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Mental Health
  • WHO definition: state of complete physical, mental and social wellness, not merely absence of disease or infirmity
  • State of emotional, psychological, and socal wellness AEB: satisfying interpersonal relationships, effective behavior and coping, a positive self concept, and emaotional stability.
History of Mental Health
  • Historically viewed as possesion by demons, punishment for religous transgressions, weakness of will or spirit, and violation of social norms
  • Mentally ill were initially lumped together with criminals
  • Throughout history asylums were developed and designed to promote safety and provide basic care for the mentally ill
  • As time passed, asylums were used to humiliate or harm the mentally ill.
Asylums cont.
  • 1547 England: hospitals were designed for the mentally, by 1775 they were treated like animals in a zoo
  • 1700's France: Asylums were designed to be a safe haven for the mentally ill. Instead the pts were beaten, starved, and tortured
Asylums cont.
  • 1882 U.S. Dorthea Dix started 32 mental health hospitals. By 1900s attendants abused pt's and isolated pt's far from communities
  • 1970s U.S. Pt's tortured in Texas, people without mental illness admitted and treated as if they were ill
Mental Health as a Medical Illness
  • 1900s: Freud studied mental illness scientifically and challenged society to view the mentally ill objectively
  • Kraeplin: classified mental disorders based on similar symptoms
  • Before the discovery of medications the following treatments were used:
  • psychosurgery
  • ECT
  • insulin induced coma
  • soaking in cold water
  • restraints
Current advances in mental health
  • 1950s: First psychotropic drugs were discovered and dramtically altered the treatment of those with mental illness
  • Thorazine (antipsychotic) and Lithium (antimanic) were the first
  • Meds dramatically shortened the length of stay
  • Pt's could be managed on an outpt basis
  • Community based resources are still quite limited for the severely mentally ill.
Stigma of Mental Illness
  • Viewed as violent, but are 15 times more likely to be assaulted than others
  • Placed in jail 3 times more often for the same crimes as non mentally ill people
  • health benefits strictly limited for these chronic mental health diseases
  • emergency rooms do not complete health assessments once a psych history is discovered
  • psych meds are frequently stopped when getting medical treatment
Pt perception of treatment
  • Consumers report that hospitalization is the worst experience of their lives
  • compare this to a person with a MI and intubation. Severe medical pt's do not feel this way
  • One goal is to improve treatment so it is seen as helpful and truly beneficial
Limited treatment of the mentally ill
  • 26% of Americans have a diagnosed mental illness
  • this does not include those not diagnosed
  • The economic burden of those with mental illness outweighs the burden of all cancer
  • leading cause of disability
NAMI (National Alliance on Mental Illness)
  • Seek parity in health care coverage
  • access to meds, especially newer ones
  • assertive community treatment (family and clients)
  • work incentives
  • reduction of restraint use (life threatening)
  • reduced criminalization (mental health courts)
  • permanent, safe, affordable housing
Development of Psych Nursing as a specialty
  • 1873: Linda Richards believed that those with mental illness should receive the same quality of care as those without, sought improved care, organized edcational programs in mental health hospitals in IL
  • 1882: First educational course of study in MA
Early Nursing Theorists
  • Hildegaard Peplau: 1950s, focus on interpersonal therapeutic relationship
  • June Mellow: 1960's, care focuses on needs and strengths, current resurgence of this focus now
Nursing standards of Care
  • addresses the role of the nurse with those with mental illness
  • Applies nursing process to this speciality
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