Foundations of Mental Health Care in Canada

Front Cover
ES1
Morrison-Valfre's Foundations of Mental Health Care in Canada
Morrison-Valfre's Foundations of Mental Health Care in Canada
Copyright
Dedication
To the Instructor
FEATURES OF THE FIRST CANADIAN EDITION
LEARNING AIDS
ANCILLARIES
For Instructors
For Students
To the Student
CHAPTER FEATURES
EVOLVE RESOURCES
Acknowledgements
Contents
I - Mental Health Care:Past and Present
1 - The History of Mental Health Care
EARLY YEARS
Ancient Societies
Greece and Rome
Middle Ages
Dark Ages
Superstitions, Witches, and Hunters
The Renaissance
The Reformation
Seventeenth Century
Eighteenth Century
NINETEENTH CENTURY
TWENTIETH CENTURY
Psychoanalysis
Influences of War
Introduction of Psychotherapeutic Medications
Adult Community Mental Health Programs
TWENTY-FIRST CENTURY
REFERENCES
2 - Current Mental Health Care Systems
MENTAL HEALTH CARE IN CANADA
Norway
The United Kingdom
Australia
The United States
CARE SETTINGS
Inpatient Care
Outpatient Care
Community Support Systems Model
Community Care Settings
Case Management
Psychosocial Rehabilitation
Consultation
Resource Linkage
Advocacy
Therapy
Crisis Intervention
Care Team
Patient and Family
PATIENT POPULATIONS
IMPACT OF MENTAL ILLNESS
Incidence of Mental Illness in Canada
Economic Issues
Social Issues
REFERENCES
3 - Ethical and Legal Issues
VALUES AND MORALS
Acquiring Values
Values Clarification
RIGHTS
Patient Rights
Care Provider Rights
ETHICS
Ethical Principles
Codes of Ethics
Ethical Conflict
LAWS AND THE LEGAL SYSTEM
General Concepts
Legal Concepts in Health Care
LAWS AND MENTAL HEALTH CARE
Patient–Caregiver Relationship
Adult Psychiatric Admissions
Areas of Potential Liability
Patient Restraint
CARE PROVIDERS’ RESPONSIBILITIES
The Reasonable and Prudent Care Provider Principle
REFERENCES
4 - Sociocultural Issues
INFLUENCES OF CULTURE
Health and Illness Beliefs
Illness Behaviours
On Mental Illness
Stress and Coping
CULTURAL ASSESSMENT
Communication
Environmental Control
Space, Territory, and Time
Social Organization
Biological Factors
CULTURE AND MENTAL HEALTH CARE
REFERENCES
5 - Theories and Therapies
HISTORICAL THEORIES
Darwin’s Theory
Psychoanalytical Theories
Psychoanalytical Therapies
Transference and Countertransference
Analytical Psychotherapy
Other Theories
Individual Psychotherapy
Interpersonal Psychology
DEVELOPMENTAL THEORIES AND THERAPIES
Cognitive Development
Psychosocial Development
BEHAVIOURAL THEORIES AND THERAPIES
B.F. Skinner
Other Behavioural Therapies
HUMANISTIC THEORIES AND THERAPIES
Perls and Gestalt Therapy
Maslow’s Influence
Maslow and the Blackfoot Nation Teepee Model
Rogers’s Patient-Centred Therapy
Current Humanistic Therapies
SYSTEMS THEORIES
COGNITIVE THEORIES AND THERAPIES
Cognitive Restructuring Therapies
Coping Skills Therapies
Problem-Solving Therapies
Reality Therapy
SOCIOCULTURAL THEORIES
Mental Illness as Myth
BIOBEHAVIOURAL THEORIES
Homeostasis
Stress Adaptation Theory
PSYCHOBIOLOGY
Psychoneuroimmunology
NURSING THEORIES
PSYCHOTHERAPIES
Individual Therapies
Group Therapies
Online Therapy
SOMATIC THERAPIES
Brain Stimulation Therapies
Pharmacotherapy
FUTURE DEVELOPMENTS
REFERENCES
6 - Complementary and Alternative Therapies
DEFINITION OF TERMS
Allopathic Medicine
Complementary Medicine
Alternative Medicine
Integrative Medicine
Holistic Care
BODY-BASED CAM THERAPIES
Whole Medical Systems
Ayurveda
Homeopathy
Naturopathy
Traditional Chinese Medicine
Biologically Based Practices
Aromatherapy
Dietary Supplements
Herbal Products
Regulation of Health Products
Body-Based Practices
Chiropractic Treatment
Chelation
Eye Movement Desensitization
Massage
Phototherapy
ENERGY-BASED CAM THERAPIES
Mind-Body Medicine
Expressive Therapy
Hypnotherapy
Meditation
Prayer and Spiritual Healing
Mindfulness
Energy Medicine
Biofield Therapies
Acupuncture. For more than 2 000 years, a treatment in Asian medicine has cured disease and alleviated suffering. Acupuncture is...
Biofeedback. Biofeedback teaches patients to control their physical responses by providing visual or auditory information about ...
Qi Gong. Qi is the Chinese name for vital energy. Qi Gong and Tai Chi are systems of movement, regulation of breathing, and medi...
Reiki. The word Reiki comes from the Japanese words rei, meaning “God’s wisdom” or “Higher Power,” and the word ki, which is “li...
Therapeutic touch. Therapeutic touch is based on the practice of laying on of the hands. The healing energies of the therapist e...
Colour therapy. As stated earlier, high-intensity light has been used to successfully treat SAD. Colour therapy is still being s...
Electromagnetic Field Therapies
TECHNOLOGY-BASED CAM APPLICATIONS
CAM Mental Health Therapies
Animal-Assisted Therapy
Culturally Based Healing
Nutrition
Pastoral Counselling
Self-Help Groups
Stress Reduction and Relaxation
WORDS OF CAUTION
Adverse Effects
Implications for Care Providers
REFERENCES
7 - Psychotherapeutic Medication Therapy
Antianxiety Medications
Antidepressant Medications
Mood-Stabilizer Medications
Antipsychotic (Neuroleptic) Medications
SIGNS AND SYMPTOMS
PATIENT CARE GUIDELINES
Assessment
Coordination
Medication Administration
Monitoring and Evaluating
Patient Teaching
SPECIAL CONSIDERATIONS
Adverse Reactions
Nonadherence
Informed Consent
REFERENCES
II - The Caregiver’s Therapeutic Skills
8 - Principles and Skills of Mental Health Care
PRINCIPLES OF MENTAL HEALTH CARE
The Mentally Healthy Adult
Mental Health Care Practice
Do No Harm
Accept Each Patient as a Whole Person
Holistic Framework
Develop Mutual Trust
Explore Behaviours and Emotions
Encourage Responsibility
Encourage Effective Adaptation
One Step at a Time
Crisis Intervention
Provide Consistency
SKILLS FOR MENTAL HEALTH CARE
Self-Awareness
Caring
Insight
Risk Taking and Failure
Acceptance
Boundaries and Overinvolvement
Commitment
Positive Outlook
Nurturing Yourself
REFERENCES
9 - Mental Health Assessment Skills
DSM-5 Diagnosis
Nursing (Therapeutic) Process
ABOUT ASSESSMENT
Data Collection
Assessment Process
Holistic Assessment
Risk Factor Assessment
The Patient at Risk
OBTAINING A HISTORY
Effective Interviews
Sociocultural Assessment
Review of Systems
PHYSICAL ASSESSMENT
MENTAL STATUS ASSESSMENT
General Description
Emotional State
Experiences
Thinking
Sensorium and Cognition
REFERENCES
10 - Therapeutic Communication
THEORIES OF COMMUNICATION
Ruesch’s Theory
Transactional Analysis
Neurolinguistic Programming
CHARACTERISTICS OF COMMUNICATION
Types of Communication
Process of Communication
Factors That Influence Communication
LEVELS OF COMMUNICATION
Verbal Communication
Nonverbal Communication
INTERCULTURAL COMMUNICATION
Intercultural Differences
THERAPEUTIC COMMUNICATION SKILLS
Listening Skills
Interacting Skills
NONTHERAPEUTIC COMMUNICATION
Barriers to Communication
Nontherapeutic Messages
PROBLEMS WITH COMMUNICATION
Communicating With Mentally Troubled Patients
Assessing Communication
REFERENCES
11 - The Therapeutic Relationship
Trust
Empathy
Autonomy
Caring
Hope
Acceptance
Rapport
Genuineness
Therapeutic Use of Self
Preparation Phase
Orientation Phase
Working Phase
Termination Phase
ROLES OF THE CARE PROVIDER
Change Agent
Teacher
Technician
Therapist
Environmental Problems
Problems With Care Providers
Problems With Patients
REFERENCES
12 - The Therapeutic Environment
USE OF THE INPATIENT SETTING
Crisis Stabilization
Acute Care and Treatment
The Chronically Mentally Ill Population
GOALS OF A THERAPEUTIC ENVIRONMENT
Help Patients Meet Needs
Teach Psychosocial (Adaptive) Skills
Physiological Needs
Safety and Security Needs
Love and Belonging Needs
Self-Esteem Needs
Self-Actualization Needs
Admission and Discharge
Adherence
REFERENCES
III - Mental Health Challenges Across the Lifespan
13 - Challenges of Childhood
NORMAL CHILDHOOD DEVELOPMENT
Common Behavioural Challenges of Childhood
Mental Health Challenges of Childhood
Environmental Issues
Homelessness
Abuse and Neglect
Parent–Child Conflicts
Primary Caregiver Dysfunction
EMOTIONAL CHALLENGES
Anxiety
Depression
Somatoform Disorders
Post-Traumatic Stress Disorder
BEHAVIOURAL CHALLENGES
Children and Violence
Children and Electronic Media
Attention-Deficit/Hyperactivity Disorder
Disruptive Behavioural (Conduct) Disorder
Oppositional Defiant Disorder
Eating Disorders
Elimination Disorders
DEVELOPMENTAL CHALLENGES
Intellectual Development Disorder
Learning Disorders
Communication Disorders
PERVASIVE DEVELOPMENTAL DISORDERS
Autism
SCHIZOPHRENIA
THERAPEUTIC ACTIONS
Meet Basic Needs
Provide Opportunities
Encourage Self-Care and Independence
REFERENCES
14 - Challenges of Adolescence
ADOLESCENT GROWTH AND DEVELOPMENT
Physical Development
Psychosocial Development
COMMON CHALLENGES OF ADOLESCENCE
Internal (Developmental) Challenges
External (Environmental) Challenges
Teens and Electronic Media
Behavioural Disorders
Emotional Disorders
Mood Disorders
Eating Disorders
Chemical Dependency
Personality Disorders
Sexual Disorders
Psychosis
Suicide
THERAPEUTIC INTERVENTIONS
Surveillance and Limit Setting
Building Self-Esteem
Skill Development
REFERENCES
15 - Challenges of Adulthood
ADULT GROWTH AND DEVELOPMENT
COMMON CHALLENGES OF ADULTHOOD
Internal (Developmental) Challenges
Personal Identity
Cultural Identity
Interpersonal Relationships
Guiding the Next Generation
Economics
External (Environmental) Challenges
Education
Lack of Social Support
Acquired Immunodeficiency Syndrome
MENTAL HEALTH CHALLENGES OF ADULTS
Therapeutic Interventions
Health Care Interventions
Preventing Mental Illness
REFERENCES
16 - Challenges of Late Adulthood
Facts and Myths of Aging
Physical Health Changes
Mental Health Changes
Research and Aging
COMMON CHALLENGES OF OLDER PERSONS
Physical Adaptations
Health Care Services
Psychosocial Adaptations
Economics
Housing
Loss and Death
Substance Abuse
Elder Abuse
Dementia, Depression, and Delirium
THERAPEUTIC INTERVENTIONS
Age-Related Interventions
Mentally Ill Older Persons
Mental Health Promotion and Prevention
REFERENCES
17 - Cognitive Impairment, Alzheimer’s Disease, and Dementia
CONFUSION HAS MANY FACES
Normal Changes in Cognition
The Three “D’s” of Confusion
Medications and the Older Population
PATIENTS WITH DELIRIUM
Finding the Cause
Treating Delirium
PATIENTS WITH DEMENTIA
Symptoms of Dementia
Gentle Persuasive Approach
Dementia Care
Causes of Dementia
ALZHEIMER’S DISEASE
Symptoms and Course
Losses of Alzheimer’s Disease
Stages of Alzheimer’s Disease
After the Diagnosis
Principles of Management
THERAPEUTIC INTERVENTIONS
Assessment
Interventions for Patients Living With Alzheimer’s Disease
Early Stage
Middle and Late Stages
Caregiver Support
Caregiver Education
REFERENCES
IV - Patients With Psychological Challenges
18 - Managing Anxiety
CONTINUUM OF ANXIETY RESPONSES
Types of Anxiety
Types of Anxiety Responses
Coping Methods
Defence Mechanisms
Crisis
Ineffective Coping
Self-Awareness and Anxiety
THEORIES RELATING TO ANXIETY
Biological Models
Psychodynamic Model
Interpersonal Model
Behavioural Model
Other Models
ANXIETY THROUGHOUT THE LIFE CYCLE
Anxiety in Childhood
Anxiety in Adolescence
Anxiety in Adulthood
Anxiety in Older Persons
ANXIETY DISORDERS
Separation Anxiety Disorder
Selective Mutism
Specific Phobia
Social Anxiety Disorder
Panic Disorders
Panic Attack Specifier
Agoraphobia
Generalized Anxiety Disorder (GAD)
Obsessive-Compulsive Disorder (OCD)
Body Dysmorphic Disorder
Hoarding Disorder
Hair-Pulling Disorder (Trichotillomania)
Excoriation Disorder (Skin Picking)
Substance-/Medication-Induced Obsessive-Compulsive and Related Disorder
Obsessive-Compulsive and Related Disorder Due to Another Medical Condition
Other Specified Obsessive-Compulsive and Related Disorder
Unspecified Obsessive-Compulsive and Related Disorder
Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Post-Traumatic Stress Disorder (PTSD)
Acute Stress Disorder
Adjustment Disorder
Other Specific Trauma- and Stressor-Related Disorder
Unspecified Trauma- and Stressor-Related Disorder
THERAPEUTIC INTERVENTIONS
REFERENCES
19 - Illness and Hospitalization
THE NATURE OF ILLNESS
Stages of the Illness Experience
Stage 1: Symptoms
Stage 2: The Sick Role
Stage 3: Medical Care
Stage 4: Dependency
Stage 5: Recovery and Rehabilitation
Effects of Illness
Illness Behaviours
THE HOSPITALIZATION EXPERIENCE
Situational Crisis
Stages of Hospitalization
Common Reactions to Hospitalization
Psychiatric Hospitalization
THERAPEUTIC INTERVENTIONS
Psychosocial Care
Supporting Significant Others
Pain Management
Discharge Planning
REFERENCES
20 - Loss and Grief
THE NATURE OF LOSS
Characteristics of Loss
Loss Behaviours Throughout the Life Cycle
THE NATURE OF GRIEF AND MOURNING
The Grieving Process
Stages of the Grieving Process
Unresolved Grief
Caregivers’ Grief
THE DYING PROCESS
Age Differences and Dying
Terminal Illness
Cultural Factors, Dying, and Mourning
Stages of Dying
THERAPEUTIC INTERVENTIONS
Hospice Care
Meeting the Needs of Dying Patients
Loss, Grief, and Mental Health
REFERENCES
21 - Depression and Other Mood Disorders
CONTINUUM OF EMOTIONAL RESPONSES
Biological Evidence
Other Theories
EMOTIONS THROUGHOUT THE LIFE CYCLE
Emotions in Childhood
Emotions in Adolescence
Emotions in Adulthood
Emotions in Older Persons
Characteristics of Mood Disorders
DEPRESSIVE DISORDERS
Disruptive Mood Dysregulation Disorder
Major Depressive Disorder
Major Depressive Disorder With Specifiers
Persistent Depressive Disorder (Dysthymia)
Premenstrual Dysphoric Disorder
Substance-/Medication-Induced Depressive Disorder
Depressive Disorder Due to Another Medical Condition
Other Specified Depressive Disorder
Unspecified Depressive Disorder
BIPOLAR AND RELATED DISORDERS
Bipolar I Disorder
Manic Episode
Hypomanic Episode
Major Depressive Episode
Bipolar II Disorder
Cyclothymic Disorder
Substance-/Medical-Induced Bipolar and Related Disorder
Bipolar and Related Disorder Due to Another Medical Condition
Other Specified Bipolar and Related Disorder
Unspecified Bipolar and Related Disorder
THERAPEUTIC INTERVENTIONS
Treatment and Therapy
Psychotherapies
Electroconvulsive Therapy
Transcranial Direct Current Stimulation
Repetitive Transcranial Magnetic Stimulation
Medication Therapies
Antidepressants
Antidepressants and Suicide Precautions
Antimanics
Nursing (Therapeutic) Process
REFERENCES
22 - Physical Challenges, Psychological Sources
ROLE OF EMOTIONS IN HEALTH
ANXIETY AND STRESS
Childhood Sources
COMMON PSYCHOPHYSICAL CHALLENGES
Theories of Psychophysical Disorders
Cultural Influences
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder
Treatment
Psychological Factors Affecting Other Medical Conditions
Other Specified Somatic Symptom and Related Disorder
Unspecified Somatic Symptom and Related Disorder
Factitious Disorder
Malingering
IMPLICATIONS FOR CARE PROVIDERS
REFERENCES
23 - Eating and Sleeping Disorders
FEEDING AND EATING DISORDERS
Pica
Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Anorexia Nervosa
Clinical Presentation
Bulimia Nervosa
Clinical Presentation
Binge Eating Disorder
Obesity
Clinical Presentation
Guidelines for Intervention
Treatments and Therapies
SLEEP–WAKE DISORDERS
Insomnia Disorder
Hypersomnolence Disorder
Narcolepsy
Breathing-Related Sleep Disorders
Obstructive Sleep Apnea/Hypopnea
Central Sleep Apnea
Sleep-Related Hypoventilation
Circadian Rhythm Sleep–Wake Disorder
Parasomnias
Non–Rapid Eye Movement Sleep Arousal Disorders
Nightmare Disorder
Rapid Eye Movement Sleep Behaviour Disorder
Restless Legs Syndrome
Substance/Medication-Induced Sleep Disorder
Other Sleep Disorders
Guidelines for Intervention
REFERENCES
24 - Dissociative Disorders
CONTINUUM OF SELF-CONCEPT RESPONSES
The Healthy Personality
Self-Concept in Childhood
Self-Concept in Adolescence
Self-Concept in Adulthood
Self-Concept in Older Adulthood
DISSOCIATIVE DISORDERS
Characteristics
Depersonalization/Derealization Disorder
Dissociative Amnesia and Dissociative Amnesia With Fugue
Dissociative Identity Disorder
Trance
Other Specified Dissociative Disorders
THERAPEUTIC INTERVENTIONS
Treatments and Therapies
Pharmacological Therapy
Nursing (Therapeutic) Process
REFERENCES
V - Patients With Psychosocial Challenges
25 - Anger and Aggression
Gender Aggression
Aggression Throughout the Life Cycle
Scope of the Problem Today
THEORIES OF ANGER AND AGGRESSION
Biological Theories
Psychosocial Theories
Sociocultural Theories
THE CYCLE OF ASSAULT
Trigger Stage
Escalation Stage
Crisis Stage
Recovery Stage
Depression Stage
Oppositional Defiant Disorder
Intermittent Explosive Disorder
Conduct Disorder
Antisocial Personality Disorder
Pyromania
Kleptomania
GUIDELINES FOR INTERVENTION
Assessing Anger and Aggression
Mental Status Assessment
Psychosocial Assessment
Therapeutic Interventions
Trauma-Informed Care
REFERENCES
26 - Outward-Focused Emotions: Violence
SOCIAL FACTORS AND VIOLENCE
Theories of Violence
Domestic Violence
Intimate Partner Abuse
Abuse During Pregnancy
Child Abuse
Adolescent Abuse
Elder Abuse
Sexual Abuse
Violence Against Health Care Workers
Violence, Trauma, and Crime
Group Abuse
Post-Traumatic Stress Disorder
Rape-Trauma Syndrome
THERAPEUTIC INTERVENTIONS
Special Assessments
Treating Victims of Violence
Preventing Violence in Your Life
REFERENCES
27 - Inward-Focused Emotions: Suicide
CONTINUUM OF BEHAVIOURAL RESPONSES
Myths About Suicide
IMPACT OF SUICIDE ON SOCIETY
Cultural Factors
Social Factors
DYNAMICS OF SUICIDE
Characteristics of Suicide
Categories of Motivation
THEORIES ABOUT SUICIDE
New Biological Evidence
Effects of Suicide on Others
Survivor Guilt
SUICIDE THROUGHOUT THE LIFE CYCLE
Suicide and Children
Suicide and Adolescents
Suicide and Adults
Suicide and Older Persons
Medical Assistance in Dying
THERAPEUTIC INTERVENTIONS
Assessment of Suicidal Potential
Therapeutic Interventions for Suicidal Patients
REFERENCES
28 - Substance-Related Disorders and Addictive Disorders
Substance Use and Age
Scope of the Problem Today
CATEGORIES OF ABUSED SUBSTANCES
Severity of Impact and Legality
Alcohol
Signs of Alcohol Intoxication
Signs of Alcohol Withdrawal
Caffeine
Cannabis
Hallucinogens
Dissociative Anaesthetics
Inhalants
Opioids (Narcotics)
Sedatives (Hypnotics or Anxiolytics)
Stimulants
Tobacco (Nicotine)
OTHER MEDICATIONS
Stages of Addiction
Substance-Related Disorders and Addictive Disorder
Clinical Presentation
Similarity Between Addiction and Other Disorders
Three Main Malfunctions Leading to Addiction
GUIDELINES FOR INTERVENTION
Assessment
Treatments and Therapies
Abstinence and Harm Reduction
Nonmedical Treatment
Medical Treatment
Relapse
Nursing/Therapeutic Process
REFERENCES
29 - Sexuality and Sexual Disorders
THE CONTINUUM OF SEXUAL RESPONSES
Self-Awareness and Sexuality
SEXUALITY THROUGHOUT THE LIFE CYCLE
Sexuality in Childhood
Sexuality in Adolescence
Sexuality in Adulthood
Sexuality in Older Adulthood
Sexuality and Disability
SEXUAL ORIENTATION
GENDER IDENTITY
Gender Identity Terminology
PARAPHILIC DISORDERS
Other Specified Paraphilic Disorders
Unspecified Paraphilic Disorder
Therapeutic Approach
Penile Plethysmograph or Phallometry
SEXUAL DYSFUNCTIONS
GENDER DYSPHORIA
PORNOGRAPHY
THERAPEUTIC INTERVENTIONS
Psychosexual Assessment
Nursing/Therapeutic Process
REFERENCES
30 - Personality Disorders
CONTINUUM OF SOCIAL RESPONSES
PERSONALITY THROUGHOUT THE LIFE CYCLE
Personality in Childhood
Personality in Adolescence
Personality in Adulthood
Personality in Older Adulthood
Biological Theories
Psychoanalytical Theories
Behavioural Theories
Sociocultural Theories
PERSONALITY DISORDERS
Eccentric Cluster
Erratic Cluster
Psychopaths and Sociopaths
Fearful Cluster
THERAPEUTIC INTERVENTIONS
Treatment and Therapy
Nursing (Therapeutic) Process
REFERENCES
31 - Brain Function, Schizophrenia, and Other Psychoses
A FEW FACTS ABOUT OUR BRAINS
BRAIN FUNCTION
Normal Brain Function
Perceptions
Thoughts
Abnormal Brain Function
Positive Symptoms
Negative Symptoms
Cognitive Symptoms
Psychosis
THE SCHIZOPHRENIA SPECTRUM
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Schizophrenia
Insight
Development and Course
Prevalence
Suicide Risk
Aggression
Interview Tips and Strategies for Patients With Schizophrenia
Uncovering Dangerous Psychotic Process
Speech Disturbances
Other Characteristics of Schizophrenia: Clinical Picture
Schizoaffective Disorder
Substance/Medication-Induced Psychotic Disorder
Psychotic Disorder Due to a Medical Condition
Catatonia Associated With a Mental Disorder
Catatonic Disorder Due to a Medical Condition
Unspecified Catatonia
Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
Unspecified Schizophrenia Spectrum and Other Psychotic Disorder
THERAPEUTIC INTERVENTIONS
Treatments and Therapies
Pharmacological Therapy
Nursing (Therapeutic) Process
Special Considerations
Neuroleptic Malignant Syndrome
Tardive Dyskinesia
Anticholinergic Effects
Nursing Responsibilities
REFERENCES
32 - Chronic Mental Health Disorders
SCOPE OF MENTAL ILLNESS
PUBLIC POLICY AND MENTAL HEALTH
Effects of Deinstitutionalization
EXPERIENCE OF CHRONIC MENTAL ILLNESS
Meeting Basic Needs
Access to Health Care
Behavioural Characteristics
Physical Characteristics
Psychological Characteristics
SPECIAL POPULATIONS
Children and Adolescents Living With Chronic Mental Illness
Older Persons Living With Chronic Mental Illness
Persons With Multiple Disorders
Inpatient Settings
Outpatient Settings
Psychiatric Rehabilitation
THERAPEUTIC INTERVENTIONS
Treatments and Therapies
Pharmacological Therapy
Nursing (Therapeutic) Process
Documentation and Transfer of Accountability
Electronic Health Record
Organization of Nursing in Mental Health Care
Assignment: The Primary Nursing Model. Since low levels of anxiety and good therapeutic relationships are so valuable for a pati...
The Nurse in Charge of the Shift. A typical mental health unit can be acute 24/7. Most nursing interventions are collective, tha...
Therapeutic Environment and Nursing Work Station. Mobile nursing stations (MNSs) on wheels equipped with a computer and locked c...
The Myth of Intermediate Observation. Unfortunately, many medical care facilities still engage in old practices without any evid...
The Myth of Chemical Restraint. All across Canada, the use of restraints to ensure personal and public safety is typically regul...
Mental Health Care in the Community
REFERENCES
33 - Challenges for the Future
CHANGES IN MENTAL HEALTH CARE
Change in Settings
Challenges Created by the Canadian Health Care System
Long-Acting Injectables
Homelessness
The Canadian Charter of Rights and Freedoms
Cultural Influences
THE MENTAL HEALTH CARE TEAM
Team Members
Interdisciplinary Interactions
Mental Health Care Delivery Settings
CHANGE AND MENTAL HEALTH PATIENTS
Competency
Empowerment of Patients
Obligations of Patients
Obligations of Care Providers
Providers of Care
Expanded Role for Nurses
The Change Process
OTHER CHALLENGES
The Challenge to Care
A Look to the Future
REFERENCES
A - Mental Status Assessment at a Glance
B - A Simple Assessment of TardiveDyskinesia Symptoms
C - Canadian Standards for Psychiatric-Mental Health Nursing
Standard II: Performs/Refines Client Assessments Through the Diagnostic and Monitoring Function
Standard III: Administers and Monitors Therapeutic Interventions
Standard IV: Effectively Manages Rapidly Changing Situations
Standard V: Intervenes Through the Teaching-Coaching Function
Standard VI: Monitors and Ensures the Quality of Health Care Practices
Standard VII: Practices Effectively Within Organizational and Work-Role Structure
Glossary
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
Index
A
B
C
D
E
F
G
H
I
J
L
M
N
N
O
P
Q
R
S
T
U
V
W
Y
Z