Transcript Mental Health Lap 1.1 - Canadian Valley Technology Center

Introduction to Mental Health Nursing
Judith Wikel RN BSN MEd
 Review
Mental Health Care in Britain,
Australia, and the United States
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Britain has a National Health Care System – tax
revenues provide most of the financing for health
care
Australia has a Public Health Care Plan – this plan
does not cover Mental Health
In the United States - Wow!
 Mental
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health in Canada
Government-administered health plan
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Based on five principles
 Universality
 Portability
 Accessibility
 Comprehensiveness
 Public administration
 United
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States continued…
Currently the emphasis is to shift from
institutional to community mental health care.
This shift is causing the demand for mental
health care to grow.
 In
the United States mentally ill people make
use of community services only sporadically.
 Often patients wait until major problems
occur before seeking treatment.
 A “Band-Aid” approach is used and often the
results in only the presenting problem to be
addressed.
 County jails are full of people needing inpatient psychiatric care.
 The
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CSS model views the client…
Holistically
As an individual
 Goal
of the CSS model is to create a support
system that fosters individual growth and
movement toward independence through the
use of coordinated social, medical, and
psychiatric services.
 Community
mental health services are based
on the needs of specific populations.
 Several services may be available in various
settings throughout the community.

For example – Local ER, Day treatment centers,
Psychiatric home care, Community mental health
centers.
 Assertive
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Community Treatment (ACT)
Provides medical, psychosocial, and
rehabilitative services via a community based
team that operates seven days a week, 24 hours
a day.
Teams usually consist of a social worker,
psychiatrist, addictions counselor and four
clinicians (two social workers and two RNs).
 Mental
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Health Care Team Interventions
Community Teams…
Meet with clients 2-4 times per week
Accompanies client to appointments and other
community activities
Help with daily living/social skills needs
Monitors medications
Nurtures relationships with persons interested in
client’s well-being
Encourages client to call team instead of using
ER
 Examples

of Community Services…
Serving Individuals

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Rape crisis centers
Meals on Wheels
 Serving

Families
Women, Infants, and Children (WIC)

Helps single parent families with nutritious food.
 Serving
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the Community
Utility companies
Government agencies
Prisons
 Psychiatrist
– MD with residency in psychiatry
 Psychiatric nurse – all levels of nursing
education
 *Expressive therapist – specialized degree in
art therapy and assisting the patient to
express their feelings.
 Dietitian – specialized training in dietetics.
 Please refer to pg 16.
 Homeless
 HIV
or AIDs
 Those in Crisis
 Clients living in rural areas
 Older Adults
The
process serves as an
organizational framework for
effective care.
 Assessment,
diagnosis, planning,
intervention, and evaluation.
Please refer to Chapter 9 and read about
how the nursing process works in Mental
Health.
 Holistic
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The nurse must see the patient as a “whole”
assessment must include gathering information
about the physical, intellectual, social, cultural,
and spiritual aspects of each client.
The more complete the picture, the more
effective the treatment approaches will be.
 Effective
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Interviews
Personal values must not cloud professional
judgments.
Do not make assumptions
Take into account the client’s cultural and
religious values and beliefs
Pay particular attention to nonverbal
communications
Have clearly set goals
Monitor your own reactions – DO NOT be
judgmental.
 General
description
 Emotional
state
 Experiences
 Thinking
 Sensorium
and cognition
Please refer to Table 9-4 on page 91.
 Thought
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process (how one thinks)
Blocking
Flight of ideas – Rapid changes from on thought
to another related thought
Loose associations
Perservation
 Though
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content (what one thinks)
Delusions
Obsession
Phobias
Preoccupations
 Others
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Amnesia
Confabulation
 Recent
memory is recall of events occurring
within the last two weeks.
 Remote memory is asking the client to recall
events form person’s
background.
 Diagnostic
and Statistical Manual of Mental
Disorders (DSM-IV-TR) - is the book providing
the Axis guidelines for clinical disorders as
they relate to Mental Health.
 Clients
are assessed and classified according
to five categories or axes. Using the
multiaxial system helps care providers gain a
more complete understanding of each
person.

Please refer to Table 9-1 and Table 9-2 Page 86
.
 The
next step in the nursing process is
Assessment, and the mental health
treatment plan is started.

Assessment includes the “gathering, verifying
and communicating of information relative to
the client”
 Data

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collection
Objective data is measured and shared.
Subjective data relates to clients’ perceptions.
 Data

collection continued
Interview is a meeting of people with the
purpose of obtaining or exchanging information.
The interview is an excellent method for
obtaining assessments. It also serves as the
starting point for building the therapeutic
relationship.
 Sociocultural
Assessment includes the
following assessments.
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Age
Ethnicity
Culture
Gender
Education
Income
Belief system
 Inpatient
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admission criterion:
A person’s behavior becomes a threat to the
safety of self or others.
People within the environment are not able or
willing to support the mentally troubled person.
The person perceives himself or herself as unable
to cope or maintain behavioral control.
 Be
sure to read all material.
 Rely
on Objectives to assist in preparing for
test.
 Clarify
 Good
with an instructor as needed.
Luck! Judith Wikel PN Instructor