Patients who develop institutionalization syndrome become: * entirely dependent upon the hospital for all aspects of their lives. entirely dependent upon medication to function outside the hospital. disinterested in greater society. extremely fearful of being institutionalized and therefore do not seek treatment. 2. An individual, who has been hospitalized for many years, yet received little or no therapy and consequently is now dependent upon the staff for all their needs, would be considered: desensitized. marginalized. * institutionalized. catatonic. 3. Patients who are assigned to live on an open ward in a psychiatric hospital are generally the only patients who can: have unsupervised visitations. * leave the psychiatric ward and visit other sections of the hospital. leave and return to the hospital any time they want. refuse treatment. 4. In closed wards of psychiatric hospitals: * attendants guard the doors and patients may not leave the ward. attendants guard the doors and patients may not have visitors. patients are heavily medicated and kept in isolation. patients have few rights or privileges and usually spend their time staring at the walls. 5. In contrast to large psychiatric hospitals, a small psychiatric unit of a general hospital is more likely to: * have all of the patients grouped together on one ward. avoid the use of medication. take only patients with one type of disorder. have an open ward. 455 6. Most psychiatric wards have a(n) ____________ in which patients can be confined temporarily if they become agitated or destructive. domiciliary closed ward * isolation room day room 7. In most psychiatric hospitals, the offices of the treatment staff, such as psychologists and clinicians, are: * separate from the psychiatric ward. within the day room of the psychiatric ward. in the nurses' station. connected to the nurses' station. 8. During the daytime, patients in most psychiatric wards are: allowed to go where they please. allowed to nap in their rooms or spend time in the day room. * not allowed to go to their sleeping rooms. heavily medicated and spend all their time in the day room. 9. Karen is a disturbed individual who has been placed in a night hospitalization program. Compared with 24-hour-a-day inpatient hospitalization, the night program will be: less effective, but also less expensive. more reliant upon medication. * less expensive and equally effective. less oriented toward therapy. Individuals who are in a day or night hospitalization program have an advantage over those who are hospitalized 24-hours-a-day in that they: * maintain consistent contact with the outside world. are more likely to receive longer insurance coverage. are statistically likely to fully recover more quickly. require less medication. 11. A _______________ is the staff member of a psychiatric hospital who is responsible for drug and electroconvulsive shock therapies. nurse practitioner psychologist head nurse * psychiatrist 12. It is often the _______________ who has the greatest influence in a patient's life on the ward. psychiatrist psychologist social worker * psychiatric nurse 13. The day-to-day running of a psychiatric ward is primarily in the hands of: psychiatrists. psychologists. social workers. * psychiatric nurses. 14. The members of the hospital staff who have the most contact with the patients are the: psychiatrists. psychologists. * psychological technicians. psychiatric nurses. 15. On most psychiatric wards the staff with the ____________ amount of formal education have the _____________ influence in the patients' daily lives. greatest; greatest greatest; broadest * least; greatest least; narrowest 16. Simona has been admitted to an inpatient psychiatric facility. Of the staff, she is most likely to become best acquainted and have more quality contact with the: head nurse. resident psychologist. ward nurses. * psychological technicians. 17. If a patient in a psychiatric hospital is placed on a suicide watch, this means: * a ward tech will stay with them 24-hours-a-day. they will spend all their time at the nurses' station. they will be confined to an isolation room 24-hours-a-day. the head nurse will stay with them 24-hours-a-day. 18. Simona has just been admitted to an inpatient psychiatric facility. The person who is most likely to help Simona maintain her link with her family and to help Simona with practical problems is: a ward tech. * a social worker. an occupational therapist. a psychiatric nurse. Ideally, the activities directed by the occupational therapists on psychiatric wards serve: * as models for normal behaviors. as effective treatments. as filler between therapy sessions. only as rewards for good behavior. 20. The goal of activity therapists is to: * increase social interaction. cure the patient's disorder. provide a break for the ward attendants. assess the depth of a patient's illness. 21. In many mental hospitals there is very little informal contact between the patients and the professional staff. This is likely because: professionals are unable to empathize with patients. * the staffs are overworked. it is important for the staff to maintain a lack of commitment to the patients. all of the above. 22. Hospitalization in a private psychiatric facility typically costs a minimum of: * $1,000 a day. $750 a day. $500 a day. $1500 a day 23. One study cited in the text revealed that almost _________ of hospital admissions for substance abuse were unnecessary. 25% * 75% 50% 10% 24. The text author writes of one hospital where the patients who were admitted for eating disorders were generally discharged after 28 or 29 days. This procedure was established because: activities engaged in for approximately 30 days are prone to become habits. the hospital concentrates exclusively on eating disorders and has a high cure rate. most eating disorders can be eliminated by 20 to 40 days of consistent care. * the patients insurance benefits ran out after 30 days. 25. ______________ is probably the most cost-effective treatment option. * Outpatient treatment Day hospitalization Night hospitalization Twenty-four-hour care 26. Which of the following is probably the best treatment option in terms of patient benefit and financial cost? day hospitalization * outpatient treatment night hospitalization 24-hour hospitalization 27. The process of deinstitutionalization involves: treating those individuals who have been housed in the back wards of asylums. restructuring the look and function of psychiatric wards to make them less bleak. members of the community reaching out to local psychiatric wards by visiting the patients. * closing mental hospitals and putting the patients back into the community. Between the years 1990 and 2000 over 40 state-run mental hospitals closed. The factor that likely contributed the most to this was: improved medications. improved stress-prevention programs. improvements in out-patient therapy. * economic pressures. 29. Deinstitutionalization led to a reduction in the number of patients in hospitals and this in turn had the effect of: * lowering the cost of hospitalization. increasing the cost of hospitalization. increasing the cost of insurance coverage. increasing outpatient costs. 30. Compared with inpatient hospitalization, outpatient treatment is: * more effective and costs significantly less. slightly less effective, but costs significantly less. less effective, but provides treatment for a greater number of patients. slightly less expensive, but equally effective. 31. By their very nature, hospital environments can have a tendency to foster a sense of _________ in individuals who are having difficulty coping with and adjusting to greater society. confidence * dependence empowerment disillusionment 32. Placing individuals with psychiatric problems in a hospital can teach them the role of patient rather than person, and this can lead to: a better personal adjustment through observation of others who are similar. a better understanding of themselves and their limitations and increased self-acceptance. immediate stress reduction resulting from the lack of extemporaneous stimuli, which in turn enhances the probability of a recovery and a return to greater society. * a letting go of personal responsibility and a degradation of the individual's self-confidence. 33. An unfortunate aspect of housing persons with psychiatric problems in a hospital environment in which they are surrounded by others who are also somewhat unbalanced is: * there are few, if any, positive role models. they become institutionalized. they learn to be stereotypically mentally ill. they withdraw and do not interact with others. 34. Paul suffers from severe depression and is about to be hospitalized. Assuming that he is not suicidal, a psychiatric ward may be a less than optimal place for him to recover because: he will not receive the amount of attention he needs from the staff. * hospitals tend to foster dependency and Paul will not have to face his problems directly. he will receive medication, but no psychotherapy to help him with his depression. hospitals in themselves are depressing and this will only make Paul's depression worse. 35. One of the major strengths of caring for patients in the community is that this setting: * provides the opportunity of learning the role of person rather than patient. fosters a sense of dependence on others which aids in the healing process. is more conducive to treatment by a greater variety of mental health professionals. increases the patient's stress levels, which in turn might increase the patient's self-confidence. Persons who suffer from psychiatric problems and who are treated within the community have an advantage over those who are treated within a hospital in that: they receive more consistent care. * they do not have to make the stressful transition from the hospital back to the community. their insurance benefits last longer. they have access to a greater variety of psychiatric professionals. 37. Treating individuals with mental health disorders in the community is likely to be more cost-effective than housing them in psychiatric wards because: the overall numbers of those being treated will drop. most community care centers receive pharmaceutical discounts. * indirect operating costs are eliminated. fewer therapists are required. 38. The economic advantages of closing state hospitals may be misleading because: the savings are directly related to indirect operational costs which in themselves are minimal. many of the discharged patients will have to rely on welfare or social security benefits. * many discharged patients end up in private facilities and their bills are paid by Medicare. many state-run mental health care facilities were actually paying for themselves. 39. Many individuals who are discharged from psychiatric wards because of the movement towards deinstitutionalization are unable to function in greater society and they end up: going to prison. living in half-way houses. being treated at community centers. * living on the street. 40. When mental hospitals were closed in the move to save money and deinstitutionalize patients, some patients were left stranded with no place to go largely because: the money that was saved was not reinvested into alternative care options. they lacked the skills which would allow them to function in society. they still suffered from their illnesses and this prevented them from functioning in society. * all of the above. 41. The term "psychiatric ghetto" refers to: outdated mental health facilities. some of the older state-run asylums which lack proper funding. * treatment centers which place greater emphasis on patient numbers than patient treatment. run-down sections of cities where deinstitutionalized mental patients live. 42. Studies comparing the effectiveness of hospital treatment to alternative forms of treatment, such as outpatient psychotherapy or daycare for those with psychiatric disorders, have shown that: 24-hour care in a reputable psychiatric facility yields the greatest patient recovery rates. in every case alternative care proved to be more effective than hospitalization. * hospitalization is not more effective than alternative forms of therapy. alternative therapy is at best a poor alternative. 43. In one study in which first-admission patients with schizophrenia were assigned to a mental hospital or to a small, homelike facility, it was found during a 2 year follow-up that patients from the homelike facility were more likely than the hospital patients to be: housed in a psychiatric hospital. * employed and living alone or with peers. unemployed and living with relatives. unchanged in terms of symptoms and living conditions. Mental hospitals are useful in their capacity to provide ___________ for those individuals who are facing overwhelming psychological difficulties and have no place to go. alternative treatment physical therapies * refuge and protection various health professionals 45. Mental hospitals still play a more vital role in the treatment of those individuals who are _____________ than community care alternatives such as outpatient therapy. * highly suicidal schizophrenic depressed suffering from adjustment disorders 46. The idea of systematically treating disturbed individuals in the community can be traced back to the town of: Cairo in the 10th century. Amsterdam in the 5th century. Paris in the 18th century. * Gheel in the 13th century. 47. Outpatient clinics are generally associated with large hospitals in big metropolitan areas. They can provide an effective alternative to hospitalization, but are potentially problematic in that: they tend to treat people from only the upper income brackets. they may not be as cost-effective as hospitalization. * they may be difficult for many patients to reach. they generally deal with only major psychological problems. 48. _________ were designed to overcome the location problem of hospital-based outpatient clinics. Halfway houses Home care programs Domiciliaries * Community health care centers 49. The initial idea behind community mental health centers was to: * make treatment more accessible in the early stages of a problem. debunk the myths associated with mental illness. provide clinicians a larger client base. provide easier access to long-term hospitalization. 50. Which of the following is not a function that community mental health centers fulfill? provide outpatient therapy with day hospitalization * provide easier access to long-term hospitalization provide round-the-clock emergency services provide educational and consultation services 51. Providing outpatient therapy, short-term inpatient hospitalization in emergencies, 24-hour emergency services, and educational and services are all goals of: * community mental health centers. outpatient therapy clinics. social services programs. halfway houses. 52. Because they are located near their clients, community mental health centers may be more ____________ than large, hospital-based treatment facilities. expensive * culturally sensitive limited provincial Byron wants to take classes or attend some type of seminar on how to avoid stress and increase life satisfaction. Which of the following facilities would be most likely to provide this service? an outpatient clinic a halfway house * a community mental health center a psychiatric hospital 54. Which of the following facilities would likely be best suited to handle a phone call at 3:00 a.m. from an individual who was having a severe mental break-down and contemplating suicide? * a community mental health center an outpatient clinic a psychiatric hospital a halfway house 55. One of the limitations of many community mental health centers is: they, ironically, have become warehouses for the mentally ill. they are seriously limited in the physical therapies they can provide. insurance costs have rendered their services out of reach for those who most need it. * an overworked staff is not able to provide prevention services. 56. Halfway houses are: * usually staffed by paraprofessionals. usually staffed by licensed mental health practitioners. designed for long-term use by residents. an excellent alternative to long-term hospitalization. 57. ___________ provide a supportive, but semistructured environment in which residents can make the transition from a hospital environment back into the community. Community mental health centers * Halfway houses Outpatient clinics Day treatment programs 58. Sarah is back in the community after living on a psychiatric ward for three years. She is being helped to adjust by the elderly couple and five other girls with whom she is currently living. Each resident understands what Sarah is facing and is very supportive. Sarah will soon look for a job and in eight months will have to find a place of her own. This situation describes a: * halfway house. rehab center. community mental health center outpatient ward. 59. ______________ is a community outreach program in Baltimore that provides home care type services for individuals who are too mentally ill to come to a hospital. COBRA D.A.R.E. * COSTAR COBALT 60. Eligia works in a home care program. His goal will be to: find and institutionalize individuals on the street who cannot care for themselves. provide education and prevention services. * provide treatment and social support for people wherever they are. take individuals who are too sick to travel alone to the outpatient clinic. The COSTAR program sponsored by John Hopkins hospital relies upon ___________ to go into the community and help individuals who cannot function totally on their own, but who are not ill enough for hospitalization. psychological technicians psychologists * psychiatric nurses paraprofessionals 62. Numerous surveys have indicated that most people: have no opinion about people who are mentally ill. have positive attitudes pertaining to people who are mentally ill. feel mentally ill people belong in the community. * fear individuals who are mentally ill and have negative attitudes towards them. 63. In one study, individuals who lived in areas in which there were or were not psychiatric treatment facilities were surveyed about the area. It was found that a majority of those persons living near a treatment facility: * were not aware of it. were concerned about the residents of the facility. reported experiencing at least one encounter with a person they perceived as mentally ill. thought it was beneficial to the community. 64. Many of the negative associations generated by mental health facilities can be ascribed to : the negative impact of their patients upon the community. * the way they are labeled. the types of treatments they promote. a lack of treatment success. 65. One mental hospital changed its name to the Madison Center. After the name change: the number of people using the center increased. * local residents passed a bond issue to provide the center additional funding. the number of people using the center decreased. residents became aware the center existed in their community. 66. In focusing on the origin of a mental illness, it is important to recognize the fact that each particular disorder: usually has one major cause. usually has one treatment which works the best. has different symptoms. * usually has a number of different potential causes. 67. Most prevention programs designed to reduce the occurrence of mental illness focus specifically on ______________ as the main contributing factor. * stress lifestyle anxiety depression 68. Which of the following would not be a component of mental illness intervention programs? * genetic factors reducing relapses early awareness stress reduction 69. Practitioners in ____________ psychology often work in government offices rather than in clinics, directing their efforts toward changing social and environmental problems that affect mental health. biological humanistic industrial * community The subspecialty of psychology known as community psychology focuses on: treating mentally ill individuals in their own homes. establishing community mental health centers. lobbying the government for research funding aimed at preventing mental illness. * eliminating societal and environmental factors which potentially contribute to mental illness. 71. Programs designed to educate expectant mothers in the prenatal and postnatal care of their babies have been seriously hampered by: a lack of success in preventing mental and physical illness. a lack of interest. * congressional budget cuts. a shortage of qualified teachers. 72. Prevention programs which provide expectant mothers with better prenatal care and preparation for motherhood have: seen limited success in terms of preventing mental illness. failed due to a lack of interest. * been successful in reducing mental illness and promoting overall health. been largely omitted from most mental health care programs. 73. When prenatal and postnatal programs are cut because of budgetary problems: short-term and long-term health care costs increase. short-term and long-term health care costs decrease. short-term health care costs increase, but long-term costs decrease. * short-term health care costs decrease, but long-term costs increase. 74. Eliminating programs that provide prenatal and postnatal care to poor women because the budget needs to be reduced and government can no longer afford these programs has the effect of: * promoting mental illness and increasing future health care costs. providing funds for more important, immediate mental health care needs. reducing unnecessary governmental expenditures. none of the above. 75. In many cases, the prevention of mental disorders is difficult at best, which means the next optimal solution for eliminating the development of psychological illness is: treatment. stress reduction. * early detection. education. 76. Individuals who face specific stressful problems that could lead to abnormal behavior, and who meet to share their experiences and help one another, are involved in: * supports groups. occupational therapy. outpatient therapy. primary intervention groups. 77. The best known support group is: COBRA. Alanon. the MD support group. * Alcoholics Anonymous. 78. Support groups provide benefits for their members through all of the following means except: * consistent reliance on medical professionals. providing problem-specific information. emotional support. providing models for success. For the most part, the help that comes from a support group is based upon: the knowledge of paraprofessionals. clinical counselors. * the experience of peers. the assistance of psychiatric nurses. 80. Most support groups consist of: a professional management group. a core leadership of paraprofessionals. * peers helping peers. patients who are organized and directed by clinicians. 81. Jacob attends free, weekly meetings at which he listens to others describe the things that are happening with them and also gets a chance to talk about himself and his issues. The people at these sessions help one another cope with their addictions and the difficulties inherent in maintaining a "straight" lifestyle. This is an example of: rehabilitation therapy. * a support group. a group counseling session. outpatient therapy. 82. _______________ provide short-term help for acute, immediate problems. * Crisis intervention centers Walk-in psychiatric clinics Support groups Day treatments 83. The text provided a case study of an undergraduate student who worked at a crisis center. Her experience demonstrates that crisis center workers: need a considerable amount of training in a variety of fields. * provide support for a variety of people with diverse problems which range in severity. generally come from a medical background or are headed into some type of medical field. serve a very narrow range of the public, most of whom are suicidal. 84. The text provides an example of an undergraduate student who worked at a crisis center. She described her co-workers as all having one common denominator, that is: * caring about people. an interest in medicine. an interest in psychology. an interest in becoming EMT's. 85. Using the case study of the undergraduate student who worked in a crisis center as a paradigm, which of the following best describes the role of a crisis center counselor? amateur psychiatrist amateur psychologist guidance counselor * supportive friend 86. _____________ provide services like telephone hotlines and 24-hour-a-day walk-in counseling. * Crisis centers Community mental health centers Outpatient clinics Halfway houses 87. The third line of defense against abnormal behavior is: prevention. treatment. early identification. * preventing relapses. The textbook reported a case study on the cost of treatment for a woman named Betty who suffers from schizophrenia. Betty's drugs are a form of: cure. * treatment and relapse prevention. crisis management. prevention. 89. The key element in relapse prevention for most individuals with psychological disorders who control their symptoms with medication is: * being aware they still have an illness. continual counseling. belonging to a support group. understanding combination drug effects. 90. In order to prevent relapses in individuals who suffer from mental disorders, it is essential to: * eliminate or control the factors that originally caused the disorder. provide a long-term treatment plan. have a backup treatment plan should the original fail. implement a program of weekly, or sometimes even daily, counseling sessions. Open wards in psychiatric hospitals contain those highly disturbed patients who have been in the establishment for a considerable time and have become somewhat institutionalized and therefore are less likely to attempt escape. True * False 92. Clinicians and other psychiatric professionals generally have their offices next to or inside the psychiatric ward so as to have more expedient access to their patients. True * False 93. James is a long time patient in a psychiatric ward and his consistent, gentle nature has earned him the trust of the staff. If this facility is like most mental hospitals, James will be able to use his sleeping quarters during the day to nap or just have some quiet time if he needs it. True * False 94. Day and night hospitalization procedures are far less expensive and at least as effective as full-time hospitalization. * True False 95. The psychological technicians on a psychiatric ward likely have the greatest overall influence in the lives of the patients. * True False 96. Informal contact between patients and the professional staff of most psychiatric hospitals is extremely limited. * True False 97. Studies indicate that nearly 40% of the days spent in hospitals by mental patients are unnecessary. * True False 98. Of all the treatment options, day hospitalization is probably the most cost-effective. True * False 99. Deinstitutionalization is the process of closing mental hospitals and sending patients to the community for treatment. * True False Marvin is in therapy and sees his counselor twice a week. In the last year he has made little progress and, in fact, seems less able to cope with life than when he started. His counselor recommended he enroll in a day hospitalization program. This is likely to cost approximately twice as much as Marvin's therapy sessions. * True False An individual who lives and is treated in a psychiatric hospital will have a less difficult time identifying with positive role models than an individual who is treated in the community. True * False Deinstitutionalization is effective in that it funnels patients into more efficient treatment programs within the community and unequivocally saves the government millions of dollars in hospital costs. True * False The number of people in mental hospitals has been drastically reduced since the 1980's. One of the major contributing factors to this phenomena has been the development of more effective drugs. * True False Marlis suffers from major depressive disorder and has not left the confines of her house in several years. If she were placed in a mental hospital and given 24-hour care, she would be more likely to improve than if she were just enrolled in an outpatient therapy program and given drugs to alleviate her symptoms. * True False Community mental health centers generally can provide short-term hospitalization, which allows patients to remain close to their friends and families and this likely facilitates recovery. * True False Most community mental health centers have a separate, full-time staff who devote all their time and energy into education and prevention programs. True * False One advantage community mental health centers have over larger, metropolitan hospitals is that the services provided by community health centers are aimed at the middle-class and based on a middle-class lifestyle. True * False Most halfway houses are transitional care facilities affiliated with a psychiatric hospital and run by psychological technicians or licensed clinical practitioners. True * False Results from numerous surveys indicate that most people would rather not have a mental health facility in their community. * True False The term "mental hospital" would likely inspire more negative connotations than the term "psychiatric care facility." * True False The implementation of Federal and State programs designed to aid those individuals who are living at or below the poverty level would have a substantial effect on the incidence of mental illness. * True False Programs which provide prenatal care and childcare classes for expectant mothers who are below or at the poverty level are effective for reducing the incidence of mental illness. * True False Most support groups provide their members access to an in-house, licensed mental health practitioner of some type. True * False Based almost exclusively on peer to peer interactions, support groups provide their members with emotional support, positive role models, and information. * True False Probably the most important component in preventing relapses in those with mental disorders is their knowledge and acceptance of the fact that medications provide a treatment and not a cure. * True False