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Chapter 07 Mental Health Long Term and Acute Services
MULTICHOICE
1. Which of the following represent the three most prevalent types of serious mental illness?
Answer : (D)
2. Which of the following terms can be equally applied either to mental illness and intellectual
disability in the same person or to mental illness and chemical dependency in the same person?
(B) MICA
(C) Bipolar
(D) MIID
Answer : (A)
(A) include aggressive consistent implementation of specialized and generic training, treatment,
health services, and related services on a 24-hour daily schedule in an institutional setting
(B) refer to a meeting of the interdisciplinary team during which the individual program plan is
reviewed and revised
(C) focus on provision of an array of community support services for persons with mental illness
sufficient to allow them to live in the least restrictive environment
(D) represent the predominant method of mental health service delivery to children with
emotional disturbances and their families, utilizing professional services tailored to meet the specific
needs of the child and family, often including the home and/or school settings
Answer : (C)
(B) refer to a meeting of the interdisciplinary team during which the individual program plan is
reviewed and revised
(C) focus on provision of an array of community support services for persons with mental illness
sufficient to allow them to live in the least restrictive environment
(D) represent the predominant method of mental health service delivery to children with emotional
disturbances and their families, utilizing professional services tailored to meet the specific needs of
the child and family, often including the home and/or school settings.
Answer : (D)
5. Judicial diversion of a person who has been certified as in need of psychiatric care to some other
form of treatment that is community based with stipulations regarding behaviors such as taking
medications, remaining sober, and maintaining residence in a designated place is called
__________________.
(D) delusion
Answer : (B)
6. The term by which persons with mental illness who are living in the community prefer to be called
is _________________.
(A) consumer
(B) client
(C) patient
(D) resident
Answer : (A)
Answer : (B)
8. A period of time during which a variety of services (inpatient and/or outpatient) are provided to a
mental health consumer for a given occurrence of illness is known as a(n)______________.
(A) hospitalization
(D) relapse
Answer : (C)
9. Financial support for persons with mental illness who have not been able to establish a work
history is available through ______________________.
(C) the Substance Abuse and Mental Health Services Administration (SAMHSA)
Answer : (A)
10. Which of the following individuals would be responsible for referral to needed services,
coordination among service providers, and monitoring for escalation of psychotic symptoms, but
would not provide treatment?
(A) psychiatrist
(B) psychologist
Answer : (D)
(A) accreditation surveyors often check to see that every progress note has a corresponding
diagnosis in the history and physical report
(B) progress notes are important as documentation that a service was performed as a basis for
reimbursement
(C) the Conditions of Participation require that physicians in psychiatric hospitals write daily
progress notes
(D) progress notes are not usually included in electronic medical records for mental health and
therefore are generally handwritten, even when the rest of the record is electronic
Answer : (B)
12. In the context of mental health, "duty to warn" means that __________________.
(A) therapists must warn persons against whom clients make threatening statements, regardless of
the fact that such threats are made within a privileged context
(B) clients should notify therapists when they perceive that their symptoms are becoming
exacerbated so that treatment can be properly escalated
(C) family members must warn therapists when the patient makes threatening statements against
caregivers
(D) mental health organizations must notify both patients and the Department of Health and Human
Services when a suspected breach of confidentiality of patient records has occurred
Answer : (A)
13. __________________ is the term for a form of disordered thinking in which a person holds
unrealistic beliefs.
(A) Hallucination
(B) Delusion
(C) Depression
Answer : (B)
(A) there is no recognized right to be free from the inappropriate use of restraint and seclusion
(B) CMS has rules regarding inappropriate physical restraint, but does not address chemical
restraint
(C) one week after use of such emergency safety interventions, involved staff and the patient must
have a face-to-face discussion and staff must document the discussion, including how such an
intervention might be avoided in the future
(D) within one hour of initiation, there must be a face-to-face assessment of the psychological and
physical wellbeing of the patient conducted by a physician or other professional qualified by special
training in the use of emergency safety interventions
Answer : (D)
15. In recent years, mental health services have placed emphasis on ________________________.
(A) psychosurgery
Answer : (C)
16. Which of the following was NOT a factor in the 2005 implementation of the inpatient psychiatric
facility prospective payment system (IPF PPS)?
(B) comorbidities
(D) MS-DRG
Answer : (A)
(A) involves collaboration across agencies, families, and youth for the purpose of improving access
and expanding community-based services and supports for children and youth with a serious
emotional disturbance and their families
(B) is a program of federal benefits paid to persons with disabilities such as mental illness who have
worked a sufficient length of time to qualify to receive Social Security benefits
(C) is a program in the federal block grant program that supplements the revenue of the community
mental health centers to provide services to adults in inpatient psychiatric crisis facilities
(D) is a program in the federal block grant program that supplements the revenue of State Mental
Health Authorities to fund both inpatient psychiatric hospitals and community mental health centers
Answer : (A)
TRUEFALSE
18. Children's home-based mental health services are individual-centered rather than family-
centered.
(A) True
(B) False
Answer : (B)
19. A mental health program could be accredited by the Joint Commission, CARF, or NCQA.
(A) True
(B) False
Answer : (A)
20. A hallucination is a false sensory perception, such as seeing, hearing, smelling, or feeling things
that are not real.
(A) True
(B) False
Answer : (A)
21. Involuntary commitment is a legal process by which individuals who are deemed to be a danger
to themselves or to others may be admitted to a facility even though they refuse or cannot consent to
the treatment.
(A) True
(B) False
Answer : (A)
22. Personality disorder is a form of serious mental illness in which a person alternates between
states of ecstatic mania and severe depression.
(A) True
(B) False
Answer : (B)
23. The Child and Adolescent Service System Program (CASSP) began as a federal initiative in the
1980s to create a comprehensive network of services for emotionally disturbed children and
adolescents, now known as systems of care.
(A) True
(B) False
Answer : (A)
24. CQI is a management concept that is at odds with the consumer empowerment movement
because of its focus on provider control in planning services and its lack of feedback mechanisms.
(A) True
(B) False
Answer : (B)
25. The Uniform Reporting System (URS) is a system by which each State Mental Health Authority
(SMHA) reports aggregate data to SAMHSA
(A) True
(B) False
Answer : (A)
26. When a consumer fails to abide by the stipulations of an outpatient commitment, it rarely results
in involuntary commitment to an inpatient facility.
(A) True
(B) False
Answer : (B)
27. The principal sources of funding for CMHCs are client fees, Medicaid, Medicare, and block grant
funding for special projects.
(A) True
(B) False
Answer : (A)
28. It is generally thought that persons with serious mental illness who are in stable mental states
do not benefit greatly from traditional talk therapy, and that in fact it may sometimes produce
negative effects by increasing stress when discussion turns to unhappy events.
(A) True
(B) False
Answer : (A)
29. The IPF PPS is Medicare's method of payment for services received by beneficiaries at
Community Mental Health Centers (CMHCs).
(A) True
(B) False
Answer : (B)
SHORTANSWER
31. _________________________ is the 2013 update to the classification system and nomenclature of
mental disorders developed by the American Psychiatric Association used as a coding system for
mental disorders.Answer : DSM-5 Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition
32. _________________________ is a legal process by which individuals who are deemed to be a danger
to themselves or to others may be admitted to an inpatient facility even though they refuse or cannot
consent to the treatment.Answer : Involuntary commitment
34. The _______________________ is a system by which each State Mental Health Authority (SMHA)
reports aggregate data to SAMHSA.Answer : Uniform Reporting System
Answer : URS
37. ______________________ is a common acronym for programs for persons dually diagnosed with
mental illness and chemical/alcohol addiction. (This abbreviation is not considered correct when
used to refer to individuals or to indicate a population.)Answer : MICA
38. ______________________ is the use of a drug or medication not part of a person's usual medical
regimen that is administered to control behavior or restrict freedom of movement.Answer :
Chemical restraint
39. _______________________________ is a mode of treatment for serious mental illness that focuses on
provision of an array of community support services (e.g., development of job skills, if needed) for
persons with mental illness, sufficient to allow them to live in the least restrictive environment
possible outside an institution.Answer : Psychosocial rehabilitation
MATCH
MATCH
ESSAY
43. Describe the difference in schizophrenia, clinical depression, and bipolar disorder.
Graders Info :
44. Describe any three of the core services likely to be needed by the majority of seriously mentally
ill persons at some point in the course of their treatment.
Graders Info :
Any three of the following:
a. Diagnostic evaluation and psychiatric medication management. These services are provided by a
psychiatrist, nurse practitioner, and/or nurse. If medical conditions unrelated to mental illness
are present, the person is typically referred to appropriate medical personnel within the
community for treatment.
b. Case management. This service area provides linkage and brokerage to other services. Its
primary function is to obtain access for the consumer to services both within and outside the
mental health setting. It is thus the "glue" that provides coordination of support across the
continuum and mitigates fragmentation of the service delivery system.
c. Day programming. This area varies somewhat from system to system. The goal is to provide an
opportunity for consumers to interact with both peers and professional staff. Some programs
offer the more traditional partial hospitalization activities described previously. Others take a
more rehabilitative approach, actively preparing and encouraging the consumer to move toward
employment in the job market or volunteer work in the community and more independent
functioning outside the mental health system.
d. Residential living. This alternative is offered to consumers whose level of functioning has been
impaired to the extent that they are not able upon remediation of their psychotic symptoms to
maintain themselves initially in an independent setting. They are placed in group home settings
(sometimes referred to as halfway houses), where they typically stay for six months to a year and
practice such necessary daily living skills as cooking, money management, and personal hygiene.
Acquisition of these skills will then allow them to function successfully in more independent
settings such as personal care homes, where they receive some assistance with meals and
medication monitoring, or in apartments or houses of their own.
e. Screening and evaluation. Determination as to the need for short-term acute psychiatric care
and/or recommendation to the courts for involuntary hospitalization is generally provided
through the CMHC professional staff.
f. After-hours crisis services. Emergency services for psychiatric crises are generally provided on a
24-hour basis through a system of on-call personnel. Where necessary, screening and evaluation
for involuntary hospitalization can also be provided in this way.
45. Describe wrap-around services for emotionally disturbed children and adolescents.
Graders Info :
Wrap-around services have become the predominant method of service delivery for emotionally
disturbed children and adolescents. Wrap-around services are community-based services that
attempt to prevent the necessity for more restrictive levels of care. As the term wrap-around
suggests, this is a comprehensive array of professional services that includes the child's home and/or
school setting. The essential features of this service approach entail individualization of services to
fit the specific needs of each child and family, maximization of the strengths of the child's family and
natural support systems as resources, and attention to the cultural values of the child's family and
community in the way that services are developed and delivered (Furman, 1997). As an almost
necessary adjunct to wrap-around services, the notion of flexible funding has come into use. This
concept allows for funding to be used for development of nontraditional services such as respite
care, which allows for brief "cooling off" periods during times of high emotional crisis when the child
can temporarily be cared for outside the home. Mentoring programs are another example of highly
successful nontraditional services in which successful members of the community are encouraged to
volunteer as companions to troubled youths of similar culture and background, as a means of
providing guidance and stability through the relationship.
Graders Info :
47. List two patient level factors that allow inpatient psychiatric facilities to receive per diem
payments.
Graders Info :
● the patient's age (increasingly higher rates for patients age 45 and older through age 80 and
above)
● variable per diem adjustments (higher per diem payments for the first days of the patient's stay,
gradually decreasing through the 22nd day of hospitalization, with no further decrease beyond that
point)
● the Medicare Severity diagnosis related group (MS-DRG) for the stay
● certain comorbidities. (Only one comorbidity adjustment is made for each comorbidity category,
but adjustments for more than one comorbidity category are possible.)
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JATKOA EDELLISEEN.
En koskaan ennen ollut sillä mielellä katsellut Isoa Väylää kuin nyt
katselin. Nyt vasta näin sen ensimmäisen kerran. Oli kuin olisi
Jumala sen edellisenä yönä luonut, laittanut virtaamaan tuohon
mökkini ikkunan alle suurena, mahtavana, luomispäivän riemua
kohisevana kyminä. Sen laineet lauloivat minulle luomisen valtavista
töistä, minun runoistani. Käyskelin kuin ensimmäinen Aadam
paratiisissa, sillä erotuksella vain, että minulla oli jalassa paksut
sarkahousut, vuotakengät ja ylläni punavalkoisen kirjava »iisländari».
Mutta — olin yksin maailmassa, yksin koko suuressa
luomakunnassa, mutta niin onnellisena, niin sydän riemua tulvillaan,
että toisinaan karjahtelin pelkästä olemisen autuudesta. Koko muu
maailma oli minulle kuin kuollut. En huomannut kirkonkylää, en
tuntenut ihmisiä, en kuullut karjan kellojen ääntä, kun se iltaisin
palasi laitumelta. Minä käyskelin Ison Väylän varrella paljain päin,
levittelin käsivarsiani ja huusin riemusta. Mitä minä välitin, jos joku
postinhakija pysähtyi minua kummissaan katselemaan. Minä
kuittasin hänet kääntämällä hänelle selkäni ja puhelin Isolle Väylälle:
»Se on sinun ansiosi, sinä mahtava virta! Sinä olet antanut minulle
esikuvan! Niinkuin sinä puhkaiset nämä korkeat hiekkamellat ja
uurrat itsellesi uoman meriäidin avaraan syliin, niin teen minäkin ja
puhkaisen tieni läpi vastusten suureen maailmaan! Ensimmäinen
Aadam tuli tunnetuksi siitä, että hän menetti paratiisin. Minä, Aatami
Kuuskoski, valloitan sen ihmiskunnalle takaisin — runoillani. Hih!
Eläköön!»
Iso Väylä! Sinä olet nähnyt minun riemuni, joka on tulvinut kuin
omat vetesi keväällä jäänlähdön aikana! Iso Väylä! Sinä olet nähnyt
minun tuskani, joka on ollut syvä kuin kadotuksen kuilu, mutta josta
olen noussut ylös uusin voimin, selkein otsin ja katse käännettynä
kohti korkeutta, missä ikuinen Tuomari asuu!
Sankarisielu.
Minä nauroin.