foundations of psychiatric mental health nursing clinical practice
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“Foundations of Psychiatric Mental Health Nursing & Clinical Practice”. Health Autonomy/independence Works towards self-actualization Able to face challenges Self-esteem-knows abilities/limitations Masters environments Reality oriented Manages stress –uses support system. Illness

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how does mental health differ from mental illness
Health

Autonomy/independence

Works towards self-actualization

Able to face challenges

Self-esteem-knows abilities/limitations

Masters environments

Reality oriented

Manages stress –uses support system

Illness

Behavioral/ psychological syndrome e/b

Dissatisfaction w/self

Ineffective/non-satisfying relationships

Dissatisfied w/place in world

Unable to cope or ineffective coping w/life stressors/events

How does Mental Health differ from Mental Illness?
mental illness today
MENTAL ILLNESS - TODAY
  • NIMH – estimates:
  • 26% Americans 18+ have diagnosable MI

(57.7 mil /yr) (2006)

  • ADHD – 3-5% school age children diagnosed
  • Great economic burden > all types of cancer.
  • In U.S. & Canada - Leading cause of disability in persons 15-44 years-old
  • Only 1:4 adults & 1:5 children & adolescents receive needed services.
  • Homeless – est. 750,000 living in streets –

1/3 with mental illness & ½ with substance abuse

historical events in mental health
“Period of Enlightenment”

Late 1700’s- 1800’s

Development of Psychopharmacology

1950” - present

Protection/safe haven

Beginning of moral tx.

Dorothy Dix- opens Asylum for the MI (provides food, clothes,shelter)

↓ agitation, ↓psychosis

↓depression

Shorter hosp stays

↓noise/violence in hospitals

Historical Events in Mental Health
slide5
“Deinstitutionalization”

1963 Community Mental Health Centers Construction Act

(J.F. Kennedy administration)

SSI/SSDI -Federal Legislation to provide income for disabled

“least restrictive environment concept”

C M H C’s built

3 components:

1) release from state hosp.

2.) diversion from hosp

3) developed alternate services In community

↑independence of MI

slide6
Lanterman Petries Short Act

( LPS Act)

1970’s changes in commitment laws

Commitment laws

72 hr hold-14 day holds -30 day holds

Conservatorships &

Guardianships

Can only be held involuntarily if:

DTS

DTO

GD

slide7
“Parity Act”

1996

Eliminated annual/lifetime $ amounts for mental health care for companies with > 50 persons

Substance abuse exempt

dsm iv tr diagnostitic statistical manual
DSM IV -tr(Diagnostitic Statistical Manual)
  • Axis I – Psychiatric Diagnosis
  • Axis II- Personality Disorder or Development Disorder
  • Axis III – Medical Diagnosis (that impacts on mental diagnosis)
  • Axis IV- Stressors (mild, moderate, severe, catastrophic – acute or enduring
  • Axis V – GAF (Global Assessment Functioning Scale) score
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