Medical Nursing Notes Mental Health and Mental Illness

Chapter 1: Mental Health and Mental Illness
1. Describe the nature of mental health and mental illness.

Mental health can be viewed as a “state of well-being in which the individual realizes
his or her own abilities, can cope with the normal stresses of life, can work productively
and fruitfully, and is able to make a contribution to his or her community.” Mental
health encompasses a balance between our physical, mental and social well-being. It
impacts the way we see our surroundings, how we think and the decisions we make.
Further evidence of mental health is seen in our ability to function well alone or with
others, to make sound judgements and accept responsibility for the outcomes, to love
and be loved, and to respond with humor when life gets tough.
The definition of Mental Illness is complicated because of various views and in-
terpretations. It can be best understood according to DSM- 5 as a “clinically sig-
nificant disturbance in an individual’s cognition, emotion regulation, or behavior that
reflects a dysfunction in the psychological, biological, or developmental processes un-
derlying mental functioning.” Whatever the cause, the disorder is usually associated
with a “significant impact on the social, occupational, or other activities” in the life of
the individual.
2. Define mental health nursing as it relates to human behavior.

Our behavior is the result of our perceptions and thought process related to a particular
behavior. The discomfort experienced in the mind, sets in motion the behavioral pat-
terns characteristic of the various mental disorders. Mental health nursing helps us to
achieve balance to the ups and downs of every day life. It uses theories of human be-
havior as its scientific framework and requires the use of the self as it’s art or expres-
sion in nursing practice. Each individual will respond in different ways based on condi-
tioning, cultural influence and mental resouces available.
3. Describe how culture, ethnicity, and religion influence the perception of

mental health and mental illness.
Factors related to the group to which one belongs also affects how people relate to one
another. Behavior often mirrors that of the group and may be altered as cultural
changes occur within the group. With all of these differences among cultures, it is not
surprising that variances can be seen among them in the manner in which they
perceive, cope with, and manage mental health issues. Although seeking professional
care for mental illness might be met by many families, the stigma and shame created by
a mental illness can lead some families to hide and deal with the affected person in
their own ways, such as seeking help from religious or faith healers within the cultural
group rather than professional providers. Some may respond outwardly to life
situations, others may be discouraged from visibly showing emotional and mental
problems. or simply deny that a problem exsist.
4. Define stress and its relationship to anxiety.

Stress is defined as the condition that results when a threat or challenge to one’s well-
being requires the person to adjust or adapt to the environment. According to Hans
Selye (well known researcher), there are 2 kinds of stress. Distress; in response to a
threat or challenge is harmful to one’s health. This is negative stress and demands an
exhausting type of energy. Eustress, on the other hand is positive and motivating, as
shown by one’s confidence in the ability to master a challenge or stressor. This type of
stress may actually enhance the feeling of well-being.
Stress is further defined in terms of acute or chronic stress. Acute Stress constitutes the
reaction to an immediate threat (fight or flight response), and usually happens when
there is a sense of imminent danger. The response is usually reversed to a relaxation
mode once the danger is past. Chronic Stress occurs when the situation is ongoing of
continuous, such as a chronic illness of a family member or job related responsibilities.
Anxiety is an automatic and unconscious biological response to a stressor that cannot

be controlled by our conscious minds. It is such a natural occurrence that it is
impossible to avoid. It is a build-in part of our instinctive response to an event that is a
threat to our well-being
5. Identify factors that contribute to stress and anxiety.

External stressors; Environmental aspects-; abusive relationships, poverty level living
Internal Stressors; Physical aspects-; chronic or terminal illness
Psychological aspects-; worry of financial burdens or unlikely disaster
6. Differentiate between adaptive and maladaptive coping strategies.

Adaptive coping is when a person uses a rational and productive way of resolving a
problem to reduce anxiety. Pallitive coping is when the solution temporarily relieves
the anxiety but the problem still exsist and has to be revisited.
Maladaptive coping is when unsuccessful attempts are made to decrease the anxiety
without attempting to solve the problem; and the anxiety remains.
7. Define grief as a process.

Grief is defined as the emotional process of coping with a loss. In a broader sense, the
reality of the loss can be applied to the absence of anything that is significant or
meaningful to our exsistence, such as divorce, loss of body part, threat to one’s health,
loss of job or source of income and or losses that result from a natural or imposed
disaster.
The grieving process describes a series of occurences in the resolution of loss. This
process provides support as an individual works through the feeling of anger,
hoplessness and futility that accompany the loss. It provides time to put things into
perspective, to place into memory that which is gone, and to emerge with a newly
developed embraced of life.
8. Identify factors that may contribute to dysfunctional grief.

-Socially unacceptable death
-Multiple losses or loss in succession
-Ambivalent feeling toward the lss of a person or objects
-Unresolved grieving from a previous loss
-Guilt with regard to circumstances at or near the time of death
-Feelings of the survivor that he or she should have died with or instead of the deceased
-Consuming feelings of worthlessness with suicidal tendencies
-Physiological response to the loss with marked decreased in functioning
-Delusional thinking or hullucinations of seeing the image or hearing the voice of the
deceased.
9. Discuss ways to assist individuals to cope with the grieving process.

To deal effectively with the client experiencing grief, the nurse must face the reality of
his or her own mortality and concept of death. The nurse needs to respect and attempt
to understand the importance of grieving for oneself and for others.
-Avoid using clichés, they reduce the genuineness of the support efforts
-Use open ended statements (can you tell me what happened), to determine at which
stage of the grieving process the client is at.
-Use leading statements to determine guilt, ambivalent feelings, anger, helpnessness
etc
-Use interventions that encourage clients to be open and honest about their feelings
-Encourage the client to journal their feelings or write letters to the deceased.
-Referr to a grief support group for additional help

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Chapter 1: Mental Health and Mental Illness

1. Describe the nature of mental health and mental illness.

2. Define mental health nursing as it relates to human behavior.

3. Describe how culture, ethnicity, and religion influence the perception of

4. Define stress and its relationship to anxiety.

Anxiety is an automatic and unconscious biological response to a stressor that cannot

5. Identify factors that contribute to stress and anxiety.

6. Differentiate between adaptive and maladaptive coping strategies.

7. Define grief as a process.

8. Identify factors that may contribute to dysfunctional grief.

9. Discuss ways to assist individuals to cope with the grieving process.

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