Chapter One Foundations of Psychiatric Mental Health Nursing Mental Health ● The WHO defines health as a state of complete physical, mental, and social wellness, not merely the absence of disease or infirmity. ● Mental health is influenced by individual factors, including biologic makeup, autonomy, and independence, self-esteem, capacity for growth, vitality, ability to fi nd meaning in life, resi li ence or hardines s, se nse of belonging, real it y orientation, and coping or stress management abilities; by interpersonal factors, including effective communication, helping others, intimacy, and maintaining a ba lance of separa teness and connect edness; and by social /cultural fac tor s, inc luding sense of communit y, access to resources, int ole rance of vio lence, support of diversity among people, mastery of the environment, and a positive yet realistic view of the world (damn, that was a mouthful!). Mental Illness ● The APA (2000) defines a mental disorder as “a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom”. ● Deviant behavior does not necessarily indicate a mental disorder. Diagnostic and statistical manual of mental disorders ● The DSM-IV-TR is a ta xon omy pub li shed by the APA. The DS M- IV-TR describes all mental disorders, outlining specific criteria for each based on clinical experience and research. ● The DSM-IV-TR has 3 purposes: ○ To provide standardized nomenclature and language for all mental health professionals. ○ To present defining characteristics or symptoms that differentiates specific diagnoses. ○ To assist in identifying the underlying causes of disorders. ● A multiaxial classification system that involves assessment on several axes, or domains of information, allows the practitioner to identify all the factors that relate to a persons condition. ○ Axis I is for identifying all major psychiatric disorders except MR and personality disorders. Examples include depression and schizophrenia. ○ Axis II is for reporting mental retardation and personality disorders as well as prominent maladaptive personality features and defense mechanisms. ○ Axis III is for reporting current medical conditions that are potentially relevant to understanding or maintaining the person’s mental disorder as well as medica l condit ions that mig ht contribute to unde rstandi ng the person. ○ Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders. Incl ude d are pr oble ms wi th the pr imar y suppor t gr oup, the soci al environment, education, occupation, housing, economics, access to health care, and the legal system. Compiled By: Bheru Lal Page 43