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EXAM 1 MENTAL HEALTH
Overview of Mental Health & Psychopharmacology
| Term | Definition |
|---|---|
| Mental Health Definition | State of emotional, psychological, and social wellness, evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability |
| Characteristics of Mental Health | Rational thinking, effective coping, resiliency, self-awareness, developmentally on task, spiritual satisfaction, happiness and joy, self-care, positive self-concept, learning and productivity, effective communication, meaningful relationships |
| Factors Influencing Mental Health | Individual (personal), Interpersonal (relationship), and Social/Cultural (environmental) |
| Individual (personal) Factors | Biological, intolerable or unrealistic worries or fears, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning of life, emotional resilience or hardiness of sense of belonging, reality orientation, coping and stress management abilities |
| Interpersonal (relationship) Factors | Ineffective communication, inadequate social support, ability to help others, intimacy and balance of separateness and connectedness |
| Social/Cultural (environmental) Factors | Unwarranted negative view of the world, discrimination (stigma, racism, classism, etc), access to adequate resources |
| Involuntary Commitment Criteria | Danger to themselves or others. Threatening or attempting suicide, can be detained in psychiatric facility for 48-72 hours on an emergency basis until a hearing can be conducted |
| Confidentiality Exceptions | Duty to warn identifiable third parties of threats made by clients. Some states require reporting, some make it an option. First always ask are they a danger to others? Is the danger a result of serious mental illness? Is the danger serious? Are the means to carry out the threat available? Is the danger targeted at identifiable victims? Is the victim accessible? |
| Stages of Crisis | Exposure to stressor, increased anxiety when usual coping is ineffective, increased efforts to deal with stressor, disequilibrium, significant distress |
| Maturation Crisis | Sometimes called developmental crisis. Predictable events in the normal course of life, such as leaving home for the first time, getting married, having a baby, and beginning a career |
| Situational Crisis | Unanticipated or sudden events that threaten the individuals integrity, such as the death of a loved one, loss of a job, and physical or emotional illness in themselves or family members |
| Adventitious/Social Crisis | Include natural disasters like floods, earthquakes, or hurricanes, war, terrorist attacks, riots, and violent crimes such as murder. |
| Tort | wrongful act that results in injury, loss, or damage. Can be intentional or unintentional |
| Negligence | unintentional tort that involves causing harm by failing to do what is reasonable and prudent person would do in a similar circumstances |
| Malpractice | type of negligence that refers specifically to professionals such as nurses and physicians |
| Duty | legally recognized relationship existed. Nurse has a duty to the client, meaning the nurse was acting in the capacity of a nurse |
| Breach of Duty | The provider failed to conform to standards of care, thereby breaching or failing the existing duty. The nurse did not act as a reasonable, prudent nurse should |
| Injury or Damage | the client suffered some type of loss, damage, or injury |
| Causation | The breach of duty was the direct cause of the loss, damage, or injury. It would not have occurred if the nurse had acted in a reasonable, prudent manner |
| Assault | any action that causes a person to fear being touched in a way that is offensive, insulting, or physically injurious without consent or authority. Such as giving an injection for failure to cooperate. |
| Intentional Torts | assault, battery, and false imprisonment |
| Battery | involves harmful or unwarranted contact with a client. Actual harm or injury may or may not have occurred. Examples include touching a client without consent, or unnecessarily restraining a client. |
| False Imprisonment | unjustifiable detention of a client, such as an inappropriate use of a restraint or seclusion |
| Ethics | branch of philosophy that deals with values of human conduct related to the rightness or wrongness of actions and to the goodness and badness of the motives and ends of such actions |
| Deontology | theory believes decisions should be based on whether an action is morally right with no regard for the result or consequences. |
| Autonomy | refers to a person's right to self-determination and independence |
| Beneficence | refers to one's duty to benefit or to promote the good of others |
| Nonmaleficence | is the requirement to do no harm to others, either intentionally or unintentionally. |
| Justice | refers to fairness, treating all people fairly and equally without regard for social or economic status, race, sex, marital status, religion, ethnicity, or cultural beliefs |
| Veracity | is the duty to be honest or truthful |
| Fidelity | refers to the obligation to honor commitments and contracts |
| Indicators of Abuse | New or changed behaviors -- Withdrawal, depression, agitation, hyperarousal -- New displays of anger, noncompliance -- Sexualized behavior -- Bowel or bladder problems -- Sleep problems -- Unexplained or curious Injuries |
| Psychopharmacology | Use of medications to treat mental illness and is related to neurobiological theories of treatment, care, and life improvement. The medications directly effect the CNS and subsequently, behavior, perceptions, thinking, and emotions. |
| Efficacy | The maximal therapeutic effect that a drug can achieve |
| Potency | Describes the amount of drug needed to achieve the maximum effect (if high = low doses are needed. If low = high doses are needed) |
| Individual Psychotherapy | Bringing about change in a person by exploring their feelings, attitudes, thinking, behavior. One-to-one relationship between the therapist and client. Progression through stages, and relationship is the key to success |
| Group therapy | Clients participate in sessions with a group of people. The members of the group all hold a common purpose and are expected to contribute to the group to benefit others and to receive benefit from others in return. |
| Discharge Planning | Should include connections to outpatient services, attention to psychosocial factors such as the client's well-being, preference for follow-up services, inclusion of family, and familiarity with outpatient service providers |
| Preventing Relapse | Involves education for both clients and their families. Interventions include symptom education, service continuity, and establishment of structure |
| Characteristics of Psychiatric Rehab | Recovery from mental illness, personal growth, quality of life, community reintegration, empowerment, increased independence, decreased hospital admissions, improved social function, improved vocational functions, continuous treatment, increased involvement in treatment decisions, improved physical health, recovered sense of self |
| Characteristics of Recovery | Accepting illness, managing symptoms effectively, being actively engaged in the community, having meaningful social contact, coping with family relationships, and valuing self and others |
| Mental Status Exam | Collection of objective data through observation of the patient and their behavior. Including how they communicate, and respond to questions, as well as physical presentation |
| Targets for First Generation Antipsychotics | Blocking dopamine-2 receptors, and acetylcholine, histamine, and norepinephrine receptors. Thereby reducing the positive symptoms of psychosis as well as reducing agitation and hyperactive behavior - help control the auditory and visual hallucinations and delusions and reduce the emotional and social withdrawal. |
| Targets for Second Generation Antipsychotics | Blocking dopamine-2 receptors and strongly blocking multiple serotonin receptors. Also blocks norepinephrine, acetylcholine, alpha1-adrenergic, and to a lesser extent, histamine and muscarinic receptors. Reduce both positive and negative symptoms of schizophrenia |
| Target for Antidepressant MAOIs | Block the breakdown of monoamine oxidase, an enzyme that degrades the neurotransmitters norepinephrine, serotonin, dopamine, epinephrine, and tyramine, and makes these neurotransmitters less available in the brain. So the blocking actually increases the availability of norepinephrine, serotonin, and dopamine. |
| Target for Tricyclic Antidepressants | Block the norepinephrine reuptake pump and the serotonin reuptake pump - thus boosting the availability of neurotransmitters serotonin, norepinephrine, histamine, muscarine, acetylcholine, and dopamine |
| Target for SSRIs (Antidepressant and Antianxiety) | Block serotonin reuptake pump and increase the concentration of the neurotransmitter serotonin. Recently revealed they have significant anti-inflammatory properties |
| Target for SNRIs (Antidepressant and Antianxiety) | Block both the serotonin and norepinephrine pumps - boosting the availability of neurotransmitters serotonin and norepinephrine. |
| Buspirone | Medication that is used for the treatment of anxiety and treatment-resistant anxiety disorders. Exact mechanism is unknown, but it binds to serotonin and dopamine receptors |
| Benzodiazepines | Act primarily on the CNS and are often the first line of defense for anxiety. The enhance the inhibitory effects of GABA |
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