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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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“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 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 • 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
“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
“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
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
“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) • 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