So let's think about this life span of mental health and mental illness.
When we're thinking about prenatal care, we are thinking about the mom
and how that mom is treating her body.
This body that's going to be the environment for the development of a new life,
so we want to make sure that even before a women is pregnant,
that we are providing that women with the education needed
to understand her nutritional status
and the importance that plays in the development of a new brain.
To make sure that that mom is doing the exercises
and things that they need to do in order to be able to reduce stress
and improve well-being even in those months just prior to thinking about getting pregnant.
Then during pregnancy, we want to make sure that that person is healthy.
So, any women who is considering pregnancy now in the United States
who goes into an obstetrician is going to be given a test for depression,
because what we have found, is that depression,
if it exist before pregnancy, is more likely to present again as postpartum depression,
which could be very dangerous both for the mom and for the new baby.
So, we are now looking at this idea of psychiatric wellness in moms
before they even are getting pregnant.
And so we also want to make sure that a mom is given the right ideas for food
and these prenatal vitamins which have increased foliate.
Now foliate is a really important vitamin that a person needs to be taking
because it helps with neural development of the developing brain of the fetus.
We also want to think about as that child is born and as that child is beginning to grow,
it's really important for that new infant to have an environment that is loving,
where they can thrive, where their needs are met.
Their needs of eating of being held and loved, of being changed, of feeling safe.
As we watch a child growing up, we start looking at them
and seeing them for any kind of mood disorders
or perhaps emotional instability that might be genetic, epigenetic,
or might be something that they are acquiring through their experiences of life.
We also want to monitor every child for adverse childhood experiences.
That impact of ACEs on a developing brain, it has a lifetime impact
and therefore the sooner we can find out if a child is experiencing adverse experiences at home,
the better it is for us to be able to help and make an intervention.
Nurses, along with other professionals like teachers, have a duty to warn.
If we see children who we feel are being abused, we must report that abuse.
We want to think about, as a child grows, and they come in to their adolescence
and they become a young adult,
it's important to remember that adolescence is a time of experimentation.
It's also a time of incredible change, physical and emotional.
We don't want to jump on the idea that every adolescent who starts crying or is elated
or becomes sad for a couple of days has a mental illness. This is very normal.
Adolescents are doing trial and seeing what works in their environment,
what works socially, and it's important for them to have the support of family members,
as well as having the support of the surrounding community.
That's their protective factors.
But if they are living in a household where there is substance use,
where there is mental illness, where there is physical abuse, they have multiple risk factors.
Risk factors that increase the likelihood of them developing a mental illness.
And it's important to remember that 75% of all mental illnesses are diagnosed
before the age of 24, so people who are working in schools, the nurses in schools,
it's so important that you have an observation and understand baseline
and what this child is like and what this child is going through.
As we move into adulthood, as well as into the seniors years,
it's important again for us to remember that 18% of Americans have a mental illness
and that doesn't include substance use disorders, so and substance use disorders
are a mental illness and can be treated.
When we think about mental illness, it is an illness. It is a brain illness.
There are treatments, there are multiple modalities for people
to be able to get out of that crisis struggling aspect,
and move up into thriving and having a good life.
Men over 65 years old have the highest rate of suicide in the United States.
Now, this can be multiple factors, but one of the factors
we should be considering is if for your entire life you are a bread winner,
you are the person in charge and then you retire
and now your income is greatly reduced;
and you were always known as the CEO
and now you're sitting around the house wondering where the socks drawer is,
this is a very big change, and so some of that suicidal ideation
or thoughts of killing oneself by suicide,
comes from the abrupt alteration and change in how we see ourselves.
And, so, it's important for us to remember as nurses,
not to call our patients grandma or grandpa or honey or papi,
because they are individuals and we should be asking them, "Excuse me, sir.
What would you like me to call you?"
They might say Al is fine, they might say, "Please, call me, Mr. J."
Also alterations in that sense of self-worth changes the way a person sees other people.
It might actually increase more isolation if suddenly,
a person doesn't feel that they are worthwhile,
that they don't have that much to talk about.
When they get together with their friends, who, perhaps, are still working
and they're talking about the big deals they're doing
and then they look at Al and say, "So, Al, what are you doing?"
And Al makes a joke and says, "Oh, last week I found out where my sock drawer was."
Everyone might laugh, but for Al that might actually really be altruism,
that reinforces that he is not so worthwhile anymore.
His self-image now is taking a beating
and he is actually providing himself with that kind of self-talk that makes him defeated.