lOMoAR cPSD|21953575 INTRODUCTION TO PSYCHIATRIC /MENTAL HEALTH NURSING : COMPREHENSIVE & COMPLETE STUDY NOTES Mental health • Mental Health is not merely the absence of illness but is the result of successful growth and adaptation to life’s stressors. • Mental health is not a one -time achievement but a continual process of trying to maintain the highest functioning. • Mental health and mental illness are not specific entities but rather they exist on a continuum. The mental health continuum is dynamic and ever -shifting, ranging from mild to moderate to severe to psychosis. • Mental health changes over time and reflects changes in cultural norms, society’s expectations and values, professional bias, and individual differences. Factors that influence mental health • Available support systems ( friends, family, community) • Spirituality, religious influences • Family influence • Developmental events • Personality traits and states • Psychosocial stressors, poverty, impaired/ inadequate parenting • Cultural/subcultural values • Health practices and beliefs • Hormonal influences • Biological influences • Inherited factors • Environmental experience s Signs of metal health • Happiness: finds life enjoyable • Control over behavior: can recognize and act on cues to existing limits. Can respond to rules, routines, and customs of any group to which they belong. • Appraisal of reality: accurate picture of what is happening around the individual. good sense of consequences, both good and bad • Effectiveness in work: within limits set by abilities, can do well in tasks attempted. when meeting mild failure persists until determines 1 lOMoAR cPSD|21953575 • Healthy self -concept: has a reasonable degree of self -confidence and sees self as capable of meeting demands • Satisfying relationships: experiences satisfaction and stability in relationships. • Effective coping strategies: uses coping strategies in a healthy way that does not cause harm to self or others. Mental illness • Mental illnesses are medical conditions that affect a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. • Mental illness can be seen as the result of a chain of events that includes flawed biological, psychological, social, and cultural processes. Signs of mental illness • Major Depressive disorder (MDD): loss of interest or pleasure in all or almost all usual activities. describes the mood as depressed, sad, hopeless, or discouraged • Control disorder (under socialized, aggressive): shows a repetitive and persistent pattern of aggressive conduct in which basic rights of others are violated. • Schizophrenic and other disorders: shows bizarre delusions, such as delusions of being controlled. Has auditory hallucinations • Adjustment disorder with work (or academic) inhibitions: shows inhibition in work or academic functioning in which previously there was adequate performance. • dependent personality disorder: passively allows others to assume responsibility for major areas of life because of the inability to function independently • borderline personality disorder: shows a pattern of unstable and intense interpersonal relationships • substance dependencies: repeatedly self -administers substances despite significant substance - related problems ( family, social relationships) Barriers to mental health treatment • Societal treatment of the mentally ill is a major barrier affecting treatment and recovery for those with mental illness. patients often face persecution, punishment , shunning, ridicule, and isolation from normal society all of which prevent people from going in to be diagnosed and treated • Stigmatizing attitudes toward the mentally ill can have harmful effects on the individual and family. Stigmatizing often interferes with the person’s ability to establish and maintain friendships, employment, and housing. Many patients with mental illness will have enormous deficits in interpersonal relationships often causing isolation and lonelin ess. 2 lOMoAR cPSD|21953575 Diagnosing mental illness • The diagnostic and statistical manual of mental disorders (DSM -5) is the current official guidebook for categorizing and diagnosing psychiatric mental health disorders. • The primary objective of the DSM -5 is to provide a common language and standard criteria for the classification of mental disorders for everyone in the health care team. • The DSM -5 describes all mental disorders, outlining specific diagnostic criteria for each based on clinical experience and research. The purpose is to provide standardized nomenclature and language. To present defining characteristics/symptoms that differentiate specific diagnoses and to assist in identifying the underlying causes of disorders. Five axes of the DSM -5 • Axis I: primary psychiatric diagnosis (may be more than one) for example m ood disorder, schizophrenia, addiction. It refers to the collection of signs and symptoms that together constitute a particular disorder. • Axis II: referred to personality disorders and mental retardation (secondary disorder). For example, a heroin addict would be diagnosed on AXIS 1 as having a substance - related disorder. Such a patient might also have a long -standing antisocial personality disorder, which would be noted on AXIS 2 ( coexisting disorder/dual diagnosis) • Axis III : general medical condition believed to be relevant to the mental disorder in question and the management of the individual. For example, many psych patients may have DM and are obese because of the psychiatric medication. Another example is neurological d ysfunction may be the cause of abnormal behavior, whereas in others it may be an important factor in the individuals overall condition. • Axis IV: was for reporting psychosocial and environmental problems that may be affecting the diagnosis, treatment, and p rognosis of the mental disorder. These may include occupational problems, educational problems, economic problems, support systems, and legal issues ( divorce, loss of job, death of loved one ) • Axis V: was called global assessment of functioning ( GAF), which indicated the person's best level of psychological, social, and occupational functioning during the preceding year, rated on a scale from 1 -100( 1 indicates a persistent danger of hurting others or self and 100 indicates superior functioning. This is a multiaxial evaluation that evaluates all factors related to a person’s condition. ( most newly admitted patients have a GFA of 35 or less Psychobiological • Biologically based mental illness: a mental disorder caused by neurotransmitter dysfunction, abnormal brain structure, inherited genetic factors, or other biological causes. Another term for biologically based mental illness is “psychobiological disorder” these biologically influenced illnesses include the following: 1) schizophrenia 2) bipolar disorder 3) major depressive 4) obsessive - 3
