Exam #4: Ch. 11

Affordable Care Act (ACA)

federal legislation that expands eligibility for Medicaid and increases access to private insurance for low-income Americans not covered by employer-provided health insurance

Treatment goals for mental disorders are

(1) reduce symptoms (2) improve personal and social functioning (3) develop and strengthen coping skills (4) promote behaviors that make a person's life better.

Nerve fibers of the brain are severed by surgical incision, popularized by Portuguese neuropsychiatrist Antônio Egas Moniz, and by U.S. neurologist Walter Freeman.

Lobotomy

An affective disorder characterized by a dysphoric mood, usually depression, and/or loss of interest or pleasure in almost all usual activities or pastimes

Major depression

Identify the major problems faced by people with mental illness who are homeless.

80% of these homeless individuals are temporarily homeless, 10% are episodically homeless, and 10% are chronically homeless. More exposed to environmental stresses and threats.

Explain the prevalence of mental disorders in the United States.

Approximately 20% of American adults (about 45 million people) have diagnosable mental disorders during a given year. 5% of adults in the United States have serious mental illness, that is, illness that interferes with some aspect of social functioning. Only 38% of those diagnosed with a mental disorder receive treatment.

Service that uses active outreach by a team of providers over an indefinite period of time to deliver intensive, individualized services

Assertive Community Treatment

Affective disorder characterized by distinct periods of elevated mood alternating with periods of depression

Bipolar disorder

First and most famous antipsychotic drug, introduced in 1954 under the brand name Thorazine

Chlorpromazine (Thorazine)

6. Briefly trace the history of mental health care in the United States, highlighting the major changes both before and after World War II.

Colonial America "distracted" persons or "lunatics," as they were called, cared for by their families or private caretakers, and only as a last resort became the responsibility of the local community. - eighteenth century when people with mental disorders were placed in undifferentiated poorhouses or almshouses alongside people with mental retardation, physical disabilities, and the otherwise deviant. - early nineteenth century the situation in the poorhouses and almshouses worsened and the first efforts were made to separate people by their type of disability. In 1751 Thomas Bond opened Pennsylvania Hospital, the first institution in America specifically designed to care for those with mental illness. Conditions in the hospital were harsh (see Figure 11.5), and treatments, which consisted of "blood letting, blistering, emetics, and warm and cold baths," were unpleasant.

Diseases that result from chronic exposure to excess levels of stressors, which produce a General Adaptation Syndrome response

Diseases of Adaptation

Neuroleptic drug

Drug that reduces nervous activity; another term for antipsychotic drugs.

Chemical straitjacket

Drug that subdues a psychiatric patient's behavior

Method of treatment for mental disorders involving the administration of electric current to the scalp to induce convulsions and unconsciousness

Electroconvulsive therapy (ECT)

Way of delivering services to people using scientific evidence that shows that the services actually work

Evidence-based

An alarm reaction that prepares one physiologically for sudden action

Fight-or-flight reaction

Community mental health center (CMHC)

Fully staffed center originally funded by the federal government that provides comprehensive mental health services to local populations

Self-help group

Group of concerned members of the community who are united by a shared interest, concern, or deficit not shared by other members of the community (Alcoholics Anonymous, for example)

Mental disorders

Health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning

An evidence-based model of employment services emphasizing real work opportunities, integrated mental health services, and individualized job supports

Individual Placement and Support

Mental Retardation Facilities and Community Mental Health Centers (CMHC) Act

Law that made the federal government responsible for assisting in the funding of mental health facilities and services

service providers controlling the disability income or other benefits received by a person with mental illness to enforce participation in treatment in return for suspending a criminal sentence imposed by a court of law

Legal leverage

court where the judges have special training and use nonadversarial procedures that mandate treatment and rehabilitation rather than incarceration if a person with mental illness is found guilty of a crime

Mental health court

Nation's leading mental health research agency, housed in the National Institutes of Health

National Institute of Mental Health (NIMH)

Moral treatment

Nineteenth century treatment in which people with mental illness were removed from the everyday life stressors of their home environments and given "asylum" in a rural setting, including rest, exercise, fresh air, and amusements

Stress

One's psychologic and physiologic response to stressors—stimuli in the physical and social environment that produce feelings of tension and strain.

laws mandating involuntary psychiatric treatment for individuals who do not understand their illness to protect the individual from harm and safeguard the public

Outpatient commitment

Primary, secondary, and tertiary prevention as they relate to mental disorders, and give an example of each.

Primary prevention reduces the incidence of new cases of mental illness and related problems. 1990s a program known as "Moving to Opportunity" randomly identified more than 4,500 low-income and mostly female-headed families and gave them vouchers to move from public housing in extremely poor neighborhoods to lower-poverty neighborhoods in the same cities. Fifteen years later, families that had received the vouchers reported better mental health and higher subjective well-being (happiness) than did the control families. Secondary prevention can reduce its prevalence by shortening the duration of episodes through prompt intervention. Ex: soldiers exposed to high levels of combat who receive intensive cognitive skills training within a few days of returning home are significantly less likely to experience symptoms of PTSD and depression later on. Tertiary prevention, treatment, and rehabilitation ameliorate the symptoms of illness and prevent further problems for the individual and the community.

Deinstitutionalization

Process of discharging, on a large scale, patients from state mental hospitals to less-restrictive community settings. Economics, idealism, and legal considerations, and new medication helped to expedite the process.

intensive, individualized services encompassing treatment, rehabilitation, and support delivered by a team of providers over an indefinite period to individuals with severe mental disorders to help them maintain stable lives in the community

Psychiatric rehabilitation

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

Published by the American Psychiatric Association. Identifies the various mental disorders, provides descriptive information and diagnostic instructions for each, and has significant implications for who merits a diagnosis, whether a treatment should be reimbursed by insurance, what school and social services a person is entitled to, the top priorities for mental health research, and what kinds of new therapeutic medications should be developed. Places disorders in discrete categories on the basis of behavioral signs and symptoms rather than definitive tests or measurements of the brain or another body system. *challenge in using a categorical system include differentiating normal reactions to life (severe grief following the death of a loved one) from diagnosable disorder (major depression). Progress in genetic research has blurred both the boundaries between mental disorders and the boundaries between disorders and normal variations in behavior.

Outcome sought by most people with mental illness; includes increased independence, effective coping, supportive relationships, community participation, and sometimes gainful employment

Recovery

Cultural Competence

Service provider's degree of compatibility with the specific culture of the population served, for example, proficiency in language(s) other than English, familiarity with cultural idioms of distress or body language, folk beliefs, and expectations regarding treatment procedures (such as medication or psychotherapy) and likely outcomes

Explain the relationship of stress to physical and mental health.

Stress is a significant cause of mental illness. People who survive disasters and soldiers returning from combat face increased risk. 20 percent of Manhattan residents living near the World Trade Center at the time of the attacks of September 11, 2001 had symptoms consistent with posttraumatic stress disorder (PTSD) 5 to 8 weeks after.

General Adaptation Syndrome (GAS)

The complex physiological responses resulting from exposure to stressors. Responding to a stressor occurs in three stages: (1) an alarm reaction, (2) a stage of resistance, and finally (3) exhaustion

Cognitive-behavioral therapy

Treatment based on learning new thought patterns and adaptive skills, with regular practice between therapy sessions

Mental illness

a collective term for all diagnosable mental disorders

National Alliance on Mental Illness (NAMI)

a national self-help group that supports the belief that major mental disorders are brain diseases that are of genetic origin and biological in nature and are diagnosable and treatable with medications

Psychotherapy

a treatment that involves verbal communication between the patient and a trained clinician

Integrative care

care a patient receives from a team of primary health care and behavioral health clinicians, working together with patients and families, using shared, cost-effective care plans that incorporate patient goals

Tardive dyskinesia

irreversible condition of involuntary and abnormal movements of the tongue, mouth, arms, and legs, which can result from long-term use of certain antipsychotic drugs (such as chlorpromazine)

Crisis Intervention Team

specially trained police in direct collaboration with mental health authorities to remove barriers to mental health care for people with mental illness involved in the justice system

mental health

state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.

Parity

the concept of equality in health care coverage for people with mental illness and those with other medical illnesses or injuries

Transinstitutionalization

transferring patients from one type of public institution to another, usually as a result of policy change

Psychopharmacological therapy

treatment for mental illness that involves medications