{"id":689,"date":"2019-05-22T20:55:14","date_gmt":"2019-05-23T00:55:14","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/mental-health-and-mental-illnesses\/"},"modified":"2024-06-05T16:34:58","modified_gmt":"2024-06-05T20:34:58","slug":"mental-health-and-mental-illnesses","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/mental-health-and-mental-illnesses\/","title":{"raw":"Mental Health and Mental Illnesses","rendered":"Mental Health and Mental Illnesses"},"content":{"raw":"A client\u2019s mental health refers to their emotional and psychological well-being<\/strong> that affects their day-to-day functioning. The World Health Organization (2014) defines mental health as a \u201cstate of well-being in which every individual realizes \u2026 [their] own potential, can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to \u2026 [their] community.\u201d Mental health is often underscreened, which reveals a significant gap considering that stress is pervasive in society.\r\n
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Clinical Tip<\/span><\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nMental health is a component of every person\u2014a state of well-being that fluctuates throughout life.\r\n\r\n<\/div>\r\n<\/div>\r\nMental illness includes conditions such as depression, anxiety, addiction, schizophrenia, post-traumatic stress disorder, among others. By definition, mental illness is a disruption in everyday function<\/strong>, which means a person\u2019s employment, relationships, and civil participation can all be impaired by mental illness.\r\n\r\nIt is important to assess a client\u2019s mental health, and if present, mental illnesses. You want to begin this component of the assessment with a statement such as, \u201cMental health is an important part of our lives and so I ask all clients about their mental health and any concerns or illnesses they may have.\u201d\r\n\r\nSee Table 7<\/strong>\u00a0for a selection of questions and statements that you may ask clients to elicit data about their mental health. Note also that there are many other factors that influence mental health, such as violence and trauma, which are addressed under the next section, Functional Health.\r\n\r\nTable 7<\/strong>: Mental health and illness assessment\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Question or Statement<\/strong><\/td>\r\nConsiderations<\/strong><\/td>\r\n<\/tr>\r\n
 \r\n\r\nTell me about your mental health.\r\n\r\n <\/td>\r\n \r\n\r\nThis question broadly focuses on health and invites a dialogue. The statement should not be asked in isolation or as a one-off question, as societally and culturally there are different meanings of what constitutes mental health and a client may not identify themselves as having mental health issues. If a client responds \u201cGood,\u201d consider probing a bit further with \u201cTell me about how so,\u201d or \"What do you mean by good?\" which allows them to respond in more depth.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nTell me about the stress in your life.\r\n\r\n <\/td>\r\n \r\n\r\nStress, by and large, is a relatable term that many clients have experienced and that is something they are likely more comfortable talking about than more difficult health issues because it is so ubiquitous. It\u2019s important to be attentive to the client\u2019s language and consider terms they may use, such as \u201cextreme stress,\u201d \u201csevere stress,\u201d \u201cunmanaged stressed,\u201d or \u201cdebilitating stress,\u201d as these may indicate an underlying mental health issue or stress that requires intervention.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHow does stress affect you?\r\n\r\n <\/td>\r\n \r\n\r\nUnderstanding how stress affects the client provides insight into the mental, physical, and social impact on them. You may need to probe about how stress affects the client physically, mentally, and socially.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHow do you cope with this stress? (may include positive or negative coping strategies.)\r\n\r\n <\/td>\r\n \r\n\r\nThis question invites discussion about coping strategies. It is important to be attentive to any self-harm coping strategies such as substance abuse, isolation\/disengagement, food restriction, purging, cutting, compulsions, and phobias as these could indicate a mental health issue. Additionally, you want to use a [pb_glossary id=\"745\"]strength-based approach[\/pb_glossary] <\/strong>to your assessment and facilitate the client\u2019s capacity to identify and use positive coping strategies.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHave you experienced a loss in your life or a death that is meaningful to you?\r\n\r\n <\/td>\r\n \r\n\r\nInviting discussions about loss and grief could be helpful for clients who have not had an outlet to speak openly about their emotions and the impact. Allowing for loss and grief to be talked about and understanding to what degree grief is affecting health is an important aspect of a mental health assessment.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHave you had a recent breakup or divorce?\r\n\r\n <\/td>\r\n \r\n\r\nEstrangement, emancipation, disruption, or severance of a relationship are not necessarily an indication of a mental illness. However, a pattern in relational disruption may indicate underlying issues such as, but not limited to, ineffective relationship skills, poor coping, or low self-esteem. Assess further if the client reports a breakup or divorce.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHave you recently lost your job or been off work?\r\n\r\n <\/td>\r\n \r\n\r\nMany clients define themselves through their work, and job loss can be disruptive to everyday life. Understanding the meaning of loss of employment is an important dimension of mental health.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHave you recently had any legal issues?\r\n\r\n <\/td>\r\n \r\n\r\nAsking about legal issues should be purposeful, not invasive. For example, a pattern of driving under the influence or possession of illicit drugs could indicate an underlying addiction. Use your clinical judgment when asking questions about legal issues, and be sure to convey an [pb_glossary id=\"747\"]unconditionally accepting way of being[\/pb_glossary]<\/strong> with the client.\r\n\r\n <\/td>\r\n<\/tr>\r\n
 \r\n\r\nHave you purchased any weapons?\r\n\r\n <\/td>\r\n \r\n\r\nThe purchase of weapons by itself is not an indication of mental illness. In Canada, some people enjoy hunting and other recreational activities that involve weapons. However, the purchase of weapons in response to threats to personal safety or to feelings of self-harm could indicate an underlying mental illness.\r\n\r\n <\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n \r\n\r\nIf the client identifies that they have a mental illness, you want to assess the onset of it, and the associated impacts, treatments, hospitalizations, complications, and disabilities. Here are some questions and statements that you may use to elicit more information about the client\u2019s well-being in light of having a mental illness:\r\n