Chapter 11: Community Mental Health Flashcards
(36 cards)
what challenges remain in terms of mental health?
how to provide services to homeless, changing perception that mental illness is linked to extreme violence, resolving probs of those w/ mental illness who are incarcerated, general public still scared of people w/ mental health concerns
what %age of people are homeless?
80% temporarily homeless, 10% episodically homeless, 10% chronically homeless
how many homeless adults have substance use disorders, depression, other co-occurring mental illnesses?
1/2
what do successful mental health interventions look like?
provision of housing and services they need
what is the relationship btwn mental illness and violence?
- Extreme violence relatively rare in people w/ mental disorders
- Much of risk attributable to comorbid factors
- What should be done to prevent violence is unclear due to issues related to individual freedoms, privacy
what is mental illness like in jails and prisons?
- More than ½ of all prison and jail inmates have mental health probs
- Correctional facilities designed to confine and punish not to treat disease
- Lack space, adequate number of qualified treatment personnel, and timely access to services
- Once released back into community, more likely to commit crime if untreated
how can we apply primary, secondary, and tertiary prevention to mental disorders?
- Primary - reduces incidence of mental illness and related probs
- Secondary - reduces prevalence by shortening duration of episodes
- Tertiary - treatment and rehabilitation
what is the goal of treatment of mental disorders?
- To reduce symptoms
- To improve personal and social functioning
what is psychopharmacological therapy?
- treatment w/ medications
- Conditions for which medications exist include: schizophrenia, bipolar disorder, major depression, anxiety, panic disorder, and OCD
- Other biomedical therapy: ECT
what is psychotherapy?
- treatment through verbal communication
- Numerous approaches
Cognitive-behavioural therapy: teach the person who has mental illness adaptive skills in coping w/ their illness - Most likely to be successful in less severe cases or when used in conjunction with other approaches
what are the benefits of using technology to treat mental illness?
delivers flexible help directly to clients’ living environments, lowers cost to patient, increases privacy of patient, may reduce feelings of coerciveness
what is psychiatric rehabilitation?
- Primary objective is most often recovery rather than cure
- Psychiatric rehab - current recovery-oriented services
- Services include: medication, therapy, adaptive skills, changing environment through accommodations @ work/school
- Practices must be evidence based
what are self-help groups?
concerned members of the community who are united by a shared interest, concern, or deficit not shared by other members of the community
what are some challenges facing mental health care?
- Multiple services needed
- Staff turnover relatively high
- System is decentralized and fragmented
- Lack of licensed providers in rural and low-income areas
- Lack of cultural competence among providers
what was mental health care like befroe WWII?
- Colonial times - people w/ mental illness cared for by families or private caretakers
- Institutionalization first appeared in 18th century
- Institutionalization in terms of mental health: being committed to a mental institutions
- Population growth led to institution growth
- Harsh treatments and unpleasant conditions
- This is bc of so many people being put into mental institutions, so they became very crowded
what was mental health care like in the moral treatment era?
- Began in 1972
- People believed that mental illness was based on moral decay
- Belief that environmental changes can affect the mind and alter behaviour
- Move people from settings causing life stressors into rural, peaceful setting
- Appeared to have success and became widely acceptable
what are mental institutions?
- State hospitals = mental institutions
- Supposed to provide therapeutic environment, based on close personal relationships btwn patients and well-trained staff
- Deterioration of services occurred as chronic nature of mental illness was discovered, long term or lifetime stays were the norm
- Max capacities quickly reached, personalized care lost, restraints (cuffs) became more practical, staff turnover high
- Didn’t account for chronic nature of mental illness
- A lot of patients would never go home
1940 - population in mental institutions was ½ million in north america
what is electroconvulsive therapy (ECT)?
- electric shock treatment
- introduced as a response to large staff case load
- When you give someone ECT, you put leather restraints and electrodes on their head and the zap you w/ large dose of electrical current
- Used when patients are suicidal
- Used to control people who were becoming too hard to handle bc of overcrowding
- After 6 months, people would go back to normal
what are lobotomies?
- separating 2 halves of the brain, can’t be undone
- Patients were a vegetable, not capable of complex emotions
- Very inhumane, not a good way to control people w/ mental illness
- Once they had a lobotomy they were easier to handle and wouldn’t cause any problems
what helped to make releasing ppl back in to the community easier?
- new medications in the 1950s
- Chlorpromazine: first and most famous antipsychotic drug, introduced in 1954, brand name: thorazine
- Neuroleptic drugs: family of drugs that reduce nervous activity
- Chemical straight jacket: drug that controls a patients behaviour
- Subdues patients behaviour, most popular ways when people were coming out of mental institutions and released into society
what is the national institute of mental health (NIMH)?
- Established in 1946 after WWII
- To foster and aid research related to cause, diagnosis, and treatment of neuropsychiatric disorders
- To provide training and award fellowships and grants for work in mental health
- To aid in the prevention, diagnosis, and treatment of neuropsychiatric disorders
what is deinstitutionalization?
- discharging of thousands of patients from mental hospitals
- Began in the 50s
deinstitutionalization was propelled by 4 factors:
- Economics: it was expensive to keep everyone in the mental institutions
- Idealism: keeping poor people live in the facilities isn’t the right thing to do
- Legal considerations: is it within the bounds of the law for us to be holding these people against their will in these mental institutions?
- Antipsychotic drugs: made deinstitutionalization more doable
- Some drugs had bad side effects
- Ex. tardive dyskinesia: is actually an irreversible condition, causes involuntary and abnormal movements of the following body parts: tongue, mouth, arms, and legs, resulted from long-term use
what are the 5 core services of community mental health centres?
inpatient care, outpatient services, 24-hour-a-day emergency care, day treatment or other partial hospitalization services, consultation and education
