Definitions

Definitions

Abuse is any crime committed against a person including those relating to prostitution or criminal sexual conduct, any non-therapeutic conduct that produces or could produce mental or emotional distress, any sexual contact between facility staff and a resident or client, or any illegal use of a vulnerable adult's person or property for profit or advantage including situations where a person obtains money, property, or services from a vulnerable adult through the use of undue influence, harassment, duress, deception or fraud. 

Affect the expression of an emotion, usually through facial expression or physical behavior.

Alcohol a drug class including ethyl alcohol and ethanol. Possible effects or intoxication may be manifested as sensory alteration, anxiety reduction, staggering, smelling alcohol on breath, a loss of coordination, slurred speech, dilated pupils, confusion and disorientation.

Baseline level of functioning is the usual abilities of the person to perform daily activities effectively.

Cannabis class of drugs includes marijuana and hashish. Possible effects or intoxication may be manifested by euphoria, relaxation, impaired memory, poor concentration, loss of coordination, more vivid sense of taste, smell, sight and hearing, fluctuating emotions and disoriented behavior.

Crisis stabilization services qualifications. Individual provider staff must have the following qualifications:

1. be a mental health professional; or
2. be a mental health practitioner working under the clinical supervision of a mental health professional; or
3. be a mental health rehabilitation worker who must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years.

As part of the mobile crisis intervention services, the team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. 

The plan should be short-term, clear, doable as much as possible by the person experiencing the crisis situation. Include specific activities that will give the person the feeling of control over his/her life and alternatives to harmful or unproductive behavior. For instance, instead of going for a drive when feeling upset, the person might decide to call a friend.

The crisis treatment plan must address

1. the needs and problems noted in the crisis assessment and
2. include measurable short-term goals,
3. cultural considerations, and
4. frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis.
5. The treatment plan must be updated as needed to reflect current goals and services.
6. This plan must include referrals to other professionals if needed after the crisis is stabilized. Coordination with the client's case manager or other service provider, if he/she has one, is very important.
7. The client and the team should have a copy of the plan

Culture is broadly defined as a common heritage or set of beliefs, norms and values. It refers to the shared and largely learned attributes of a group of people. Anthropologists often describe culture as a system of shared meanings. People are placed, either by census categories or through self-identification, into the same racial or ethnic group are often assumed to share the same culture. This assumption is an overgeneralization because not all members grouped together in a given category will share the same culture. Many may identify with other social groups to which they feel stronger cultural ties such as being Catholic, a Minnesotan, teenaged or gay.

Cultural identity refers to the culture with which someone identifies and to which he or she looks for standards of behavior. Given the variety of ways in which to define a cultural group, many people consider themselves to have multiple cultural identities.

Depressant class of drugs includes barbiturates, tranquilizers and chloral hydrate. Possible effects or intoxication may be manifested by sensory alteration, anxiety reduction, intoxication, calmness, relaxed muscles, slurred speech, impaired judgment, loss of motor coordination and difficulty concentrating. 

Duty to Warn law is found in Minn. Statute 148.975-976. The law requires specified professionals to warm an intended victim if the professional knows that a patient has made a specific serious threat of physical violence against a specific person. If the target of the threat cannot be located, the professional may inform the local law enforcement agency.

Dysphoria is a deep sadness, anxiety and restlessness.

Emergency Services The 1987 Mental Health Act, Mn. Statute 245.462 subd.11, defines emergency services as an immediate response service available on a 24-hour, seven-day-a-week basis for persons having a psychiatric crisis, a mental health crisis, or emergency.

Ethnicity refers to a common heritage shared by a particular group. Heritage includes similar history, language, rituals, and preferences for music and foods. Historical experiences are pivotal to understanding ethnic identity and current health status.

Hallucinogenic class of drugs includes PCP, LSD, Mescaline and Ecstasy. Possible effects or intoxications may be manifested by rapidly changing feelings, anxiety, distorted perception of time, hallucinations, dizziness, confusion, suspicion, extreme changes in behavior and mood, chills, irregular breathing, sweating and shaking hands.

Health Officer is defined as a person who is a licensed physician, licensed psychologist, licensed social worker, psychiatric or public health nurse or a formally designated member of a pre-petition screening unit. 

Latrogenic is any state induced in a patient by a physician's words or actions.

Lethality is a potential for harm to self or others.

Licit is another term for legal.

Local mental health authority According to the Minnesota Mental Health Act of 1987 (Mn. Statute 245.461 to 245.486) each of these eighty-seven counties is the local mental health authority within the county boundaries. As the local mental health authority, counties are required to provide a number of mental health services to citizens who reside there. Among these is Emergency Mental Health Services.

Mental Health is the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people and the ability to adapt to change and to cope with adversity.

Mental Illness is a term that refers collectively to all mental disorders, which are health conditions characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.

Private or Confidential Data Collection on Individuals (Mn. Statute 13.05) A lot of information in this law, there is more than the basic categories below.

1. General standards for collection and storage. Collection and storage of all data on individuals and the use and dissemination of private and confidential data on individuals shall be limited to that necessary for the administration and management of programs specifically authorized by the legislature or local governing body or mandated by the federal government. (Mn. Statute 13.05, subd. 3.)
2. Private data may be used by and disseminated to any person or entity if the individual subject or subjects of the data have given their informed consent. (Mn. statute 13.05, subd, 4(d).)
3. Private or confidential data may be used and disseminated to individuals or entities subsequent to the collection of the data when the responsible authority maintaining the data has the request approval for a new or different use of dissemination of the data and that request has been specifically approved by the commissioner as necessary to carry out a function assigned by law. (Mn. Statute 13.05, subd, 4(c).)
4. Private or confidential data may be used and disseminated to individuals or entities specifically authorized access to that data by state, local, or federal law enacted or promulgated after the collection of the data. (Mn. Statute 13.05, subd 4(b).)
5. Data collected prior to August 1, 1975, and which have not been treated as public data, may be used, stored, and disseminated for the purposes for which the data was originally collected or for purposes which are specifically approved by the commissioner as necessary to public health, safety, or welfare. (Mn. Statute 13.05, subd 4(a).)
6. The use of summary data derived from private or confidential data on individuals under the jurisdiction of one or more responsible authorities is permitted. (Mn. Statute 13.05, subd, 7.)

The Mental Health Rehabilitation Act defines a mental health crisis as an adult behavioral, emotional, or psychiatric situation which, but for the provision of crisis response services, would likely result in significantly reduced levels of functioning in primary activities of daily living, or in an emergency situation, or in the placement of the recipient in a more restrictive setting, including, but not limited to, inpatient hospitalization.

A mental health crisis assessment means an immediate face-to-face assessment by a physician, a mental health professional or mental health practitioner under the clinical supervision of a mental health professional following a screening that suggests the adult may be experiencing a mental health crisis or a mental health emergency situation.

Mental health emergency is defined as an adult behavioral, emotional, or psychiatric situation that causes an immediate need for mental health services. In other words, the person is pushed enough off balance that, without assistance, he or she will be unable to rebalance his/her system and as a result will not be able to function at an independent level.

Mental health mobile crisis intervention services are face-to-face, short-term, intensive mental health services initiated during a mental health crisis or mental health emergency to help the recipient cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the recipient's baseline level of functioning. (1) This service is provided on-site by a mobile crisis intervention team outside of an inpatient hospital setting. Mental health mobile crisis intervention services must be available 24 hours, seven days a week. (2) The initial screening must consider other available services to determine which service intervention would best address the recipient's needs and circumstances. (3) The mobile crisis intervention team must be available to meet promptly face-to-face with a person in a mental health crisis or emergency in a community setting. (4) The intervention must consist of a mental health crisis assessment and a crisis treatment plan. (5) The treatment plan must also include recommendations for any needed crisis stabilization services for the recipient. 

Mental health crisis stabilization services means individualized mental health services provided to a recipient following crisis intervention services which are designed to restore the recipient to the recipient's prior functional level. Mental health crisis stabilization services may be provided in the recipients home, the home of a family member, or friend of the recipient, another community setting, or a short-term supervised, licensed residential program. Mental health crisis stabilization does not include hospitalization or day treatment. An eligible recipient is an individual who is (1) age 18 or older, (2) is screened as possibly experiencing a mental health crisis or mental health emergency where a mental health crisis assessment is needed and (3) is assessed as experiencing a mental health crisis or emergency, and mental health crisis intervention or crisis intervention and stabilization services are determined to be medically necessary.

Mental health practitioner means a person providing services to persons with mental illness.

For the provision of Medicaid Services, a mental health professional is a person providing clinical services in the treatment of mental illness qualified in at least one of the following ways and is qualified per Mn. Statutes 147 or 148 in:

• psychiatric nursing
• clinical social work
• psychology
• psychiatry
• marriage and family therapy

A mental health rehabilitation worker qualification is a staff person working under the direction of a mental health practitioner or mental health professional, and under the clinical supervision of a mental health professional in the implementation of rehabilitative mental health services as identified in the recipient's individual treatment plan.

For provision of adult mental health mobile crisis intervention services, the mobile crisis team must have at least two people with at least one member providing on-site crisis intervention services when needed. The team must be comprised of either:

•  at least two mental health professionals or
• a combination of at least one mental health professional and one mental health practitioner
  
  • The mental health practitioner must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years and
  • be under the clinical supervision of a mental health professional on the team.
  • Either team member may provide mobile crisis response services individually as long as a mental health professional is available for consultation.

Team members must be experienced in:

• mental health assessment,
• crisis intervention techniques,
• clinical decision-making under emergency conditions and must have knowledge of local services and resources.

The team must be able to recommend and coordinate the team's services with appropriate local resources such as the county social services agency, mental health services, and local law enforcement when necessary.

Mental Health Problems are signs and symptoms of insufficient intensity or duration to meet the criteria for any mental disorder.

Minority is a term used to signify the groups' limited political power and social resources, as well as their unequal access to opportunities, social rewards and social status. The term is not meant to connote inferiority or to indicate small demographic size.

Narcotics class of drugs includes morphine, codeine and heroin. Possible effects or intoxication may be manifested by euphoria, drowsiness, respiratory depression and constricted pupils.

Neglect is failure by a caretaker to supply or ensure the supply of necessary food, clothing, shelter, health care or supervision for a vulnerable adult. This may include self-neglect by the vulnerable adult.

Peace officer includes any sheriff or municipal or other local police officer or state patrol officer when engaged in the authorized duties of office.

Precipitator is an event, action or concern that causes a crisis.

Pre-petition screening unit are professionals identified by a county to review, process and initiate commitment hearings for people who have a chemical dependency, intellectual disability or mental illness and are thought to be a danger to themselves or others.

Polydipsia, otherwise known as water intoxication; can cause a myriad of symptoms that may appear to be mental illness symptoms. People who engage in polydipsia drink enormous quantities of water every day and essentially dilute the chemicals that carry the nerve impulses in their bodies. Symptoms resulting from polydipsia may include agitation, delusions, hallucinations, etc. Seizure, coma, and death can occur in severe cases.

Psychotropic medications act on the brain or the mind.

Racial and ethnic minority groups in the United States according to Federal classifications, African Americans (blacks), American Indians and Alaska Natives, Asian Americans and Pacific Islanders and white Americans (whites) are races. Hispanic American (Latino) is an ethnicity and may apply to a person of any race according to the U.S. Office of Management and Budget (OMB). For example, many people from the Dominican Republic identify their ethnicity as Hispanic or Latino and their race as black.

Serious and Persistent Mental Illness (SPMI) is a phrase developed and defined for the Minnesota Comprehensive Mental Health Act. A person must meet a number of criteria in order to be considered to be seriously and persistently mentally ill. However, these components boil down to the fact that a person must have a mental illness that interferes with his or her ability to function without some professional support in the community. Many people who have mental illness struggle with symptoms on a daily basis but function well when they receive the support that they need. Support may take the form of medications, assistance with living skills, supportive interaction with peers and professionals, etc.

Steroid class of drugs includes dianabol and nandrolone. Possible effects or intoxication may be manifested by quick weight and muscle gains, extremely aggressive behavior and skin rashes.

Stimulant class of drugs includes cocaine, amphetamines, and methamphetamines. Possible effects of intoxication may be manifested by increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite, loss of coordination, perspiration, blurred vision, dizziness, restlessness, anxiety, excessive activity, talkativeness, irritability, argumentativeness or nervousness. 

Surgeon General recommendations on Mental Health are:

• Mental Health is fundamental to health. 
• Mental illnesses are real health conditions.
• The efficacy of mental health treatments is well documented.
• A range of treatments exists for most mental disorders.

Telephone responders. According to the Minnesota Mental Health Act, The county board shall require that all service providers of emergency services to adults with mental illness provide immediate direct access to a mental health professional during regular business hours. For evenings, weekends, and holidays, the service may be by direct toll free telephone access to a mental health professional, a mental health practitioner, or until January 1, 1991, a designated person with training in human services who receives clinical supervision from a mental health professional, or a mental health practitioner.

A Vulnerable adult can be anyone over age 18 who:

• Has a physical, mental or emotional disorder that makes it difficult for the person to care for themselves without help and to protect themselves from maltreatment
• Is in a hospital, nursing home, transitional care unit, assisted living, housing with services, board and care, foster care or other licensed care facility
• Receives services such as home care, day services, personal care assistance or other licensed services.