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Dictionary of Mental Health Terms A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Advance directive: This is an official form that you may choose to complete, stating that you understand that if you become incapable of, or are withholding informed consent for your mental health treatment due to the symptoms of your diagnosed mental disorder, that your Declaration will go into effect. Anorexia nervosa: Anorexia nervosa is an eating disorder characterized by unusual eating habits such as avoiding food and meals, picking out a few foods and eating them in small amounts, weighing food, and counting the calories of all foods. Individuals with anorexia nervosa may also exercise excessively. Anxiety disorders: Anxiety disorders range from feelings of uneasiness to immobilizing bouts of terror. Most people experience anxiety at some point in their lives and some nervousness in anticipation of a real situation. However, if a person cannot shake unwarranted worries, or if the feelings are jarring to the point of avoiding everyday activities, he or she most likely has an anxiety disorder. Assessment: A professional review of a person’s need that is done when services are first sought from a caregiver. The assessment includes a review of physical and mental health, intelligence, school performance/work performance, family situation, and behavior in the community. The assessment identifies the strength of the individual and family. Together, the caregiver and individual decide what kind of treatment and supports, if any, are needed. Attention-deficit/hyperactivity disorder (ADHD): Attention-deficit/hyperactivity disorder, sometimes called ADHD, is a chronic condition and the most commonly diagnosed behavioral disorder among children and adolescents. It affects between 3 and 5 percent of school-aged children in a 6-month period (U.S. Department of Health and Human Services, 1999). Children and adolescents with attention-deficit/hyperactivity disorder have difficulty controlling their behavior in school and social settings. They also tend to be accident-prone. Although some of these young people may not earn high grades in school, most have normal or above-normal intelligence. Autism or autism spectrum disorders (ASD): Autism, also called autistic disorder, is a complex developmental disability that appears in early childhood, usually before age 3. Autism prevents children and adolescents from interacting normally with other people and affects almost every aspect of their social and psychological development.
Behavioral healthcare: Continuum of services for individuals at risk of, or suffering from, mental, addictive, or other behavioral health disorders. Behavioral therapy: As the name implies, behavioral therapy focuses on behavior-changing unwanted behaviors through rewards, reinforcements, and desensitization. Desensitization, or Exposure Therapy, is a process of confronting something that arouses anxiety, discomfort, or fear and overcoming the unwanted responses. Behavioral therapy often involves the cooperation of others, especially family and close friends, to reinforce a desired behavior. Benefit package: Services covered by a health insurance plan and the financial terms of such coverage. These include cost, limitation on the amounts of services, and annual or lifetime spending limits. Binge-eating disorder: Binge-eating is an eating disorder characterized by frequent episodes of compulsive overeating, but unlike bulimia, the eating is not followed by purging. During food binges, individuals with this disorder often eat alone and very quickly, regardless of whether they feel hungry or full. Bipolar disorder (BPD): Extreme mood swings punctuated by periods of generally even-keeled behavior characterize this disorder. Bipolar disorder tends to run in families. This disorder typically begins in the mid-twenties and continues throughout life. Without treatment, people who have bipolar disorder often go through devastating life events such as marital breakups, job loss, substance abuse and suicide. Borderline personality disorder: Symptoms of borderline personality disorder, a serious mental illness, include pervasive instability in moods, interpersonal relationships, self-image, and behavior. The instability can affect family and work life, long-term planning and the individual’s sense of self-identity. Bulimia nervosa: Bulimia nervosa is an eating disorder characterized by excessive eating. People who have bulimia will eat an excessive amount of food in a single episode and almost immediately make themselves vomit or use laxatives or diuretics (water pills) to get rid of the food in their bodies. This behavior often is referred to as the “binge/purge” cycle. Like people with anorexia, people with bulimia have an intense fear of gaining weight.
Case manager: An individual who organizes and coordinates services and supports for people with mental health problems and their families. (Alternate terms: service coordinator, advocate, and facilitator.) Case management: A service that helps people arrange for appropriate services and supports. A case manager coordinates mental health, social work, educational, health, vocational, transportation, advocacy, respite care, and recreational services, as needed. The case manager makes sure that the changing needs of the individual are met. Clinical psychologist: A clinical psychologist is a professional with a doctoral degree in psychology and is licensed in the State of Utah who specializes in therapy. Clinical social worker: Clinical social workers are health professionals trained in client-centered advocacy that assist clients with information, referral, and direct help in dealing with local, State, or Federal government agencies. As a result, they often serve as case managers to help people “navigate the system.” Clinical social workers cannot write prescriptions. Cognitive therapy: Cognitive therapy aims to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or even self-destructive. The goal is to replace such thinking with a more balanced view that, in turn, leads to more fulfilling and productive behavior. Cognitive/behavioral therapy: A combination of cognitive and behavioral therapies, this approach helps people change negative thought patterns, beliefs, and behaviors so they can manage symptoms and enjoy more productive, less stressful lives. Community services: Services that are provided in a community setting. Community services refer to all services not provided in an inpatient setting. Conduct disorders: Children with conduct disorder repeatedly violate the personal or property rights of others and the basic expectations of society. A diagnosis of conduct disorder is likely when these symptoms continue for 6 months or longer. Conduct disorder is known as a “disruptive behavior disorder” because of its impact on children and their families, neighbors and schools. Consumer: Any individual who does or could receive health care or services. Includes other more specialized terms such as beneficiary, client, customer, eligible member, recipient, or patient. Couples counseling and family therapy: These two similar approaches to therapy involve discussions and problem-solving sessions facilitated by a therapist-sometimes with the couple or entire family group, sometimes with individuals. Such therapy can help couples and family members improve their understanding of, and the way they respond to, one another. This type of therapy can resolve patterns of behavior that might lead to more severe mental illness. Family therapy can help educate the individuals about the nature of mental disorders and teach them skills to cope better with the effects of having a family member with a mental illness-such as how to deal with feelings of anger or guilt. Crisis residential treatment services: Short-term, round-the-clock help provided in a non-hospital setting during a crisis. For example, when a child or adult becomes aggressive and uncontrollable, despite supports, the individual can be temporarily placed in a crisis residential treatment service. The purposes of this care are to avoid inpatient hospitalization, help stabilize the person, and determine the next appropriate step.
Day treatment: Day treatment includes special education, counseling, parent training, vocational training, skill building, crisis intervention, and recreational therapy. It lasts at least 4 hours a day. Day treatment programs work in conjunction with mental health, recreation, and education organizations and may even be provided by them. Deductible: The amount an individual must pay for health care expenses before insurance (or a self-insured company) begins to pay its contract share. Often insurance plans are based on yearly deductible amounts. Delusions: Delusions are bizarre thoughts that have no basis in reality. Dementia: Dementia is a problem in the brain that makes it hard for a person to remember, learn and communicate; eventually it becomes difficult for a person to take care of himself or herself. This disorder can also affect a person’s mood and personality. Depression: Depression is a mood disorder characterized by intense feelings of sadness that persist beyond a few weeks. Two neurotransmitters-natural substances that allow brain cells to communicate with one another-are implicated in depression: serotonin and norepinephrine. Diagnostic evaluation: The aim of a general psychiatric evaluation are 1) to establish a psychiatric diagnosis, 2) to collect data sufficient to permit a case formulation, and 3) to develop an initial treatment plan, with particular consideration of any immediate interventions that may be needed to ensure the patient’s safety, or, if the evaluation is a reassessment of a patient in long-term treatment, to revise the plan of treatment in accord with new perspectives gained from the evaluation. Discharge: A discharge is the formal termination of service, generally when treatment has been completed or through administrative authority. Dissociative disorders: Dissociative disorders are so-called because they are marked by a dissociation from or interruption of a person’s fundamental aspects of waking consciousness (such as one’s personal identity, one’s personal history, etc.) Drop-in center: A social club offering peer support and flexible schedule of activities; may operate on evenings and weekends. Drug formulary: The list of prescription drugs for which a particular employer or State Medicaid program will pay. Formularies are either “closed,” including only certain drugs or “open,” including all drugs. Both types of formularies typically impose a cost scale requiring consumers to pay more for certain brands or types of drugs. Dual diagnosis/ dual diagnosis services: A person who has both an alcohol or drug problem and an emotional/psychiatric problem is said to have a dual diagnosis. Dual disability services: Treatments for people who suffer from a developmental disability and a mental illness.
Early intervention: Identifying persons at high risk prior to their having a serious consequence, or persons at high risk who have had limited serious consequences, related to substance use on the job, or having a significant person, economic, legal, or health/mental health consequence, and providing these persons at high risk with appropriate counseling, treatment education, or other intervention. Eating disorders: Eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder, which are serious, often chronic, and life-threatening. Employee Assistance Plan (EAP): Resources provided by employers either as part of, or separate from, employer-sponsored health plans. EAPs typically provide preventive care measures, various health care screenings, and/or wellness activities.
Foster care: Provision of a living arrangement in a household other than that of the client’s/patient’s family.
Generalized anxiety disorder (GAD): Generalized anxiety disorder is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it. Group therapy: This form of therapy involves groups of usually 4 to 12 people who have similar problems and who meet regularly with a therapist. The therapist uses the emotional interactions of the group’s members to help them get relief from distress and possibly modify their behavior.
Hallucinations: Hallucinations are experiences of sensations that have no source. Some examples of hallucinations include hearing nonexistent voices, seeing nonexistent things, and experiencing burning or pain sensations with no physical cause. Health Insurance Portability and Accountability Act (HIPAA): This 1996 act provides protections for consumers in group health insurance plans. HIPAA prevents health plans from excluding health coverage of pre-existing conditions and discriminating on the basis of health status. Health Maintenance Organization (HMO): A type of managed care plan that acts as both insurer and provider of a comprehensive set of health care services to an enrolled population. Services are furnished through a network of providers.
Individual therapy: Therapy tailored for a patient/client that is administered one-to-one. Information and referral services: Information services are those designed to impart information on the availability of clinical resources and how to access them. Referral services are those that direct or guide a client/patient to appropriate services provided outside of your organization. Inpatient hospitalization: Mental health treatment provided in a hospital setting 24 hours a day. Inpatient hospitalization provides: 1) short-term treatment in cases where an individual is in crisis and possibly a danger to his/herself or others, and 2) diagnosis and treatment when the patient cannot be evaluated or treated appropriately in an outpatient setting. Intake/screening: Services designed to briefly assess the type and degree of a client’s/patient’s mental health condition to determine whether services are needed and to link him/her to the most appropriate and available service. Services may include interviews, psychological testing, physical examinations including speech/hearing, and laboratory studies.
Local mental health authority: Local organizational entity (usually with some statutory authority) that centrally maintains administrative, clinical and fiscal authority for a geographically specific and organized system of health care. In Utah, the local mental health authorities are the counties.
Major depression: Major depression is persistent sadness, loss, or passing mood states and can significantly interfere with an individual’s thoughts, behavior, mood, activity, and physical health. Managed care: An organized system for delivering comprehensive mental health services that allows the managed care entity to determine what services will be provided to an individual in return for a prearranged financial payment. Generally, managed care controls health care costs and discourages unnecessary hospitalization and overuse of specialists, and the health plan operates under contract to a payer. Medicaid: Medicaid is a health insurance assistance program funded by Federal, State and local monies. It is run by State guidelines and assists low-income persons by paying for most medical expenses. Medically necessary: Health insurers often specify that, in order to be covered, a treatment or drug must be medically necessary for the consumer. Anything that falls outside of the realm of medical necessity is usually not covered. The plan will use prior authorization and utilization management procedures to determine whether or not the term “medically necessary” is applicable. Medicare: Medicare is a Federal insurance program serving the disabled and persons over the age of 65. Most costs are paid via trust funds that beneficiaries have paid into throughout the courses of their lives; small deductibles and some co-payments are required. Medication therapy: Prescription, administration, assessment of drug effectiveness, and monitoring of potential side effects of psychotropic medications. Mental health: How a person thinks, feels, and acts when faced with life’s situations. Mental health is how people look at themselves, their lives, and the other people in their lives; how they evaluate their challenges and problems, and explore choices. This includes handling stress, relating to other people and making decisions. Mental health problems: Mental health problems are real. They affect one’s thoughts, body, feelings and behavior. Mental health problems are not just a passing phase. They can be severe, seriously interfere with a person’s life, and even cause a person to become disabled. Mental health problems include depression, bipolar disorder (manic-depressive illness), attention-deficit/hyperactivity disorder, anxiety disorders, eating disorders, schizophrenia, conduct disorder, and other disorders. Mental illnesses: This term is usually used to refer to severe mental health problems in adults.
Nurse practitioner: A nurse practitioner is a registered nurse who works in an expanded role and manages patients’ medical conditions.
Obsessive-compulsive disorder (OCD): Obsessive Compulsive Disorder is a chronic, relapsing illness. People who have it suffer from recurrent and unwanted thoughts or rituals. The obsessions and the need to perform rituals can take over a person’s life if left untreated. They feel they cannot control these thoughts or rituals.
Panic disorder: People with panic disorder experience heart-pounding terror that strikes suddenly and without warning. Since they cannot predict when a panic attack will seize them, many people live in persistent worry that another one could overcome them at any moment. Paranoia/ paranoid disorders: Symptoms of paranoia include feelings of persecution and an exaggerated sense of self-importance. The disorder is present in many mental disorders and it is rare as an isolated mental illness. A person with paranoia can usually work and function in everyday life since the delusions involve only one area. However, their lives can be isolated and limited. Phobias: Phobias are irrational fears that lead people to altogether avoid specific things or situations that trigger intense anxiety. Phobias occur in several forms, for example, agoraphobia is the fear of being in any situation that might trigger a panic attack and from which escape might be difficult; social phobia is a fear of being extremely embarrassed in front of people. Physician assistant: A physician assistant is a trained professional who provides health care services under the supervision of a licensed physician. Plan of care: A treatment plan especially designed for the individual, based on individual strengths and needs. The caregiver develops the plan with input from the patient. The plan established goals and details appropriate treatment and services to meet the special needs of the patient. Post traumatic stress disorder (PTSD): Post-traumatic stress disorder is an anxiety disorder that develops as a result of witnessing or experiencing a traumatic occurrence, especially life threatening events. PTSD can interfere with a person’s ability to hold a job or to develop intimate relationships with others. Prevention: The public health model of prevention includes primary, secondary, and tertiary prevention. An Institute of Medicine Committee (IOM) set forth another definition in which prevention refers to those interventions that take place before the onset of a disorder. IOM classifies preventive interventions as 1) universal preventive interventions, which target the general public or an entire population not identified on the basis of individual risk, 2) selective preventive interventions, which target populations whose risk of a disorder is significantly higher than average at present or over a lifetime, and 3) indicated preventive interventions, which target high-risk individuals who have minimal but detectable signs or symptoms that may lead to a mental disorder. Primary care physician (or provider) (PCP): Physicians with the following specialties: group practice, family practice, internal medicine, obstetrics/gynecology, and pediatrics. The PCP is usually responsible for monitoring an individual’s overall medical care and referring the individual to more specialized physicians for additional care. Psychiatrist: A psychiatrist is a professional who completed both medical school and training in psychiatry and is a specialist in diagnosing and treating mental illness. Psycho-education Information and education about an illness, its diagnosis, common or recommended interventions, as well as opportunities for questions and feedback that are provided to a patient and his/her spouse or family. Psychosocial rehabilitation: Therapeutic activities or interventions provided individually or in groups that may include development and maintenance of daily and community-living skills, self-care, and skills training including grooming, bodily care, feeding, social skills training, and development of basic language skills.
Recovery/resiliency: Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential Registered nurse (RN): A registered nurse is a trained professional with a nursing degree who provides patient care and administers medicine. Residential services: Services provided over a 24-hour period or any portion of the day which a patient resided, on an on-going basis, in a State facility or other facility and received treatment. Residential treatment centers: Facilities that provide treatment 24 hours a day and can usually serve more than 12 people at a time. Individuals receive increased supervision and care. Treatment may include individual, group, family therapy; behavior therapy; special education; recreation therapy; and medical services. Residential treatment is usually more long-term than inpatient hospitalization. Centers are also known as therapeutic group homes.
Schizophrenia: Schizophrenia is a mental disorder characterized by “positive” and “negative” symptoms. Psychotic or positive symptoms include delusions, hallucinations, and disordered thinking (apparent from a person’s fragmented, disconnected and sometimes nonsensical speech). Negative symptoms include social withdrawal, extreme apathy, diminished motivation, and blunted emotional expression. Schizoaffective disorder: Schizoaffective disorder is one of the more common, chronic, and disabling mental illnesses. As the name implies, it is characterized by a combination of symptoms of schizophrenia and an affective (mood) disorder. School-based services: School-based treatment and support interventions designed to identify emotional disturbances and/or assist parents, teachers, and counselors in developing comprehensive strategies for addressing these disturbances. School-based services also include counseling or other school-based programs for emotionally disturbed children, adolescents, and their families within the school, home and community environment. Seasonal affective disorder (SAD): Seasonal affective disorder (SAD) is a form of depression that appears related to fluctuations in the exposure to natural light. It usually strikes during autumn and often continues through the winter when natural light is reduced. Researchers have found that people who have SAD can be helped with the symptoms of their illness if they spend blocks of time bathed in light from a special full-spectrum light source called a “light box.” Self-help: Self-help generally refers to groups or meetings that: involve people who have similar needs; are facilitated by a consumer, survivor, or other layperson; assist people to deal with a “life-disrupting” event such as a death, abuse, serious accident, addiction, or diagnosis of a physical, emotional or mental disability, for oneself or a relative; are operated on an informal, free-of-charge, and nonprofit basis; provide support and education; and are voluntary, anonymous, and confidential. Many people with mental illnesses find that self-help groups are an invaluable resource for recovery and for empowerment. Serious emotional disturbances (SED): Diagnosable disorders in children and adolescents that severely disrupt their daily functioning in the home, school, or community. Serious emotional disturbances affect one in 10 young people. These disorders include depression, attention-deficit/hyperactivity, anxiety disorders, conduct disorder, and eating disorders. Pursuant to section 1912© of the Public Health Service Act, children with a serious emotional disturbance are persons up to age 18 who currently have or at any time during the last year had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-III-R (and subsequent revisions). Serious mental illness (SMI): Pursuant to section 1912© of the Public Health Service Act, adults with serious mental illness (SMI) are persons age 18 and over who currently have or at any time during the past year had a diagnosable mental behavioral or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM-IV or their ICD-9-CM equivalent (and subsequent revisions) with the exception of DSM-IV “V” codes, substance use disorders, and developmental disorders, which are excluded, unless they co-occur with another diagnosable serious mental illness, which has resulted in functional impairment with substantially interferes with or limits one or more major life activities. Service: A type of support or clinical intervention designed to address the specific mental health needs of the individual, including an adult, child and his or her family. A service could be provided only one time or repeated over a course of time, as determined by the individual's needs. Social phobia or social anxiety disorder: Social phobia or social anxiety disorder is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. State Children’s Health Insurance Plan (SCHIP): Under Title XXI of the Balanced Budget Act of 1997, the availability of health insurance for children with no insurance or for children from low-income families was expanded by the creation of SCHIP. SCHIP operates as part of a State’s Medicaid program. State Hospital: A publicly funded inpatient facility for persons with mental illness. The Utah State Hospital is located in Provo, Utah. Substance abuse disorders: Misuse of medications, alcohol or other illegal substances. Suicide/suicidal behavior: Suicide is the 8th leading cause of death in the United States, claiming about 30,000 lives a year. Ninety percent of persons who commit suicide have depression or another diagnosable mental or substance abuse disorder. Suicide attempts are among the leading causes of hospital admissions in persons under age 35. The highest suicide rates in the U.S. are found in white men over the age of 85. Suicide can be prevented. Supported employment: Supportive services that include assisting individuals in finding work; assessing individuals’ skills, attitudes, behaviors, and interest relative to work; providing vocational rehabilitation and/or other training; and providing work opportunities. Includes transitional and supported employment services. Supported housing: Services to assist individuals in finding and maintaining appropriate housing arrangements. Supportive residential services: Moderately staffed housing arrangements for clients/patients. Includes supervised apartments, satellite facilities, group homes, halfway houses, mental health shelter-care facilities, and other facilities.
Therapeutic foster care: A service which provides treatment for troubled children within private homes of trained families. The approach combines the normalizing influence of family-based care with specialized treatment interventions, thereby creating a therapeutic environment in the context of a nurturing family home.
Vocational rehabilitation services: Services that include job finding/development, assessment and enhancement of work-related skills, attitudes, and behaviors as well as provision of job experience to clients/patients. Includes transitional employment where a person receives support from professionals to get and maintain a job.
Wraparound services: Services that address consumers' total health care needs to achieve health or wellness. These services “wrap around” core clinical interventions, usually medical. Typical examples include such services as financial support, transportation, housing, job training, specialized treatment, or educational support.
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