?
known ideas may not be put into practice ASAP
how is technology showing promise to help?
things like telemedicine-speaking to a therapist over the phone or video conference-increases access to care
-providers consumers access to data such as self help, education, treatment, outcomes, etc
mental health in schools
1/5 of kids show symptoms and many of them are not identified
barriers to mental health care in schools
lack of funding and lack of community based resources to help kids and families
contracted service
hospital pays another facility to provide extra room
-ex) AR state hospital pays the Corning facility to operate extra beds
