NR 326 MENTAL HEALTH GUIDE NOTES SUMMARY

MENTAL HEALTH GUIDE NOTES Mental Illness/Mental Health - Mental illness includes disorders that affect mood, behavior, and thinking - Often cause significant stress and impaired functioning Diagnostic & Statistical Manual of Mental Health (DSM-5) → 3 purposes - Provide standardized nomenclature and language for all mental health professionals - To present defining characteristics or symptoms that differentiate specific diagnoses - To assist in identifying the underlying causes of disorders Healthy People 2020 Objective for MH - Increase number of people identified, diagnoses, treated, helped to live healthier lives - Decrease rates of suicide, homelessness - Increase employment for those with serious mental illness - Provide more services for incarcerated persons with mental health problems Therapeutic Communication-therapeutic responses, concrete and abstract messages - Empathetic - Supportive (NOT giving advice) - Build trust - Recognize their emotions - “I’m sorry you feel that way” - “I’m sorry this is happening to you” - “I know/understand this is difficult” See page 99 table 6.1 for further information Defense mechanisms - Compensation → overachieving in one area to compensate for failures in another - Denial → unable to face reality; refusal to admit the truth/admit there is a problem - Displacement→ taking out frustrations, feelings, and impulses on people or objects - Intellectualization → avoid thinking about the stressful, emotional aspect of the situation and instead focus only on the intellectual component - Projection → taking own unacceptable qualities or feelings and ascribing them to other people - EX: if you have a strong dislike for someone, you might instead believe that he or she doesn’t like you - Undoing → trying to make up for what one feels are inappropriate thoughts, feelings, behaviors - EX: if you hurt someone's feelings you might offer to do something nice or them in order to assuage your anxiety or guilt - Rationalization → avoiding true reason for behavior, making an excuse - EX: a person who is turned down might rationalize the situation by saying they weren’t attracted to each other - Reaction formation→ EX: treating someone who strongly dislike in an excessively friendly manner in order to hide true feelings - Regression→ backtracking; abandoning coping strategies and revert back to old patterns - Suppression→ keep information out of conscious awareness; however memories don't disappear and continue to influence our behaviors. - EX - person who repressed memories of abuse suffered as a child may have difficulty forming relationships in life Proxemics and Privacy a Distance of zones between people during communication - Nurse/client should be 3-6 feet apart Verbal Communication Skills - Use of concrete message - Be specific and clear - Elicit more accurate responses Concrete versus abstract messages: - Words are explicit and need no interpretation; speaker uses nouns instead of pronouns-for example "What health symptoms caused you to come to the hospital today?" (Concrete) Mental Health Assessment-Categories General appearance & motor behavior/activity Mood and affect (how you look) & attitude Thought process and content Assessment of suicide or harm towards others - Suicidal ideas - Lethality Sensorium & intellectual process Sensory & perceptual alterations Judgement & insight Cognitive abilities Self-concept Roles & relationships Physiological and self care concerns Inpatient Care Inpatient hospital: - Impatient units must provide rapid assessment, stabilization of symptoms, and discharge planning, and they must accomplish goals quickly Clients’ rights & legality: - Patients Rights (Box 9.1 on page 151 lists all rights) - Code of ethics and Standards of Care (See box 9.4 on page 157) Patients rights= Right to treat & Right to refuse→ voluntary or involuntary can still refuse meds (unless harming others) Legal= nurses duty to warn- identifiable victim/plan Involuntary vs. Voluntary Admissions: - Voluntary = Client is willing to seek treatment and agrees to be hospitalized - Health care providers can involuntary admit someone if they are a danger to themselves or others. They will be admitted till they no longer pose a threat. - Involuntary can still refuse meds (Unless causing harm) - Laws are different in all states but mostly similar - A person can be detained in a psychiatric facility for 48 to 72 hours on an emergency basis until a hearing can be conducted to determine whether or not he or she should be committed to a facility for treatment for a specified period Crisis-Initial priority SAFETY IS THE NUMBER 1 PRIORITY (5 steps) - assess pt and problem - plan therapeutic intervention - Interventions - resolution to crisis