NUR361 Final Exam
1. Mental Health •Not the same as absence of mental illness
•State of well-being that supports individuals in coping,
realizing goals and abilities, learning and working
•Shaped by personal stressors and resilience, social sup-
ports and services, living conditions, economic & geopo-
litical circumstances, etc.
•Good ___________ can be experienced while having a
mental illness
2. Mental Illness •Disturbances to patterns of behaviour, thinking, or emo-
tions
•Accompanied by distress or suffering as well as function-
al impairment
•Approximately 60% of _________________ have their
onset before age of 25 (in most individuals)
•Symptoms and exacerbations of illness can fluctuate
throughout lifecourse
•Frequently co-occur with other types of illnesses or con-
ditions
•Risk factors are many and diverse
3. Where does •Primary care (screening and foundational management,
mental health integration of MH teaching into physical health care) and
care happen? community-based interventions
•Outpatient mental health services
•Transitional and intensive outpatient/community based
mental health services (such as day programs)
, NUR361 Final Exam
•Crisis response and acute psychiatric inpatient settings
- most 'intense' level of care
4. What is UofT's Spectrum from self-care to care from others practices for
Stepped Care mental health
Approach?
5. What are the •Funding models in Canadian provinces - they typically
complexities of only cover hospital or physician-based services, rather
mental health than access to psychologists, CBT housing supports and
care services? medications
•Wait times for access to appropriate care - Generally,
wait times, especially for children, are upwards of a year.
•Continuity of care between settings - not typically done
well. Especially going from peds to adult care, therefore
many young adults fall through the cracks
•Challenges, trauma, and safety risks related to involun-
tary care
•Resources focused on acute and crisis services, lack of
resources invested into community settings and upstream
care
•Interactions with police and over-representation in crimi-
nal justice system - who are untrained to deal with mental
health can lead to fatalities. This leads to mis-trust in the
healthcare. Also an overrepresentation of mental health
patients who are incarcerated.
•Siloed mental and physical health care systems
, NUR361 Final Exam
•Stigma and discrimination
6. Stigma Negative or unfavourable social attitude attached to a par-
ticular characteristic (e.g. mental illness, addiction) that
results in discriminatory speech/actions
7. Self-stigma Perceptions/experiences of individuals living with mental
or substance related disorders
- Key deterrent in seeking support and treatment
8. Interpersonal or Endorsing negative stereotypes, resulting in discriminato-
social stigma ry speech or actions
- Focus of many anti-stigma campaigns
9. Structural Stig- Rooted in policies and procedures of social institutions
ma which maintain social or health inequities of people living
with mental illness
10. Intersectional Intersection of MH stigma with other forms of oppression
Stigma (e.g. racism, transphobia)
11. Mental health •Feelings of being devalued, dismissed, and dehuman-
stigma in health- ized
care settings •"Therapeutic pessimism"
•Lack of awareness and skills
•"Diagnostic overshadowing" - every symptom experi-
enced gets attributed to the person's mental illness (e.g.
pain in your head, drug seeking behavior).
Leads to...
•Delays in help-seeking
•Discontinuation of treatment
•Safety concerns
12. What are •Can all guide interventions that complement or move
the common- beyond assessment and management of symptoms
alities across
frameworks and •Emphasis on lived and living experience and expertise
models guiding
, NUR361 Final Exam
mental health •Strengths-based approach
care practices?
•All include recognition that humans are cultural beings
whose understandings of health and illness may or may
not align with the dominant medical understanding
13. Bio/psycho/so- •Can guide both nursing assessment and interventions
cial/spiritual
framework •View individuals in the context of their physical and social
environments in addition to their biology and psychologi-
cal characteristics
•Helps us to develop a holistic understanding of an indi-
vidual's lived experience and, strengths, and resources in
addition to their health problems
14. Nursing assess- Biological domain
ment - BPSS •Health history and status, physical examination (e.g. vital
framework signs, nutritional status, diagnostic testing, etc.), physical
functioning (e.g. ability to eat, sleep, move, etc.), biologi-
cal treatments (e.g. pharmacologic)
Psychological domain
•Includes manifestations of psychiatric illnesses, re-
sponses to psychiatric illness, self-concept
•Mental status exam and risk assessments
•Assessment of ability to effectively manage stressors
Social domain
•Living situation, family structure and dynamics, support
systems and current relationships, occupation, educa-
tion, culture, income
Spiritual domain
•Interplay of other three domains
•Sense of connection to world, understanding of what
gives life meaning and purpose, linked to personal identity
in relation to family/community/nature/other, potentially
includes religious beliefs and practices
1. Mental Health •Not the same as absence of mental illness
•State of well-being that supports individuals in coping,
realizing goals and abilities, learning and working
•Shaped by personal stressors and resilience, social sup-
ports and services, living conditions, economic & geopo-
litical circumstances, etc.
•Good ___________ can be experienced while having a
mental illness
2. Mental Illness •Disturbances to patterns of behaviour, thinking, or emo-
tions
•Accompanied by distress or suffering as well as function-
al impairment
•Approximately 60% of _________________ have their
onset before age of 25 (in most individuals)
•Symptoms and exacerbations of illness can fluctuate
throughout lifecourse
•Frequently co-occur with other types of illnesses or con-
ditions
•Risk factors are many and diverse
3. Where does •Primary care (screening and foundational management,
mental health integration of MH teaching into physical health care) and
care happen? community-based interventions
•Outpatient mental health services
•Transitional and intensive outpatient/community based
mental health services (such as day programs)
, NUR361 Final Exam
•Crisis response and acute psychiatric inpatient settings
- most 'intense' level of care
4. What is UofT's Spectrum from self-care to care from others practices for
Stepped Care mental health
Approach?
5. What are the •Funding models in Canadian provinces - they typically
complexities of only cover hospital or physician-based services, rather
mental health than access to psychologists, CBT housing supports and
care services? medications
•Wait times for access to appropriate care - Generally,
wait times, especially for children, are upwards of a year.
•Continuity of care between settings - not typically done
well. Especially going from peds to adult care, therefore
many young adults fall through the cracks
•Challenges, trauma, and safety risks related to involun-
tary care
•Resources focused on acute and crisis services, lack of
resources invested into community settings and upstream
care
•Interactions with police and over-representation in crimi-
nal justice system - who are untrained to deal with mental
health can lead to fatalities. This leads to mis-trust in the
healthcare. Also an overrepresentation of mental health
patients who are incarcerated.
•Siloed mental and physical health care systems
, NUR361 Final Exam
•Stigma and discrimination
6. Stigma Negative or unfavourable social attitude attached to a par-
ticular characteristic (e.g. mental illness, addiction) that
results in discriminatory speech/actions
7. Self-stigma Perceptions/experiences of individuals living with mental
or substance related disorders
- Key deterrent in seeking support and treatment
8. Interpersonal or Endorsing negative stereotypes, resulting in discriminato-
social stigma ry speech or actions
- Focus of many anti-stigma campaigns
9. Structural Stig- Rooted in policies and procedures of social institutions
ma which maintain social or health inequities of people living
with mental illness
10. Intersectional Intersection of MH stigma with other forms of oppression
Stigma (e.g. racism, transphobia)
11. Mental health •Feelings of being devalued, dismissed, and dehuman-
stigma in health- ized
care settings •"Therapeutic pessimism"
•Lack of awareness and skills
•"Diagnostic overshadowing" - every symptom experi-
enced gets attributed to the person's mental illness (e.g.
pain in your head, drug seeking behavior).
Leads to...
•Delays in help-seeking
•Discontinuation of treatment
•Safety concerns
12. What are •Can all guide interventions that complement or move
the common- beyond assessment and management of symptoms
alities across
frameworks and •Emphasis on lived and living experience and expertise
models guiding
, NUR361 Final Exam
mental health •Strengths-based approach
care practices?
•All include recognition that humans are cultural beings
whose understandings of health and illness may or may
not align with the dominant medical understanding
13. Bio/psycho/so- •Can guide both nursing assessment and interventions
cial/spiritual
framework •View individuals in the context of their physical and social
environments in addition to their biology and psychologi-
cal characteristics
•Helps us to develop a holistic understanding of an indi-
vidual's lived experience and, strengths, and resources in
addition to their health problems
14. Nursing assess- Biological domain
ment - BPSS •Health history and status, physical examination (e.g. vital
framework signs, nutritional status, diagnostic testing, etc.), physical
functioning (e.g. ability to eat, sleep, move, etc.), biologi-
cal treatments (e.g. pharmacologic)
Psychological domain
•Includes manifestations of psychiatric illnesses, re-
sponses to psychiatric illness, self-concept
•Mental status exam and risk assessments
•Assessment of ability to effectively manage stressors
Social domain
•Living situation, family structure and dynamics, support
systems and current relationships, occupation, educa-
tion, culture, income
Spiritual domain
•Interplay of other three domains
•Sense of connection to world, understanding of what
gives life meaning and purpose, linked to personal identity
in relation to family/community/nature/other, potentially
includes religious beliefs and practices
