Chapter 2 Mental health and mental illness Mental health and

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Chapter 2

• Mental health and mental illness

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Mental health and mental illness

• Mental health Successful performance of mental
  functions with the ability to
• -engage in productive activities
• -enjoy fulfilling relationship
• -change or cope with adversity
• Mental Illness A clinically significant
  behavioral or psychological syndrome experienced
  by a person and marked by distress, disability,
  or the risk of suffering disability or loss of
  freedom.

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Mental health and mental illness

• Myths and Misconceptions
• -Mentally ill is to be different and odd
• Mentally healthy person must be logical and
  rational
• Psychiatric definition of normal mental health
  changes over time (Sadock Sadock, 2007)
• -reflects changes in cultural norms,
  societies expectations and values, professional
  bias, and individual differences
• No one definition of mental health fits all
• -individuals with mental health issues have
  attributes of strength/high functioning
• -persons with mental health have issues
  related to dysfunction at different times in
  their lives)

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Diagnostic and statistical manual of mental
disorders (DSM-IV)

• 5 Axis System
• Axis 1 Psychiatric Disorder
• Axis 2 Personality Disorder and Mental
  retardation
• Axis 3 Medical Disorder
• Axis 4 Psychosocial and Environmental Problems
• Axis 5 Global Assessment of Functioning (GAF)
• Classifies and categorizes mental disorders
• Incorporates cultural awareness

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Epidemiology

• Definition
• Quantitative study of distribution of mental
  disorders in human population
• Prevalence Rate
• Proportion of a population with mental disorder
• at a given time
• Lifetime Prevalence of Mental Disorders
• Published study (Kessler, et al., 2005),
  concluded ½ Americans will meet criteria for
  DSM-IV disorder sometime in their lifetime, with
  the 1st onset in childhood or adolescence

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Prevalence and epidemiology of the psychiatric
disorders in USA
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Mental health vs. mental illness

• Signs of mental illness
• Major Depressive Disorder
• Impulse Control Disorder
• Schizophrenic Disorder
• Adjustment Disorder with
• work/academic inhibition
• Antisocial personality disorder
• Borderline personality disorder
• Substance dependencies

• Signs of mental health
• Happiness
• Control over behavior
• Appraisal of reality
• Effectiveness in work
• A healthy self concept
• Satisfying relationships
• Effective coping strategies

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Mental health parity act

• Passed by Congress 1996
• Requires insurers that provide mental health
  coverage to offer benefits at the same level
  provided for medical and surgical coverage

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Example of DSM-IV evaluation documentation

• Axis I Major depression disorder, recurrent,
• severe, Alcohol dependence, Alcohol
  
• withdrawal
• Axis II Borderline personality disorder
• Axis III Diabetes Type 2, HTN
• Axis IV Job jeopardy, death of spouse,
  
• homeless
• Axis V GAF 35

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Biological based mental illnesses

• Caused by neurotransmitter dysfunction, abnormal
  brain structure, inherited genetic factors, or
  other biological causes
• Can be classified as medical diseases
• Includes the following
• Schizophrenia
• Bipolar disorder
• Major depression
• Obsessive compulsive and panic disorders
• Post traumatic stress disorder
• Autism
• Anorexia Nervosa
• Attention and hyperactivity disorder

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Influences that affect a persons mental health

• Biological
• Hormonal
• Inherited factors
• Personality traits
• Cultural beliefs/values
• Support systems (family, friends, community)
• Negative influences (psychosocial stressors)
• Spirituality/religion
• Environmental experiences
• Demographic/geographic location

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Nursing diagnosis and NANDA international

• A clinical judgment about individual, family, or
  community responses to actual or potential health
  problems and life processes (e.g. hallucinations,
  self-esteem issues, inability to function in a
  job or family)
• Helps target the symptoms and needs of patients
  so they can ideally achieve a higher level of
  functioning and quality of life
• http//www.nanda.org/Home.aspx

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Cultural related symptoms

• Influence of culture on behavior and the way in
  which symptoms present may reflect a persons
  cultural pattern
• Symptoms need to be understood in terms of a
  persons cultural background
• Caution do not stereotype
• -lack of cultural awareness can result in
  improper care or delivery of inappropriate
  services