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Understanding Mental Health and Illness

Explore the concepts of mental health and mental illness, debunk myths, learn about the DSM-IV, epidemiology, signs of illnesses, and influences affecting mental health. Discover the importance of cultural awareness and nursing diagnoses.

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Understanding Mental Health and Illness

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  1. Chapter 2 Mental health and mental illness

  2. Mental health and mental illness • Mental health: Successful performance of mental functions with the ability to: -engage in productive activities -enjoy fulfilling relationship -change or cope with adversity • Mental Illness: A clinically significant behavioral or psychological syndrome experienced by a person and marked by distress, disability, or the risk of suffering disability or loss of freedom.

  3. Mental health and mental illness • Myths and Misconceptions -Mentally ill is to be different and odd • Mentally healthy person must be logical and rational • Psychiatric definition of normal mental health changes over time (Sadock & Sadock, 2007) -reflects changes in cultural norms, societies’ expectations and values, professional bias, and individual differences • No one definition of mental health fits all: -individuals with mental health issues have attributes of strength/high functioning -persons with mental health have issues related to dysfunction at different times in their lives)

  4. Diagnostic and statistical manual of mental disorders (DSM-IV) • 5 Axis System • Axis 1: Psychiatric Disorder • Axis 2: Personality Disorder and Mental retardation • Axis 3: Medical Disorder • Axis 4: Psychosocial and Environmental Problems • Axis 5: Global Assessment of Functioning (GAF) • Classifies and categorizes mental disorders • Incorporates cultural awareness

  5. Epidemiology • Definition • Quantitative study of distribution of mental disorders in human population • Prevalence Rate • Proportion of a population with mental disorder at a given time • Lifetime Prevalence of Mental Disorders • Published study (Kessler, et al., 2005), concluded ½ Americans will meet criteria for DSM-IV disorder sometime in their lifetime, with the 1st onset in childhood or adolescence

  6. Prevalence and epidemiology of the psychiatric disorders in USA

  7. Signs of mental illness Major Depressive Disorder Impulse Control Disorder Schizophrenic Disorder Adjustment Disorder with work/academic inhibition Antisocial personality disorder Borderline personality disorder Substance dependencies Mental health vs. mental illness • Signs of mental health • Happiness • Control over behavior • Appraisal of reality • Effectiveness in work • A healthy self concept • Satisfying relationships • Effective coping strategies

  8. Mental health parity act • Passed by Congress 1996 • Requires insurers that provide mental health coverage to offer benefits at the same level provided for medical and surgical coverage

  9. Example of DSM-IV evaluation documentation Axis I: Major depression disorder, recurrent, severe, Alcohol dependence, Alcohol withdrawal Axis II: Borderline personality disorder Axis III: Diabetes Type 2, HTN Axis IV: Job jeopardy, death of spouse, homeless Axis V: GAF 35

  10. Biological based mental illnesses • Caused by neurotransmitter dysfunction, abnormal brain structure, inherited genetic factors, or other biological causes • Can be classified as medical diseases • Includes the following: • Schizophrenia • Bipolar disorder • Major depression • Obsessive compulsive and panic disorders • Post traumatic stress disorder • Autism • Anorexia Nervosa • Attention and hyperactivity disorder

  11. Influences that affect a person’s mental health • Biological • Hormonal • Inherited factors • Personality traits • Cultural beliefs/values • Support systems (family, friends, community) • Negative influences (psychosocial stressors) • Spirituality/religion • Environmental experiences • Demographic/geographic location

  12. Nursing diagnosis and NANDA international A clinical judgment about individual, family, or community responses to actual or potential health problems and life processes (e.g. hallucinations, self-esteem issues, inability to function in a job or family) Helps target the symptoms and needs of patients so they can ideally achieve a higher level of functioning and quality of life http://www.nanda.org/Home.aspx

  13. Cultural related symptoms • Influence of culture on behavior and the way in which symptoms present may reflect a person’s cultural pattern • Symptoms need to be understood in terms of a person’s cultural background • Caution: do not stereotype -lack of cultural awareness can result in improper care or delivery of inappropriate services

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