MENTAL HEALTH NURSING PDF
Library of Congress Cataloging-in-Publication Data. Videbeck, Sheila L. Psychiatric-mental health nursing / Sheila L. Videbeck; [illustrations by Cathy J. Miller]. PSYCHIATRIC NURSING resourceone.info - Free download as PDF File .pdf), Text File .txt) or read online for free. need it. Atlas: Nurses in Mental Health presents results of a global survey on the availability, education, training and role of nurses in mental health care.
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Mental Health Nursing. GRADUATE DIPLOMA IN CLINICAL NURSING. COURSE CODE: 1GDGD 1 year full-time; 2 years part time. External mode. Psychiatric Nursing. Alemayehu Galmessa. Alemaya University. In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center. Mental Health and Mental Illness. 1. 2. Principles and Concepts of Mental Health Nursing. 3. Personality Development and Theories. 4. Conceptual.
Those with mental disorders were viewed as being either divine or demonic, depending on their behavior. Individuals seen as divine were worshipped and adored; those seen as demonic were ostracized, punished, and sometimes burned at the stake.
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Later, Aristotle 3 8 2 - 3 2 2 BC attempted to relate mental disorders to physical disorders and developed his theory that the amounts of blood, water, and yellow and black bile in the body controlled the emotions. These four substances, or humors, corresponded with happiness, calmness, anger, and sadness. Imbalances of the four humors were believed to cause mental disorders, so treatment was aimed at restoring balance through bloodletting, starving, and purging.
Such "treatments" persisted well into the 19th century Baly, In early Christian times 1 - 1 0 0 0 AD , primitive beliefs and superstitions were strong. All diseases were again blamed on demons, and the mentally ill were viewed as possessed. Priests performed exorcisms to rid evil spirits. W h e n that failed, they used more severe and brutal measures, such as incarceration in dungeons, flogging, and starving.
During the Renaissance 1 3 0 0 - 1 6 0 0 , people with mental illness were distinguished from criminals in England. Those considered harmless were allowed to wander the countryside or live in rural communities, but the more "dangerous lunatics" were thrown in prison, chained, and starved Rosenblatt, 1 9 8 4.
In , the Hospital of St. Mary of Bethlehem was officially declared a hospital for the insane, the first of its kind. By , visitors at the institution were charged a fee for the privilege of viewing and ridiculing the inmates, who were seen as animals, less than human McMillan, During this same period in the colonies later the United States , the mentally ill were considered evil or possessed and were punished.
Witch hunts were conducted, and of fenders were burned at the stake. In the s, a period of enlightenment concerning persons with mental illness began.
Phillippe Pinel in France and William Tukes in England formulated the concept of asylum as a safe refuge or haven offering protection at institutions where people had been whipped, beaten, and starved just because they were mentally ill Gollaher, With this movement began the moral treatment of the mentally ill.
In the United States, Dorothea Dix 1 8 0 2 - 1 8 8 7 began a crusade to reform the treatment of mental illness after a visit to Tukes' institution in England. She was instrumental in opening 32 state hospitals that offered asylum to the suffering.
Dix believed that society was obligated to those who were mentally ill and promoted adequate shelter, nutritious food, and warm clothing Gollaher, The period of enlightenment was short-lived. Within years after establishment of the first asylum, state hospitals were in trouble. Attendants were accused of abusing the residents, the rural locations of hospitals were viewed as isolating patients from their families and homes, and the phrase insane asylum took on a negative connotation.
Sigmund Freud and Treatment The period of scientific study and treatment of mental disorders began with Sigmund Freud 1 8 5 6 - 1 9 3 9 and others, such as Emil Kraepelin 1 8 5 6 - 1 9 2 6 and Eugene Bleuler 1 8 5 7 - 1 9 3 9.
With these men, the study of psychiatry and the diagnosis and treatment of mental illness started in earnest. Freud challenged society to view human beings objectively.
He studied the mind, its disorders, and their treatment as no one had before. Many other theorists built on Freud's pioneering work see Chapter 3. Kraepelin began classifying mental disorders according to their symptoms, and Bleuler coined the term schizophrenia.
PSYCHIATRIC NURSING NOTES.pdf
Chlorpromazine Thorazine , an antipsychotic drug, and lithium, an antimanic agent, were the first drugs to be developed. Over the following 10 years, monoamine oxidase inhibitor antidepressants; halopericlol Haldol , an antipsychotic; tricyclic antidepressants; and antianxiety agents, called benzodiazepines, were introduced. For the first time, drugs actually reduced agitation, psychotic thinking, and depression.
Hospital stays were shortened, and many people were well enough to go home. The level of noise, chaos, and violence greatly diminished in the hospital setting Trudeau, The movement toward treating those with mental illness in less restrictive environments gained momentum in with the enactment of the Community Mental Health Centers Construction Act.
Deinstitutionalization, a deliberate shift from institutional care in state hospitals to community facilities, began. Community mental health centers served smaller geographic catchment, or service, areas that provided less restrictive treatment located closer to individuals' homes, families, and friends.
These centers provided emer- gency care, inpatient care, outpatient services, partial hospitalization, screening services, and education. Thus, deinstitutionalization accomplished the release of individuals from long-term stays in state institutions, the decrease in admissions to hospitals, and the development of communitybased services as an alternative to hospital care.
This allowed people with severe and persistent mental illness to be more independent financially and to not rely on family for money.
States were able to spend less money on care of the mentally ill than they had when these individuals were in state hospitals because this program was federally funded. Also, commitment laws changed in the early s, making it more difficult to commit people for mental health treatment against their will. This further decreased the state hospital populations and, consequently, the money that states spent on them.
Furthermore, mental illness or serious emotional disturbances impair daily activities for an estimated 10 million adults and 4 million children and adolescents. More than 10 million children younger than 7 years grow up in homes where at least one parent suffers from significant mental illness or substance abuse, a situation that hinders the readiness of these children to start school.
The economic burden of mental i l lness in the United States, including both health care costs and lost productivity, exceeds the economic burden caused by all kinds of cancer. Mental disorders are the leading cause of disability in the United States and Canada for persons 15 to 4 4 years of age.
Yet only one in four adults and one in five children and adolescents requiring mental health services get the care they need.
Some believe that deinstitutionalization has had negative as well as positive effects. Such findings have led to the term revolving door effect. Although people with severe and persistent mental illness have shorter hospital stays, they are admitted to hospitals more frequently. The continuous flow of clients being admitted and discharged quickly overwhelms general hospital psychiatric units.
In some cities, emergency department visits for acutely disturbed persons have increased. Shorter hospital stays further complicate frequent, repeated hospital admissions.
People with severe and persistent mental illness may show signs of improvement in a few days but are not stabilized. Thus, they are discharged into the community without being able to cope with community living. The result frequently is decompensation and rehospitalization. In addition, many people have a dual problem of both severe mental illness and substance abuse.
Use of alcohol and drugs exacerbates symptoms of mental illness, again making rehospitalization more likely. Substance abuse issues cannot be dealt with in the 3 to 5 clays typical for admissions in the current managed care environment.
Homelessness is a major problem in the United States today. The National Resource and Training Center on Homelessness and Mental Illness 2 0 0 6 estimates that one third of adult homeless persons have a serious mental illness and that more than one half also have substance abuse problems. Those who are homeless and mentally ill are found in parks, airport and bus terminals, alleys and stairwells, jails, and other public places.
International Journal of Mental Health Nursing
Some use shelters, halfway houses, or board-and-care rooms; others rent cheap hotel rooms when they can afford it. Homelessness worsens psychiatric problems for many people with mental illness who end up on the streets, contributing to a vicious cycle.
North and colleagues found that rates of mental illness, particularly major depression, and substance abuse are increasing among the homeless population. Many of the problems of the homeless mentally ill, as well as those who pass through the revolving door of psychiatric care, stem from the lack of adequate community resources.
Money saved by states when state hospitals were Revolving door closed has not been transferred to community programs and support. Inpatient psychiatric treatment still accounts for most of the spending for mental health in the United States, so community mental health has never been given the financial base it needs to be effective. In addition, mental health services provided in the community must be individualized, available, and culturally relevant to be effective.
In 1 9 9 3 , the federal government created and funded Access to Community Care and Effective Services and Support ACCESS to begin to address the needs of people with mental illness who were homeless either all or part of the time. The goals of ACCESS were to improve access to comprehensive services across a continuum of care, reduce duplication and cost of services, and improve the efficiency of services. Programs such as these provide services to people who otherwise would not receive them and have proved successful in treating psychiatric illness and in decreasing homelessness Goldman et al.
Unfortunately, only one in four affected adults and one in five children and adolescents receive treatment Department of Health and Human Services [DHHS], Statistics like these underlie the Healthy People objectives for mental health proposed by the U. DHHS ; Box 1. These objectives, originally developed as Healthy People , were revised in January 2 0 0 0 to increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives.
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Dr Edo Shonin. Yuli Triretno. Burnout and low vitality have repeatedly been reported amongst nurses [ 7 - 9 ]. In this context vitality is defined as a sense of general wellbeing, optimism and flourishing, and can be considered to represent the opposite end of a spectrum to stress and burnout [ 10 ]. Low vitality and CMDs may result from a variety of workplace, organisational and individual factors [ 11 , 12 ].
These include working environments where nurses lack autonomy and discretion, and where access to support and learning is limited [ 13 ]; where high levels of emotional exhaustion and burnout occur [ 14 ]; where nurses experience frequent workplace stress [ 15 , 16 ], high workloads and low reward [ 17 ], and where rotational shift patterns result in poor sleep patterns [ 18 ].
Mental health repercussions may occur where nurses are subjected to high public and professional expectations [ 19 ], workplace violence [ 5 , 20 ] and role conflict [ 21 ]; in environments where there is high patient mortality, traumatic events or situations [ 22 ] and conflict with physicians [ 23 ].
Beyond the importance to the individuals involved, in the nursing workforce low vitality and high CMDs have implications for patient care.
Journal of Psychosocial Nursing and Mental Health Services
They have been strongly associated with nursing productivity [ 24 ], absenteeism and presenteeism attending work while sick [ 25 ]; with poor work performance, reduced productivity, workplace errors, decreased quality of patient care and low levels of patient satisfaction [ 26 ].
It is critical that employers understand issues relating to mental health, wellbeing and vitality in the nursing workforce to enhance performance and prevent compromise to care delivery. A crucial step in addressing low vitality and CMDs is early identification of unhealthy behaviours, health symptoms and complaints.
This will enable interventions to be developed to promote mental wellbeing, flourishing and vitality in the nursing workforce [ 27 ]. Encouragement of healthy habits in the nursing workforce may facilitate workplace cultures grounded in positive energy and vitality [ 28 ].
This study entails first steps in developing understanding of mental health and wellbeing in the nursing workforce. Study design This study used a cross sectional survey design. Guided by the processes of Intervention Mapping [ 29 ], material from a series of literature reviews of the current state of knowledge of health promotion, lifestyle and behavioural interventions for women and nurses was used to identify survey elements, variables and items to map behavioural health risk factors of working nurses.
This paper reports only mental health —related components.Services and support are provided according to the plan with GPs and psychiatrists regularly reviewing plans with the mental health nurse. Guided by the processes of Intervention Mapping [ 29 ], material from a series of literature reviews of the current state of knowledge of health promotion, lifestyle and behavioural interventions for women and nurses was used to identify survey elements, variables and items to map behavioural health risk factors of working nurses.
He studied the mind, its disorders, and their treatment as no one had before.
The World Health Organization defines health as a state of complete physical, mental, and social wellness, not merely the absence of disease or infirmity. Search inside document. A crucial step in addressing low vitality and CMDs is early identification of unhealthy behaviours, health symptoms and complaints.
Respondents had a mean age of
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