How to pts come to a mental health facility? Voluntarily and Involuntarily
Types of Holds
51/50: Three Day Hold (72 Hrs) Pts must meet criteria
DTS: Danger to self
DTO: Danger to others
GD: Gravely Disabled
52/50: 14 Day Hold
Could stay up to additional 14 days.
52/60: 14 more days.
52/70: 30 Day hold.
10/2/50 Medication Cocktail: 10-haldol 2-Ativan 50-Benadryl (Benadryl is helped to give EPS,
Extrapyramidal Symptoms).
By the end of a 30-day hold, if pt is still not improving, the provider might try and place pt on conservatorship.
Conservatorship: Pt must be seen by a judge; provider is requesting this. This lasts up to 1 year. Pt should have a conservator.
Could be family/friend/lawyer. They could have a PUBLIC conservator assigned to them if they have no one that can fill this
role.
Role of Resilience
-Closely associated w/the process of adapting to change & trauma
-It is the ability & capacity for people to secure the resources they need to support their well-being.
Influence of Culture
-Mental health is culturally defined & based on interpretations of effective functioning according to societal norms.
-Mentally ill patients can behave in a way that is socially unacceptable.
-Cultures can differ with their views regarding mental illness but also the types of behavior categorized as mental illness.
Social Influences of Mental Healthcare: NAMI
-In the US, integration of equality for all became a priority.
-Consumer movement also promoted the notion of recovery.
DECADE OF THE BRAIN -A lot of progress was made during the times of neural development, gene
mapping, & other aspects of neuroscience & brain research.
, CLASSIFCATION OF MENTAL DISORDERS
-DSM-5: this provides criteria for psychiatric disorders & a basis for the development of comprehensive
& appropriate interventions.
Disorders based on criteria in clinical settings like:
-Inpatient -Consultation-liaison -Primary Care
-Outpatient -Clinics -Community Populations
-Partial Hospitalization -Private Practice
Sigmund Freuds Psychoanalytic Theory -Belief: Mental illness related to unresolved issues that
originated in childhood.
LEVELS OF AWARENESS: CONSCIOUS, PRECONSCIOUS, UNCONSCIOUS
Erik Erikson’s Ego Theory Belief: Culture & society exert significant influence on personality.
-Eight predetermined & consecutive life stages
-IDENTIFY A SCENARIO FOR EACH STAGES
Harry Stack Sullivan’s Interpersonal Theory -Belief: Personality can be observed w/in interpersonal
relationships.
-Purpose: All behavior is to get needs met through interpersonal interactions & to decrease or avoid
anxiety.
Hildegard Peplau’s Theory (Pre-orientation phase, Orientation phase, working phase, termination
phase)
-Pelau was the 1st nurse to identify psych mental health nursing both as an essential element of general nursing & as a specialty
area.
-Nurses are both participants & observers in therapeutic conversations.
-Promoted interventions to lower anxiety with the aim of improving patients’ abilities to think & function @ more satisfactory
levels.
Pre-Orientation Phase: When the nurse plans for the 1st session w/the pt by gathering info & reviewing
records.
Orientation Phase: An atmosphere is established which rapport can grow.
Nurse role is clarified & responsibilities of both pt & nurse are defined.
Contract containing the time, place, date & duration of the meetings is discussed.
Confidentiality is discussed & assumed.
Terms of termination are introduced.
Pt problems are articulated & mutually agreed-upon goals are established.
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