Alterations in Mental Health-an overview

MENTAL HEALTH CARE

STUDY MATERIAL

2016

MENTAL HEALTH CARE

PURPOSE:

The purpose of this offering is to provide the healthcare professional with an understanding of introductory concepts related to mental health care. This course consists of home study materials and components.

OBJECTIVES:

Upon completion of this course, the learner will:

1. Describe types of mental illness.

2. Identify common mental illnesses.

3. Explain basic concepts related to mental health care.

4. Identify aspects of documentation related to mental health care.

5. Describe policies related to mental health care.

INTRODUCTION

According to The National Institute of Mental Health (NIMH), approximately 26% of American adults over the age of 18 suffer some kind of mental disorder. An understanding of mental healthcare revolves around societal norms, values and beliefs. One of the older definitions of mental illness viewed behaviors outside what was viewed as normal as mental illness. As time evolved mental health refers to a state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.

What is Mental Illness?

Mental Illness: Any of various conditions characterized by impairment of an individual's normal cognitive, emotional, or behavioral functioning, and caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma. Also called emotional illness, mental disease, and mental disorder.

Warning Signs of Mental Illness

• Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult.

• Fear or suspiciousness of others or a strong nervous feeling.

• Uncharacteristic, peculiar behavior. Dramatic sleep and appetite changes or deterioration in personal hygiene.

• Rapid or dramatic shifts in feelings or “mood swings.”

Diagnosing Mental Illness

The diagnosis of mental illness is made according to specific criteria, using the Diagnostic and Statistical Manual of Mental Disorder (DSM-V TR). The DSM contains description, diagnosis, treatment and research findings. The DSM-VTR is used to organize patient care and treatment, and is used by researchers and health care workers

Axes: The DSM-IV-TR systemizes psychiatric diagnoses in five axes:

Axis I: Major mental disorders, developmental disorders and learning disabilities.

Axis II: Underlying pervasive or personality conditions, as well as mental retardation.

Axis III: Any non-psychiatric medical condition.

Axis IV: Social functioning and impact of symptoms.

Axis V: Global Assessment of Functioning.

Types of Mental Illnesses

Holistic medicine acknowledges the connection between mental and physical functions. Psychobiological disorders are those mental disorders that have a specific, identifiable biological influence and have been recognized in legislation to help patients obtain insurance coverage. These disorders include:

■ Schizophrenia

Schizophrenia is a brain disease that affects cognition, thoughts, behaviors, language, and accurate perception of reality. This term is used for a group of disorders, which are characterized by severe disturbances in thought, associative looseness, and impaired reality including hallucinations, delusions, and anti-social behavior. It is typically diagnosed in the late teens or early 20s.

■ Bipolar Disorder

Bipolar disorder is defined as having moods that alternate between extremes of depression and elation. Periods of normal mood occur, and when episodes occur they are either depressive or manic. Bipolar disorder can be broken down into categories:

■ Bipolar I disorder involves at least one episode of mania alternating with at least one depressive episode.

■ Bipolar II disorder involves hypo manic episode(s) alternating with depressive episodes.

■ Major Depression

A major depressive disorder (sometimes referred to as clinical depression, or major depression) occurs when a person has a severe depressed mood and a loss of interest or pleasure in daily activities consistently for at least two weeks. This must be a marked change from the person’s normal state of mind. Mood moves from mild depression to severe at the start of an episode. In addition, there must be a negative impact on social, occupational, and/or educational functioning.

■ Obsessive-Compulsive Disorder

Perfectionism with a focus on orderliness and control. Taken to an extreme, their obsession with details may make it difficult to complete a task. They genuinely care about their friends and family but do not have insight as to how their behavior can damage close relationships

■ Panic Disorders

A panic disorder is defined by recurrent panic attacks. Panic attacks create the high-level anxiety, with symptoms such as shortness of breath, nausea, feelings of losing control and dying, choking sensation, heart palpitations and chest pain.

■ Posttraumatic Stress Disorder

PTSD occurs after experiencing or witnessing a traumatic event such as natural disasters, military combat, serious accidents, personal assaults, etc. These situations can cause fear, helplessness, and/or an increased startle reflex resulting in symptoms such as nightmares, flashbacks, sleeping problems, and feelings of isolation. In some cases these symptoms appear right after the precipitating event, but in other cases the symptoms appear as much as years later.

■ Autism

Autism is part of a larger group of disorders called pervasive developmental disorders (PDD). Autism is a developmental disability that comes from a neurological disorder that affects the normal functioning of the brain. It is characterized by the abnormal development of communication skills, social skills, and reasoning. Males are affected four times as often as females. Children may appear normal until around the age of 30 months. Characteristic traits include lack of eye contact, repetition of words or phrases, unmotivated tantrums, inability to express needs verbally, and insensitivity to pain.

How to Care for the Mentally Ill

The goal of mental health care is to provide for the needs of the patient. Health care workers assist people with mental illness in leading more productive and autonomous lives. HCW ... and to promote mental health through service, advocacy, and education, to allow the patient to remain healthy regardless of age or disability. Mental health care is paid for by the government through Medicare and/or Medicaid; private insurance or health maintenance organizations (HMOs) patients themselves, certain non-profit community, charitable disease advocacy organizations or faith-based organizations.

Caring for people with alterations in mental health includes:

• Always encourage compliance with medications

• Assess the ABCs: appearance, behavior and combativeness

• Be consistent, reduce stress by assisting them to adjust to the effects of the illness

• Be critical thinkers, always think patient safety first

• Avoid losing your temper or becoming critical of them

• Collaborate with the patient’s family and friends to support them

• Maintain an appropriate distance, eye contact and listen

• Have good abilities to provide health education

• Be culturally competent

Policies, procedures and documentation in Mental Health

Always remember to report and document the following observations:

• Any change in abilities or thinking

• Changes in mood, especially withdrawal

• Any person, object or event that appears to upset the person

• Comments, referrals or attempts to harm self or anyone else, even if said jokingly

• Any failure to take medications or absence from therapy

• Changes in patient condition

• Informed consents regarding medication and treatments

• Reaction to medication

• Symptoms

• Concerns of patients

• Pertinent incidences in the healthcare settings

Review

It is important to remember that mental illness can develop at any age or stage of a person’s life. As such, health care workers must be able to identify the main signs and symptoms of each. Each person with an alteration in mental health may receive the appropriate care and assistance they need to return to optimum function, once an appropriate diagnosis is made.

References

Halter, M. (2014). Varcarolis’ Foundations of Psychiatric Mental Health Nursing. (7th ed). St. Louis, MO: Elsevier