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Mental Health


What is the definition of 'mental health'?	The capacity of individuals and groups to interact with one another and their environment in ways that promote wellbeing, optimal development and use of mental abilities to achieve individual and collective goals consistent with justice.
What is the 'Recovery Model of Care'?	it includes notions of hope, optimism, an individuals strengths and wellness. it describes less about absence of symptoms. It is a process rather than an outcome.
What is a mental illness?	A mental illness encompasses the vast spectrum of cognitive, emotional and behavioural disorders that interfere with social and emotional wellbeing, and consequently the lives of people.
What is intrapersonal communication ?	communicating with oneself
what is dyadic communication?	two persons interacting. It is the most common form of communication.
what is small group communication ?	participating with other members
What is public communication?	group becomes too large for all members to contribute
What is mass communication?	messages that are transmitted to large audiences . There is no personal contact between sender and receiver
What is effective communication?	- able to choose their actions from a range of behaviours. - necessary to know what skills work best in a certain situation. - choosing the best way to send a message.
What must we consider when deciding how to respond to a message	1. the context 2. the goal. 3. the other person
What is the National Mental Health Strategy	it was implemented in 1992 by the Australian Health Ministers. It recognised the impact of mental health problems had on the individual, families, communities and the health system
What were the priorities of the National Mental Health Strategy ?	1. services should be provided in an interdisciplinary manner to achieve good outcomes. 2. people have potential for growth & right to opportunities. 3. priority should be given to those with severe problems. 4. have the justifiable right to protection.
What is therapeutic communication?	the face-to-face process of interacting that focuses on advancing the physical and emotional well-being of a patient.
what are the characteristics of therapeutic communication?	1. open mindedness 2. empathy 3. authenticity 4. self awareness 5. non judgemental
why should we use therapeutic communication?	it improves patient satisfaction, positive clinical outcomes, more likely to accept treatment
What are some reasons for not using therapeutic communication	1. limited time 2. lack of knowledge and education 3. patient may get upset
How can we strengthen our skills in therapeutic communication?	1. imagine being the patient 2. view through a third eye 3. understand the patient history and background 4. participate in clinical supervision
How can we maximise therapeutic communication ?	1. active listening 2. stay silent 3. establishing guidelines 4. open ended questions
what are the 5 steps for achieving self mindfulness?	1. look after yourself 2. make time to be social 3. strengthen commitment to personal growth 4. have a quiet space 5. regularly examine motivation to providing patient centred therapeutic care
What is a therapeutic encounter ?	A relationship that is developed for the sole purpose to benefit the patient
what are the patients rights in a therapeutic encounter ?	1. expect a thorough examination 2. informed about their health 3. questions answered honestly 4. up to date treatment 5. confidentiality 6. receive consistent care
What is responsible communication ?	we as paramedics are liable to be called in to answer for our own conduct and obligations.
what steps must be taken to solve problems in. therapeutic relationship ?	1. Assess 2. Diagnose 3. Plan 4. Implement 5. Evaluate
What are some characteristics of a paramedic that communicates responsibly ?	focuses on the problem, considers the position of the family, becomes a patient advocate, is open to learning trust intuition, maintains a sense of wonder of the human experience
what makes up responsible communication?	communicate in a logical way + knowledge of a condition + facts encountered = responsible communication
What is Patient Centred Care?	Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions =.
How is PCC beneficial for a patient ?	open mindedness, ethical, self aware, sense of responsibility for their actions
what are some qualities of PCC clinicians	appreciates peoples distinct history, seeks to understand the patients history, aims to involve and inform the patient, promotes active involvement, shares treatment decisions
What is a story catcher ?	a practitioner at the heart of language. Someone who listens and understands what the patient is saying, and is able to relate with empathy.
Why is it important to listen to a patents story ?	to understand their point of view, to access self care knowledge, able to learn what is important to them, allows us to create a care plan that is best suited to them.
what does it mean to listen?	use open body language, make eye contact, pay attention, don't interrupt
What is non-verbal communication?	communication without the use of spoken language.
What is true presence ?	Bear witness to the patient experience, understand their perspective, respect their dignity, and right's to self determination.
How can we achieve true presence ?	It is at the core of pcc. Building skills in communication in the relationship helps build meaning in moments of connection. Clarify own expectations, responsibilities, and opportunities.
What are consequentialist ethics?	maximum overall happiness results as a consequence from certain actions
What are Deontological Ethics?	An actions is ethical if it is guided by a set of universal moral rules
What are Virtue Ethics ?	An action is ethical if it is motivated by virtue.
What are the four principles of bioethics ?	1. non-malifience 2. autonomy 3. justice 4. beneficence
What are some common misunderstandings in ethics ?	1. acting ethically means just helping people 2. " following the law 3. is only something to worry about in difficult cases 4. is about avoiding moral dilemmas 5. is relative
What is a paramedics code of conduct ?	respect, integrity, confidentiality, responsibility, competence, consent, research, ethical review
How should you act in an ethical dilemma ?	1. use the bioethics principles 2. use professional code of conduct 3. an argument for an alternate course of actions 4. legal regulations
What is consent ?	to agree to something
What are the forms of consent ?	implied, verbal, written
What is implied consent ?	Most common form. Patient indicates via act or gesture that they have no objection to the treatment or procedure being proposed.
What is verbal consent ?	following a conversation with ash patient. The patient agrees to what the paramedic suggests
What is written consent ?	Used for a procedure that is invasive or carries considerable risk
What are the requirements for consent to be valid?	1. must be voluntary 2. patient has been provided with sufficient information 3. consent covers treatment that has to be provided 4. patient has the capacity to make the decision
What is the assessment of capacity ?	1. the patient is able to take in, and understand the treatment information 2. patient believes the information 3. able to weigh up risks and benefits
what is the best way to ensure a patient has capacity ?	ask then to recite the treatment information in their own words
What is refusal of treatment?	every adult has the right to refuse treatment. The right is not limited to decisions that others may regard as sensible or even rational.
Decision making capacity	is central in cases involving patient initiated refusal of treatment. The patient myst clarify with the patient what exactly they are refusing and why, whether that applies to changing circumstances.
What is the presumption of capacity?	every individual has the ability to make decisions, unless it can be shown that the patient does not understand the information
What are some factors that reduce capacity?	chronic or debilitating illnesses, severe intellectual disabilities, or a serious Brian injury. It may also be temporarily deprived from intoxication.
What is wellbeing ?	a multidimensional concept evolving every part of a person. It includes, emotional, spiritual, intellectual and psychical.
What are some short term effects of stress?	increased adrenaline, sympathetic nervous system activates
What are some long term effects of stress?	increased cortisol levels, remodelling of cardiac and vascular tissue, sleep disorders, chronic pain, depression
What is acute stress?	happens straight away and the stress doesn't last longer than a few weeks.
What is chronic stress?	6 + months of having stress
why do we perform a MSE ?	history, signs and symptoms, and analysing what is going on. Allows us to guide the patient to where they need to be. Specific standard of examination to ensure continuity of care.
What are the domains to an MSE	appearance, behaviour, mood, affect, speech, cognition, judgement, insight, thoughts, perception.
What is a MSE?	a systematic appraisal of the appearance, behaviour, mental functioning and overall demeanour of a person.
What is the biopsychosocial Model?	Suggests that illness is a result of a complex interplay of psychological, social and biological factors each of which need to be factored into our assessment and treatment of our patient.
What are the advantages of a Biopsychosocial Model?	takes into account a greater range of individual variation, ensures that important factors in health status are not missed during assessment, uses a combination of social, physiological, physical treatments.
What are some de-escalation techniques?	respect, positive strategies, listen to their story, offer voluntary anxiolytics, remove from situation
What are the key principles in the use of restraints?	1. protections of fundamental human rights 2. protection against inhumane treatment 3. right to highest attainable standards of care 4. right to medical examination 5. documentation and notification 6. right to review mechanism
What is seclusion?	the deliberate confinement of involuntary patient.
What are some mechanical restraint devices?	belts, harness, sheets, straps, mittens
What is depression ?	a situation where a person feels low and can last for weeks to years. can be caused by a situation and can occur for no apparent reason. Depression is more than a low mood, its a serious condition that affect your physical as well as mental health
What causes depression	result of recent events combined with other long term personal factors, as opposed to one immediate recent issue or event.
what are some biological factors for developing depression?	Genetic factors have a lot to do with the way the neurotransmitter, serotonin is balanced in the brain. Serotonin plays a fundamental role in regulating vital biological functions such as quality of sleep, concentration, memory, and appetite
What are some psychological factors for developing depression?	An increased risk of getting depression can also be a result of a history of having too many negative life events, or prolonged stress. Another reason for depression is prolonged mental and physical abuse as a child.
what are some social factors for developing depression?	experiencing traumatic situations, early separation, lack of social support, or harassment can cause people to be depressed. Sometimes people are not equipped with the information that is needed to cope with these emotionally difficult time and people be
common depression behaviours	less social, not getting work done, withdrawing from friends and family, unable to concentrate
common depression feelings	overwhelmed, guilty, irritable, frustrated, lacking in confidence, unhappy, indecisive, disappointed, miserable, sad
common depression thoughts	"I am a failure" "it is my fault" "Nothing good ever happens to me" "I am worthless" "life is not worth living" "people would be better off without me
common depression physical effects	tired, sick and run down, headaches and muscle pains, sleep problems, loss of appetite, weight loss or gain
what are some different types of depression?	major depression, melancholia, psychotic depression, antenatal and postnatal depression, bipolar disorder, dysthymia disorder, seasonal affective disorder
what are some depression specific questions ?	how have you been feeling? what has your mood been like? have you been feeling low? have you lost interest in stuff you used to enjoy? how have you been sleeping?
What is anxiety?	common response to a situation where we feel under pressure, they usually pass once the stressful situation has passed or removed.
Anxiety trends	1 in 4 people in Australia experience anxiety
What is generalised anxiety disorder?	feel anxious and worried most of the time, not just in specific stressful situations, and these worries are intense and interfere with their daily lives. Their worries relate to several aspects of everyday life, including work, health, family etc.
what is social phobia ?	performing in front of others and social situations can lead to intense anxiety. They may fear being judged, criticised, or laughed at in front of others.
What is specific phobia?	react to objects, activities, or situations by imagining irrationally exaggerating the danger. Feelings of panic, fear or terror are completely out of proportion to the actual threat. These types of reactions may be indicative of a specific phobia.
What is obsessive compulsive disorder?	People with OCD often feel intense shame about their need to carry out these compulsions. These feelings of shame can exacerbate the problem and the shame, and consequent secrecy associated with OCD can lead to a delay in diagnosis and treatment.
What is post traumatic stress disorder?	particular set of reactions that can develop in people who have been through traumatic event which threatened their life or safety, or others around them.
What is panic disorder?	Panic disorder can be characterised by: The presence of recurring and unexpected panic attacks, Worrying for at least a month after having a panic attack with the fear of having another
What is cognitive behaviour therapy?	involves working with a professional to identify thought and behaviour patterns that are either making you more likely to become depressed or stopping you from getting better when you're experiencing depression.
What is interpersonal Therapy ?	helps you recognise patterns in your relationships that make you more vulnerable to depression. Identifying these patterns means you can focus on improving relationships, coping with grief and finding new ways to get along with others.
What is behaviour therapy?	focuses on encouraging activities that are rewarding, pleasant or satisfying, aiming to reverse the patterns of avoidance, withdrawal and inactivity that make depression worse.
What is mindfulness-based cognitive therapy ?	teaches you to focus on the present moment - just noticing whatever you're experiencing, whether it is pleasant or unpleasant - without trying to change it. It started with physical sensations, but then moves on to emotions and thoughts
What is self-harm?	Is the deliberate act of inflicting pain or injury by cutting or some other form of self-mutilation. This may seem completely foreign to some people. But 80% of young people self harm.
What is suicide?	Suicide is the act of taking one's own life.
What are some risk factors that contribute to suicide ?	previous attempts, substance abuse, family history, poor job satisfaction, socially isolated
What are the groups that are more at risk of suicide?	males, over 45, rural and remote, indigenous, youth, lgbti.
What are some suicide screening questions?	have things been so bad that you thought it would be better not to be here? Have you thought of hurting yourself? Have you tried to harm yourself? Have you made any plans?
what is a psychiatric patient assessment?	1. history of presenting illness 2. symptoms 3. precipitating events 4. risk of harm 5. past history 6. family history 7. social history 8. premorbid personality 9. MSE
what is a provisional diagnosis ?	a temporary diagnosis until more information regarding the illness is retrieved.
what is bipolar disorder?	cycling moods between elevated and depressed. There are two types of bipolar disorder.
what are the two types of bipolar disorder?	bipolar 1 & bipolar 2
What is bipolar 1?	refers to people who have experienced at least one manic episode, though many will have experienced more than one and also have experienced epodes of depression
what is bipolar 2 ?	people who have experience episodes of hypomania and depression at least 4 times a year.
What are some symptoms of mania?	elevated mood, irritability, increased energy, flight of ideas, rapid speech, enhanced libido, impaired judgement
what causes mania?	genetics and family history. Neurotransmitters imbalances in brain chemicals as well as stressful events can also trigger the disorder.
What is psychosis ?	a state of loss of reality and includes hallucination, delusions, or thought disorder. Psychosis can refer to a single event.
What is a psychotic episode?	a temporary event of psychosis
wht are some types of psychosis?	1. schizophrenia 2. schizoaffective disorder 3. substance induced psychosis
what is schizophrenia ?	a spilt between dream state and reality
what are the different types of schizophrenia ?	1. paranoid 2. undifferentiated 3. catatonic 4. disorganised
what is paranoid schizophrenia ?	Inc. delusions, hallucinations but no prominent negative or disorganised symptoms.
what is disorganised schizophrenia ?	disturbance of affect, and thoughts stream. symptoms include, delusions, hallucinations, disorganised thoughts, and behaviour.
what is catatonic schizophrenia?	extreme negativism, maintenance and fixed posture. They have prominent motor disturbances.
What are positive symptoms?	those that are in excess of common or ordinary experiences.
What is a negative symptoms ?	Those that take away or suggest a deficit in relation to common or ordinary experiences.
what are hallucination?	false sensory perceptions that arise without external stimulus
What are the types of hallucinations ?	Auditory - hearing, Visual - seeing, Tactile - feeling, gustatory - tasting, olfactory - smelling
What are delusions>	A false and firmly held belief that the person believes despite no evidence.
what are bizarre delusions?	the beliefs are implausible
what are non bizarre delusions?	involves a belief that on a balance of probability, it could occur
what are some hallucination specific questions?	who are you talking to? can you hear/see them? what are they saying? do they know if it is real? Have you used any drugs?
What are some schizophrenia specific questions?	when were you diagnosed? are you on medication? Do they hear/see things? are they likely to self harm?
what are some common conditions for elderly?	dementia, delirium
what is dementia?	syndrome of acquired, chronic cognitive impairment occurring in clear consciousness, sufficient to interfere with social and occupational functioning and characterised by impairment in at least 2 cognitive doma
what are the types of dementia?	1. alzheimers, 2. vasular dementia, 3. dementia and levy bodies, 4. mixed dementia
what are some symptoms of dementia?	irritability, depressed mood, wandering, delusions, anxiety, hallucinations, personality change
what is delirium?	an acute decline in cognition and attention
what are some causes of delirium?	medications, infections, illness, substance abuse
what is the management of delirium ?	eliminate all possible causes including, hypoxia, hypotension, hypoglycaemia
what are the most common disorders experienced by adolescence ?	depression, anxiety, eating disorders
what are some factors that influence the development of mental illness?	intelligence, family environment, maltreatment, parental ill health, chronic illness
what is anorexia nervosa ?	significant disturbance in the perception of the shape or size of the body, Refusal to maintain a minimally normal body weight, Irrational fear of gaining weigh
what is bulimia nervosa?	re-occurrence of uncontrolled periods of binge-eating,followed by behaviors designed to compensate for the binge.
what is depressive disorder?	experienced by adolescents which is a major depressive disorder characterised by one or more major episodes of depression.
what is conduct disorder?	children presenting with antisocial behaviour in the following areas; aggression to people or animals, destruction of property, theft
what is substance abuse?	the continued use of a substance despite negative consequences
what are the criteria for substance abuse?	1. maladaptive pattern of substance use leading to distress 2. they have never met the criteria for substance dependance
what is serotonin syndrome ?	a drug induced syndrome, that is characterised by mental, autonomic and neuromuscular changes.
what are some issues that impact the mental health care for indigenous people ?	1. geographic isolation 2. lack of culturally aware services 3. lack of indigenous staff 4. stigma and stereotyping

Created by: sophielass

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