Week 3 Flashcards
what is psychosis
- used to describe conditions that affect the mind, in which people have trouble distinguishing between what is real and what is not
describe symptoms of psychosis (4)
- affect the way a person thinks, feels, and behaves
- varies greatly from person to person
- can come on suddenly or gradually
- categorized as positive or negative
what are positive symptoms of psychosis?
- symptoms that add to or distort the peron’s normal functioning
list examples of positive symptoms of psychosis (3)
- delusions
- hallucinations
- disorganized speech, thoughts, or behaviors
what are negative symptoms of psychosis
- symptoms that involve normal functioning becoming lost or reduced
list examples of negative symptoms (5)
- restricted emotional and facial expression
- restricted speech and verbal fluency
- difficulty w generating ideas or thoughts
- reduced ability to begin tasks
- reduced socialization and motivation
what are causes and risk factors of psychosis (5)
- genetic factors
- stressful events
- substance use
- imbalance in brain chemicals
- mental and physical disorders
what is the Mental Health Act of Manitoba (MMHA)
- sets out in law the admission and treatment requirements for pts in psychiatric facilities
the Act aims to strike a balance between 2 sets of principles:
- the rights given to all citizens under the Canadian Charter or Rights and Freedoms
- society’s obligation to provide care and treatment to those individuals who, at times, may not appreciate their need for treatment due to their mental illness (may not feel they need care)
persons admitted to a psychiatric facility are either: (2)
- voluntary
2. involuntary
i am not including cards on all of the individual forms because she said we did not need to know them all for the final, just understand the general process. plus, worse comes to worse it’s an open book exam
…..
patients have the right to…
- know the reason for being detained
- communicate, via phone and mail, with the provincial ombusdsman, patient rep, and mental health advocate
- retain counsel (lawyer) without delay
- apply to the mental health review board
- appeal any decision made by the review board, by applying to a manitoba court
what are some potential issues in voluntary treatment for the patient? (10)
- trauma
- feeling like rights are taken away
- feeling coerced
- feel don’t need to be there
- feel bretrayed
- blame family or police
- anger
- embarassment
- feel part of a conspiracy, may play into their delusions
- may feel relieved
what are some potential issues in involuntary treatment for the family (5)
- guilt
- ashamed
- relieved
- feel conflicted
- frustration
what are some potential issues w involuntary treatment for HCP
- ethical dilemas
- concerns for safety
- feel conflicted
- stigma (concious or subconscious)
- frustration if pt uncooperative
what does not criminally responsible (NCR) mean
- no person is criminally responsible for an act committed or an omission made while sufferring from a mental disorder that rendered the person incapable of appreciating the nature & quality of the act or omission or of knowing it was wrong
- under the Criminal Code of Canada
if an individual is found NCR, what happens?
- become under the forensic care system
describe bill 5 - amendment to the mental health act
- strikes out “serious and immediate threat” and substitued “risk of serious harm”
- under the MHA, the medical director of a psychiatric facility may disclose info in a clinical record to any person to prevent or less a risk of serious harm to the pt’s health or safety or that of another person
what is trauma
- a traumatic event involves a single experience or enduring repeated or multiple experiences, that completely overwhelm the individual’s ability to cope or integrate the ideas & emotions involved in the experience
- it is not the event that determines whether something is traumatic, but the individuals experience and meaning they make of it
what is trauma informed care (TIC)
- a program, organization, or system that is traum-informed realizes the widespread impact of trauma & understands potential paths for recovery
- recognizes the signs and symptoms of trauma in pts, families, staff, and others involved w the system
- responds by fully integrating knowledge about trauma into policies, procedures, and practices & seeks to actively resist re-traumatization
what are the 6 broad principles of TIC
- safety
- trustworthiness & transparency
- peer support
- collaboration & mutuality
- empowerment, voice, and choice
- cultural, historical, and gender issues
describe the principle of safety r/t TIC
- is everything being done to ensure the client’s physical and emotional safety?
describe the principle of trustworthiness and transparency r/t TIC
- are expectations and interactions for everyone clear & consistent?
- boundaries, respect, non-judgemental approach
describe the principle of peer support r/t TIC
- those w lived experiences can be critical resources for support
describe the principle of collaboration & mutuality r/t TIC
- members of the organization can contribute equally
describe the principle of empowerment, voice, and choice r/t TIC
- developing plans of actions that require patient-centered approaches and empower clients
describe the principle of cultural, historical, and gender issues r/t TIC
- culturally sensitive, free of biases, and stereotypes
what type of care is done r/t TIC
- least restrictive care
why is least restrictive care important (3)
- when seclusion, restraints are used we add to the trauma experienced by the pt & may traumatize/re-traumatize a pt
- safety first: pt needs to feel safe
- many pts on psychiatric units have histories of abuse
what is TIC strategy to eliminate seclusion & restraint
- developing a personal safety plan
what is included w a personal safety plan
- triggers
- self-management
- distractions
- prevent & plan
what are some questions to ask ASAP to help develop a personal safety plan? (5)
- what helps you stay calm? what works & what doesnt?
- trauma history: how can we avoid revisiting past traumatic experiences?
- what upsets you?
- what are some signs that you are getting upset?
- would you be willing to speak to one of the staff if you were feeling upset?
what is seclusion
- voluntary or involuntary confinement of a pt alone in a room locked from the outside for care and treatment
what are the indications for seclusions/restraints (4)
- only in emergencies when danger is imminent (whether voluntary or involuntary status)
- only when the behavior of the person presents a greater risk than the risks associated w using these practices
- to help the pt re-establish behavior control
- only when all other less restrictive measures (ex. meds) have proven ineffective and should be used for the least amount of time
what is key after a restraint has been used?
- debriefing
who should be debriefed after a restraint has been used
- the person affected
- the staff
- other pts or visitors if appropriate
describe debriefing after a restraint has been used
- a chance to reflect, learn, and to modify the care plan to prevent recurrence
- important in the context of recovery
a comprehensive assessment includes:
- complete health history
- physical exam
- considers the psychological, emotional, social, spiritual, ethnic, and cultural dimensions of health
- attends to the meaning of the client’s health & illness experience
- evaluates how all of this affects the individual’s daily living
what are some sources & types of data collected during data collection (9)
- objective data
- subjective info (pt interview)
- physical exam
- mental status assessment
- pharmacological
- history of present illness
- psychiatric history
- history of substance use/abuse
- collateral info (with consent ex. family)
