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1. Chapter 21: Community Mental Health
Chapter 21: Community Mental Health ON Chapter 21: Community Mental HealthYou are a
school nurse in a middle school when Jamal comes to the nurse’s office requesting
medication for a headache. You notice that his eyes are red, and it appears as if he has been
crying. You ask if he is hurt, but he denies it. The phone rings in the office, and a teacher tells
you that a female student has approached her concerned about Jamal. The teacher tells you
that Jamal sent her a text message saying that he flunked his biology examination and
wished he was dead.1. If Jamal shared with you a suicide plan that includes harming himself
with a weapon, what would be your first nursing intervention?2. What educational program
would you develop for the middle school to educate students about ways to cope with stress
and how to respond if a friend needs ?Chapter 21: Community Mental
Healthattachment_1Unformatted Attachment PreviewChapter 21: Community Mental
Health Chapter Highlights ? Epidemiology of mental illness from a public health perspective
? Early intervention in the treatment of schizophrenia ? Strategies to enhance treatment
adherence ? Public health implications for children with behavioral disorders ? Evolution of
community mental health ? Policy development and legislation for mental health services ?
Role and responsibilities of the community mental health practitioner Copyright © 2020
Wolters Kluwer · All Rights Reserved Question #1 Is the following statement true or false?
Genetic, biologic, and environmental risk factors all influence the incidence of mental
illness. Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #1 True
Rationale: Genetic, biologic, and environmental risk factors all influence the incidence of
mental illness. Early intervention can minimize the morbidity associated with mental
illness. Copyright © 2020 Wolters Kluwer · All Rights Reserved Cultural Context of Mental
Illness ? Genetic, biologic, and environmental risk factors all influence the incidence of
mental illness. ? Mental health and, conversely, mental illness are concepts bound by
culture. ? Understanding of what connotes mental health is shaped by social norms that
evolve from generation to generation. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Definitions of Mental Health ? No universally accepted definition of mental health;
for practical purposes, widely accepted parameters for what behaviors connote
psychopathology must be used to measure o Incidence o Morbidity o Mortality Copyright ©
2020 Wolters Kluwer · All Rights Reserved Scope of Mental Illness ? There is no difference
in lifetime prevalence rates of major mental illness between developed and developing
countries. ? The projected lifetime risk of developing a major mental illness is highest in
countries where the population is subject to sustained violence. ? Psychiatric disorders are

2. the leading cause of disability worldwide. Copyright © 2020 Wolters Kluwer · All Rights
Reserved Question #2 Is the following statement true or false? Rationale: Adherence to
psychopharmacology and psychotherapy does not enhance recovery from mental illness.
Copyright © 2020 Wolters Kluwer · All Rights Reserved Answer to Question #2 False
Rationale: Adherence to psychopharmacology and psychotherapy enhances recovery from
mental illness. Copyright © 2020 Wolters Kluwer · All Rights Reserved Schizophrenia ?
Epidemiology ? Chapter 21: Community Mental HealthEarly intervention programs for
first?episode psychosis ? Primary prevention programs ? Enhancing treatment adherence in
schizophrenia ? Role of community mental health teams in treatment of schizophrenia
Copyright © 2020 Wolters Kluwer · All Rights Reserved Epidemiology of Schizophrenia ?
About 1% of the world’s population suffers from schizophrenia. ? Symptoms of
schizophrenia typically first appear in late adolescence or young adulthood and persist
throughout a person’s life, causing significant impairment in all aspects of a person’s
psychosocial functioning. Copyright © 2020 Wolters Kluwer · All Rights Reserved Early
Intervention Programs for First?Episode Psychosis ? Early intervention programs—
specialized teams of professionals whose primary goal is to maintain the individual’s
current level of educational and vocational functioning through early treatment Copyright
© 2020 Wolters Kluwer · All Rights Reserved Enhancing Treatment Adherence in
Schizophrenia ? Nonadherence to medication is the most common factor associated with
relapse and recurrence of psychotic symptoms ? Nursing interventions to enhance
medication adherence applicable to those with chronic mental illness Copyright © 2020
Wolters Kluwer · All Rights Reserved High?Risk Populations ? The unemployed, the poor,
and the homeless all report higher levels of depression, anxiety, schizophrenia, and
substance abuse than do the general population. ? The number of mentally ill clients who
are homeless has steadily increased in the United States as state governments embarked on
a systematic plan to “deinstitutionalize” the mentally ill. Copyright © 2020 Wolters Kluwer ·
All Rights Reserved Role of Community Mental Health Teams in Treatment of Schizophrenia
? Respite services, day treatment facilities, and sheltered workshops are a few of the
outpatient services that help alleviate the daily burden of care for families. ? To address
these shortcomings in the delivery of care, community mental health teams coordinate both
the psychosocial and the psychopharmacological needs. Copyright © 2020 Wolters Kluwer ·
All Rights Reserved Mood and Anxiety Disorders ? Epidemiology o Social factors o Biologic
theories of depression and anxiety ? Nursing interventions Copyright © 2020 Wolters
Kluwer · All Rights Reserved Attention?Deficit/Hyperactivity Disorders and Emotional
Disorders in Children The main characteristics that help healthcare practitioners, including
school nurses, differentiate ADHD from bipolar disorder are the pervasiveness of the
symptoms and the predominant symptoms. Copyright © 2020 Wolters Kluwer · All Rights
Reserved The Precipitous Rise in Autism—A Public Health Crisis ? Long?term outcomes of
children with autism are improved with early identification and treatment. ? Screening tools
for autism have been developed, but most are for use in toddlers and not in infants. ?
Screening for prodromal symptoms in infancy; some of the more debilitating features of the
disorder might be mitigated with early intervention and treatment. Copyright © 2020
Wolters Kluwer · All Rights Reserved Question #3 Is the following statement true or false?

3. Public health initiatives to educate communities about mental health can be effective in
lowering the incidence of high?risk behaviors such as alcoholism. Copyright © 2020
Wolters Kluwer · All Rights Reserved Answer to Question #3 False Rationale: Public health
initiatives to educate communities about mental health can be effective in lowering the
incidence of high?risk behaviors such as suicide. Copyright © 2020 Wolters Kluwer · All
Rights Reserved Evolution of Community Mental Health #1 ? Chapter 21: Community
Mental HealthCommunity?based treatment of the mentally ill gained momentum as World
War II veterans returned home exhibiting the symptoms of posttraumatic stress disorder. ?
Aided by advances in the development of pharmacologic treatment of the mentally ill, the
numbers of patients treated in state mental hospitals precipitously declined. ? The
continuum of care for the chronically mentally ill includes community services, such as ive
housing and employment. Copyright © 2020 Wolters Kluwer · All Rights Reserved
Evolution of Community Mental Health #2 ? Since deinstitutionalization began, there has
been an outcry of frustration from nurses in the community about the lack of ive services
to meet the needs of people with chronic mental illness. ? Public health initiatives to educate
communities about mental health can be effective in lowering the incidence of high?risk
behaviors such as suicide. Copyright © 2020 Wolters Kluwer · All Rights Reserved Question
#4 Is the following statement true or false? The continuum of care for the chronically
mentally ill includes community services, such as ive housing and employment. Copyright
© 2020 Wolters Kluwer · All Rights Reserved Answer to Question #4 True Rationale: The
continuum of care for the chronically mentally ill includes community services, such as ive
housing and employment. Copyright © 2020 Wolters Kluwer · All Rights Reserved
Legislation for Parity in Mental Health Insurance Benefits ? All health insurance coverage,
including deductibles, copays, coinsurance, and out?of?pocket expenses, as well as all
treatment limitations, including frequency of treatment, number of visits, days of coverage,
or other similar limits, will be the same regardless of health need or diagnosis. Copyright ©
2020 Wolters Kluwer · All Rights Reserved Role and Responsibilities of the Community
Mental Health Practitioner ? Teacher ? Clinician ? Advocate Copyright © 2020 Wolters
Kluwer · All Rights Reserved Psychological First Aid ? Populations traumatized by disasters
? Populations at risk for psychological trauma ? Psychological first aid is recommended to
help survivors and first responders to natural and intentional disasters. Copyright © 2020
Wolters Kluwer · All Rights Reserved …Chapter 21: Community Mental Health