Foundations of mental health
This tool measures childhood trauma.
Adverse Childhood Experiences (ACEs)
True or False: A patient admitted to the psych unit for an involuntary committal can refuse medication or therapy.
True
True or False: Mental health and mental illness are the same thing.
False
According to Maslow's hierarchy of needs, which one is the most important?
Physiological needs
True or False: Defense mechanisms are always "negative"
False
It is important to establish these when meeting a patient for the first time.
Trust & Rapport
Describe a "timeout."
A timeout is when the patient returns to their room to avoid escalating in the milieu. During a timeout, the door remains unlocked, allowing the client to leave at any time.
Name at least three social determinants of health.
Financial, Environmental, Education, Life course factors, Community, Access to healthcare, Government policies, Housing security
Reaching one's full potential (according to Maslow) is...
Self-actualization
What defense mechanism is often used to when a patient refuses to accept reality?
Denial
Name 4 factors that can affect mental health.
Negative influences, hormones, genes, stress, poverty, abuse, impaired parenting, spirituality, religion, culture, support systems, personality traits, health beliefs, environmental experiences
What is the difference between voluntary and involuntary commitment?
Voluntary commitment is when the patient agrees to stay in a psychiatric unit, whereas involuntary commitment is when the patient is admitted without their permission for safety reasons.
List the 3 types of stigma
Public, Individual and Institutional.
Erik Erikson developed 8 stages that describe an individual's life span. What is the last stage?
Integrity versus despair
Describe defense mechanisms and why people use them.
Defense mechanisms are unconscious psychological strategies that protect the ego from anxiety and emotional pain
This model is similar to "nature versus nurture" concept.
The Diasthesis-Stress Model
What is the purpose of a psychiatric advanced directive?
For patients to express wishes for psychiatric care
(therapies, medications, surrogate decision maker, visitors)
Name three important components of the milieu
Safety, environment, socialization, group therapy, meals, games, entertainment.
Name at least three physiological needs in Maslow's hierarchy.
Safety, clothing, shelter, temperature, nutrition, clean water, reproduction, oxygen
This defense mechanism is when people revert to childlike behaviors due to stress.
Regression
Name four diseases/psychiatric issues that are risk factors for those individuals who have higher ACE scores.
COPD, diabetes, asthma, depression, anxiety, suicidal ideations, cancer, autoimmune diseases, behavioral issues
This bioethics example is avoiding the use of restraints at all costs.
Malificence
Describe what "duty to warn" means.
Duty to warn is when a therapist or nurse is mandated to report a patient who makes a credible comment regarding harming others.
Name three challenges that may occur in an older individual who is experiencing despair rather than integrity.
Unable to be satisfied with their life, regretting past choices, feeling depressed and hopeless, increased risk of suicide, facing their own mortality, isolation, loneliness
How can nurses help individuals displaying negative defense mechanisms?
Address the underlying anxiety, trauma and pain that caused it
Describe transference
Transference is when the patient views the nurse as someone who "reminds them of someone else, leading to boundary blurring.
What law states that insurance companies must cover both mental health and physical health issues equally?
Mental Health Parity & Addiction Act (2008)
Describe the differences between explicit and implicit bias.
Explicit= Conscious thoughts and emotions to a specific group
Implicit= Subconscious reactions, attitudes and beliefs to a group
Which psychologist developed defense mechanisms?
Sigmund Freud
You are angry after doing poorly on an exam. When you go home, you "take it out" on your loved ones. What is this common defense mechanism?
Displacement
Describe countertransference.
Countertransference is when the nurse views the patient as someone who "reminds them of someone else," leading to boundary blurring.
Name the three types of restraints.
Physical, chemical and seclusion
Name three maladaptive behaviors, and three adaptive behaviors.
Maladaptive: Drug/alcohol use, shopping, gambling, smoking, binge eating, aggressive behaviors, lashing out on others
Adaptive: Journaling, meditation, exercise, spirituality, mindfulness, yoga, reading, walking the dog
Name three indicators that demonstrate an older individual is experiencing integrity.
Shares stories and wisdom with others, expresses contentment with life choices, maintains a positive outlook on life, discusses end-of-life wishes, accepts the aging process, feels they have a "sense of purpose"
You spend money on a fancy dress for a vacation, even though you already own too many. Name the defense mechanism.
Rationalization