387: Week 4 - Setting the Context for Mental Health

Question 1

Name a few of the trends that currently exist regarding mental illness and those that suffer mental illness

Answer 1

• lack of community support/resources for mentally ill
• development of outreach mental health services and mobile crisis teams to respond to individuals in the community with severe mental illness
• “revolving door” effect -> ind. w/ severe mental illness move in and out of acute care, and may move in and out of the jail system
• presence of link b/t mental illness and substance abuse
• lack of affordable housing for those suffering from severe mental illness
• fragmentation of services

Question 2

What contributed significantly to the high population of homeless ind w/ mental illness?

Answer 2

De-institutionalization of psychiatric hospitals

Question 3

What are some of the reasons why ind with or w/o mental illness are admitted into acute care?

Answer 3

1. Underlying medical condition of psychiatric or non-psychiatric nature
2. Dangerous de-compensation of long-term treatment (tolerance to current med, ineffective med, need for med initiation, new type of med or additional med)
3. Failure of community-based treatment
4. Clear risk of danger to one’s self or others

Question 4

Describe Canada’s Mental Health Act. What is its purpose?

Answer 4

• A law that allows for involuntary detention and treatment of individuals either diagnosed with or exhibiting symptoms of mental illness
• Criteria for detaining an individual:
  1. Substantial disorder w/ gross impairment in functioning
  2. Presents an immediate danger to self or others
  3. Refusal of voluntary admission when above criteria is met

Question 5

With regards to Canada’s Mental Health Act define “Apprehension” and “Detention”

Answer 5

Apprehension -> individual must be taken to hospital; initiated by either police, physician or provincial judge
Detention -> ind may be detained for 24 hr for assessment and treatment; admission certificate is valid for the first 24hr detention, subsequent certificate (total of 2 w/i first 24/hr period) is needed for mandatory 1 month detention

Question 6

What are the Nursing Goals regarding acute hospitalization of ind w/ mental illness?

Answer 6

• > prevention of self-harm
• > prevention of harm to others
• > crisis stabilization and return to community
• > initiation/modification of psychotropic meds
• > brief, specific problem solving to promote stabilization
• > immediate, rapid planning for outpatient therapy