Mental Health and Wellbeing

Mental Health

• Mental health is an essential part of one's total health, more than just the absence of mental disabilities or disorders.
• According to WHO (2014), mental health is "a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community."
• A healthy mental status is necessary for:
  • Thinking clearly
  • Responding appropriately
  • Functioning effectively in all ADLs (Activities of Daily Living)
• Factors affecting mental health:
  • Economic and social factors (e.g. rapid changes, stressful work conditions, isolation)
  • Unhealthy lifestyle choices
  • Exposure to violence
  • Personality factors (e.g. poor decision-making skills, low self-concept)
  • Changes or impairments in the neurologic system
  • Psychological development level and issues
• Mental disorders can cause significant distress or impaired functioning, leading to:
  • Dissatisfaction with self, relationships, and ineffective coping
  • Feeling overwhelmed or hopeless

Mental Status Assessment

• Use the mnemonic "BATOMI" to assess mental status:
  • Behavior
  • Appearance and Affect
  • Thought
  • Orientation
  • Memory and Motivation
  • Insight and Intellect
• Observe:
  • Eye contact
  • Body language
  • Personal space
  • Motor activity (e.g. tremors, tics)
  • Goal direction (e.g. purposeful, bizarre)
  • Gait
  • Gestures or mannerisms
• Note:
  • Scars, tattoos, skin texture
  • Distinctive hairstyle or color
  • Clothes: style, appropriateness
  • Grooming: cleanliness
  • Height, weight, body shape
  • Mobility
  • Estimated age vs. actual age

Thought Process and Speech

• Affect: observable behavior representing emotional expression
  • Constricted, blunted, flat, inappropriate, or labile
• Mood: subjective feeling of emotion coloring perception of the world
  • Depression, anger, anxiety, dysphoric, elevated, euthymic, expansive, or irritable
• Speech:
  • Tone of voice (e.g. monotone)
  • Flow and rate of speech (e.g. rapid, slow, staccato)
  • Volume (e.g. softly spoken)
  • Clarity (e.g. pressured)
  • Defects (e.g. stammering, stuttering)

Delusions and Hallucinations

• Delusions:
  • Grandiose
  • Paranoid
  • Persecutory
  • Somatic
  • Nihilistic
  • Bizarre
  • Poverty
  • Ideas of reference
  • Illusions
• Hallucinations:
  • Auditory
  • Visual
  • Tactile
  • Olfactory
  • Gustatory

Cognitive Functioning

• Orientation:
  • Person
  • Time
  • Place
  • Situation
• Memory:
  • Immediate
  • Short-term
  • Long-term
• Attention:
  • Concentration
  • Simple calculations
  • Abstract/concrete thinking
• Comprehension:
  • Understanding of current situation
  • Self-awareness
  • Ability to think things through
  • General knowledge

Development and Growth

• Growth:
  • Increase in size or mass of tissue
  • Change in size, proportion, disappearance of old features, and acquisition of new ones
  • Refers to physical changes
  • Can be quantified
• Development:
  • Refers to overall changes in the individual
  • Implies maturation of functions
  • Related to maturation and myelination of the nervous system
  • Acquisition of skills for optimal functioning
• Growth vs. Development:
  • Growth is a part of the developmental process
  • Growth stops when maturity is attained, while development continues throughout life
  • Growth involves bodily changes, while development involves changes in the quality or character of the individual

Theories of Development

• Erik Erikson's Stages of Psychosocial Development
• Jean Piaget's Stages of Cognitive Development
• Lawrence Kohlberg's Theory of Moral Development