History and Basic Concepts of Mental Health and Mental Illness Assist. Professor Dr. Ali K. Al-Mesrawi

The historical overview of care of the mentally ill client

In the Beginning  No known treatment for the mentally ill before 1840 Mental illness perceived as incurable Only “reasonable” intervention was removing mentally ill persons from the community The Birth of Community Mental Health  Provided for reimbursement of mental health services through health care  Resulted in the “deinstitutionalization” of the mentally ill

Deinstitutionalization of the Mentally Ill  The deinstitutionalization movement occurred throughout the late 1950’s and early 1960’s 500,000 people lived in mental hospitals in 1955 Right to freedom at issue  Communities unable to sustain care for mentally ill Insufficient planning Budget cuts reduced mandated تكاليف services Mentally ill became homeless

The Problems That Remain  The mentally ill comprise a great majority of the homeless population  Many person with chronic mental illness end up in jails and emergency rooms  Not enough community services/facilities to provide adequate care for mental illness  Continuing stigma of mental illness

The concepts related to mental health and mental illness

Mental health The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age- appropriate and congruent with local and cultural norms. Mental illness Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with local and cultural norms, and interfere with the individual’s social, occupational, and/or physical functioning.

Self-esteem One’s opinion of oneself; a confidence and satisfaction in oneself. Self-awareness An awareness of one’s own personality or individuality. Sanity الصحة العقلية Soundness or health of mind; one’s ability to bear legal responsibility for one’s actions. Resilience Ability to recover from or adjust easily to misfortune مصيبة or change.

Well-being The state of being happy, healthy, or prosperous مزدهر. Empowerment التمكين To promote the self-actualization or influence of. Assertiveness The expression of opinions, needs, and feelings without negating the opinions, needs, and feelings of others.

The members of mental health team and their roles

Psychiatrist  Medical doctor with special training in mental illness and behavioral/emotional problems  Diagnoses conditions and prescribes medical treatment Nurse  Administers medications  Conducts group education sessions  Provides patient support and directs patient care Psychiatric technician  Assists nursing staff  Provides support to client

Social worker  Community resource education  Discharge planning Recreation therapist  Incorporates leisure activities in group settings to demonstrate healthy coping mechanisms Clinical psychologist  Provides individual and group therapy  Performs psychiatric testing Therapist  Provides individual therapy  Conducts group therapy sessions

psychiatric client rights

 Right to the least restrictive treatment  alternative  The nurse must attempt to provide treatment in a manner that least restricts freedom  Right to informed consent  Informed consent is the client’s permission to perform treatment  Legal liability مسؤولية for informed consent lies with the physician  The nurse acts as the client’s advocate to ensure informed consent was obtained

 Right to refuse treatment  The patient has the right to refuse treatment to the extent permitted by law, and to be informed of the medical consequences of his or her action  Right to confidentiality  Protection of client records and communications

 Right to keep personal items  People in a hospital or other treatment facility retain the right to keep their personal possessions  Items must be protected and returned upon release from the facility  Exceptions include: the belonging poses يشكل a serious threat to self or others items that may be dangerous would be held in a secure place during hospitalization personal items must be returned to the client upon release from the facility (each facility has own guidelines regarding confiscated مصادرة illegal items)

 Psychiatric patients have the right to freedom from restraint or seclusion except in an emergency situation: Restraints or seclusion are used for an individual whose behavior is out of control and who poses an inherent risk to the physical safety and psychological well-being of the individual and staff or others.

Criteria for hospitalization of a mentally ill client

In order to be considered eligible مؤهل for admission to an acute inpatient psychiatric unit, an individual must meet one or more of the following criteria:  The client is an imminent وشيك threat to himself/herself  The client poses an imminent threat to the safety and/or well-being of others  The client is unable to provide for his/her basic needs in spite of having adequate resources  The client is out of control

Voluntary hospitalization and involuntary hospitalization

Voluntary Hospitalization  Admission process similar to medical hospitalization  Patient may stay as long as treatment is deemed necessary  Patient can leave at any time Involuntary Hospitalization  Client is hospitalized without consent  Situation must be considered an emergency  Client receives observation and treatment for mental illness  May occur when an individual is unable to take care of his/her basic needs in spite of having adequate resources to do so

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