Mental Health and Mental Illness

Mark C. Crider, PhD, MSN, RN

Monday August 25, 2014

Objectives

Describe the continuum of mental

health and mental illness.
Explore the role of resilience in the
prevention of and recovery from mental
illness and consider resilience in
response to stress.
Identify how culture influences the view
of mental illnesses and behaviors
associated with them.
Discuss the nature/nurture origins of
psychiatric disorders.
Summarize the social influences of
mental health care in the United States.
Explain how epidemiological studies
can improve medical and nursing care.

Identify how the Diagnostic and

Statistical Manual, 5th edition (DSM5) is used for diagnosing psychiatric
conditions.
Describe the specialty of psychiatric
mental health nursing and list three
phenomena of concern.
Compare and contrast a DSM-5 medical
diagnosis with a nursing diagnosis.
Discuss future challenges and
opportunities for mental health care in
the United States.
Describe direct and indirect advocacy
opportunities for psychiatric mental
health nurses.

Mental Health

Able to recognize own potential

Cope with normal stress
Work productively
Make contribution to community

Traits of Mental Health

Ability to

Think rationally
Communicate appropriately
Learn
Grow emotionally
Be resilient
Have a healthy self-esteem

Case Study

Mrs. M is your neighbor. She works full time and

is dealing with a troubled teenage son and her
elderly parents. She confides in you that she
cant deal with her life right now.

Case Study (Cont.)

How could you assess her mental health?

Mental Illness

Disorders with definable diagnosis

Significant dysfunction in mental functioning
related to

Developmental
Biological
Physiological disturbances

Culturally defined

Resilience

Ability and capacity to secure resources needed

to support well-being
Characterized by

Optimism
Sense of mastery
Competence

Essential to recovery (see Chapter 1, p. 7)

Diathesis-Stress Model

Diathesis Biological predisposition

Stress Environmental stress or trauma
Most accepted explanation for mental illness
Combination of genetic vulnerability and
negative environmental stressors

Case Study (Cont.)

Returning to the problem of your neighbor, Mrs.

M, who is having difficulty coping with a full-time
job, teenage son, and elderly parents, what
about your neighbors behavior might indicate a
mental illness?

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Social Influences on
Mental Health Care

Consumer/recovery movement
National Alliance on Mental Illness (NAMI)
Decade of the brain
New Freedom Commission on Mental Health
(see Chapter 1, p. 8 Box 1-2)

Mental Health Parity Act

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Epidemiology of
Mental Disorders

Study distribution of mental disorders

Identify high-risk groups

Identify high-risk factors

Incidence - # of new cases in a given time

period
Prevalence total # of cases, new and existing,
in a given time period

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Clinical Epidemiology

Groups treated for specific mental disorders

studied for

Natural history of illness

Diagnostic screening tests
Interventions

Results used to describe frequency of

Mental disorders
Symptoms appearing together

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DSM-5

The Diagnostic and Statistical Manual of Mental

Disorders, 5th edition

Official medical guidelines of the American

Psychiatric Association for diagnosing
psychiatric disorders
See Chapter 1, p. 11

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ICD-9-CM

International Classification of Diseases

Clinical descriptions of mental and behavior
disorders

2 broad classifications
Organic Psychotic Disorders
Other Psychoses

Subclassifications
Neurotic, personality, and other nonpsychotic disorders

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Psychiatric Mental Health Nurses

Employ purposeful use of self

Use nursing, psychosocial, neurobiological
theories and research
Work with people throughout the life span
Employed in a variety of settings

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NANDA-I

The North American Nursing Diagnosis

Association International
(NANDA-I) describes a nursing diagnosis as a
clinical judgment about individual, family, or
community responses to actual or potential
health problems and life processes.

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Levels of Psychiatric
Nursing Practice

Basic Level
Advanced Practice
Each has clearly defined roles

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Future Challenges and Roles

Aging population
Increasing cultural diversity
Expanding technology
Patient advocacy
Legislative involvement
Comorbidity

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Audience Response Questions

1. A person has a high level of resilience. Which
other characteristic would the nurse expect this
person to have?
A.
B.
C.
D.

Optimism
Patriotism
Aggressiveness
Depressed affect

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Audience Response Questions

2. Which of these mental health problems has the
highest annual prevalence in the United
States?
A.
B.
C.
D.

Schizophrenia
Alzheimers disease
Major depressive disorder
Generalized anxiety disorder

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