Mental Health

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Mental Health
2012-01-04 00:51:54

Mental Health
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  1. Definition of Mental Health
    Ability to cope with and adjust to the recurrent stresses of living in an acceptable way
  2. Mental health is influenced by WHAT three factors?
    • inherited characteristics
    • childhood nurturing
    • life circumstances
  3. Individual is mentally ill when behaviors:
    • interfere with daily activities
    • impair judgment
    • alter reality
  4. Treatments that were geared to remove evil spirits
    • bleeding
    • massage
    • blistering
    • enducing vomitting
    • trephining - cutting holes in the skull to encourage the evil spirits to leave
  5. Hippocrates
    Viewed mental illness as an imbalanced of humors (air, fire, water, & earth)
  6. Plato
    • Believed patients should be in their comfortable period
    • -Massage
    • -Warm Baths
    • -Beautiful Music
    • -Peaceful surroundings

    Rational soul controlled the irrational soul could be compared with the belief of the more recent psychological theorist, Freud.
  7. Arabic influence:
    • Extensive knowledge of drugs and awareness
    • universities were established
    • large institution were established and mentally ill individuals were herded into "lunatic systems"
  8. Who established the first English institution for the mentally ill and when was it founded?
    Sheriff of London established the first English institution in 1247
  9. Bethleham Royal Hospital
    • Lunatic asylum and infamous for its brutal treatments
    • Also known as Bedlam
  10. Philippe Pinel (1792)
    • Director of two paris hospitals
    • Advocated acceptance of the mentally ill as human beings
  11. In 1794, ________ was built in New York City.
    Bellevue Hospital
  12. Alice Fisher (1700s)
    A Florence Nightingale-trained nurse that helped improve care for the mentally ill
  13. Dr. Benjamin Rush
    • "Diseases of the Mind" - psychiatric text
    • His book advocated:
    • Clean conditions
    • Good air, lighting, and food
    • Kindness
  14. Dorothea Dix
    • surveyed asylums, jails, and almhouses
    • Because of her voice, care for the mentally ill greatly improved
  15. Clifford Beers (20th century)
    • "A Mind That Found Itself"
    • Committee for Mental Hygiene was formed in 1909
    • Focused on removing stigma of mental illness
  16. Sigmund Freud
  17. Hill-Burton Act (1937)
    funded the construction of psychiatric units throughout the United States
  18. National Mental Health Act (1946)
    Provided funding for programs in research, training of mental health professionals, and expansion of state mental health facilities
  19. National Institutute of Mental Health (1949)
    Provide research and training related to mental illness
  20. Psychotherapeautic Drugs
    Chemicals that affect the mind
  21. John Cade (1949)
    Discovered that lithium carbonate was effective in controlling mood swings seen in bipolar illness
  22. The introduction of psychotherapeautic drugs in the 1950s led to
    Deinstitutionalization - release of large numbers of mentally ill persons into the community
  23. Community Mental Health Centers Act (1963)
    Construction of mental health centers in communities
  24. Medicare/Medicaid Bill (1965)
    Release of 75% of institutionalized mentally ill persons in the community
  25. President's Commission of Mental Health (1978)
    • Introduced Jimmy Carter
    • Assess mental health needs of the nation
  26. Mental Health Systems Act (1980)
    • Address community mental health care and clients' rights
    • Funding for mental health reform changed dramatically when new president was elected
  27. Omnibus Budget Reconciliation Act (1981)
    • Repealed the Mental Health Systems Act.
    • Block Grant Funding - designated amount of federal funding
  28. Omnibus Budget Reconciliation Act (1987)
    Prevent housing of mentally ill patients in nursing homes
  29. National Alliance for Mental Illness (NAMI) (2006)
    • Conducted the "first comprehensive survey and grading"
    • Gave US grade of a D because of poor funding, limited availability for care, access to care, and greated involvement of consumers and their families)
  30. Belief
    Conviction that we believe is true whether or not it is based on fact
  31. Value
    • held dear, a feeling about the worth of an item, idea, or behavior
    • formed in childhood
  32. Values Clarification
    Step by step process to help identify significant value
  33. Morals reflect
    • One's attitudes, beliefs, and values
    • An individuals right or wrong behavior
    • Developed through childhood
  34. Rights
    • Power, priviledge, or existence to which one has a just claim
    • Help define social interactions because they contain the principle of justice, they equally and fairly apply to all citizens
    • associated with obligations
  35. The Patient's Bill of Rights (1972)
    All clients have the rights to respectful care, privacy, confidentiality, continuity of care, and relevant information
  36. The Patient's Bill of Rights addresses clients' rights to:
    • Examine their bills
    • Refuse treatment
    • Participate in research
  37. The Patient Care Partnership
    Statements of rights exists for old, young, disabled, pregnant, dying, developmentally disabled, and mentally ill.
  38. Mental health clients can lose rights in two ways:
    • Not able to recognize their rights, much less exercise them
    • Mental health delivery system can impose limits on clients' abilities to exercise their rights
  39. The rights of nurses and other care providers relate to
    • Respect
    • Safety
    • Competent assistance
  40. Ethics
    • set of rules or values that govern right behavior
    • Reflect: values, morals, principles of right and wrong
    • Protect the rights of people
  41. Ethical codes serve two purposes:
    • Act as guidelines for standards of practice
    • Let the public know what behaviors can be expected from their health care providers
  42. Autonomy
    Right of people to act for themselves & make personal choices, including refusal of treatment
  43. Beneficience
    Actively do good
  44. Nonmaleficience
    Do no harm
  45. Justice
    All clients are treated equally, fairly, and respectfully
  46. Fidelity
    Obligation to keep your word
  47. Veracity
    Duty to tell the truth
  48. Difference between policies and procedures:
    • Policies: statements that define a course of action
    • Procedures: how course of action is physically done
  49. Advocacy
    acts on the behalf of the patient protecting their right to make their own decisions
  50. Confidentiality
    • Keeping patient info private from third parties
    • Only exceptions to break confidentiality is: abuse, suicidal, homosidal
  51. Right to die/DNR situations
    Choice to refuse treatment to prolong their life
  52. Abortion
    personal feelings cannot affect patients care w. opposite views than you
  53. Organ donation/transplants
    • Legal obligation to providing the option of organ donation
    • 18+ have the option of donating
  54. Child/elder abuse
    Cannot legally keep confidential
  55. Whistle blowing
    Reporting a nursing collegue or unethical issue compose great emotional stress but it is a MUST.
  56. Public Law (Criminal Laws)
    • Focuses on the law between government and its citizens
    • Protects the members of society
    • Consists of misdemenours and felonies
  57. Private Law (Civil Laws)
    • Focuses on the law between citizens and/or institutions
    • Torts and contracts
  58. Assault (intentional tort)
    act in which their is a threat to do bodily harm
  59. Battery (intentional tort)
    • Physical touching without permission
    • Unauthorized physical harm
  60. False Imprisonment (intentional tort)
    • Interferring with patients freedom of movement
    • Ex: Restraining patient from leaving the facility
  61. Appropriate guidelines include monitoring:
    restraints every 15 minutes and exercise patient every 2 hours
  62. Invasion of Privacy
    Violating private patient or family matters, taking photographs without consent
  63. Defamation of Character
    When information is shared with the third party
  64. Slander
    Verbal character attack
  65. Libel
    Written attack
  66. Fraud
    Giving false information
  67. Unintentional Torts
    • situations resulting in injury.
    • conduct falls below standard of care
  68. Negligence
    Something was not done right or at all
  69. Malpractice
    Negligence on the part of the nurse
  70. 4 Elements of Malpractice
    • Duty of Care
    • Breach of Duty
    • Causation
    • Injury
  71. Nurse Practice Act
    Scope of Practice
  72. Institutional Policies
    Statements by facilities
  73. Standards of Practice
  74. Recent Sedatives (special situations)
    Wait full 4 hours before informed consent signed
  75. Illiterate/non-English speaking (special situations)
    • Have to be read to the patient in their own language by a translator
    • 2 nurses must witness the consent being signed
  76. Incompetent/Comatose (special situations)
    If left unsigned and physician has to write in progress notes the reason
  77. Minor (special situations)
    • Parent/Legal Guardian are responsible for consenting
    • Not applicable to emancipated, married, or minors seeking STD help
  78. Emergencies (special situations)
    • Can perform procedure without consent
    • Ex: Car accidents
  79. Elopement
    • "The runners"
    • Runaways from facilities - can be held liable if harmed
  80. Duty to Warn
    Patient who threaten to hurt someone, we must protect those potential victims from possible harm
  81. Example of reportable data:
    • Abuse
    • Gunshot wounds
    • Communical diseases (contagious)