Week 1 Flashcards
how widespread is mental health?
- affects many Canadians both directly and indirectly
- about 1 in 5 Canadians
describe the effect of mental health on QOL
- most significant to one’s emotional well-being & QOL
why is it important to understand the history of mental illness
- to help understand the concept of recovery
- learning about the history & treatment of individuals w mental illness eventually lead to the development of the concept of Recovery & Recovery Oriented Practice
describe the historical perspectives of mental health care & mental illness (6)
- individuals were thought as evil spirits, demonic possessions, brain disturbances
- individuals were killed, left to die, trephined (hole into back of skull to “release spirits”)
- were banished outside the “city walls”
- belief that people were affected by the moon (where “lunatic” came from)
- churches sometimes looked after those w mental illness
- started w barbaric treatment bc mental illness wasnt understood
what is an example of early forms of institutional care
- Bethlehem (Bedlam) in 1400s –> oldest hospital for treating the mentally ill
describe the conditions of the Bethlehem hospital (3)
- horrific conditions
- v crowded
- patients were treated like an exhibit to high society
what occurred in the 1700s r/t mental health care
- more humane treatment began
- belief that the insane were ill, needed treatment, and should be under the care of physicians
what contribution did philippe phil in France make to mental health care
- made efforts to stop abuses
- instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as “moral therapy/treatment”
who is an example of a social reformer for mental health care/illness
- dorthea dix
describe the contributions of Dorthea Dix for mental health care
- visited inmates in prisons & saw a mix of people, including people w mental illness
- came up with the idea for special, humane housing for people w mental illnesses, leading to large hospital = asylums
- thought asylums would be good, but they were built away from general population/society in rural towns, and conditions became overcrowded, contibuted to stigma
what is considered the asylum era
- the 19th and early 20th centuries
what are some characteristics of the asylum era/institutionalization (6)
- lots of custodial care (ADLs)
- overcrowding
- pts cut off from society
- occurrences of abuse
- pts had no rights & families could have their family member committed –> pts wanted to leave but couldn’t
- no effective treatment, but other “treatments” done
what are 3 examples of treatments done in asylums
- hydrotherapy
- insulin shock
- lobotomy
what is hydrotherapy
- involves exposing pts to water (bath, shower, etc.) for 3 days which they thought would cure them
what is insulin shock
- a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks
what is a lobotomy
- barbaric treatment
- nearly all pts received one
- involves severing connections in the brain’s prefrontal cortex
describe pts post-lobotomy (4)
- no emotions or feelings after
- needed total care
- no problem solving
- no independence
what were some significant influences in the treatment of mental illness (6)
- sigmund freud & psychoanalysis
- intro of antipsychotic meds
- canadian mental health association (CHHA)
- mental health act
- universal health care
- new demands for research and education
what was the biggest factor in the treatment of mental illness
- intro of antipsychotic meds in the 1950s –> until then there was no treatment
what are 2 examples of anti-psychotic medications-
- Chlorpromazine
- haldol
what is the mental health act
- created to protect pt rights
- sets out in law the admission and treatment requirements for patients in psychiatric facilities
what significant theories influenced mental health (6)
- psychoanalytic/psychodynamic theories
- humanistic therapies
- behavioral theories
- cognitive theories
- biological theories
- interpersonal theories
review the study guide for theories posted on UM learn
….
briefly describe the contributions of psychoanalysis to mental health care (2)
- made the connection of trauma & dissociation
- considered how does developmental childhood contribute to mental illness
briefly describe the contributions of humanistic therapies to mental health care (3)
- includes Maslow’s hierarchy of needs
- see potential/positive in people’s human behaviors
- see positive potential in human beings
briefly describe the contributions of behavioral therapy to mental health care (3)
- involved rewarding good behavior
- and negative consequences for bad behavior
- some treatments were based on this
ex. w eating disorders: if gain weight = rewarded w passes or privileges
briefly describe the contribution of cognitive theories to mental health care
- considered the relationship between negative thoughts and behaviors
describe the nurses role in mental health care historically (3)
- provided custodial care
- conditions controlled by staff
- medical model of care dominated –> pt was at the bottom & told what to do, no say in care
describe Hildegard Peplau’s contribution to mental health care (4)
- “grandmother of psychiatric nursing”
- introduced change in publishing her nursing theory in Interpersonal Relations for Nursing
- described the phases of the therapeutic nurse-client relationship (until then nurses only provided custodial care)
- took students to talk to pts
what occurred in the 1970s
- era of deinstitutionalization –> shift to community care
- the vision of community mental health care
describe the era of deinstitutionalization
- saw that pts did not need to be asylums –> could live independently but needed supports
- vision of community mental health: availability & equal access to all lvls of mental health prevention, treatment, and services would be available to those experiencing mental health problems
what ended up happening w the era of deinstitutionalization
- discharge huge #s of people into the community, thinking they would have community services, but there rlly wasn’t enough access to them
define stigma
- negative, discriminatory, and rejecting attitudes & behavior toward a characteristic or element exhibited by an individual or group
describe the impact of stigma on individuals w mental illness
- often the stigma of mental illness has a greater negative impact on an individual than the illness itself
what are aspects of stigma (10)
- public or social stigma
- stereotyping, prejudicial attitudes
- labelling –> ex. “pchixophrenic”
- avoidance of seeking care
- separating “them” from “us”
- stigma by HCP
- self-stigma
- discrimination –> employment, rental, NIMBY
- cultural variations
- availability of research for mental illness/health
what is self-stigma
- the feeling that its wrong to be struggling w mental health
- the feeling that you’re not good enough
describe cultural variations r/t stigma
- may restrict expression of emotion
- may not be able to talk about mental health in certain cultures
- come cultures are hesitant to recognize mental illness as a problem
define mental health
- a state of well-being in which the individual realizes their own abilities, can cope w the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community
- the capacity to feel, think, act in ways that enhance our ability to enjoy life and deal w the challenges we face
what is critical w mental health
- adaptability
define mental health problem
- diminished capacities, whether cognitive, emotional, interpersonal, etc. that interfere w person’s enjoyment of life
define mental illness (3)
- all diagnosable mental disorders
- health conditions characterized by major/significant alterations in thinking, mood, behavior
- associated w distress and/or impaired functioning
define serious mental illness
- encompass illnesses w potential to be more incapacitating
what is used by professionals for diagnosis of mental disorders
- diagnostic and statistical manual of mental disorders (DSM-V)
describe the universality of mental health
- everyone has the potential to be mentally healthy
- you can have a mental illness but be mentally healthy
describe the relationship between mental health & physical health
- mental health shapes the way we think, feel, and communicate
- you can be physically ill but mentally healthy
what is mental health promotion
- the process of enhancing the capacity of individuals and communities to take control over their lives & improve their mental health
what are significant influences in mental health care today (3)
- senator michael kirby
- mental health commission of Canada
- canadian mental health strategy
describe the influence of senator michael kirby on mental health care today (3)
- highlighted fragmented care –> difficulties in access between urban and rural area
- social, economic, and policy considerations
- “out of the shadows at last”
describe the influence of the Mental Health Comission of Canada on mental health care today
- provide research, grants, etc.
what was the first canadian mental health strategy
- Changing directions, changing lives
what are the 6 strategic directions of changing direction, changing lives mental health strategy
- promotion & prevention
- recovery & rights
- access to services
- disparities & diversity
- first nations, inuit, and metis
- leadership & collaboration
what recent shift in philosophy occurred in r/t mental health care
- biomedical model –> recovery oriented practice
describe the approach in the biomedical model
- top down approach (idrk what this means)
describe recovery oriented practice (4)
- envisioned as a path rather than a destination w an endpoint –> may not mean a cure
- conveys a vision of meaning, purpose, hope, and fulfilling dreams in one’s life
- involves “consumers” taking a much more active role to regain power and control –> necessary for self-dignity and self-determinations
- includes understanding the lived experiences of others (personal stories, artwork, etc.)
define recovery
- a non-linear process of self-organization and adaptation that offsets the personal disintegration of mental illness and enables the individual to reconceive his or her sense of self & wellbeing on all biopsychosocial levels
what is a more local public policy the is a significant influence in mental health care today
- “Recovery: hope changes everything –> a guide to recovery-oriented system transformation in Manitoba”
