Learning Objectives

1.	Identify themes and research advances in the field of mental health.
2.	Discuss the origins of stigma and its impact.
3.	Recognize the relationship between brain function and behavior.
4.	Identify approaches to prevention and treatment of mental disorders.
5.	Recognize the impact of the organization and financing of mental-health care.
6.	Discuss the impact of consumer and family movements in the area of mental-health service delivery.
7.	Utilize a lifespan approach to the consideration of mental health and mental illness.
8.	Discuss mental health in a social and cultural context.
9.	Discuss the impact of nature and nurture in the area of mental health.
10.	Describe common psychiatric disorders and their prevalence throughout the lifespan.
11.	Recognize preventative measures and effective clinical interventions for children, adults and older adults.
12.	Identify barriers to accessing mental-health services for children, adults and older adults.
13.	Describe the costs and financing mechanisms for mental-health services.
14.	Recognize the benefits and limitations of confidentiality.
15.	Discuss the recommendations of the Surgeon General's Report for the future of mental-health service delivery.

Course Contents

1.	Introduction and Themes
		Overarching Themes
			Mental Health and Mental Illness: A Public Health Approach
			Mental Disorders are Disabling
			Mental Health and Mental Illness: Points on a Continuum
			Mind and Body are Inseparable
			The Roots of Stigma
				Separation of Treatment Systems
				Public Attitudes About Mental Illness: 1950s to 1990s
				Stigma and Seeking Help for Mental Disorders
				Stigma and Paying for Mental Disorder Treatment
				Reducing Stigma
		The Science Base of the Report
			Reliance on Scientific Evidence
				Research Methods
				Levels of Evidence
		Overview of the Report’s Chapters
		Chapter Conclusions
			Chapter 2: The Fundamentals of Mental Health and Mental Illness
			Chapter 3: Children and Mental Health
			Chapter 4: Adults and Mental Health
			Chapter 5: Older Adults and Mental Health
			Chapter 6: Organization and Financing of Mental Health Services
			Chapter 7: Confidentiality of Mental Health Information: Ethical, Legal, and Policy Issues
			Chapter 8: A Vision for the Future—Actions for Mental Health in the New Millennium
		Preparation of the Report
		References
2.	The Fundamentals of Mental Health and Mental Illness
		The Neuroscience of Mental Health
			Complexity of the Brain I: Structural
			Complexity of the Brain II: Neurochemical
			Complexity of the Brain III: Plasticity
		Imaging the Brain
		Overview of Mental Illness
			Manifestations of Mental Illness
				Anxiety
				Psychosis
				Disturbance of mood
				Disturbance of Cognition
				Other Symptoms
			Diagnosis of Mental Illness
			Epidemiology of Mental Illness
				Adults
				Children and Adolescents
				Older Adults
			Future Directions for Epidemiology
			Costs of Mental Illness
		Overview of Etiology
			Biopsychosocial Model of Disease
			Understanding Correlation, Causation, and Consequences
			Biological Influences on Mental Health and Mental Illness
				The Genetics of Behavior and Mental Illness
				Infectious Influences
					PANDAS
			Psychosocial Influences on Mental Health and Mental Illness
				Psychodynamic Theories
				Behaviorism and Social Learning Theory
			The Integrative Science of Mental Illness and Health
		Overview of Development, Temperament, and Risk Factors
			Physical Development
			Theories of Psychological Development
				Paiget: Cognitive Development Theory
				Erik Erikson: Psychoanalytic Development Theory
				John Bowlby: Attachment Theory of Development
			Nature and Nurture: The Ultimate Synthesis
		Overview of Prevention
			Definitions of Prevention
			Risk Factors and Protective Factors
		Overview of Treatment
			Introduction to Range of Treatments
			Psychotherapy
				Psychodynamic Therapy
				Behavioral Therapy
				Humanistic Therapy
			Pharmacological Therapies
				Mechanisms of Action
				Complementary and Alternative Treatment
			Issues in Treatment
				Placebo Response
				Benefits and Risks
				Gap Between Efficacy and Effectiveness
				Barriers to Seeking Help
		Overview of Mental Health Services
			Overall Patterns of Use
			History of Mental Health Services
		Overview of Cultural Diversity and Mental Health Services
			Introduction to Cultural Diversity and Demographics
				Coping Styles
			Family and Community as Resources
				Epidemiology and Utilization of Services
				African Americans
				Asian/Pacific Islanders
				Hispanic Americans
				Native Americans
			Barriers to the Receipt of Treatment
				Help-Seeking Behavior
				Mistrust
				Stigma
				Cost
				Clinician Bias
			Improving Treatment for Minority Groups
				Ethnopsychopharmacology
				Minority-Oriented Services
				Cultural Competence
			Rural Mental Health Services
		Overview of Consumer and Family Movements
			Origins and Goals of Consumer Groups
				Self-Help Groups
			Accomplishments of Consumer Organizations
			Family Advocacy
		Overview of Recovery
			Introduction and Definitions
			Impact of the Recovery Concept
		Conclusions
			Mental Health and Mental Illness Across the Lifespan
		References
3.	Children and Mental Health
		Normal Development
			Theories of Development
				Development Viewed as a Series of Stages
				Development Viewed as a Series of Stages
				Behavioral Development
			Social and Language Development
				Parent-Child Relationships
				Origins of Language
				Relationships With Other Children
			Temperament
			Developmental Psychopathology
				Current Developmental Theory Applied to Child Mental Health and Illness
		Overview of Risk Factors and Prevention
			Risk Factors
				Biological Influences on Mental Disorders
				Psychosocial Risk Factors
				Family and Genetic Risk Factors
				Effects of Parental Depression
				Stressful Life Events
				Childhood Maltreatment
				Peer and Sibling Influences
				Correlations and Interactions Among Risk Factors
			Prevention
				Project Head Start
				Carolina Abecedarian Project
				Infant Health and Development Program
				Elmira Prenatal/Early Infancy Project
				Primary Mental Health Project
				Other Prevention Programs and Strategies
		Overview of Mental Disorders in Children
			General Categories of Mental Disorders of Children
			Assessment and Diagnosis
			Evaluation Process
			Treatment Strategies
				Psychotherapy
				Psychopharmacology
		Attention-Deficit/Hyperactivity Disorder
				Prevalence
				Causes
			Treatment
				Pharmacological Treatment
					Psychostimulants
					Dosing
					Side Effects
					Other Medications
				Psychosocial Treatment
					Behavioral Approaches
					Cognitive-Behavioral Therapy
					Psychoeducation
				Multimodal Treatments
				Treatment Controversies
					Overprescription of Stimulants
					Safety of Long-Term Stimulant Use
		Depression and Suicide in Children and Adolescents
			Conditions Associated With Depression
			Prevalence
				Major Depression
				Dysthymic Disorder
				Suicide
			Course and Natural History
			Causes
				Family and Genetic Factors
				Gender Differences
				Biological Factors
				Cognitive Factors
				Risk Factors for Suicide and Suicidal Behavior
			Consequences
			Treatment
				Depression
					Psychosocial Interventions
					Pharmacological Treatment
				Bipolar Disorder
					Pharmacological Treatment
				Suicide
					Psychotherapeutic Treatments
					Psychopharmacological Treatments
					Intervention After a Suicidal Death of a Relative, Friend, or Acquaintance
					Community-Based Suicide Prevention
					Crisis Hotlines
					Method Restriction
					Media Counseling
					Indirect Case-Finding Through Education
					Direct Case-Finding
					Aggressive Treatment of Mood Disorders
					Air Force Suicide Prevention Program — A Community Approach
		Other Mental Disorders in Children and Adolescents
			Anxiety Disorders
				Separation Anxiety Disorder
				Generalized Anxiety Disorder
				Social Phobia
				Treatment of Anxiety
				Obsessive-Compulsive Disorder
			Autism
				Treatment
			Disruptive Disorders
				Treatment
			Substance Use Disorders in Adolescents
			Eating Disorders
		Services Interventions
			Treatment Interventions
				Outpatient Treatment
				Partial Hospitalization/Day Treatment
				Residential Treatment Centers
				Inpatient Treatment
			Newer Community-Based Interventions
				Case Management
					Team Approaches to Case Management
				Home-Based Services
					Family Preservation Programs Under the Child Welfare System
					Multisystemic Therapy
				Therapeutic Foster Care
				Therapeutic Group Homes
			Crisis Services
		Service Delivery
			Service Utilization
				Utilization in Relation to Need
				Early Termination of Treatment
				Poverty and Utilization
				Culture and Utilization
			Service Systems and Financing
				Private Sector
				Public Sector
				Children Served by the Public Sector
				Managed Care in the Public Sector
			Culturally Appropriate Social Support Services
			Support and Assistance for Families
				New Roles for Families in Systems of Care
				Family Support
				Family Support Groups
				Practical Support
			Integrated System Model
			Effectiveness of Systems of Care
				The Fort Bragg Study
				The Stark County Study
			Summary: Effectiveness of Systems of Care
		Conclusions
		References
4.	Adults and Mental Health
		Chapter Overview
			Mental Health in Adulthood
				Personality Traits
					Self-Esteem
					Neuroticism
					Avoidance
					Impulsivity
					Sociopathy
			Stressful Life Events
				Past Trauma and Child Sexual Abuse
				Domestic Violence
				Interventions for Stressful Life Events
			Prevention of Mental Disorders
		Anxiety Disorders
			Types of Anxiety Disorders
				Panic Attacks and Panic Disorder
				Agoraphobia
				Specific Phobias
				Social Phobia
				Generalized Anxiety Disorder
				Obsessive-Compulsive Disorder
				Acute and Post-Traumatic Stress Disorders
			Etiology of Anxiety Disorders
				Acute Stress Response
				New Views About the Anatomical and Biochemical Basis of Anxiety
				Neurotransmitter Alterations
				Psychological Views of Anxiety
			Treatment of Anxiety Disorders
				Counseling and Psychotherapy
				Pharmacotherapy
					Benzodiazepines
					Antidepressants
					Buspirone
				Combinations of Psychotherapy and Pharmacotherapy
		Mood Disorders
			Complications and Comorbidities
				Clinical Depression Versus Normal Sadness
			Assessment: Diagnosis and Syndrome Severity
				Major Depressive Disorder
				Dysthymia
				Bipolar Disorder
				Cyclothymia
				Differential Diagnosis
			Etiology of Mood Disorders
				Biologic Factors in Depression Monoamine Hypothesis
				Evolving Views of Depression
				Anxiety and Depression
				Psychosocial and Genetic Factors in Depression
				Stressful Life Events
				Cognitive Factors
				Temperament and Personality
				Gender
				Genetic Factors in Depression and Bipolar Disorder
			Treatment of Mood Disorders
				Stages of Therapy
					Acute Phase Therapy
					Continuation Phase Therapy
					Maintenance Phase Therapies
			Specific Treatments for Episodes of Depression and Mania
				Treatment of Major Depressive Episodes
					Pharmacotherapies
					Alternate Pharmacotherapies
					Augmentation Strategies
					Psychotherapy and Counseling
					Bipolar Depression
					Pharmacotherapy, Psychosocial Therapy, and Multimodal Therapy
					Preventing Relapse of Major Depressive Episodes
				Treatment of Mania
					Acute Phase Efficacy
					Maintenance Treatment to Prevent Recurrences of Mania
				Service Delivery for Mood Disorders
		Schizophrenia
			Overview
				Cognitive Dysfunction
				Functional Impairment
				Cultural Variation
				Prevalence
					Prevalence of Comorbid Medical Illness
			Course and Recovery
				Gender and Age at Onset
			Etiology of Schizophrenia
			Interventions
				Pharmacotherapy
				Ethnopsychopharmacology
				Psychosocial Treatments
					Psychotherapy
					Family Interventions
					Psychosocial Rehabilitation and Skills Development
					Coping and Self-Monitoring
					Vocational Rehabilitation
		Service Delivery
			Case Management
			Assertive Community Treatment
			Psychosocial Rehabilitation Services
			Inpatient Hospitalization and Community Alternatives for Crisis Care
			Services for Substance Abuse and Severe Mental Illness
		Other Services And Supports
			Consumer Self-Help
			Consumer-Operated Programs
			Consumer Advocacy
			Family Self-Help
			Family Advocacy
			Human Services
				Housing
				Income, Education, and Employment
				Health Coverage
			Integrating Service Systems
		Conclusions
		References
5.	Older Adults and Mental Health
		Chapter Overview
			Normal Life-Cycle Tasks
			Cognitive Capacity With Aging
			Change, Human Potential, and Creativity
			Coping With Loss and Bereavement
		Overview of Mental Disorders in Older Adults
			Assessment and Diagnosis
			Overview of Prevention
				Primary Prevention
				Prevention of Depression and Suicide
				Treatment-Related Prevention
				Prevention of Excess Disability
				Prevention of Premature Institutionalization
			Overview of Treatment
				Pharmacological Treatment
					Increased Risk of Side Effects
					Polypharmacy
				Treatment Compliance
				Psychosocial Interventions
				Gap Between Efficacy and Effectiveness
		Depression in Older Adults
			Diagnosis of Major and “Minor” Depression
				Late-Onset Depression
				Prevalence and Incidence
				Barriers to Diagnosis and Treatment
				Course
				Interactions With Somatic Illness
			Consequences of Depression
			Cost
			Etiology of Late-Onset Depression
			Treatment of Depression in Older Adults
				Pharmacological Treatment
					Tricyclic Antidepressants
					Selective Serotonin Reuptake Inhibitors and Other Newer Antidepressants
					Multimodal Therapy
					Course of Treatment
				Electroconvulsive Therapy
				Psychosocial Treatment of Depression
		Alzheimer’s Disease
			Assessment and Diagnosis of Alzheimer’s Disease
				Mild Cognitive Impairment
				Behavioral Symptoms
				Course
				Prevalence and Incidence
				Cost
			Etiology of Alzheimer’s Disease
				Biological Factors
			Protective Factors
				Histopathology
				Role of Acetylcholine
			Pharmacological Treatment of Alzheimer’s Disease
				Acetylcholinesterase Inhibitors
				Treatment of Behavioral Symptoms
			Psychosocial Treatment of Alzheimer’s Disease Patients and Caregivers
		Other Mental Disorders in Older Adults
			Anxiety Disorders
				Prevalence of Anxiety
				Treatment of Anxiety
			Schizophrenia in Late Life
				Prevalence and Cost
				Late-Onset Schizophrenia
				Course and Recovery
				Etiology of Late-Onset Schizophrenia
				Treatment of Schizophrenia in Late Life
			Alcohol and Substance Use Disorders in Older Adults
				Epidemiology
					Alcohol Abuse and Dependence
					Misuse of Prescription and Over-the-Counter Medications
					Illicit Drug Abuse and Dependence
				Course
				Treatment of Substance Abuse and Dependence
		Service Delivery
			Overview of Services
			Service Settings and the New Landscape for Aging
				Primary Care
				Adult Day Centers and Other Community Care Settings
				Nursing Homes
				Services for Persons With Severe and Persistent Mental Disorders
			Financing Services for Older Adults
				Increased Role of Managed Care
				Carved-In Mental Health Services for Older Adults
				Carved-Out Mental Health Services for Older Adults
				Outcomes Under Managed Care
		Other Services and Supports
			Support and Self-Help Groups
			Education and Health Promotion
			Families and Caregivers
			Communities and Social Services
		Conclusions
		References
6.	Organizing and Financing Mental Health Services
		Overview of the Current Service System
			The Structure of the U.S. Mental Health Service System
			The Public and Private Sectors
			Patterns of Use
				Adults
				Children and Adolescents
		The Costs of Mental Illness
			Indirect Costs
			Direct Costs
			Mental Health Spending
			Spending by the Public and Private Sectors
			Trends in Spending
			Mental Health Compared With Total Health
		Financing and Managing Mental Health Care
			History of Financing and the Roots of Inequality
			Goals for Mental Health Insurance Coverage
			Patterns of Insurance Coverage for Mental Health Care
			Traditional Insurance and the Dynamics of Cost Containment
			Managed Care
				Major Types of Managed Care Plans
				The Ascent of Managed Care
			Dynamics of Cost Controls in Managed Care
			Managed Care Effects on Mental Health Services Access and Quality
			Impact on Access to Services
			Impact on Quality of Care
		Toward Parity in Coverage of Mental Health Care
			Benefit Restrictions and Parity
			Legislative Trends Affecting Parity in Mental Health Insurance Coverage
		Conclusions
		Appendix 6-A: Quality and Consumers’ Rights
		References
7.	Confidentiality of Mental Health Information
		Chapter Overview
		Ethical Issues About Confidentiality
		Values Underlying Confidentiality
			Reducing Stigma
			Fostering Trust
			Protecting Privacy
		Research on Confidentiality and Mental Health Treatment
		Current State of Confidentiality Law
			Overview of State Confidentiality Laws
			Exceptions to Confidentiality
				Consent by the Person in Treatment
				Disclosure to the Client
				Disclosure to Other Providers
				Disclosure to Payers
				Disclosure of Information to Families
				Oversight and Public Health Reporting
				Research
				Disclosure to Law Enforcement Agencies
				Disclosure to Protect Third Parties
		Federal Confidentiality Laws
		Potential Problems With the Current Legal Framework
		Summary
		Conclusions
		References
8.	A Vision for the Future
		Continue To Build the Science Base
		Overcome Stigma
		Improve Public Awareness of Effective Treatment
		Ensure the Supply of Mental Health Services and Providers
		Ensure Delivery of State-of-the-Art Treatments
		Tailor Treatment to Age, Gender, Race, and Culture
		Facilitate Entry Into Treatment
		Reduce Financial Barriers to Treatment
		Conclusion
		References
	Post Test

Comments:

"Well written material- Excellent! Easy to understand. Test questions easily understood." - J.D., RN, TX

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