Chapter 2
Mental health and mental illness
Mental health and mental illness
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Mental health: Successful performance of
mental functions with the ability to:
-engage in productive activities
-enjoy fulfilling relationship
-change or cope with adversity
Mental Illness: A clinically significant behavioral
or psychological syndrome experienced by a
person and marked by distress, disability, or the
risk of suffering disability or loss of freedom.
Mental health and mental illness
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Myths and Misconceptions
-Mentally ill is to be different and odd
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Mentally healthy person must be logical and rational
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Psychiatric definition of normal mental health changes over time
(Sadock & Sadock, 2007)
-reflects changes in cultural norms, societies’ expectations and
values, professional bias, and individual differences
No one definition of mental health fits all:
-individuals with mental health issues have attributes of
strength/high functioning
-persons with mental health have issues related to dysfunction at
different times in their lives)
Diagnostic and statistical manual of
mental disorders (DSM-IV)
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5 Axis System
 Axis
1: Psychiatric Disorder
 Axis 2: Personality Disorder and Mental retardation
 Axis 3: Medical Disorder
 Axis 4: Psychosocial and Environmental Problems
 Axis 5: Global Assessment of Functioning (GAF)
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Classifies and categorizes mental disorders
Incorporates cultural awareness
Epidemiology

Definition
 Quantitative
study of distribution of mental disorders
in human population
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Prevalence Rate
 Proportion
of a population with mental disorder
at a given time
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Lifetime Prevalence of Mental Disorders
 Published
study (Kessler, et al., 2005), concluded ½
Americans will meet criteria for DSM-IV disorder
sometime in their lifetime, with the 1st onset in
childhood or adolescence
Prevalence and epidemiology of
the psychiatric disorders in USA
Disorder
Prevalence
over 12 mo
(%)
Est #
people
affected
Epidemiolo
gy
Schizophreni 1.1
a
2.2 million
Men &
women
Mood
disorders
9.5
18.8 million
Women 2x
men
MDD
5
9.9 million
Women 2x
men, lead
cause
disability
Anxiety
Disorders,
PTSD, GAD
13.3
19.1 million
Co-occur
with
depressive
Mental health vs. mental illness
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Signs of mental health
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Major Depressive
Disorder
 Impulse Control Disorder
 Schizophrenic Disorder
 Adjustment Disorder with
work/academic inhibition
 Antisocial personality
disorder
 Borderline personality
disorder
 Substance dependencies
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Happiness
Control over behavior
Appraisal of reality
Effectiveness in work
A healthy self concept
Satisfying relationships
Effective coping strategies
Signs of mental illness
Mental health parity act
Passed by Congress 1996
 Requires insurers that provide mental
health coverage to offer benefits at the
same level provided for medical and
surgical coverage
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Example of DSM-IV evaluation
documentation
Axis I: Major depression disorder, recurrent,
severe, Alcohol dependence, Alcohol
withdrawal
Axis II: Borderline personality disorder
Axis III: Diabetes Type 2, HTN
Axis IV: Job jeopardy, death of spouse,
homeless
Axis V: GAF 35
Biological based mental illnesses
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Caused by neurotransmitter dysfunction, abnormal brain
structure, inherited genetic factors, or other biological
causes
Can be classified as medical diseases
Includes the following:
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Schizophrenia
Bipolar disorder
Major depression
Obsessive compulsive and panic disorders
Post traumatic stress disorder
Autism
Anorexia Nervosa
Attention and hyperactivity disorder
Influences that affect a person’s
mental health
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Biological
Hormonal
Inherited factors
Personality traits
Cultural beliefs/values
Support systems (family, friends, community)
Negative influences (psychosocial stressors)
Spirituality/religion
Environmental experiences
Demographic/geographic location
Nursing diagnosis and NANDA
international
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A clinical judgment about individual, family, or
community responses to actual or potential
health problems and life processes (e.g.
hallucinations, self-esteem issues, inability to
function in a job or family)
Helps target the symptoms and needs of
patients so they can ideally achieve a higher
level of functioning and quality of life
http://www.nanda.org/Home.aspx
Cultural related symptoms
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Influence of culture on behavior and the way in
which symptoms present may reflect a person’s
cultural pattern
Symptoms need to be understood in terms of a
person’s cultural background
Caution: do not stereotype
-lack of cultural awareness can result in
improper care or delivery of inappropriate
services