Title NCM 117 LEC PRELIMS ✅

NCM 117 LEC PRELIMS by TONS and MADS PRELIMS COVERAGE Life of a Psychiatric Nurse PRELIMS COVERAGE 1 OUTLINE 1 MENTAL HEALTH AND THE PHILIPPINES 2 OVERVIEW OF PSYCHIATRIC NURSING (CHAPTER 1) 4 DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS 5th edition (DSM-5) 4 ❖ Three (3) purposes: 4 ❖ DSM-5 Multiaxial Classification System 4 HISTORICAL PERSPECTIVES OF THE TREATMENT OF MENTAL ILLNESS 4 I. Ancient Times 4 II. Period of Enlightenment and Creation of Mental Institutions 5 III. Sigmund Freud and Treatment of Mental Disorders 5 IV. Psychopharmacology Period (Development of Psychopharmacology) 5 V. Deinstitutionalization Period (Move toward Community Mental Health) 5 MENTAL ILLNESS IN THE 21ST CENTURY 5 PSYCHIATRIC NURSING PRACTICE 6 HISTORY AND TRENDS OF PSYCHIATRIC MENTAL HEALTH ILLNESS in PREHISTORIC ERA 7 Neurobiologic Theories 7 Psychiatric Foundation 8 NEURO 9 CENTRAL NERVOUS SYSTEM (CNS) 9 PERIPHERAL NERVOUS SYSTEM 10 Neurotransmitters 10 BRAIN IMAGING TECHNIQUES 11 Limitations of Brain Imaging Techniques 11 NEUROLOGIC CAUSES OF MENTAL ILLNESS 12 Psychosocial Theories (Chapter 3) 12 Psychosocial Theories 12 Theoretical Foundations 13 Psychosocial Theories: Therapeutic models and its relevance to nursing practice 17 Lazarus Interactional Model 18 STRESS, DEFENSE MECHANISM AND CRISIS INTERVENTION 19 ANXIETY, ANXIETY DISORDER, & STRESS 19 STRESS 19 ANXIETY 20 CONFLICT 22 DEFENSE MECHANISMS 22 GRIEF 23 CRISIS THEORY & INTERVENTION 24 CRISIS 24 BASIC NURSING INTERVENTIONS FOR 24 TYPES OF DELUSIONS 25 UNUSUAL SPEECH PATTERNS OF CLIENTS WITH SCHIZOPHRENIA 25 TYPES OF HALLUCINATIONS 25 CHN: MENTAL HEALTH GLOBAL ACTION PROGRAM (MHGAP) 25 R.A 11036: Philippine Mental Health Act of 2018 26 MENTAL HEALTH GAP ACTION PROGRAM (mhGAP) 27

NCM 117 LEC PRELIMS by TONS and MADS MENTAL HEALTH AND THE PHILIPPINES Mental health conditions ❖ increasing worldwide and 14% of the total global burden is due to untreated versions of these. ❖ 20%: estimated percentage of the world's children and adolescents that have a mental health condition, causing 1 in 5 years LWD. ❖ 14% (out of 1.4 M Filipinos): According to a 2010 census, these were the amount of Filipinos who identified to have a disability due to a mental disorder. ❖ Trend of the suicide rates in the Philippines from 1984 to 2005: Increased (0.23 to 3.59 per 100,000 in males and 0.12 to 1.09 per 100,000 in females) ❖ Six disorders which has been included in the 2017 global burden of disease study (S, B, MD, E, AU, DU) ➢ Schizophrenia (0.2%) ➢ Bipolar disorder (0.5%) ➢ Major depressive disorder (1.1%) ➢ Epilepsy (0.4%) ➢ Alcohol use disorders (0.9%) ➢ Drug use disorders (0.7%) COVID-19 pandemic ❖ After the declaration of this, there was a dramatic increase in the prevalence of mental health problems both nationally and internationally. ❖ Patients and healthcare workers = psychological effects ❖ Negative emotions and psychological distress - general population: These are how patients, healthcare workers, and the general population were affected by the pandemic 1. True or False: While human resources for health (HRH) are few, they are distributed around the Philippines. a. False (HRH in the mental health specialty is very few and most are employed in Metro Manila. Most provinces even have no access to a psychiatrist.) b. Examples of human resources for mental health: Psychiatrists, psychiatric nurses, psychologists, trained health providers in mhGAP, and trained staff on MHPSS disaster preparedness 2. True or False: Specialized care is mainly offered by private provider and in tertiary health institutions. There are only 2 government-owned psychiatric hospitals, 46 psychiatric inpatient units, and 29 outpatient mental health facilities nationwide. The scarcity of health facilities offering specialized mental health care leads to a gap in the availability of mental health specialists in provinces to offer mental health at secondary health institutions and those who are capable of supervising the integration of mental health services in the primacy care setting. 3. True or False: Informed consent is waived in instances when the client is accompanied by caregivers such as family members during the course of treatment. This can be attributed to Filipinos having close-knit families who render care to members with physical and psychological illnesses. Republic Act. no. 11036 (Philippine Mental Health Act) ❖ This republic act seeks to develop and establish access to comprehensive and integrated mental health services, responsive to the needs of the clients. The majority of mental health services are provided in hospital settings. ❖ This legislation seeks to establish a national mental health policy which will enhance the delivery of integrated mental health services while promoting and protecting the rights of individuals accessing mental health services. ❖ Under its provisions, it commits to promoting the mental well-being of individuals and allows for persons affected by mental health conditions to exercise the full range of human rights (i.e.; informed patient consent for treatment) and participate fully in society free from stigmatization and discrimination. ❖ It also incorporates the rights of patient relatives and/or guardians and the provision of psychosocial support to concerned individuals as required. It further recognizes the role of mental health professionals (medical doctor, psychologist, nurse, social worker, or any other appropriately-trained and qualified person with specific skills in mental health service provision) ❖ Philippine Council for Mental Health (PCMH) ➢ Under the mental health act or RA 11036, this is established as a policy-making advisory body chaired by the DOH and composed of other government agencies such as the Departments of Education, Labor and Employment, Interior and Local Government, the Commissions on Human Rights (CHR), and Higher Education (CHED) ❖ National Mental Health Program ➢ In the mid 1990s, this was institutionalized to integrate mental health services in community settings through trainings of municipal health doctors and nurses on the identification and management of psychiatric morbidities and psychosocial problems. Though there are mental health services offered in the community, these services are known to be underdeveloped and lack the resources needed for its full implementation and evaluation. DOH Administrative Order No. 8 series of 2001, followed by DOH Administrative Order No. 2016- 0039 Revised Operational Framework for a Comprehensive National Mental Health Program ❖ These were the first few mental health policies. During this period, there was still no singular mental health legislation, and the laws concerning mental health services are governed by different laws such as the Revised Penal Code. ❖ Health budget is largely allocated to mental hospitals and payment for health care is mostly from an out-of-pocket basis by service users- This is how the health budget is allocated in the Philippines and how it affects the general population ❖ Professional accountability, unconditional respect, wholistic health, quality practice milieu, respect for autonomy, protecting against discrimination - These are core values that mental health nurses are obliged to exercise (PA, UR, WH, QPM, PAD, R for A) ❖ Informed consent and supported decision-making - These are included to be core principles of RA 11036 aside from defining mental illness and establishing an integrative mental health system ❖ Informed consent - The act provides for this which refers to consent voluntarily given by a service user to a plan for treatment. This necessitates this from the client before receiving treatment or care, including the right to withdraw such consent. 2