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- Prevalence of mental
ill- ness/substance abuse 1 in 5 canadines experience mental illness People with mental illness are twice as likely to have substance use disorder People with substance use disorder are up to 3 times more likely to have mental illness
- Mental health definition Mental health is a state of wellbeing in which individuals realize
self-potential, cope with life stressors, and are able to work productively and contribute to their society. Is integral to gen- eral health and can be possessed and enhanced, including in presence of mental illness
- Mental health KEYES More than absent or presence of illness
"Flourishing" (KEYES) Subjective sense of wellbeing:
- Positive functioning in life Psychological well-being
Emotional well-being Social well-being
- Mental illness Mental illnesses are diagnosed clinical conditions that are
NOT the opposite of mental health
- Mental illness KEYS "Languishing"- emptiness, stagnation languishing in life
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- Mental health
continuum - flourishing/thriving with ill- ness can have great mental health with illness, learn to be resil- llience, ask for help, self manage, doesn't hid from their feel- ings
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- Mental disorders are Health conditions characterized by alteration in a variety of
factors that include mood and attect, behaviour and thinking and condition The disorders are associated with various degrees of distress and impaired functioning
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- Recovery is Related to mental illness means "giving and retaining
hope, understanding of ones, abilities, disabilities, endgame t in an active life, personal autonomy, social identity, meaning and purpose in life and a positive sense of self NOT a synonymous with "cure"
- Trauma is prevalent in
which ppl
- Core principles of trauma
in- formed approach
- Principles of the Trauma-
In- formed Approach 90% women seeking treatment or substance use 32% Canadian adults report trauma experiencing child abuse 25% grade 6-12 students report being bullied Realize. Recognize. Respond. Reduce. Re-traumatization
- acknowledge prevalence & impact
- safety
- trust
- choice
Relation & collaborative
Acknowledge prevalence and impact of trauma and violence, promote safety, work in ways that build trust, otter choice, work in relationship no collaboration, share power
- Goals of trauma informed ap- Realize the prevalence and trauma
proac h Recognize the sign of trauma Respond in ways that reduce re-tramatization
- Stigma Public stigma of people with mental health
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First Nations mental wellness continuum
- First Nations mental
wellness continuum... Mental wellness is a balance of mental, physical, spiritual, emotional balance enriched as individuals have; PURPOSE in their daily lives HOPE for their future and those of their families that is ground- ed in sense if identity, unique indigenous values and having belief in spirt Sense of BELONGING and connectedness with family, to com- munity and culture Sense of MEANING and an understanding of how their lives and those families and communities are part of creation and a rich history Help ppl build connections so they are not alone Look at indigenous way of health; HOPE, MEANING, PURPOSE, SENSE OF BELONGING will help people move away from self harm
- Cultural competency Knowledge and awareness of cultural and health related be-
liefs, practices and cultural values of diverse populations Develops skill in providing care that is culturally sensitive
- Cultural humility Self-reflection of personal place f power, identity, and biases
and how that may interface when interacting with people Appreciates intersectionality and dynamic nature of people's identity
- Cultural safety Both process & outcomes
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Goal is greater equity and addressing "root causes of power imbalances and inequities social relationships in healthcare
- Cultural safety equation Cultural safety = cultural awareness + cultural sensitivity + cul-
tural competence
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- Racism and mental health large amount of american studies have found racism is per-
vasive and has adverse health ettects on tacilzed and ethnic minority groups
- in Canada there is a lack of lack of race based data and paucity of studies
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- in Canada racism +
mental health
- Racism - Williams et al
(2000) definition
- Williams et al- ideology of in-
feriority
- williams et al- negative
atti- tudes & beliefs
- williams et al-
differential treatment
- 3 mechanisms: racism
affects mental health there are persistent health disparities amoing raclized groups espaically Black and Indigenous peoples in Canada with deep correlations with socio economic status and ditterential access to health care conceptualises the term "racism" to refer to an "organised sys- tem that leads to the subjugation of some human population groups relative to others" human population groups are categorised & ranked relative to others development of negative attitudes and beliefs toward racial out groups (prejudice) incorporated in societal policies and institutions ditterential treatment of members of the outgroups by individ- uals and instiutions
- institutional discrimination
- experiences of discrimination
- stigma of inferiority
- institutional discrimination restrict socioeconomic mobility (less money, can't move for-
ward in career) people will begin to believe this discrimination and will start to isolate themselves
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resulting in racial ditterences (SES) & exposure to poor living conditions and limiting of opportunities and social mobility
- experiences of discrimination adversely attect mental health
psychological stress and distress
- stigma of inferiority internalised negative stereotyping & stigma
attect psychosocial functioning
- Anti- black racism
historical roots (williams,
-perpetuated by ideologies that reinforced slave trade and colonisation
- actively translated into policies that restrict access to educa-
tion, employment, social mobility, integration of African Ameri- cans through segregation in the usa through racist polices and laws
- negative racial stereotypes pervasive in society and culture
undermine and impede equitable access
- impact socio-economic status and social determinants of
health which are sting predictors of mental health
- Anti-Indigenous racism - colonisation
- systemic and cultural genocide
- institionalized system racism in polices and practices
- Stigma definition a mark of shame or discredit: stains bore the stigma of cow-
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ardice plural usually stigmata: an identifying mark or characteristic specially
- levels of stigma: social society, culture, and communities endorse negative stereo-
types and act in harmful/discriminatory ways
- levels of stigma: structural
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- self acceptance
- positive relationships
- personal growth
- purpose in life
- environmental mastery
- autonomy/ self-determination
- social coherence
- social actualisation
- social integration
- social acceptance
- social contribution
- positive feelings about life
- satisfied with life
- perceptions and evaluations of positive and
negative attect
- barriers to timely access to services
- poorer outcomes when accessing services
- poorer experiences when receiving services
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tal Health and Substance Use Services
- trauma- informed
approach perspectives
- late entry to services (too sick or acute when first entry)
- entry to services through criminal justice system
- historical trauma
- intergenerational trauma
- violence and oppression
-trauma of racism, discrimination & stigma
- loos & grief
- resilience and hope
- move away from... what is wrong with the person?
WANT: what has happened to the person?
- Settings nurses work in homes, jails, correction centers, family practice, emergency,
private practice, corporate setting
- CASN & CFMN entry to
prac- tice mental health and addic- tion competencies for under- grad nursing education
- therapeutic
communication skills
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- the communication
process of the patient, don't swear even if the patient is doing it)
- Use self-disclosure cautiously & only when it serves a thera-
peutic purpose
- Avoid social relationships with clients
- Maintain client confidentiality (maybe try journaling, reflect
on things that happen in the day bc you can't share with others)
- Assess competence to determine level of understanding
- Non-judgemental attitude
- Guide client
- Use clarifying statements
- self awareness (nurses require self awareness, like journaling,
(all happens at the same time) become aware of who you are as a therapeutic person)
- verbal
- non-verbal
- empathetic linkage
- therapeutic
communication skills: non verbal
- Silence (Provides time for the client to put thoughts and
feelings into words, regain composure or continue talking), active listening, facial expressions (look inviting and welcom- ing, just not s huge smile like a clown, modulate with the patient- attective attunement- match there expression of the patient), body language, gestures (be mindful if you have nervous tickets, often in mental health assessments nurses will often video themselves to
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see to make sure your mannerism is open), learning forward (sit on an angle, don't sit right next to each other bc if one wants to leave they can) 90% of your message is non-verbal Learn to sit in long periods of time in silence with active listen- ing
