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community health chapter 11

Created by: Eugenia Rolfson Elite Notetaker

community health chapter 11


Mental health

Emotional and social well-being, including one's psychological resources for dealing with day-to-day problems of life.

Mental disorders

Health conditions characterized by alterations in thinking, mood or behavior (or some combination) associated with distress and/or impaired functioning.


Diagnostic and Statistical Manuel of Mental Disorders, the most influential book in mental health

How cultural differences can affect psychiatric diagnosis

Latinos tend to be more quiet and reserved and this subdued and discouraged demeanor could easily be mistaken for depression if a doctor is not culturally competent.

Major causes of mental disorders

Genetic influences on complex brain functions, physiologic disruptions in hormones, intrauterine infections, malnutrition, maladaptive family functioning, stress, pre-natal exposure to physical, chemical, and biological agents (secondhand cigarette smoke). Brain function impairment can be caused by trauma or disease. Mental impairment can be caused by environmental factors or lead poisoning. Psychological sources include maladaptive family functioning, parent with mental illness, substance abuse, criminality, experiencing violence, physical or sexual abuse, or neglect.

Why is mental health one of the major community health problems in the U.S.?

In 2001 the number two and three leading causes for death in youth ages 1-24 was homicide and suicide which, in young people, is related to a mood disorder. Lots of youth do drugs and alcohol which shows they are unable to deal with the problems of life due to lacking necessary psychological resources.

What is stress and how does it relate to physical and mental health?

Stress is one's psychologic and physiologic response to stressors. It relates to physical and mental health because if someone lives in a chronic state of stress their immune system becomes compromised and they are unable to fight off illnesses or diseases. It affects one's mental health by altering their moods and damaging their relationships and social contexts.

History of mental health care in the U.S.

Colonial America, people with mental issues were cared for by their family or private caretakers. Those "lunatics" who were not cared for by their family became the community's responsibility. In the 1700s institutionalizations first appeared. People with mental illnesses began to be clumped and crammed into hospitals and institutions which quickly became overcrowded. Budget cuts happened and not enough staff was working. Electroconvulsive therapy (ECT) and lobotomy were invented. After WWI the government became more involved in mental health care. The National Institute of Mental Health was established, creating more awareness for mental health support and research. Many patients began to be let out of mental wards, in hopes of giving them a shot at their human rights, and because of the economic push and pull. New antipsychotic drugs were also used and became a main source of treatment. These drugs reduced nervous activity. An emphasis was also placed on the community helping them.


Process of discharging, on a large scale, patients from state mental hospitals to less restrictive community settings. Four forces propelled it forward (1) economics, (2) idealism, (3) legal considerations, (4) development and marketing of antipsychotic drugs. Economically, the states needed to reduce the expenditures for mental hospitals and spend it on education, roads, and welfare. Questions also began being raised about the legality of keeping people locked up, and antipsychotic drugs helped those with mental issues to be able to function more normally.

Movement towards community mental health centers

The report of the joint commission on mental illness and health recommended that acute mental illnesses be treated in a community-based setting. This was seen as secondary prevention, in hopes of preventing the development of more serious illnesses.

Mental and physical problems of the homeless

People who are homeless are more exposed to environmental factors such as extremes in temperature, moisture, burns, crowding, assults, and motor-vehicle related accidents. They also suffer anxiety, and most abuse alcohol and other drugs. Many suffer from substance disorders or major depression.

"Legal leverage" and mental health courts

Legal leverage can be used to compel treatment and special mental health courts. Applied to the patient to accept treatment may involve service providers taking control of the patients disability income and/or suspending the patient's eligibility for subsidized housing.

Primary prevention in relation to mental health care services

Forestall the onset of mental illness. Examples are training in cognitive problem solving to prevent dropping out of school and social support groups for the newly widowed to prevent depression.

Secondary prevention in relation to mental health care services

Reduce prevalence by shortening the duration of episodes. Employee assistance programs, juvenile delinquency diversion programs, and crisis intervention programs are examples.

Tertiary prevention in relation to mental health care services

Ameliorates the illness and prevents further problems. Intensive community treatment programs and psychiatric rehabilitation are two examples.

Three basic approaches to treatment for mental disorders

1.Psychotherapy-involves treatment through verbal communication. Numerous approaches include interpersonal, couple, group, and family. Psychodynamics psychotherapy examines current problems as they relate to earlier experiences. Cognitive-behavioral therapy focuses on how maladaptive feelings and behaviors are the result of distorted thinking and uses structured procedures to promote new thought patterns. 2.Psychopharmacologic therapy- treatment with medication, biological approach that is more "user friendly" than ETC or lobotomy. Based on the recognition that mental illnesses are medical illnesses that can be treated with drugs. Another form is ECT when an alternating electric current passes through the brain to produce unconsciousness and convulsive seizure. Used for serious illnesses, such as major depression or schizophrenia. 3. Psychiatric rehabilitation - focused more on recovery instead of cure. Recovery meaning progressing towards independence, coping with symptoms, being satisfied with life, and being able to exercise the adult rights and privileges that come with community life. There is a strong emphasis on changing the environment through accommodations at work or school. One of the best known methods is the Madison Model also called Assertive Community Treatment (ACT). This delivers intense, individualized services encompassing treatment, rehabilitation, and support over an indefinite period.

Recovery for people in U.S. and less developed countires

Recovery in the U.S. and other developed countries usually means being socially isolated, homeless, or in jail. Mental illnesses are seen, and often stigmatized as someone with a "broken brain." In developing countries, however, mental illnesses are often seen as something brought on by spirits, a stern test from god that a faithful person should graciously accept. People with mental illnesses are often married with kids, and the community surrounds and supports them.

Name: community health chapter 11
Uploaded: 04/26/2016
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