CHAPTER 30 MENTAL HEALTH CAREERS

Chapter 30 Learning Objectives Define at least eight terms relating to mental health care. Describe the function of the mental health care team.

Chapter 30 Learning Objectives Specify the role of selected members of the mental health care team, including the personal qualities, levels of education, and credentialing requirements. Define mental health and mental hygiene.

Chapter 30 Learning Objectives Describe at least four psychoneurotic disorders. Describe at least two types of psychosis. Describe procedures for use of physical restraint.

Chapter 30 Learning Objectives Identify at least three techniques of reality orientation.

Careers in Mental Health Care The function of the mental health care team is to provide care and treatment for individuals with disorders of the mind or emotional or behavioral issues. Mental health care workers need to have good communication skills, an interest in behavior, emotional stability, and patience. The field of mental health care is constantly growing because of the increasing age of the population. The higher cost of health care has contributed to moving the mental health care services out of facilities and into the community.

Mental Health Careers

Mental Health Career Educational Cost and Earnings

Psychiatrist Psychiatrists are licensed physicians specializing in the treatment of mental, emotional, and behavioral disorders. They determine the type and severity of a disorder and plan necessary therapy. Education 4-year residency after earning a medical degree Must be licensed

Psychiatrist Specialties in psychiatry Psychotherapy Child practice Psychoanalysis Behavior therapy Forensics Industrial or organizational practice

Psychologist Study of human behavior and mental processes to understand and explain human actions Education Doctorate (PhD, EdD, or PsyD) degree Internship before licensure or certification, which is required to practice independently Most psychologists earn a doctoral degree. Individuals with a master’s degree work under the supervision of a doctor of psychology. Certification or licensing is required in all states. More than 40% of psychologists are self-employed.

Areas of Specialization for Psychologists Consumer Environmental Developmental Rehabilitative Organizational Education Social Clinical Cross-cultural Quantitative

Forms of Therapy

Support Personnel Psychiatric technician may Interview Lead group sessions Give daily care Make home visits In some cases, may administer medications Education 2-year associate degree Many states require licensure Psychiatric technicians are also known as mental health technicians, human service workers, or mental health associates.

Support Personnel Psychiatric assistant Helps clients with mental health problems under the direction of nurses and physicians Helps with activities of daily living (ADLs) and socializing Leads recreational activities Observes patients for unusual behavior and reports observations Training On-the-job (approximately 6 months)

Mental Health Most people with mental or developmental problems live in communities, not institutions. Assisted living centers and nursing homes also provide care. Other alternatives Foster care Day care centers Half-way houses Group homes In the past, people with mental or developmental problems were placed in asylums or sanatoriums.

Mental Health Psychoneuroses are functional disturbances of the mind. Individual does not lose touch with reality. Person often knows that the reactions experienced are not appropriate. Anxiety is a feeling of fear or apprehension. Depression is a feeling of sadness. Phobias are specific unrealistic fears. Hypochondria is the belief in imaginary illness. Everyone experiences anxiety and depression.

Mental Health Psychoses are severe or major mental disorders, and the affected individual is not in contact with reality. Person does not know that the behavior and thoughts are abnormal. Manic-depressive or bipolar psychosis Severe depression is followed by elation or excited behavior Paranoia Person feels persecuted and plotted against by others

Mental Health Deprivation syndrome Dissociative disorders Condition in children resulting from inadequate nutrition and an environment unsuited for normal growth and development Children develop intellectual slowing and difficulty fitting into society. Dissociative disorders Person loses or changes identity. Example: multiple personalities

Mental Health Treatment of mental disorders Psychotherapy Medication Discussion to help understand and cope with problems Medication Group therapy People share their feelings with others who have the same problem. Electroconvulsive therapy Uses electric shock to interrupt temporarily the normal functions of the brain Behavior modification Used to change the individual’s lifestyle

Forms of Therapy

Mental Health Suicide may occur when a mental disorder is severe. Other risk factors for suicide Alcohol and substance abuse Major stressing event Psychotherapy and medication are methods used to prevent suicide.

Common Warning Signs of Suicide

Research in Mental Disorders Neurobiology Studies the correlation between brain function and psychological behavior Right brain-left brain control The right hemisphere of the brain controls creative and nonvebal thinking. The left hemisphere controls logical and verbal thought. “New theory” hypothesis by neurobiologists There are periods of specific development (neuroplasticity) during which the brain needs certain experiences for optimal development to occur.

Research in Mental Disorders Some research shows that genes influence a person’s personality and mental behavior. Minnesota Center for Twin Adoption Research Sociobiology (e.g., studies of identical twins separated at birth displaying same mannerisms)

Functional Areas of the Brain FIGURE 30-3 Functional areas of the brain. (From Milliken ME, Campbell G: Essential competencies for patient care, St. Louis, 1995, Mosby.)

Mental Hygiene Some patients with mental disorders may need special treatment techniques to live safely. Restraints Made of leather or cloth Used to protect patients from harming themselves or others Physician’s order for restraint required in many states Must be applied correctly to avoid injury Used for short periods Proper body alignment should be observed and maintained during restraint.

Geri-Chair FIGURE 30-4 The geriatric chair is also a physical restraint. Restraints are used only with a physician’s order so that the patient is protected from injury. (From Sorrentino S: Mosby’s textbook for long-term care assistants, ed 3, St. Louis, 1999, Mosby.)

Mental Hygiene Reality orientation is a form of rehabilitation used for confusion or “loss of reality.” Caregiver should identify self and role each time. Caregiver clarifies and repeats procedures as necessary. Instructions should be short and simple. A calm, relaxed environment and routine should be observed. A systematic approach is taken to orientation. Use of clock, calendars, newspapers, and other items helps. Loss of hearing, loss of sight, or confinement may lead to temporary confusion.

Performance Instruction Restraints Must be ordered by a physician Least restrictive is preferred Use of “safe” restraints Should be applied according to manufacturer’s instructions Should be snug but allow some movement and blood circulation Circulation in the restrained area should be checked every 15 minutes.

Performance Instruction Reality orientation Health care worker should state her or his name and role with each visit to the room. Patient’s name should be called with each visit. Health care worker should clarify and repeat the procedure for the person to understand. Speaking slowly and clearly is important. A calm, relaxed environment is provided for the patient. Clocks, calendars, and newspapers help orient the patient to the present. A calm, relaxed environment and a routine may help reduce the anxiety caused by confusion.

Summary The function of the mental health team is to provide care and treatment for individuals with disorders of the mind, emotion, or behavior.

Summary The role of the psychiatrist is to determine the type and severity of a mental disorder and provide treatment. Psychologists use interviews, testing, and observation to treat mental and emotional disorders. The challenging work requires the worker to be creative in finding solutions to problems. Mental health care workers must be emotionally stable and mature. They must lead and inspire others while demonstrating patience and perseverance.

Summary Mental health is a state of mind in which a person can cope with problems and maintain emotional balance and satisfaction in living. Mental hygiene includes the methods used to preserve and promote mental health. Four types of psychoneuroses are anxiety, depression, panic disorder, and phobias.

Summary Two types of psychosis are schizophrenia and bipolar disorder. The procedures for use of physical restraint include obtaining a written order from a physician, using the least restraint necessary to provide for safety, and checking that restraints are applied properly.

Summary Three techniques of reality orientation are displaying clocks and calendars, addressing the patient by name, and placing articles in the same place.