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Foundations of Psychiatric Mental Health Nursing Clinical Practice

How does Mental Health differ from Mental Illness?. HealthAutonomy/independenceWorks towards self-actualizationAble to face challengesSelf-esteem-knows abilities/limitationsMasters environmentsReality orientedManages stress

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Foundations of Psychiatric Mental Health Nursing Clinical Practice

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    1. “Foundations of Psychiatric Mental Health Nursing & Clinical Practice”

    2. 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

    3. 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 & ˝ with substance abuse

    4. 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

    5. “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

    6. 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

    7. “Parity Act” 1996 Eliminated annual/lifetime $ amounts for mental health care for companies with > 50 persons Substance abuse exempt

    8. 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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