Transcript Chapter 2
Chapter 2 Mental health and mental illness 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. 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) 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 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 Prevalence and epidemiology of the psychiatric disorders in USA Disorder Prevalence over 12 mo (%) Est # people affected Epidemiolo gy Schizophreni 1.1 a 2.2 million Men & women Mood disorders 9.5 18.8 million Women 2x men MDD 5 9.9 million Women 2x men, lead cause disability Anxiety Disorders, PTSD, GAD 13.3 19.1 million Co-occur with depressive Mental health vs. mental illness Signs of mental health Major Depressive Disorder Impulse Control Disorder Schizophrenic Disorder Adjustment Disorder with work/academic inhibition Antisocial personality disorder Borderline personality disorder Substance dependencies Happiness Control over behavior Appraisal of reality Effectiveness in work A healthy self concept Satisfying relationships Effective coping strategies Signs of mental illness 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 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 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 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 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 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