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Glossary of Ch. 1 - Mental Health (Past to Present)

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Created by daisy497

What are some of the roles of nurses who work in mental health?
1. Advocator
2. Establishing relationships
3. Educator

What skills are necessary for mental health nurses?
1. Therapeutic communication
2. Monitoring drug levels
3. Assessment skills (ex. adverse reaction; psychotropic drugs can lead to lock jaw causing respiratory distress)
4. Therapeutic intervetions
5. Rapidly changing situations
6. Teaching/Coaching
7. Diagnostic





Experiences of patient with a mental illness:
- Stigma (Have to deal with their illness as well as the reactions of others)
- Very debilitating (impacts occupation and education; more debilitating than a physical illness)
Early Forms of Care:
1. Early 19th Century: care by families
2. 1400's: small-scale asylums (charitable)
3. 1700's: Humane treatment (Pinel)
- Enlightenment movement: started treating people with mental disorders more humanely
4. Late 18/19th century: large institutions
- Waterford (1854)

*diverse approaches to care and treatment






Canada - Asylum Building
1. New Brunswick (1848): The Provincial Lunatic Asylum (1st asylum in Canada)
2. NL: Waterford (1854)
- hospital for mental and nervous diseases
- renamed in 1972
- today less than 200 beds
- many outpatient/community based services

*Lack of privacy and overcrowding causes more aggression






Legal Basis for Mental Health Care (Legislation)
1. British North American Act (1867) 2. Mental Health Care - provincially based 3. All provinces have mental health legislation 4. NL (OLD legislation): didn't take into account patients rights until 1973 5. 2006: Mental Health Care & Treatment Act
(Legislation) Legal Basis for Mental Health Care:
1. British North American Act (1867)
2. Mental Health Care: provincially based
3. All provinces have mental health legislation
4. NL (OLD legislation): didn't take into account patients rights until 1973
5. 2006: Mental Health Care & Treatment Act



Dorothea Dix
(Social Reformer)
- school teacher
- influenced change in Canada & US (state-supported public care)
- changed treatment of conditions in jails/asylums
- called for more state hospitals and more training for people who provided care
- the type of care at the time was custodial care!!



Charles Clarke
(Social Reformer)
- psychiatrist
- called for NURSE training for asylum peronnel (more humane treatment)
Clifford Beers (1908)
(Social Reformer)
- wrote an autobiography called: A Mind That Found Itself
- he was abused, choked and almost killed (this lead to him becoming a reformer and seeking change)
Canadian Mental Health Association (CMHA)
- previously known as Canadian National Committee for Mental Hygiene
(CNCMH)
- formed by Clifford Beers in 1918
- {Strategies}


Training school for Nurses
- implemented by Dr. Charles Clarke
- in Ontario
- for female nurses
- Males still attended to people with mental illnesses (but training obtained a lower status)
- Box 1.1 (p.8)
- Males started being trained in Western Canada
- 1920: 1st PMH (Pyschiatric and Mental Health Nursing) textbook published: showing how patients should be treated in Mental Health facilities





Modern Thinking
1900's: opposing views (related to psychosocial/biologic view)
- Sigmund Freud developed the Psychoanalytic Theory
- belief that mental illnesses are primarily caused by psychological factors

Integration of Biologic Theories:
1. 1940's: treatments were introduced (ex. insulin therapy, hydrotherapy: placing them in cold water, lobotomies: cutting optic nerve in eye to prevent aggressive behaviour)
2. ***1950's: psychopharmacologic agents introduced (ex. Chloropromazine)
3. 1970's: Lithium (salt) used for treating bipolar and mania

*in the 50's, the war just ended and people were returning with trauma (aka shell shock)







Post World War II
- 1950's-1960's: universal health insurance
- 1950's models of nursing education in Canada
- Canadian National Committee of Mental Hygiene (CNCMH) name changed to Canadian Mental Health Association (CMHA)
- changed to general hospital-based psychiatric care
- ***Deinstitutionalization: closed asylums and let them go into society - they were living on the streets and in substandard housing
- Canadian Federation of Mental Health Nurses (CFMHN) founded in 1988




Hildegard Peplau
- studied Interpersonal Relationships
- "Grandmother of psychiatry"
- published Interpersonal Relations in Nursing (1952)
- Therapeutic reationship (the foundation of nursing practice)




Health Care Reform
- #1 problem: funding for mental health
- Community-based care
- 4 Kirby reports published
- Mental Health Commission (2007) - NATIONAL approach to mental health issues


Mental Health Commission of Canada
Toward Recovery and Well Being: Framework for a Mental Health Strategy for Canada
http://www.mentalhealthcommission.ca
Mental Health Commission of Canada (MHCC) Goals:
1. Reform of mental health POLICY & SERVICE delivery (more policies)
2. NATIONAL approach to mental health issues
3. Reducing STIGMA & DISCRIMINATION ("Changing Minds")
4. EVIDENCE-BASED information (Dissemination)

*drugs are not always the answer. many drugs are ineffective




What factors influence stigma in the mental health area?
- media
- aging population
- *DEVALUATION of mental health nursing by other areas of nursing (emphasis today is on technological skills and not communication - therefore it is DEVALUED)
-


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