MENTAL HEALTH Flashcards

Question

Whats the role of the Community mental health team?

Answer 1

This is an MDT of mental health professionals working together to provide care and support for people with complex or severe mental health need in the community - systematic assessment of patient health or social care needs - formation of agreed plan to address needs - allocation of care coordinator to keep in touch with and coordination care with patient

Answer 2

- person-centred approach - recovery-orientated care - evidence-based practice - rapidly accessible - range of services functioning as a system

Answer 3

Psychiatrist Community psychiatric nurse Social worker Support worker Occupational therapists Clinical psychologists Primary health care worker Team manager e.g. senior nurse or social worker (dont see pt themselves but just run the team)

Answer 4

assess and diagnose pt, prescribe medication, may be involved in administering psychotherapy

Answer 5

A registered nurse visit pt at home, see pt in out-patient departments, can help co-ordinate care for a pt, can administer medications and monitor effects

Answer 6

A professional who provides support and advocacy for people with mental health conditions Allow pt to talk through their needs and consider social care implications - includes ensuring patient rights under MHA are consider Can help with accessing benefits, housing and social care services

Answer 7

A trained staff member who provides practical assistance and emotional support for people with mental health conditions, including help with daily living tasks, socialization, and leisure activities.

Answer 8

Help improve ADLs, identify what pt can’t do and what support they need to allow them to become independent and regain skills Help in developing and maintaining their ability to engage in meaningful activities, such as work, hobbies, and self-care.

Answer 9

A mental health professional who provides psychotherapies

Answer 10

Assess and signpost pt, can also provide them with short-term therapy

Answer 11

Support mental health crises in the community e.g. suicidal thoughts, self-harm, experiencing psychosis, severe panic attacks, putting others at risk Offer short term support to prevent hospital admission or can arrange for pt to go to hospital if pt is very unwell May offer medication, arrange regular visits, make sure pt is in touch with other services to get long term support

Answer 12

A team that provides early intervention and treatment for individuals experiencing their first episode of psychosis Provide self-management skills, housing and debt management, employment support, relapse prevention work, psychological and pharmacological interventions, carer’s assessments, crisis plan, regular checks and monitoring

Answer 13

they works with an identified group of service users who have severe mental health problems and aren’t currently engaging effectively with mental health services. They aim to reduce hopsital admission by helping with family living e.g. taking meds, social support, accessing crisis support quickly,. Care plan for family and friends

Answer 14

Children and Adolescent Mental Health Services

Answer 15

Those that work with those who have committed serious crimes

Answer 16

Increased funding from government A shift to focussing on community-based care and a greater emphasis on early intervention and prevention - crisis resolution teams, early intervention for psychosis teams, community mental health teams There has been a move towards integrating mental health services with primary care Move to reduce stigma Increased used of evidence-based treatments a e.g. CBT and meds Increased focus on recovery and supporting people to lead fulfilling and meaningful lives! Increased involvement of service users and carers in the planning and delivery of mental health services

Answer 17

Leading cause of disability and contributes significantly to global burden of disease 24% women and 13% men diagnosed with depression in their lifetime in England (approx. 1 in 5) More common in females however more men die by suicide More common in lower socioeconomic classes and urban areas Common in pts with chronic conditions 50% of cases occur <40 (peak onset 25-40) Peak onset is 50-70 for depression with psychotic features

Answer 18

Family History and Genetics Childhood experiences Female Previous mental illness Trauma, stress, major life events Physical illness Personality type (neuroticism/perfectionism/low self-esteem/negative patterns of thinking) Recent childbirth Substance misuse Medications e.g. steroids

Answer 19

MDT approach is best practice GP or Psychiatrist - assess and diagnose pt, prescribe pharmacological mx Psychologist - deliver psychotherapy (CBT most commonly) Community psychiatric nurse - visit pt in their homes, outpatient departments or GP, give practical advice/support, help with medication and monitor for effects Occupational therapists - help people get back to doing practical things of everyday life Social worker - responsible for pt’s care plan approach Crisis team - suicide attempt/ideation and self-harm

Answer 20

Women are more likely 19% to men 12% Those from a more disadvantages socio-economic background are at greater risk the prevalence of self-reported depression was highest among Black adults (22%), followed by South Asian adults (20%), and White adults (16%). However, the prevalence of self-reported anxiety was highest among South Asian adults (23%), followed by Black adults (19%), and White adults (15%).

Answer 21

Afrocaribbean presrnt less frequently to GPs Mediterranean tend to present more with somatic sympotms Chinese make greater use of body language to express distress Japanese - depression is seen as a black mark and is shameful and stops marriages so pt may not confess

Answer 22

Language barriers and social isolation

Answer 23

Some cultures where women don’t work / leave house, man works but does nothing for house / kids are more predisposed to depression following death of spouse as role change is significant Some cultures think shouldn’t grieve as disrespectful; others think should mourn for long time Some cultures may not accept western theories for depression (biochemical changes) & therefore not accept treatment for it in the way that a practitioner wants to prescribe it

Answer 24

Ethnic minorities, particularly Afro-Caribbean in America have a 4x higher rate of psychosis, whilst Latin Americans have a 3x higher rate

Answer 25

Many deaf people feel socially excluded and isolated, which can impact on mental health and also the accessibility of mental health services May also impact their ability to communicate how they’re feeling High levels of unemployment which is known to affect psychological wellbeing of the patient

Answer 26

Seeking medical help Adopting a healthy lifestyle Using coping strategies

Answer 27

Denial Avoidance Overuse of meds or substance misuse

Answer 28

Individual beliefs, personality traits, and coping skills can influence how individuals respond to physical symptoms. For instance, individuals who are more optimistic and have a positive outlook on life may be more likely to adopt healthy coping strategies.

Answer 29

Family support and dynamics can influence how individuals respond to physical symptoms. For example, a supportive family environment can provide emotional support and encourage healthy lifestyle changes.

Answer 30

Cultural beliefs, norms, and values can impact how individuals perceive and respond to physical symptoms. For example, some cultural beliefs may stigmatize seeking medical help or using medication, which can lead to unhealthy adjustment responses.

Answer 31

- empower individuals and communities to take control o their mental health - improving QOL - Raising awareness and reducing stigma - supporting healthy lifestyles - building resilience and coping skills - early intervention and treatment - education ad training

Answer 32

Reducing stressors that can cause mental health e.g. better housing, raising minimum wage Mass media campaigns on the importance of good mental health Simple coping techniques for stress from GP/school/employers More education for HCP being aware of potential poor mental health Advising parenting skills to promote healthy development in children Education for teachers about noticing issues with children and preventing bullying School curriculums about resilience, life skills Promotion of body size aceptance and reducing stigma about cultural or ethnic differences Education about bad health behaviours e.g. smoking Tackling parenteral unemployment Tackling other social and economic inequalities Early intervention for mental illness

Answer 33

Cognitive changes can affect mental health Chronic pain can cause frustration, depression,anxiety Social isolation as we lose loved ones or find it diffiuclt to maintain social connections Medication side effects Physical disability may lead to feelings of helplessness and decreased self-esteem Loss and grief

Answer 34

Community mental health teams Dementia support services Counselling and psychotherapy Social activities Telehealth services Housing support Care workers Housekeeping and domestic work Companionship services Sitting service na despite care for carers Old age psychiatric team

Answer 35

a type of care where individuals live in a residential facility that provides them with personal care and support services. Residential care can be provided for a variety of reasons, including old age, physical disability, and mental health problems. They have their own private room but share common areas. The facility is staffed by trained care workers who provide assistance with daily activities 24 hours e.g. meals, bathing,meds help Semi-independant

Answer 36

A 24 hour care facility for highly dependant residents who are unable to care for themselves The residents have individualised care plans There are regular doctor visits and lots of nursing Staffa available Some nursing homes will specialise in one mental health condition e.g. dementia

Answer 37

These homes provide temporary care for individuals who need a short break from caring responsibilities or who require additional support after a hospital stay. Respite care homes can provide a safe and supportive environment for individuals to rest and recover.

Answer 38

These homes provide accommodation and support for individuals with disabilities or mental health conditions who wish to live independently. Staff in supported living homes can provide assistance with daily tasks and help residents to develop the skills they need to live independently.

Answer 39

Residential care homes provide accommodation and personal care for individuals who may need help with daily tasks but do not require nursing care.the residents pay for this. usually associated with mental health conditins. Staff in residential care homes are trained to provide support with personal care, meals, and medication, among other things. Residents in residential care homes typically have their own room, and communal spaces are shared with other residents. Supported living homes, on the other hand, provide accommodation and support for individuals with disabilities or mental health conditions who wish to live independently. Staff in supported living homes can provide assistance with daily tasks and help residents to develop the skills they need to live independently. Residents in supported living homes typically have their own self-contained apartment or bungalow, and they are responsible for managing their own living space and daily routines.

Answer 40

UK law that aimed to improve the rights and support for carers of people with disabilities. The main provisions of the Act were: - introduction of a duty on local authorities to assess needs of carers - establishment of a duty on local authorities to provider carers with info and advice on services available for them - provision of a right for carers to request ans assessment of their own needs - requirement for local authorities to consult with carers whe developing and reviewing social care policies

Answer 41

These are family members, friends, or neighbors who provide unpaid care to a person with a physical or mental health condition, disability, or frailty.

Answer 42

These are paid professionals who provide care and support services in a variety of settings, including care homes, hospitals, and community settings.

Answer 43

These are temporary carers who provide care and support to give the primary carer a break or to cover for a short-term absence.

Answer 44

the emotional, physical, and financial strain experienced by informal caregivers who provide care to individuals with physical or mental health conditions, disabilities, or frailty. It is a common and serious problem that can lead to negative health outcomes for caregivers and the people they care for.

Answer 45

Increased caregiving responsibilities Financial strain Lack of support from family and friends Limited social interaction and support Reduced quality of life Emotional distress Physical strain Poor physical health Limited resources and access to services

Answer 46

The consequences of caregiver burden can include stress, anxiety, depression, social isolation, burnout, and physical health problems. It can also lead to a decline in the quality of care provided and can negatively impact the well-being of the person being cared for.

Answer 47

Providing access to respite care Offering support groups and counseling services Providing education and training on caregiving skills Offering financial support, such as carer's allowances and benefits Providing access to assistive technology and home adaptations to make caregiving easier Providing access to healthcare services and mental health support Improving communication and collaboration between caregivers and healthcare professionals Addressing systemic issues that contribute to caregiver burden, such as limited access to services and inadequate funding for social care.

Answer 48

An assessment conducted to identify the impact of caring on the caregivers wellbeing and their ability to continue providing care It involves things such as financial support required, impact of caring on caregivers personal life and mental health, need for repute care etc

Answer 49

Carer's Allowance: Carers who are providing care for at least 35 hours a week for a disabled person may be entitled to a Carer's Allowance from the governmentwhich is 81.90 a week Flexible working: Carers have the right to request flexible working arrangements from their employers to accommodate their caring responsibilities. Protection from discrimination: Carers are protected from discrimination by the Equality Act 2010. Right to a carer's assessment: Carers have the right to request a carer's assessment from their local authority or healthcare provider to identify their support needs.

Answer 50

A benefit provided by the government in the Uk to support carers To be eligible the carer must provide at least 35 hours of care per week, be at least 16, not in full-time education, not studying for 21 hours a week or more, your earnings are £151 or less a week after tax It’s currently 81.90 per week

Answer 51

- promote healthy development and resilience by encouraging healthy coping strategies and stress management skills - identifying and addressing risk factors e.g. poverty, violence and trauma - address parental anxiety or stress as this can impact children’s mental health (normalising parenteral anxiety can hel reduce stigma around mental health and encourage families to seek support when needed) Promote good sleep habits Drug and alcohol education Counselling Exercise and physical activity

Answer 52

Normal for children <6 even if “toilet-trained” Exclude a physical problem Educate parent about appropriate toilet training methods Behaviour therapy e.g. Star chart Pharmacological treatments used as last resort e.g. nasal, oral, sublingual desmopressin or imipramine

Answer 53

Refusal to go to school could be due to anxiety in spite of parental pressure May be a symptom of separation anxiety, social phobia, depression or adjustment disorder

Answer 54

Secure attachment relationships Higher intelligence Good communication skills Religious faith Clear, firm and consistent discipline from parent Wide supportive network of friends and family

Answer 55

School - identify early signs of mental health problems and provide support or referrals Health visitors - information and support to parents e.g attachment, parenting skills Social services - can provide support for families experiencing challenges such as poverty, abuse or neglect which can contribute to MH problems Educational psychologists - trained to identify and address learning and behavioural problems in children e.g. anxiety, ADHD

Answer 56

Initial impact of diagnosis: fear, anger grief(Determined by understanding, patient’s reaction, nature of relationship) Long term impact: Isolation and loss of time to spend with family and friends Feelings of struggling to cope Stressed - worrying/caring for someone who is vulnerable 24/7 Neglect own physical and mental needs leading to reduction in well-being Courtesy stigma

Answer 57

Relationship becomes skewed as one partner becomes less able to contribute in ways such as: Practically – maintenance of house, chores etc Companionship Emotionally Sexually Financially

Answer 58

Role reversal Conflict between family members If child is young can reduce opportunities for socialising, educational attainment etc

Answer 59

Difficulty communicating with staff including letter and telephone calls Crisis team often phone consultation Advice/management may not be applicable to those who are sensory impaired Psychotherapy is often difficult to conduct

Answer 60

Addiction closely follows levels of criminal activities - assault, domestic violence, robbery Clinics and provisions of medial therapy cost billions Affects work productivity due to being hungover or having abscences Large increase in hospital admissions due to alcohol

Answer 61

Directly or indirectly causes many health conditions large increase in hospital admissions attributable to alcohol (+ other substance abuse) Psychological effects - depression very common, schizophrenia associated with heavy cannabis use, long term effects down the line (worthlessness, lack of self-respect)

Answer 62

5 million family members have to deal with problem drinker Problems include: Arguments, destruction of relationships Violence Debt if loss of job or spent on substance Promiscuity Abuse/neglect (can have significant implications for children) Increased psychological morbidity and primary care attendance for family members

Answer 63

Genetics - way you metabolise + how the drugs affects you (we differ in our inherent susceptibility) Social - peer pressures, family influence (learned acceptable behaviour) Occupation - high in unskilled labourers Social stressors - debt, stressful life events Intellectual disability Mental illness Males>females Availability of drug

Answer 64

Conditioning - taking drug removes negative SE’s of withdrawal (negative reinforcement) Physiological - tolerance develops - need to increase dose for the same effect Psychological crutch - becomes a habitual method of dealing with dress (negative coping mechanism) Social - peers and socialising becomes drug-orientated

Answer 65

Continued repetition of a behaviour despite adverse consequences

Answer 66

a cognitive disorder that involves emotional–motivational withdrawal symptoms upon cessation of prolonged drug abuse or certain repetitive behaviors.

Answer 67

Salience – substance takes priority over other behaviour Compulsion – despite negative consequences Tolerance Withdrawal upon abstinence Relief after abstinence Narrowing of repertoire – neglect of other interests Reinstatement upon abstinence

Answer 68

Pleasure producing potency Rapid onset of action Short duration of action Tolerance and withdrawal

Answer 69

Personality factors Social factors Withdrawal symptoms

Answer 70

Educational startegies in school Mass media campaigns about risk e.g. DRINK AWARE Government policies including earlier closing times of establishments selling alcohol, banning alcohol advertisement, banning drinking in public places, increasing tax, law for minimum age, illegal recreational drug use, identifying at risk populations

Answer 71

Screening for problem drinkers in clinical encounters Identifying high risk populations to give advice to Hep B immunisation Needle exchange services

Answer 72

Physical treatment of alcohol and drug related health problems in those with known addiction problems Psychological treatment in those with known alcohol problems Fortification of food or prescription of vitamins to ensure better nutritional status Drug Rehabilitation centres and relapse prevention schemes Screening for blood-borne viruses Reduce stigma around getting help Self-help groups Court-enforced drug testing and treatment orders

Answer 73

Unemployment Financial diffiuclties Relationship breakdowns Homelessness Social isolation Legal consequences

Answer 74

Aka the transtheoretical model Pre-contemplation (no intention on changing behaviour yet) Contemplation (aware of a problem but no commitment to action) Preparation (intent on taking action) Action (active modification!) Maintenance (sustained change where new behaviours replace old) Relapse (falling back into old patterns of behavior) This is an upward spiral where they learn from each relapse

Answer 75

A directive patient-centred counselling style that aims to help pts explore and resolve their ambivalence about behaviour change Four principles: - Express empathy by using reflective listening to convey understanding of the pt’s point of view and underlying drives - Develop the discrepancy between the pt’s most deeply held values and their current behaviour - Sidestep resistance by responding with empathy and understanding rather than confrontation - Support self-efficacy by building the pt’s confidence that change is possible

Answer 76

An individual in the precontemplation stage may not be aware of the need for behavior change or may not feel ready to change their behavior. Health promotion strategies for this stage may involve raising awareness of mental health issues and providing information on the benefits of seeking help.

Answer 77

In the contemplation stage, the individual may be considering making a change but may still be ambivalent about it. Health promotion strategies for this stage may involve providing options and resources for seeking help, such as mental health support groups or therapy.

Answer 78

In the preparation stage, the individual may be actively planning to make a change but may still need support and encouragement. Health promotion strategies for this stage may involve providing specific information on available resources and support for mental health issues.

Answer 79

n the action stage, the individual is actively making changes to their behavior and may benefit from ongoing support and encouragement. Health promotion strategies for this stage may involve providing practical tools and skills to maintain positive mental health and offering ongoing support and motivation.

Answer 80

Finally, in the maintenance stage, the individual has successfully changed their behavior and may need support to sustain these changes over time. Health promotion strategies for this stage may involve offering continued support and resources for maintaining positive mental health and preventing relapse.

Answer 81

Mind Samaritans Childline Rethink mental illness Local authorities Privbator sector providers e.g. counsellors Education sector

Answer 82

Rates are stable Highest rates in unemployed, uni students, doctors, lawyers, farmers, policemen >90% have a psychiatric illness - mostly depression Women are more likely to attempt but men are more likely to die most common cause of death in men under 40

Answer 83

Females more common More common in young eople Highest rates in lowest social classes 20% of those with psychiatric illness deliberately self harm Majority of pt have experiences a major life event Usually impulsive following a situational crisis

Answer 84

FHx MH disorder Chronic physical illness Previous attempts at DSH/ suicide Access to lethal methods (vets, pharmacist, dentists, doctors, farmers) Recent post-discharge period Specific mental illnesses have a higher rate: anorexia, severe depression, psychosis, BAD, PD, substance misuse

Answer 85

Females>Males 10:1 Typical age of onset for female is 16-17, age of onset for male is 12 Equal distribution of social classes - possible some excess in upper/middle class

Answer 86

Genetic Psychodynamic models: - Family pathology - enmeshment (blurring of boundaries), rigidity, over-protectiveness, lack of conflict resolution, weak generational boundaries - Individual pathology - disturbed body image possibly due to dietary problems in early life, parents’ preoccupation with food, lack of sense of identity Analytical model - regression to childhood, fixation on oral stage, escape from emotional problems of adolescence

Answer 87

Genetics Family pathology Control - only part of their life they feel that they can control Puberty - some pts see it as a way of ‘putting off’ puberty and the demands of it (particularly sexual ones) Social pressure - society’s influence and public attitude can contribute to mind set of a pt with an eating disorder (particularly in western society) Depression Personal characteristics: Low self-esteem, Perfectionism Emotional distress Co-morbidities - high incidence of eating disorder in those with DM, CF and other chronic illness Premorbid experiences - recreational pressure to be slim e.g. gymnast, dancer, sexual abuse, dieting behaviour in family, criticism about weight/eating behaviours

Answer 88

A Uk legislation that introduced new rights and provisions for working parents and carers It provided additional paternity leave, the right to request flexible working to carers, adoption leave, statutory maternity pay for 39 weeks and the right to take paid time off for antenatal care appointments (Most relevant bit is that is allows carers to request flexible working hours!

Answer 89

Caring minimum 35 hours a week >16 Care recipient in middle/higher rate of disability living allowance Cannot be in full time education or be earning >123 pounds a week <65

Answer 90

FHx depression/ BPAD Adverse childhood experiences (abuse, relentless criticism, parental loss, perceived lack of affection) Unemployment Lower SES Social isolation Life events Physical illness

Answer 91

Passing Withdrawing Covering Resisting

Answer 92

The strategy of suppressing one’s stigmatised identity to avoid the negative consequences of stigma i..e not seeking help

Answer 93

The strategy of disengaging or isolating oneself from social situations and interactions in which one’s stigmatised identify may be exposed

Answer 94

The strategy of downplaying one’s stigmatised identity in order to avoid negative reactions from others i..e trying to blend in

Answer 95

the strategies and actions taken by individuals or groups to challenge or confront stigmatization and discrimination based on identity

Answer 96

Labelling = distinguishing differences between people Stereotyping = making assumptions based on those differences Prejudice = formation of negative attitudes and beliefs about stigmatised individuals Othering = separates person e.g. diabetes - diabetics Discrimination = treating someone differently based on their stigmatised identity e.g. denying health care

Answer 97

Equality Act 2010

Answer 98

Fear of stigma may act as health-seeking barrier. Doctors judging pt Concerns about confidentiality and if doctors see their records they will stigmatise Treatments can lead to stigma Misdiagnosis Reduced quality of care Rescued research funding

Answer 99

Affects up to 20% of attendees

Answer 100

They work with groups of service users who have severe mental health problems and aren’t currently engaging effectively with mental health services They support complex mental health needs and aim to prevent you going back to hospital Note these are no longer available in most areas and you will now get support from the community mental health team

Answer 101

A community-based team that helps you access psychological therapies, improves physical health care, employment support, personalised and trauma informed care, medicines management and support for self-harm and coexisting substance use

Answer 102

They support you if you have a mental health crisis outside hospital and you need urgent mental health support They offer short term support to help prevent hopsital admission but an arrange for you to go to hospital if you are very unwell

Answer 103

They work with you during your first experience of psychosis Some places only offer services to people under 35 but NICE recommends it to be open to people of all ages

Answer 104

provides specialist psychological and psychiatric interventions to assess, treat and manage individuals who, as a consequence of mental illness or personality disorder, have offended, or, present a potential to offend and therefore pose a risk to themselves or others.

Answer 105

section 2 may be used if health professionals think pt are a danger to themselves e.g. if they’re severely neglecting themselves or being aggressive Section 3 may be used if they need treatment Try to use this as a last resort if patients would rather be at home then you can arrange help there e.g. an OT and PT assessment to prevent falls

Answer 106

a court that deals with decisions or actions taken under the Mental Capacity Act. You would need to apply to the Court if someone needs permission from the Court to make decisions about you.

Answer 107

Right to appeal i.e. ask for discharge or apply to mental health tribunal Right to get support from an independent mental health advocate Right to ask for and be told information e.g. what section you are on Right or refuse treatment under sections 4,5,35,135,136 or if you are under MHA guardianship or conditional discharge Right to make a complaint through your IMHA

Answer 108

Sectioned under MHA Dont have capacity to decide on treatment Emergency, life-saving treatment

Answer 109

Living in the community without restrictions Voluntary pt in hospital On CTO (unless responsible clinician recalls you to hopsital) Being treated for a physical HEALT porblem (unless you lack capacity)

Answer 110

The act that makes provisions about the oversight and management of the appropriate use of force(i.e. restraints) in relation to people in mental health units

Answer 111

Is there a time of day best for the pt e.g. think about sundowning in dementia - maybe they have capacity in the morning? Could you see the pt at home in a familiar environment Would having another person present who knows the person well help? Does the pt require help in understanding the informative given e.g. simple language, pictures, hearing loop, supportive written formation Are they always this confused? Maybe they have delirium secondary to infection and are more likely to have capacity once this has been treated

Answer 112

The same powers to manage financial affairs as the donor had

Answer 113

CMV Rubella Toxoplasmosis Herpes simplex virus Zika virus

MENTAL HEALTH Flashcards

(138 cards)