Mental Health Nursing I NURS 1300 Unit I Basic Concepts of Mental Health

Objective 1 Define mental health Dynamic process in which a person’s physical, cognitive, affective, behavioral, and social dimensions interact functionally with one another and the environment

Objective 2 Define mental illness Abnormal mental condition or disorder that disrupts a person’s thinking, feeling, mood, ability to relate to others, and daily functioning

Objective 3 Discuss current attitudes about mental illness Continued stigma Mental health parity Impetus for research diagnostic studies medications

Objective 4 Describe sociocultural influences on mental health Racism and discrimination misinterpretation of symptoms misdiagnosis or inappropriate treatment Fears of stigmatization and breaches in confidentiality

Objective 5 Discuss the data collection of the client with a mental health alteration Mental Status Examination (MSE) description of all areas of the client’s mental functioning includes assessment of appearance, mood and affect, speech and language, thought content, perceptual disturbances, insight and judgment, sensorium, memory and attention, and general intellectual level

Objective 6 Discuss diagnostic tests as they relate to the client with a mental health alteration Basic metabolic profile Electroencephalogram (EEG) CT scan PET scan MRI

Objective 7 Define the DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders (DSM) Handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them

Objective 8 Compare voluntary and involuntary commitment Voluntary admission similar to medical hospitalization patient may leave at any time Involuntary commitment client is hospitalized without consent becomes necessary when mental illness/condition manifested by symptoms that make it impossible for affected client to understand need for treatment

Objective 9 Describe patient rights as they relate to the client with mental health alterations Mental Health Systems Act of 1980: Universal Bill of Rights for Mental Health Patients Right to least restrictive treatment alternative Right to informed consent Right to refuse treatment Right to confidentiality Right to keep personal items

Right to the least restrictive treatment alternative: Less restrictive measures should be attempted before seclusion and restraints are used Right to informed consent: Physician must explain treatment in terms the client fully understands Responsibility is with the physician, not the nurse

Right to refuse treatment: Except in the cases in which the refusal is the result of a mental or cognitive impairment, or the client’s disease process is such that it is impossible for him or her to understand the need for medical intervention Right to confidentiality: Limits access to a client’s information Those individuals involved in care are the only ones with rights to access medical information

Right to keep personal items: People in a hospital or other treatment facility retain the right to keep their personal possessions unless those belongings pose a serious threat to themselves or others Items that may be dangerous would be held in a secure place during the individual’s hospitalization

Objective 10 Describe basic measures when caring for the client with a mental health alteration

24-hour therapeutic milieu management therapeutic milieu involves a manipulation of the environment in an effort to create behavioral changes and to improve the psychological health and functioning of the individual goal is for the client to learn adaptive coping, interaction, and relationship skills that can be generalized to other aspects of his or her life Provision of ongoing assessment of client’s mental and physical condition Administration of medications Assistance of client with therapeutic activities as needed Focus on one-to-one relationship development and maintenance

Objective 11 Identify basic treatment modalities for the client with a mental health alteration Therapies Medication Hospitalization Electroconvulsive therapy

Therapies: Psychotherapy (“talk therapy”) Group therapy Family therapy Hypnotherapy

Medication: Antipsychotics Anxiolytics Antidepressants Antimanics Anticonvulsants

Hospitalization: ensures safety of self and others Electroconvulsive therapy (ECT): electrical shock delivered to the brain to induce seizures

Objective 12 Identify legal and ethical concepts specific to the client with a mental health alteration

Patients hospitalized voluntarily retain their civil rights (except right to bear arms) Confidentiality and privacy Defamation of character occurs when the sharing of information is detrimental to client’s reputation