Exam (elaborations)
NUR361 Week 7-12
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Exam of 41 pages for the course NUR361 at NUR361 (NUR361 Week 7-12)
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NUR361 Week 7-121. Different from the absence of mental illness. Doesn't mean that you don't
have a mental illness or disorder so you have mental health.
Integral to our overall health
A state of well-being in which the individual realizes their own potential, can
cope with the normal stresses of life, can work productively and fruitfully, and
is able to make a contribution to their own community
Individuals who live with a mental disorder is capable of all of this
Even when one develops a mental health problem or illness. They can never-
theless experience good mental health: Mental Health
2. Intensity and duration of symptoms can vary widely from person to person
as well as by type of problem or illness
No 2 people experience a mental health problem the same way
Symptoms do not always follow a regular pattern, and can be a one-time event
or cause episodes over many years (chronic)
Can bring about profound feelings of hopelessness and worthlessness, which
can lead to thoughts of suicide
No single cause and no one is immune
Thought to be the result of a complex mix of social, economic, psychological,
biological and genetic factors
If there are factors related to all those things that come together, and manifest
as a mental illness, it is understandable that two people will not present in the
exact same way: Mental Health Problems and Illnesses or Disorders
3. To deliver the right care (appropriate medical, nursing, psychological, social
and spiritual services), bu the right person, to the right person and/or family
members, at the right time and in the right place
Interprofessional care= right care
There are challenges for individuals to access types of services in the com-
munity
Facilities and stability, continuity and comprehensiveness of service provi-
sion to an individual over their lifetime
We do have the national mental health strategy- helped us think of specific
things we need to do to get there: Goal of psychiatric and mental health care
4. The clinical settings do not reflect the only place that mental health nursing
happens
Represents the complex, integrated system of services provided by health
professionals in general and by those with specialized psychiatric and mental
expertise, as well as the supports provided by informal providers and organi-
zations within the community that help people to maintain and to restore their
mental health and well-being
, NUR361 Week 7-12
Right across society and healthcare institutions, as well as someone's home,
people can except comprehensive and mental health services
The continuum of psychiatric mental health treatment
Red arrow reflects from the bottom (least at risk and most independent), and
to the top (more acute and in-need of intensive type of treatment)
Ongoing outpatient treatment - long-term basis for many people living with
mental disorders in the community, private therapy offices of councillors
Transitional outpatient treatment - usually provided on a long term basis,
they can live within their home but they will have ongoing case management,
counselling and support to maintain their mental health and their ability to
experience good engagement in their life
Intensive outpatient treatment - partial hospitalization programs, short term
treatment settings. Individuals will be admitted during the day time, and will
be able to go home at night. Mon-Friday basis, or on weekends as well.
Those that go to partial hospitalization programs are often referred to by
an acute inpatient setting, and now can be in a more partial hospitalization
program. Usually they have about 5-6 hours of treatment per day and 5 days
per week. Length of stay in PHP about 2-3 weeks and care is provided by an
interprofessional team.
Psychiatric home care and assertive community treatment (has access to a
team of individuals and a case manager).
Intensive substance use programs.
Most acute treatment
Locked inpatient unit
24 hour crisis bed
Reserved for patients who are not able to live well in the community at this
point so they require more 24/7 treatment and care.
Trend internationally to deinstitutionalize to move mental health services
outside of these inpatient facilities and push it more out to the community
, NUR361 Week 7-12
--- because of funding, societal values in relation to those that have mental
illness, emergence of a lot of mental health treatments, inpatient settings
were overcrowded, criticism for overuse of restraints, patients became very
institutionalized and dependent on others.
What didn't happen was a shift in the funding of community services. We
have a lot more in the community and less inpatient, however not sufficient
funding to provide the high quality care they were hoping would happen with
the deinstitutionalization.
Crisis intervention team- when psychiatric mental health care moved to the
community, there was a need identified for some services to address acute
mental health things that erupted. The community overall, was unprepared
to deal with acute incidents so these crisis teams came about. If there was
an acute mental health issue, the police would be called, the police alone
are not the most effective or prepared responders. These crisis intervention
teams involve someone from the interdisciplinary team ex. Psychiatrist, social
worker etc. paired up with the police so there is that joint response to an acute
mental crisis in the community. This is for individuals who are receiving care
anywhere outside an acute inpatient unit.: Continuum of Care
5. Healthcare professionals that don't have the expertise
Unestimated about how much knowledge is needed to know
Access to services - long wait time
Continuity of care in the community
Stigma of mental illness and disrimination (compounded by ageism, hetero-
sexism, homophobia, ableism, racism, etc.)
All of these compound this stigma that someone with mental illness is already
exposed to
-Structural barriers to full participation in work, education and community life
-There are barriers to be able for people to realize that those with mental
disorders can be a contributing member of society etc.
-Lack of mental health services in everyday settings (homes, schools, work-
places)
-Mental health services need to not only be in a healthcare setting but across
society
-Lacking a lot of services in homes etc.
Fragmentation (and underfunding) of services, treatments and supports
-Lack continuity and easy access
-Disparities in risk factors and access to culturally appropriate mental health
, NUR361 Week 7-12
services and treatments across communities
-Certain community groups are more at risk for mental illness, and certain
community groups will struggle to find services that are culturally relevant
and meaningful
-Unsuccessful transitions form intensive services (gaps in discharge plan-
ning; lack of follow-up care)
-Discharge and transition between services are done well ex. Follow up
Informal caregiver burnout
-Take a huge responsibility in managing mental illness in society and they lack
supports they need to prevent burnout: Hazards in healthcare and beyond
6. Stereotyping= expecting individuals to act in a characteristic manner that
condors, most often, to a negative perception of their cultural groups ex.
Poorly groomed, dangerous, crazy those describing mental illness
ex. poorly groomed
Prejudice= a hostile attitude toward others simply because they belong to a
group that is considered to have objectionable characteristics ex. We will have
a hostile attitude to those who look ex. Crazy, hostile etc., avoiding them at all
costs
discrimination= negative differential treatment of others because they are
members of a certain group or identified as being negatively different
ex. sometimes due to a structural barrier
Stigma= negative, discriminatory , and rejecting attitudes and behaviour to-
ward a characteristic or element exhibited by an individual or group (self
(internilze all these attitudes that the public might have of them because they
have a mental illness and they start believing it) , public, structural):
7. A belief system that makes it okay to pick on, make fun of, discriminate,
reject, silence, discredit, pathologize, de-centre, kindly undermine and commit
violence against the mad. Sanism is an oppression, it is the reason for stigma,
and it can happen even with the best of intentions
Associated with the mad movement
Profoundly discriminatory and harmful to people who have mental illness: -
Sanism
8. People living with mental health problems and illnesses often report that the
experience of stigma- from members of the public, from friends, family and
co-workers, and even at times from the very service systems that they turn to
for help- has a more devastating impact on them than the illness itself
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