Chapter 01Mental Health and Mental Illness Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Mental Health Defined • Physical, mental, and social well-being are intact • A “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (NIMH, 2004) Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Mental Illness Defined • DSM-IV-TR: “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (impairment in one or more important areas of functioning)” Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Cultural, Ethnic, and Religious Influences • Variances in perceiving, coping with, and managing mental health issues • Examples – Turn to faith healers – Deny that a problem exists – View symptoms as punishment for wrongdoing Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Defining Stress • A condition that results when a threat or challenge to our well-being requires us to adapt or make an adjustment – Distress – Eustress – “Fight or flight” response Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Defining Anxiety • Built-in response to a real or perceived threat to our well-being • Four levels – Mild – Moderate – Severe – Panic Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Contributing Factors to Stress and Anxiety • External stressors – Adverse aspects of the environment • Internal stressors – Physical – Psychological Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Coping with Stress and Anxiety • Positive outcome – Adaptive coping – Palliative coping • Negative outcome – Maladaptive coping – Dysfunctional coping Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Adaptive Coping Strategies • Reframing • Positive self-talk, humor • Assertiveness training • Problem-solving and communication skills • Relaxation techniques, self-care • Support systems • Faith in spiritual power and in yourself Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Psychological Crisis • A state of disorganization during which time usual coping strategies fail • Individual feels helpless and lost • May result from – Unrealistic perception of a threatening event – Lack of a support system – Inadequate coping ability Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Crisis Intervention • Deal with the present situation; early intervention is best • Reduce anxiety level • Help client define the problem • Determine available support • Help client set realistic goals for resolution • Provide support and reassurance • Provide for client’s safety and security Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Grief and Loss • Griefan emotional process of coping • Lossan actual/perceived change of relationship with lost person or object Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Grief • Anticipatory grief – When expecting a loss in the near future • Conventional grief – Following a loss – Bereavement • Age-related concepts of loss Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Stages of Grief (Kubler-Ross) • Shock and denial • Anger and pain • Negotiation and bargaining • Withdrawal and depression • Acceptance and resolution Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Dysfunctional Grief • Failure to cope successfully with loss – Chronic sorrow – Contributing factors to unresolved grief • Socially unacceptable death • Missing person • Multiple losses • Ambivalent feelings toward the lost person • Guilt Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Defining Anger • An emotion triggered in response to threats, insulting situations, or anything that hampers the intended action of an individual • May be directed at an individual, group, or self • Builds into bitterness Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Defining Violence and Abuse • Violencean intense feeling toward an individual that starts with verbal or physical threats and assaults that victimize the person • Abusecompelling destructive action against an individual against his or her will – May be physical, sexual, verbal, emotional, or neglectful Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Managing Anger • Recognize the origin of emotional response • Engage in physical activity • Stand up for rights, beliefs, or values • Talk with someone who will listen • Learn to forgive Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question • Tell whether the following statement is true or false. Stress can help people function at optimal levels. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer • True • Rationale: Stress is a part of everyday living. Mild stress can motivate and propel people toward accomplishment and success. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question • Grief that comes when one is expecting a loss in the near future is called A. Conventional grief B. Dysfunctional grief C. Anticipatory grief D. Chronic sorrow Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer • C. Anticipatory grief • Rationale: Anticipatory grief is a response in individuals or families that occurs when a loss is expected in the near future. It can be a helpful concept for nurses working with terminally ill patients and patients who are anticipating the loss of a body part or a change in body functioning. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Question • According to Dr. Kubler-Ross, which stage is the first step of the grieving process? A. Anger B. Denial C. Acceptance D. Bargaining Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer • B. Denial • Rationale: In the first stage of grief, a person who has experienced a loss wants to avoid the reality of it and may act as if nothing happened. Denial allows a person time to gather coping strategies for the grieving process ahead. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
