1. CHAPTER 30 MENTAL HEALTH CAREERS

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

3. 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.

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

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

6. 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.

7. Mental Health Careers

8. Mental Health Career Educational Cost and Earnings

9. 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

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

11. 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.

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

13. Forms of Therapy

14. 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.

15. 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)

16. 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.

17. 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.

18. 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

19. 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

20. 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

21. Forms of Therapy

22. 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.

23. Common Warning Signs of Suicide

24. 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.

25. 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)

26. 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.)

27. 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.

28. 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.)

29. 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.

30. 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.

31. 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.

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

33. 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.

34. 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.

35. 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.

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