Mental Health and Mental

Illness

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

What is mental health?

The WHO defines mental health as a state of well-

being in which each individual is able to realize his or her

own potential, cope with the normal stresses of life, work
productively, and make a contribution to the community.
Mental health provides people with the capacity for rational
thinking, communication skills, learning, emotional growth,
resilience, and self-esteem (U.S. Department of Health and
Human Services [USDHHS], 1999).
Mental health is on a continuum for most,-good days and
bad days included
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

Mental Health
Able to recognize own potential
Cope with normal stress
Work productively
Make contribution to community

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Traits of Mental Health

Ability to
Think rationally
Communicate appropriately
Learn
Grow emotionally
Be resilient
Have a healthy self-esteem

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Case Study
Mrs. M is your neighbor. She works full time

and is dealing with a troubled teenage son

and her elderly parents. She confides in you
that she cant deal with her life right now.

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Case Study (Cont.)

How could you assess her mental health?

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Mental Illness
Disorders with definable diagnosis
Significant dysfunction in mental functioning

related to
Developmental

: environmental problems

(nature vs nurture)
Biological: Alzheimer's, genetic tendencies

Culturally defined:
Anorexia (some developed countries)
Running Amok (Southeast Asia)
Pibloktoq (Greenland, Alaska)
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

Resilience
Ability and capacity to secure resources

needed to support well-being

Characterized by
Optimism
Sense of mastery
Competence

Essential to recovery

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Diathesis-Stress Model
Diathesis Biological predisposition
Stress Environmental stress or trauma
Most accepted explanation for mental illness
Combination of genetic vulnerability and

negative environmental stressors

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

Case Study (Cont.)

Returning to the problem of your neighbor,

Mrs. M, who is having difficulty coping with a

full-time job, teenage son, and elderly
parents, what about your neighbors behavior
might indicate a mental illness?

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

10

Social Influences on
Mental
Health
Care

Consumer/recovery movement

Pt centered. People have an illness, they are

not the illness. ex. don't say schizophrenic

instead say a person with schizophrenia

National Alliance on Mental Illness (NAMI)

Decade of the brain
New Freedom Commission on Mental Health
Mental Health Parity Act

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

11

Epidemiology of
Mental
Disorders
Study distribution
of mental disorders
Identify high-risk groups
Identify high-risk factors

Incidence- new cases occurring in any given

year
Prevalence how many people have the
condition at an given time

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

12

Clinical Epidemiology
Groups treated for specific mental disorders

studied for
Natural history of illness
Diagnostic screening tests
Interventions

Results used to describe frequency of

Mental disorders
Symptoms appearing together

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

13

DSM-5
The Diagnostic and Statistical Manual of

Mental Disorders, 5th edition

Official medical guidelines of the American

Psychiatric Association for diagnosing

psychiatric disorders
This is where we find the criteria for
classifying different mental health disorders
This is the classification system mainly used in
the United States
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

14

ICD-9-CM
International Classification of Diseases
Clinical descriptions of mental and behavior

disorders
2 broad classifications
Subclassifications

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

15

Psychiatric Mental Health

Nurses
Employ purposeful use of self
Use nursing, psychosocial, neurobiological

theories and research

Work with people throughout the life span
Employed in a variety of settings

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

16

NANDA-I
The North American Nursing Diagnosis

Association International
(NANDA-I) describes a nursing diagnosis as a
clinical judgment about individual, family, or
community responses to actual or potential
health problems and life processes.
Approved nursing diagnosis
Ex. ineffective coping
http://www.mentalhealthcaring.com/2009/03/n
anda-nursing-diagnosis-and-behaviors.html
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

17

Levels of Psychiatric
Nursing Practice

Basic Level
Passed state RN licensure and can work as RN
After two years as nurse, 2000 clinical hrs. in psychiatric setting and 30 hrs. continuing ed. can
take certification exam and become RN-BC.
Advanced Practice
Clinical Nurse Specialist
Psychiatric Nurse Practitioner

Prescriptive privileges
Diagnostic privileges
Psychotherapy

Each has clearly defined roles

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

18

Future Challenges and

Roles
Aging population
Increasing cultural diversity
Expanding technology
Patient advocacy
Legislative involvement

Copyright 2014, 2010, 2006 by Saunders, an

imprint of Elsevier Inc.

19

Audience Response
Questions
1. A person has a high level of resilience. Which
other characteristic would the nurse expect
this person to have?
A.
B.
C.
D.

Optimism
Patriotism
Aggressiveness
Depressed affect
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

20

Audience Response
Questions
2. Which of these mental health problems has
the highest annual prevalence in the United
States?
A.
B.
C.
D.

Schizophrenia
Alzheimers disease
Major depressive disorder
Generalized anxiety disorder
Copyright 2014, 2010, 2006 by Saunders, an
imprint of Elsevier Inc.

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