Chap. 1: Understanding Mental Health

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Chap. 1 Understanding Mental Health Mental
Illness

• J. Davis BSN, RN

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Definition of Mental Health

• Changes as culture society changes views
  attitude of mental health
• 7 Important characteristics of Mental Health
• Interpret reality accurately
• Have a healthy self-concept
• Are able to relate to others
• Achieve a sense of meaning in life
• Demonstrate creativity/productivity
• Have control over their behavior
• Adapt to change conflict

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Mental Health

• Reality what really is or exists
• Self-concept realistic appraisal of self
  acceptance of who they really are
• Insight self-understanding allows people to
  see own motivations or reasons behind their
  feelings/behavior

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Mental Health

• Human beings thrive when they are w/ others
• Love is the most important human emotion
• Normal human development is not possible in
  isolation
• Humans seek reasons meaning in life
• Mentally healthy people can control their
  behavior
• Mentally healthy people are adaptable
• All people have the potential for growth toward
  greater mental health

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Mental Disorders

• Illnesses w/ symptoms related to thinking,
  feeling, or behavior
• May be due to genetic, biological, social,
  chemical or psychological influences
• The definitive source for diagnostic criteria for
  mental disorders is the DSM (Diagnostic
  Statistical Manual of Mental Disorders)

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DSM

• Standard terminology for mental disorders set
  of criteria for diagnosing them
• Allows for a thorough diagnostic process
• DSMs fixe-axis diagnosis system
• Axis I Clinical Psychiatric Disorders
• Axis II Personality Disorders or Mental
  Retardation
• Axis III General Medical Conditions
• Axis IV Psychosocial Environmental Problems
• Axis V Global Assessment of Functioning

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Mental Illness (cont)

• Nurses dont diagnose but must understand how
  diagnoses are made
• Physician looks _at_ disease management of disease
• Nurses look _at_ how the client is affected by the
  disease (focus is on clients response to illness)

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Five Most Common Mental Disorders

• Major depressive disorder
• Alcohol abuse
• Schizophrenia
• Self-inflicted injuries
• Bipolar disorder

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Stigma

• Stigma a mark of disgrace
• Causes people to have a negative attitude towards
  people w/ mental illness
• Because of stigma, some mentally ill people wont
  seek treatment

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Historical Perspectives

• In very early times, mental illness was thought
  to be due to supernatural forces (i.e. demons or
  divine influences)
• Hippocrates, theory of disease-blood, phlegm,
  yellow bile, black bile
• Renaissance mental illness affected by the moon
  (lunatic) mentally ill were ill-treated beaten
• 1790s moral treatment of mentally ill

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Historical Perspectives (cont)

• Quakers believed that treating people w/ kindness
  in a pleasant environment could help bring
  recovery
• Quaker philosophy formed foundation for milieu
  therapy
• Milieu therapy the environment of the client is
  considered part of the therapy (still used today)
• Dorothea Dix (19th cent) advocate for the
  mentally ill
• Around the 20th cent places started to
  incorporate formal training for the mentally ill

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Historical Perspectives (cont)

• 1930s brought about somatic therapies (physical
  therapies for mental illness) i.e. coma therapy,
  insulin shock therapy, electroshock therapy
• 1950s brought about psychotropic drug therapies
  Thorazine Lithium were widely used to treat
  psychosis (loss of reality)
• Deinstitutionalization began in 1950s
• Pts treated in least restrictive environment
• Cheaper to treat people in community than in
  hospital
• Resulted though in people not receiving ANY
  treatment
• Progress is still being made today in tx of
  mental illness but stigma remains

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Nurses Role

• Role in Mental Health Promotion
• Prevention-(primary, secondary, tertiary)
• Primary-prevention from being affected (i.e. drug
  abuse education)
• Secondary-affected individuals are identified
  treated
• Tertiary-serves people already severely affected
  attempts to help them recover prevent further
  disability
• Treatment during acute phase
• Rehabilitation after recovery

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Vulnerability of Mentally Ill

• The mentally ill are often too disabled to speak
  effectively for themselves
• MOST IMPORTANT ROLE OF THE NURSE FOR THE MENTALLY
  ILL IS THAT OF CLIENT ADVOCATE!

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Reference

• Eby, L. Brown, N. (2009). Mental health
  nursing. Pearson Prentice Hall Upper Saddle
  River, New Jersey.