1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 29 Mental Health and Illness

2. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Mental Health and Illness Prevalence Lack of access to mental health care Role of Community Health Nurse  Outreach  Enhancing access to care

3. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Foundations of Caring Historical foundations Moral treatment and psychoanalysis Community mental health movement

4. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Theories from Allied Disciplines Psychodynamic  Freud Social-Interpersonal  Psychotherapy Behavioral  Skinner

5. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Neurobiological Concepts Illness of the brain Frequently caused by  Lesion  Toxin  Abnormality of neuroanatomy  Neurotransmitters

6. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Nursing Theories Theories applicable to mental health Emphasize caring, communication, and relationships Focus: nurse-patient relationship

7. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Influences on Community Mental Health Disease burden associated with mental illness Community mental health reform Deinstitutionalization Incarceration

8. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Influences on Community Mental Health Economic factors Consumer activism Cultural factors International trends  Home care

9. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Factors that Contribute to the Problem Stigma associated with mental illness Treat individuals with mental illness respectfully Educate public about mental illness

10. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Mental Health Nursing Practice Community locations enhance access to care Common settings  Home, school, job site Practice models Supervised living

11. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Health Promotion/Illness Prevention Goal of Prevention  Decrease onset, duration, and residual disability Primary Prevention  Anticipatory guidance, education, and support

12. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Nurse’s Role in Mental Health and Illness Care Promotion of optimal well-being Promotion of self-care Promotion of healthy relationships Symptom management

13. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Secondary Prevention Goals  Decrease incidence  Decrease duration of illness Targets high-risk individuals Nursing interventions

14. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Tertiary Prevention Goal  Decrease morbidity associated with chronic illness Nursing interventions  Education  Promotion of self-care  Case management

15. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Suicide Incidence  Trends Risk Factors  History of mental illness  Substance abuse  Family violence

16. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Nursing Interventions for the Suicidal Client Assess suicidal ideation  Detailed plan  Lethality of method  Availability of rescue opportunities Referrals

17. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Community Health Nursing Practice Screening, assessment intake, and evaluation Nursing support interventions  Communication  Therapeutic relationships Psychobiological Interventions

18. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Community Health Nursing Practice Health teaching Case management Health care activities Home visits Community action

19. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 29 Advanced Psychiatric/Mental Health Nursing Master’s prepared or higher Certified in specialty Roles  Consultant  Educator  Counselor  May prescribe