Mental Health Overview

Mental Health

• Mental health includes emotional, psychological, and social well-being.
• Mental disorders are characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships.

Mental Health Professionals

• Psychiatrist: a medical doctor who treats mental, emotional, and behavioral disorders using medication and psychotherapy.
• Psychologist: possesses a doctoral degree in psychology and treats emotional and social abnormalities with psychotherapy.
• Social workers, counselors, and therapists: assist in diagnosis, provide counseling, and enhance overall wellbeing.

Types of Psychiatric Treatment

• Psychotherapy: cognitive therapy, behavioral therapy, and others.
• Cognitive therapy: helps patients identify and correct distorted, maladaptive beliefs.
• Behavioral therapy: uses thought exercises or experiences to facilitate symptom reduction.
• Drug therapy.
• Brain stimulation therapy: electroconvulsive therapy (ECT) uses an electric current to produce a cerebral seizure under anesthesia.

Voluntary and Involuntary Admission

• Voluntary admission: a patient admits themselves or is admitted by their guardian with their agreement.
• Consent must be in writing and signed, or verbal and witnessed and put in writing by someone not treating the patient at the time.
• Involuntary admission: a patient is admitted by a court order to a psychiatric hospital or unit, often due to being a danger to themselves or others, or unable to care for themselves.

Seclusion and Restraints

• Seclusion: to keep a patient from hurting others or causing substantial property damage.
• Physical restraints: to keep a patient from physically hurting themselves or others, or causing substantial property damage.

Suicide

• Suicidal ideation: thoughts about killing oneself, might include a plan.
• Suicide attempt: self-injury trying to kill oneself, but the patient does not die.
• Suicide: self-injury trying to kill oneself, resulting in death.
• Suicide threat: saying they want to hurt themselves despite no intention of dying.
• Suicide gesture: hurting themselves to make others think they want to die, despite no intention of dying.
• Nonsuicidal self-injurious thoughts: thoughts of self-harming without wanting to die.
• Nonsuicidal self-injury: self-harming without wanting to die.

Management of Suicide

• Medical stabilization for attempted suicide patients +/- hospitalization.
• Managing underlying factors and psychiatric disorders.

Personality Disorders

• Personality: patterns of perceiving, relating to, and thinking about the environment and oneself.
• Personality disorder: personality traits are inflexible and maladaptive across a wide range of situations, leading to significant distress and impairment of functioning.

Prevalence and Clusters

• Antisocial personality disorder is more common in males.
• Borderline, histrionic, and dependent personality disorders are more common in females.
• Clusters:
  • Cluster A: withdrawn, cold, suspicious, or irrational (paranoid, schizoid, schizotypal).
  • Cluster B: theatrical, emotional, and attention-seeking (antisocial, borderline, histrionic, narcissistic).
  • Cluster C: anxious and tense (avoidant, dependent, obsessive-compulsive).

DSM-5 Criteria for Personality Disorders

• Inflexible and pervasive pattern across a range of situations.
• Not a result of drugs or another psychological disorder.
• If criteria are met prior to the onset of schizophrenia, it is considered schizoid personality disorder (premorbid).
• Causes significant distress or negative consequences.
• Seen in 2+: cognition, affectivity, interpersonal functioning, impulse control.