N345

1. N345 Content Organization Review

2. Please note: Powerpoint lecture slides are a guide only. You will find that your own detailed notes are very important as well.

3. N345 Organization and Review Pointers Required content focuses on all the material we have covered in class, including readings: • Powerpoint slides • Class discussions and group work —learning form each other (some of the more complex topics are best covered with collective discussion where a richer depth is possible) • Handouts (e.g Doorway physical exam) • Required readings from peer reviewed journals AND Grey literature (e.g. social determinants article, CNA documents). (These articles will be ‘on’ the two midterms in the form of one general question, and you will be given a choice of several readings) • Required readings from textbook (please read the entire required chapters for essential background knowledge, BUT focus on material that we have covered in class

4. Section I:Core Concepts for clinical practice • Mental Health is everywhere: The learning space • Historical and societal context for mental health and mental illness • Discrimination, stigma, cultural safety, including links to the CAN Code of Ethics • The cycle of oppression (biased information, stereotyping, prejudice, discrimination (action or inaction based on prejudice), oppression (discrimination backed up by societal power) • Mental status exam (the 9 components and their application to anxiety, panic, depression)

5. The Mental Status Exam • The 9 components, their definitions, and application to anxiety, panic, depression) • Attitude, Behaviour • Speech • Mood • Affect • Thought Form • Thought Content • Perceptions • Cognitive Function • Judgment and Insight

6. Introduction to Intersectionality • The social determinants of health • The ‘isms’ as social determinants of health (sexism, racism, ageism…) • Geography as a social determinant of health (e.g. whether or not you live in a rural or urban area, whether or not you live near polluting factories…) For clients (and us), all of these areas ‘intersect’ and overlap (e.g. a rural senior and her/his decreased access to health services)

7. The DSM and the multiaxial system • DSM: its purpose and some of its limitations • The DSM Multiaxial System • I: Clinical disorders, other conditions that may be the focus on clinical attention • II: Personality disorders, mental retardation (note critique) • III: general medical conditions • IV: Psychosocial and environmental problems • V: Global assessment of functioning

8. Anxiety Disorders • DSM-IV TR: Generalized Anxiety Disorder criteria • Mindfulness as a core nursing skill • What is mindfulness? • How does it apply in the real world of our clinical practice? (group work and class discussions) • DSM-IV TR: Panic Disorder criteria • Levels of anxiety: Alterations in perceptual field, ability to learn and physical or other characteristics (associated with mild, moderate, severe and panic levels of anxiety)

9. PTSD • Historical context • DSM definitions an applications • Focus on therapeutic boundaries • Therapeutic boundaries in the context of trauma work: • Containment • Believing • The wounded healer • The road to healing • Beginning with the fundamentals • Consciousness raising • Working with trauma material (maybe…)

10. Biological basis for understanding psychotropic drugs • First: The social determinants of psychotropic drug prescription—critical social science meets the psychiatric system… • The cellular composition f the brain • How are neural messages transmitted? • How is neurotransmission involved in the mechanisms of drug action? • What is a neurotransmitter and how is it related to psychotropic drug action? • The anti-anxiety drugs (GABA; also note that we will revisit these drugs when we discuss addictions)

11. Depression • DSM-IV TR: major depressive disorder criteria • Possible Mental Status Exam Findings • Primary risk factors for depression • Depression secondary to medical conditions • Depression secondary to substances or medications • Guidelines for counseling people with depression (including rationale and examples provided in slides) • Introduction to brief therapy (also called solution-focused therapy)