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Flashcards in Exam 3.1 Deck (50):
1

Mental illness

Leading cause of disability in north America and Europe, refers collectively to all diagnosable mental disorders

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Mental health

State of successful performance of mental function

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Mental disorders

Health conditions characterized by alterations in thinking, mood, or behavior associated with distress and/or impaired functioning

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Causes of mental disorders

Poor prenatal care, stress, trauma, disease, nutrition deficiency, maladaptive family functioning

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Stress

Psychological and physiological response to stressors

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General Adaptation Syndrome (GAS)

Normal level of resistance vs. stages of alarm, resistance, and exhaustion

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Avoiding stressful situations is preferable to

Managing stress

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Mental health is

one of the most pervasive health problems in the US

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Mental health care in colonial America

care by families or private caretakers

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Mental health care in the 18th century

institutionalization first appeared, care in undifferentiated poorhouses or almshouses alongside people with non-mental disorder diagnosis

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Mental health care in early 19th century

first efforts to separate people based on type of disability

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The Moral treatment era

began in 1972, belief that environmental changes could affect the mind and alter behavior, people removed from everyday life and stressors of home, given asylum in country environment, initially deemed successful, overcrowding

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State hospitals

built but deterioration of services occured as chronic nature of mental illness was discovered, long term or lifetime stays were the norm, capacities quickly reached, personalized care lost, restraints more practical, staff turnover high, 1940 population nearly half a million, many elderly, budget cuts led to crowding and subsistence care, lobotomies practiced

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Dorothea Dix

advocated for public hospitals providing decent care for indigents with mental illness

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Electroconvulsive Therapy (ECT)

introduced in 1939, still used today

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National Mental Health Act of 1946

established National Institute of Mental Health, foster and aid research of neuropsychiatric disorders, provide training and award fellowships and grants for work in mental health, aid states in prevention, diagnosis, and treatment of neuropsychiatric disorders

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Deinstitutionalization

discharging of tens of thousands of patients from state hospitals and the resettling and maintaining of those persons in less restrictive community settings, began in early 1950s, not preplanned policy, propelled by economics, idealism, legal considerations, and discovery of antipsychotic drugs

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Mental Retardation Facilities and Community Mental Health Centers Act

funding to establish fully staffed, fulltime community mental health centers across US, core services: outpatient services, 24 hour emergency care, day treatment or partial hospitalization, screenings

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Mental health care concerns in America today

significant improvements in treatment and supports for people with serious mental illness

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Challenges of mental health care today

continued absence of a comprehensive, coordinated system, deinstitutionalization, homelessness

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Deinstitutionalization equals

trans-insitiutionalization to prisons, jails and nursing homes

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Serious mental illness and homelessness

2.1 million Americans a year, about half have substance abuse disorders, major depression and other co-occuring mental illness, need safe, affordable housing, successful interventions require provision of housing that individuals choose and want to live in, and needed services

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The new asylums

jails and prisons

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Prevalence of serious mental illness in jails

15% of state and federal inmates, 24% in local jails

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Challenges of treatment in US prisons

overcrowding, lake of adequate space to offer treatment, lack of qualified treatment personnel, lack of timely access to services, more likely to commit crime if untreated once released back into community

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Primary prevention of mental health problems

reduces the incidence of mental illness and related problems, high quality early education to economically disadvantaged preschool children and support to their families

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Secondary prevention of mental health problems

reduces the prevalence but not incidence of mental illness, cognitive skills training to reduce prevalence of PTSD, employee assistance programs

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Tertiary treatment of mental health problems

reduce symptoms, improve personal and social functioning, develop and strengthen coping skills, promote behaviors that improve life

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Psychotherapy

Tx through verbal communication to resolve issues and problems, family, couple, individual, psychodynamic and supportive therapy, patient learns skills to modify thinking and behavior

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Psychopharmacology

treatment with medications

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Psychiatric rehabilitation

intensive individualized services encompassing treatment, rehab, and support delivered by a team of providers over an indefinite period to individuals with severe mental disorders to help them maintain stable lives in the community

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Recovery from mental issues

progress toward financial and residential independence, managing symptoms effectively, satisfaction with life, basic personhood, mental and physical well-being, supportive relationships, opportunities to spend time productively, self-determination

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Mental health care system in US

faces challenges, multiple services needed, but some unavailable in some locations, stigmatization of individuals and their family members, decentralized and fragmented (avoids bureaucracy), few resources for rural and low-income counties, lack of adherence to treatment, drop out rates

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Medicaid for mental health

pays more than half of government funded mental health care

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Mental Health Parity and Addiction Act of 2008

requires that if health care coverage includes mental health or substance abuse disorders, there must be parity with physical disorders in any limitations or restrictions

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ACA and mental health

expands eligibility for medicaid whose income is less than 133% of poverty, medicaid required to cover mental health and substance abuse disorder services at parity with medical-surgical benefits, shifts huge new costs to states already struggling, does nothing to expand the number of practitioners

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There are nearly 500,000

mentally ill being held in jails and prisons throughout America

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Failure in society

no safety net for all the persons no longer being treated by mental health agencies, now in prisons instead of state mental hospitals

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Prison population

at risk in institutions and when they leave

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16% of prisoners

have been diagnosed with mental illness

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In Ohio, mentally ill inmates

separated from general population and housed in mental health units where treated

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More deaths, illnesses, and disabilities attributed to

Abuse of alcohol, tobacco, and other drugs than any other preventable disease

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Drug

Substance other than food or vitamins that, when taken in small quantities, alter one's physical, mental, or emotional state

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Psychoactive drugs

Alter sensory perceptions, mood, thought processes, or behavior

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Drug misuse

Inappropriate use of prescription or nonprescription drugs

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Drug abuse

Taking of a drug for a non-medically approved purpose, continued use of a legal drug with the knowledge that it is hazardous, underage use

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Drug dependence

When one believes that a particular drug is necessary for normal functioning

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Dosage

The amount of a drug that is administered

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Segregation

probably the worst thing that can happen to mentally ill inmates

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Isolation

increases the risk of becoming mentally ill, makes mentally ill worse