Unit 03 Factors affecting Mental Health and Illness.pptx

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1. INTRODUCTION TO PSYCHIATRIC NURSING Presented by : Sumaira George Acknowledged By : M . Zubair Assistant Professor INS/ KMU

2. Mental Health ??????? MENTAL ILLNESS

3. Seven Signs of Mental Health Happiness Control over behavior Appraisal of reality Effectiveness in work Healthy self-concept Satisfying relationships (give and receive love) Effective coping strategies

4. Traits of Mental Health Ability to Deal with conflicting emotions Live without undue fear, guilt, or anxiety Take responsibility for one's own actions Think clearly Negotiate each developmental task

5. Prevalence of Psychiatric Disorders USA The Department of Health and Human Services and the National Institute of Mental Health (2004) provide the following statistics: 57.7 million Americans have a mental illness. That is 26.2 per cent of Americans 18 or older. Four of the ten leading causes of disability include: major depression, bipolar disorder, schizophrenia and obsessive compulsive disorder. The economic burden of mental illness in the USA, exceeds $ 170 billion.

6. National Institute of Mental Health 2002 USA Statistics Affective Disorders- 9.5 pre-cent. 18.8 million Suicide- 29,350 people committed suicide Schizophrenia- 1.1 percent, 2.2 million Anxiety disorders- 13.3 percent, 19.1 million Eating disorders- 2- 5 percent of population ADHD- 4.1 percent of youth ages 9 to 17 Substance abuse- 11.3 percent of the population

7. Theories of Mental Illness PSYCHOBIOLOGICAL PSYCHOLOGICAL

8. PSYCHOBIOLOGICAL Genetic Other Biological Influences The Role of the Environment

9. Dopamine DA Schizophrenia, Mania Parkinson’s, Depression Norepinephrine NE Mania Depression Serotonin 5-HT Anxiety Depression Gamma-amino- GABA Reduction of buturic acid anxiety Anxiety Acetyl-Choline Ach Depression Alzheimer’s PSYCHOBIOLOGICAL Neurotransmitter/ Receptor/ Disorder

10. PSYCHOLOGICAL Freud's Psychoanalytic Theory Conscious, preconscious, unconscious Id, ego, superego Defense mechanisms and Anxiety Theories of personality

11. PSYCHOLOGICAL PSYCHOANALYTICAL “EGO FUNCTIONS” REALITY TESTING SENSE OF REALITY JUDGEMENT IMPULSE CONTROL THOUGHT PROCESS ARISE DEFENSIVE FUNCTIONING OBJECT RELATIONS AUTONOMOUS FUNCTIONING STIMULOUS BARRIER MASTERY COMPETENCE SYNTHETIC INTEGRATIVE FUNCTIONING EGO SELF ESTEEM

12. PSYCHOLOGICAL Freud “Psychosexual Stages of Development” Oral (0-18mos Anal (18mos-3yrs) Phallic (3-6yrs.) Latency (6-12yrs) Genital (13-20yrs)

13. PSYCHOLOGICAL ERIKSON “Psychosocial Stages of Development” Trust vs Mistrust Autonomy vs Shame and Doubt Initiative vs Guilt

14. PSYCHOLOGICAL ERIKSON (cont) Industry vs Inferiority Identity vs Role Confusion Intimacy vs Isolation

15. PSYCHOLOGICAL ERIKSON (cont) Generativity vs Stagnation Ego Integrity vs Despair

16. Maslow’s Hierarchy of Needs 6. Self-Transcendent Needs 5. Self- Actualization Needs 4. Esteem Needs 3. Love and Belonging Needs 2. Safety Needs 1. Physiological Needs Emphasis on human potential and client’s strengths Establishes what is most important in sequences of nursing actions “ Sets Priorities” Varcarolis p. 20-21

17. Psychiatric Mental Health Nursing and the Nursing Process 1. Assessment 2. Nursing Diagnosis 6. Evaluation 3. Outcome Identification 4. Planning 5. Implementation

18. Factors Affecting Mental Health and Nursing Assessment Support systems Family influences Developmental events Cultural beliefs and values Health practices Negative influences

19. PSYCHIATRIC ASSESSMENT Construct database Mental status examination (MSE) Psychosocial assessment Physical examination History taking Interviews Standardized rating scales Verifying the data

20. DIAGNOSIS OF PSYCHIATRIC ILLNESS Medical - DSM-IV-TV (Diagnostic and Statistical Classification of Mental Disorders) Nursing - NANDA (North American Nursing Diagnosis Association)

21. Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision DSM-IV-TR Mental disorders are considered a manifestation of a Behavioral Psychological Biological dysfunction of the individual

22. DSM- IV- TR MULTI-AXIAL CLASSIFICATION Axis I- All major psychiatric disorders Axis II- Personality disorders; Mental retardation Axis III- Current medical conditions that are relevant to the mental disorder Axis IV- Psychosocial and environmental problems Axis V- Global Assessment of Function (GAF)

23. Therapeutic Approaches Psychoanalysis Short term psychotherapy Cognitive Therapy Behavior Therapy Modeling Operant Conditioning Systemic desensitization Aversion Therapy Milieu Therapy Individual, group and family therapy

24. CULTURAL BIASES Consider cultural differences that influence health Be accepting of changing families Be open, consider differences in order to provide sensitive, competent care

25. GOALS and Interventions of Psychiatric Care Directed to… Anxiety + Reality testing + Self esteem = Level of functioning and manage disease process

26. Factors Affect mental health

27. CAUSES OF MENTAL ILLNESS Most mental illnesses are caused by a chemical imbalance in the brain, But we don't always know what causes the chemical imbalance.

28. CONTRIBUTING FACTORS IN MENTAL ILLNESS Bio-psycho-social model _attempts to consider a number of factors that might contribute to or affect mental illness, in three main categories: 1. Biological factors _(physiology and biochemistry, and genetic inheritance) 2. Psychological factors (emotional experience, interpersonal interactions and the person's upbringing) 3. Social factors (related to cultural background and current life situation).

29. Contii … ✓ These factors may operate separately or in combination, at different times in a person's life. ✓ According to their timing in relation to the illness, they can be said to; a)predispose the person to the illness, b)precipitate it or, c)perpetuate it:

30. Contii .. Predisposing factors exist long before onset of illness. Precipitating factors are stressors occurring just before the appearance of symptoms, either when illness is first experienced, or when it relapses. Perpetuating factors prevent or delay resolution or improvement of symptoms. Protective factors reduce a person's vulnerability to the illness.

31. In other ways, the contributing factors could also be grouped into two factors, and these are; ➤ Physical Factors ➤ Psychological Factors

32. Physical factors The physical factors include the ff., *Trauma, e.g. head injury, *Drug abuse/drug dependence, e.g. pethidine , **Alcohol use/dependence, e.g. alcoholics, *Acute Infection, e.g. cerebral malaria, typhoid fever, meningitis, *Chronic Illness, e.g. diabetes, HTN **Poisons & Toxins, e.g. chemicals like insecticide (DDT), herbicide,

33. PSYCHOLOGICAL FACTORS ➤ Losses such as; 1. Loss of loved one/ berevement 2. Loss of job 3. Financial losses ➤ Failure in exam/failure in life ➤ Severe poverty ➤ Rape/Defilement > Unemployment Demands at home/work ➤ Being robbed

34. Contii … ➤ Domestic violence esp. spousal and child abuse. Marital problems such as divorce or separation ➤ Broken Relationship such as being jilted ➤ Parental strife/conflict. Disaster like natural or artificial, or both.

35. Thankyou