Mental health

• Recovery model

  Involves the person having hope, responsibility, knowledge. Recovery begins immediately. Client/patient centred approach. Holistic approach. Assists a person having a meaningful life with or without distress. Sense of connection, personal protective factors, community engagement.
• Anorexia


  • High risk of mortality
  • Serious physical and mental health symptoms
  • Fear of gaining weight
• Bulimia


  Out of control- over eat
• Antidepressants


  Targeting noradrenaline and serotonin neurotransmitters (SSRIs)<|>Emotional – depressed mood, feelings of worthlessness, hopelessness<|>Physical- sleep, appetite, agitation<|>Cognitive- ↓Concentration, memory
• Suicide – greatest risk factor is depression
• Suicide risk factors


  • S- sex, single, separated, widowed
  • U- unemployed, retired, redundant
  • I – identification
  • C- chronic physical , mental
  • I –improvement
  • D- depression
  • A- age, alcohol
  • L- lethality
• Most people don't want their lives to end, they want the pain to end
• Positive symptoms of Schizophrenia


  Hallucinations, Delusions, Thought Disordered
• Negative symptoms of Schizophrenia

  Flattened affect, alogia (poverty of speech), avolition (lack of motivation), anhedonia (inability to feel or express pleasure), asociality (social withdrawal)
• First Generation Antipsychotics (Typical)

  Haloperidol - Positive symptoms, EPSE (extra pyramidal side effects). Akathisia (Inability to remain still/restlessness), Dystonia (muscle spasms) Oculogyric Crisis (eyes rolling back), Parkinsonism (slow movements (bradykinesia), rigidity, tremors), Tardive Dyskinesia (uncontrollable facial movements, including mouth IRREVERSIBLE).
• Second Generation Antipsychotics (Atypical)

  Eg Clozapine, Risperidone, Olanzapine - Positive & Negative symptoms, ↓EPSE, Metabolic effects- Wt gain, ↑CVD, ↑Diabetes, Agranulocytosis (decreased neutrophils), Constipation
• Lithium

  Lithium carbonate.

  Narrow therapeutic window 0.6-1.2 mmol, Lithium Toxicity -tremor, Nausea and Vomiting, drowsiness, confusion.severe – kidney failure-death.

  Creatinine clearance tests determine the kidneys function with filtering creatinine. Can determine if kidneys are not functioning well. Affect renal system.
• Bipolar Affective Disorder

  Mania, Hypomania, Euthymia, Depression
• Zopiclone

  Hypnotic/Sedative. Used for insomnia- depression, anxiety, bipolar, psychosis, Addictive. Has a metallic taste to prevent an overdose. People can develop a tolerance, best to use sparingly and in acute situations.
• Determining a person's suicidal potential

  • History of previous suicide attempts
  • Suicide plan
  • Emotional state
  • Self-esteem
• Lithium carbonate therapy


  Creatinine clearance tests ordered to determine the functioning of the renal system
• Criteria for Mental Health Act


  Person is refusing treatment and mentally disordered = Abnormal state of Mind. They are at risk of causing harm to self or others. Have a reduced risk of capacity to care for self.
• Antidepressants/SSRI’s/SNRI’s


  work by raising a persons mood.

  SSRi’s enhance serotonin. Are not lethal if overdose occurs. To be taken in morning as they can disrupt sleep. can take 3-4 weeks before therapeutic effect. E.g. sertraline, fluoxetine (Prozac), citalopram, paroxetine.

  SNRI’s enhance serotonin and norepinephrine. E.g. Lexapro, duloxetine.
• Benzodiazepines 


  Enhance the effectiveness of neurotransmitters, Gamma-amniobutyric acid (GABA). GABA are neurotransmitters from the parasympathetic nervous system (PSNS) which is responsible for the body’s rest and digest responses when resting, eating, and relaxing. Decreases HR and RR, and Increases digestion. Therefore, benzo’s calm people down, help people feel chill. Often used in ACUTE distress. Very addicitve but useful for anxiety disorders, GAD, OCD, PTSD, panic attacks. Use for 2-3 weeks usually.
• Antipsychotics 


  Block dopamine receptors. Used for psychosis, schizophrenia.

  1st Generation: Typical, treat positive symptoms. E.g. Haloperidol.

  2nd Generation: Atypical, treat positive and negative symptoms. E.g. clozapine, risperidone, quetiapine, aripriprazole, olanzapine.
• antidepressants Tricyclics 


  Tricyclics are very sedating, good for sleep. They are LETHAL if overdose occurs. Not recommended for active suicidal tendencies. E.g. Amitriptyline, doxepin.
• Neuroleptic Malignant Syndrome 


  Is a rare and life-threatening reaction to the use of almost any kind of neuroleptic (antipsychotics) medication. Causes high fever and muscle stiffness.