Mental Health and Florida's Baker Act

Mental Health and Illness

• Mental health is a state of well-being where individuals cope with life stressors, work productively, and contribute to society.
• Stress accounts for a significant percentage of physician visits.
• Mental illness is characterized by dysregulation of mood, thought, or behavior, impacting 1 in 5 adults annually.
• Suicide is a leading cause of death in adolescents.
• Environmental, cultural, and genetic factors contribute to mental illness.
• Physical health issues, hormonal changes, medication reactions, substance abuse, diet, and stress are all potential causes.

Florida's Baker Act

• The Baker Act (1971) provides for voluntary and involuntary admissions for mental health crises.
• Involuntary admissions are allowed when a person is a danger to themselves or others, and refuses a voluntary exam.
• This Act regulates crisis stabilization units (CSUs) and short-term residential care (SRTs).
• Patients are monitored for 72 hours, with an average stay of 4.5 days.

History of Psychiatric Hospitals and Treatment

• Early treatments included restraints, strong drugs, and unusual procedures like plunge baths/shock therapy and bloodletting.
• Dorothea Dix championed the establishment of state hospitals.
• Nellie Bly conducted undercover research on treatments at hospitals in the late 1800s.
• Compulsory sterilization and lobotomies were practiced.
• The 1960s saw the Community Mental Health Center Act, reducing state hospital numbers significantly, along with the introduction of antipsychotics.
• Subsequent legislation and acts have addressed funding cuts and efforts to deinstitutionalize care.
• Thorazine, the first antipsychotic, significantly improved patient care in the 1950s

Restraints and Triggers

• Physical restraints and chemical restraints are used.
• Physical restraints require continuous monitoring and assessment, and release as soon as possible.
• Chemical restraints include Haldol & Ativan.
• Triggers that cause distress or agitation can be internal (e.g., feeling isolated) or external (e.g., room checks).
• Early warning signs of distress are important to notice.

Therapeutic Communication

• Therapeutic communication is crucial in patient care
• Communication must be clear, concise, accurate and complete.
• Active listening, paraphrasing, and reflecting are key techniques for effective communication.
• Empathy and genuine interest are paramount.
• Understanding the patient's perspective is important for therapeutic communication.
• Nonverbal communication often conveys information just as important as verbal.
• Maintaining appropriate professional boundaries is crucial to the therapeutic relationship.

Social Determinants of Mental Health

• Social determinants of health significantly impact mental health outcomes.
• Factors like income, employment, housing, and social support systems all affect a person's mental health.
• Homelessness has significant correlations with mental health challenges.

Mental Status Examination (MSE)

• The Mental Status Exam (MSE) is a systematic process used for assessment of a person's mental health.
• Key components include appearance, behavior, speech, thoughts, mood, affect, perceptions, judgment, and level of consciousness.
• Assessments need to be observed and recorded.
• The MSE is crucial in diagnosing, planing, implementing and evaluating care.

Theories of Mental Health

• Various psychological theories, including psychoanalytic, developmental, interpersonal, humanistic, behavioral, and existential theories, provide frameworks for understanding mental health and illness. These theories inform different treatment and therapy options.
• Each theory offers a unique perspective on human behavior and mental processes, with different treatment approaches reflecting their focus.

Complementary and Alternative Therapies

• Complementary and alternative therapies are also potential options in treatment, alongside typical modern methods.

Nursing Process

• This structured approach guides care delivery and includes assessment, diagnosis, planning, implementation, and evaluation steps.
• Assessment involves gathering data through observations, interviews, and records.
• Effective interventions are planned and assessed, leading to positive patient outcomes.

Psychiatric Emergencies and Crisis Intervention

• Psychiatric emergencies may involve severe problems from acute delusions to suicidal thoughts or drug overdoses.
• Crisis intervention may involve 24/7 observation, inpatient admissions, or other degrees of care.
• Coordinated discharge plans for follow-up care are essential.