Glossary of Mental Health TermsSearch for Resources
The extent to which an individual who needs care and services is able to receive them. Access is more than having insurance coverage or the ability to pay for services. It is also determined by the availability of services, acceptability of services, cultural appropriateness, location, hours of operation, transportation needs, and cost.
Services that are affordable, located nearby, and open during evenings and weekends. Staff is sensitive to and incorporates individual and cultural values. Staff is also sensitive to barriers that may keep a person from getting help. For example, an adolescent may be more willing to attend a support group meeting in a church or club near home than to travel to a mental health center. An accessible service can handle consumer demand without placing people on a long waiting list.
Includes art, dance, music, recreational and occupational therapies, and psychodrama.
Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives.
Emotional and/or behavioral problems following a specific stressor, which significantly interferes with social, work, or school functioning.
Costs not linked directly to the provision of medical care. Includes marketing, claims processing, billing, and medical record keeping, among others.
An alternative approach to mental health care is one that emphasizes the interrelationship between mind, body, and spirit. Although some alternative approaches have a long history, many remain controversial.
Anorexia has the highest mortality rate of any psychiatric illness. It is an eating disorder characterized by restricting food, intense fears of weight gain, and distorted body image. Inadequate calorie intake and/or excessive energy expenditure result in potentially life-threatening damage to the body and metabolism. Supportive care by health care providers, structured behavioral therapy, psychotherapy, and anti-depressant drug therapy are some of the methods that are used for treatment. Despite stereotypes perpetuated by media, anyone, regardless of gender, race, or sexuality, can develop Anorexia.
Anosognosia is a condition that causes an individual to be unaware of or unable to accurately perceive their mental health condition and its effects. Anosognosia can be considered a lack of insight into one’s own state of mental health. It typically means an individual does not realize they have a mental health issue or is unaware of its extent. For example, a person may experience delusions and not realize they are delusions but instead believe them to be real.
This condition differs from denial. A person in denial is often consciously aware of a fact but refuses to accept it.
Anti-Social Personality Disorder
Persons with this disorder characteristically disregard the feelings, property, authority, and respect of others, for their own personal gain. This may include violent or aggressive acts involving or targeting other individuals, without a sense or remorse or guilt for any of their destructive actions.
Anxiety is your body’s natural response to stress. It is a feeling of fear and apprehension about what’s to come. Symptoms range from chronic, exaggerated worry, tension, and irritability and appear to have no cause or are more intense than the situation warrants. Physical signs, such as restlessness, trouble falling or staying asleep, headaches, trembling, twitching, muscle tension, or sweating, often accompany these psychological symptoms. Anxiety is among the most common, most treatable mental 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.
Any willing provider
A requirement that a health plan contract for the delivery of health care services with any provider in the area who would like to provide such services to the plan's enrollees.
Designed to meet the specific needs of each individual child and family. For example, one family may need day treatment, while another may need home-based services. Appropriate services for one child and family may not be appropriate for another. Appropriate services usually are provided in the child's community.
Assertive Community Treatment
A multi-disciplinary clinical team approach of providing 24-hour, intensive community services in the individual's natural setting that help individuals with serious mental illness live in the community.
A professional review of child and family needs that is done when services are first sought from a caregiver. The assessment of the child includes a review of physical and mental health, intelligence, school performance, family situation, and behavior in the community. The assessment identifies the strengths of the child and family. Together, the caregiver and family decide what kind of treatment and supports, if any, are needed.
Attention Deficit Hyperactivity Disorder(ADD-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, 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.
The automatic assignment of a person to a health insurance plan (typically done under Medicaid plans).
Average Length of Stay
This represents the average time a client receives a specified service during a specified time period. This is generally computed by counting all the days that clients received the service during the time period and dividing by the number of clients that received the service during the same period. (Days a person was on furlough or not receiving are not counted.)
Avoidant Personality Disorder
Persons with this disorder are hypersensitive to rejection and thus, avoid situations with any potential for conflict. This reaction is fear-driven, however, persons with avoidant personality disorder become disturbed by their own social isolation, withdrawal, and inability to form close, interpersonal relationships.
Behavioral heath care firm
Specialized (for-profit) managed care organizations focusing on mental health and substance abuse benefits, which they term "behavioral healthcare." These firms offer employers and public agencies a managed mental health and substance abuse benefit.
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.
Binge Eating Disorder
Binge eating disorder (BED) is a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating. It is the most common eating disorder in the United States.
Biofeedback is learning to control muscle tension and "involuntary" body functioning, such as heart rate and skin temperature; it can be a path to mastering one's fears. It is used in combination with, or as an alternative to, medication to treat disorders such as anxiety, panic, and phobias.
Medication alone, or in combination with psychotherapy, has proven to be an effective treatment for a number of emotional, behavioral, and mental disorders. Any treatment involving medicine is a biomedical treatment. The kind of medication a psychiatrist prescribes varies with the disorder and the individual being treated.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.
There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes
Body Dysmorphic Disorder
The excessive preoccupation with either a small or imagined defect in one's physical appearance.
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.
Boundaries are limits people set in order to create a healthy sense of personal space. Boundaries can be physical or emotional in nature, and they help distinguish the desires, needs, and preferences of one person from anothe
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.
A person who has special training to help people with mental health problems. Examples include social workers, teachers, psychologists, psychiatrists, and mentors.
An individual who organizes and coordinates services and supports for children with mental health problems and their families. (Alternate terms: service coordinator, advocate, and facilitator.)
Child protective services
Designed to safeguard the child when abuse, neglect, or abandonment is suspected, or when there is no family to take care of the child. Examples of help delivered in the home include financial assistance, vocational training, homemaker services, and daycare. If in-home supports are insufficient, the child may be removed from the home on a temporary or permanent basis. Ideally, the goal is to keep the child with the family whenever possible.
Children and adolescents at risk for mental health problems
Children are at greater risk for developing mental health problems when certain factors occur in their lives or environments. Factors include physical abuse, emotional abuse or neglect, harmful stress, discrimination, poverty, loss of a loved one, frequent relocation, alcohol and other drug use, trauma, and exposure to violence.
A clinical psychologist is a professional with a doctoral degree in psychology 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.
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.
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.
Services that include contacts with significant others involved in the client's/patient's life for the purpose of discussing the client's/patient's emotional or behavioral problems or the collateral's relationship with the client/patient.
Services that are provided in a community setting. Community services refer to all services not provided in an inpatient setting.
A compulsion is a behavior designed to reduce psychic distress or discomfort due to factors such as depression or anxiety. Individuals engaging in compulsions typically feel an irresistible need to engage in the compulsive behavior. Everyday behaviors such as hand-washing, praying, and counting can become compulsions.
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.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
An act that allows workers and their families to continue their employer-sponsored health insurance for a certain amount of time after terminating employment. COBRA imposes different restrictions on individuals who leave their jobs voluntarily versus involuntarily.
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.
Consumer Run Services
Mental health treatment or support services that are provided by current or former mental health consumers. Includes social clubs, peer- support groups, and other peer-organized or consumer-run activities.
Continuous quality improvement (CQI)
An approach to health care quality management borrowed from the manufacturing sector. It builds on traditional quality assurance methods by putting in place a management structure that continuously gathers and assesses data that are then used to improve performance and design more efficient systems of care. Also known as total quality management (TQM).
Continuum of care
A term that implies a progression of services that a child moves through, usually one service at a time. More recently, it has come to mean comprehensive services. Also see system of care and wraparound services.
Child-serving organizations talk with the family and agree upon a plan of care that meets the child's needs. These organizations can include mental health, education, juvenile justice, and child welfare. Case management is necessary to coordinate services. Also see family-centered services and wraparound services.
Coping mechanisms are the strategies people often use in the face of stress and/or trauma to help manage difficult and/or painful emotions. Coping mechanisms can help people adjust to stressful events while maintaining their emotional well-being.
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.
Any prior health insurance coverage that a person has received. Creditable coverage is used to decrease exclusion periods for pre- existing conditions when an individual switches insurance plans. Insurers cannot exclude coverage of pre-existing conditions, but may impose an exclusion period (no more than 12 months) before covering such conditions. (See also, Health Insurance Portability and Accountability Act)
Crisis residential treatment services
Short-term, round-the-clock help provided in a nonhospital setting during a crisis. For example, when a child becomes aggressive and uncontrollable, despite in-home supports, a parent can temporarily place the child in a crisis residential treatment service. The purposes of this care are to avoid inpatient hospitalization, help stabilize the child, and determine the next appropriate step.
Help that is sensitive and responsive to cultural differences. Caregivers are aware of the impact of culture and possess skills to help provide services that respond appropriately to a person's unique cultural differences, including race and ethnicity, national origin, religion, age, gender, sexual orientation, or physical disability. They also adapt their skills to fit a family's values and customs.
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.
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 are bizarre thoughts that have no basis in reality.
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer's is the most common type of dementia.
Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks..
The aims 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.
A discharge is the formal termination of service, generally when treatment has been completed or through administrative authority.
A social club offering peer support and flexible schedule of activities: may operate on evenings and/ weekends.
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.
DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition)
An official manual of mental health problems developed by the American Psychiatric Association. Psychiatrists, psychologists, social workers, and other health and mental health care providers use this reference book to understand and diagnose mental health problems. Insurance companies and health care providers also use the terms and explanations in this book when discussing mental health problems.
Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person’s life. It is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.
A process used to recognize warning signs for mental health problems and to take early action against factors that put individuals at risk. Early intervention can help children get better in less time and can prevent problems from becoming worse.
Locating or providing a full range of educational services from basic literacy through the General Equivalency Diploma and college courses. Includes special education at the pre-primary, primary, secondary, and adult levels.
Also known as ECT, this highly controversial technique uses low voltage electrical stimulation of the brain to treat some forms of major depression, acute mania, and some forms of schizophrenia. This potentially life- saving technique is considered only when other therapies have failed, when a person is seriously medically ill and/or unable to take medication, or when a person is very likely to commit suicide. Substantial improvements in the equipment, dosing guidelines, and anesthesia have significantly reduced the possibility of side effects.
A planned program to provide psychiatric care in emergency situations with staff specifically assigned for this purpose. Includes crisis intervention, which enables the individual, family members and friends to cope with the emergency while maintaining the individual's status as a functioning community member to the greatest extent possible.
Emergency and crisis services
A group of services that is available 24 hours a day, 7 days a week, to help during a mental health emergency. Examples include telephone crisis hotlines, suicide hotlines, crisis counseling, crisis residential treatment services, crisis outreach teams, and crisis respite care.
Emergency Medical Treatment and Labor Act (EMTALA)
EMTALA, also referred to as the Federal Anti- patient Dumping Law link An act pertaining to emergency medical situations. EMTALA requires hospitals to provide emergency treatment to individuals, regardless of insurance status and ability to pay (EMTALA, 2002).
Employment/Vocational Rehabilitation Services
A broad range of services designed to address skills necessary for participation in job- related activities.
Help designed to meet the specific needs of each individual child and family. Children and families should not be expected to fit into services that do not meet their needs. Also see appropriate services, coordinated services, wraparound services, and cultural competence.
A broad range of living arrangements that simulate a family situation. This includes foster care and small group homes.
Family support services
Help designed to keep the family together, while coping with mental health problems that affect them. These services may include consumer information workshops, in-home supports, family therapy, parenting training, crisis services, and respite care.
Fee for Service
A type of health care plan under which health care providers are paid for individual medical services rendered.
Primary care physician or local agency responsible for coordinating and managing the health care needs of members. Generally, in order for specialty services such as mental health and hospital care to be covered, the gatekeeper must first approve the referral.
Gender dysphoria, also known as gender incongruence, may be experienced by transgender individuals and others whose gender does not align with the gender they were assigned at birth. Some people may develop mental health concerns as a result of distress experienced with gender dysphoria, but this incongruence itself is not a mental health condition, just as being transgender is not a mental health condition.
Many—though not all—trans people experience dysphoria. Non-binary, agender, and other gender non-conforming individuals might also experience dysphoria, as may some intersex people. Anxiety, depression, stress, and feelings of isolation may develop in those who experience dysphoria, and a therapist or counselor can offer support to individuals coping with these and other concerns.
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 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.
Help provided in a family's home either for a defined period of time or for as long as it takes to deal with a mental health problem. Examples include parent training, counseling, and working with family members to identify, find, or provide other necessary help. The goal is to prevent the child from being placed outside of the home. (Alternate term: in-home supports.)
When local health plans (or local hospitals) merge. This practice was popular in the late 1990s and was used to expand regional business presence.
Indemnity insurance plans are an alternative to managed care plans. These plans charge consumers a set amount for coverage and reimburse (fully or partially) consumers for most medical services.
Independent living services
Support for a young person living on his or her own. These services include therapeutic group homes, supervised apartment living, and job placement. Services teach youth how to handle financial, medical, housing, transportation, and other daily living needs, as well as how to get along with others.
Therapy tailored for a patient/client that is administered one-on-one.
Services designed to meet the unique needs of each child and family. Services are individualized when the caregivers pay attention to the needs and strengths, ages, and stages of development of the child and individual family members. Also see appropriate services and family-centered services.
In Home Family Services
Mental health treatment and support services offered to children and adolescents with mental illness and to their family members in their own homes or apartments.
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, guide, or a client/patient with appropriate services provided outside of your organization.
Mental health treatment provided in a hospital setting 24 hours a day. Inpatient hospitalization provides: (1) short-term treatment in cases where a child 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.
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.
Intensive case management
Intensive community services for individuals with severe and persistent mental illness that are designed to improve planning for their service needs. Services include outreach, evaluation, and support.
Intensive Residential Services
Intensively staffed housing arrangements for clients/patients. May include medical, psychosocial, vocational, recreational or other support services.
Through one-on-one conversations, this approach focuses on the patient's current life and relationships within the family, social, and work environments. The goal is to identify and resolve problems with insight, as well as build on strengths.
An intervention is a staged approach for encouraging someone experiencing mental health problems and/or addiction to seek treatment. Although it is often used with people who have substance abuse problems, it may be used with anyone who is avoiding treatment or engaging in self-destructive behavior.
Legal services provided to ensure the protection and maintenance of a client's/patient's rights.
Length of Stay
The duration of an episode of care for a covered person. The number of days an individual stays in a hospital or inpatient facility.
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.
A mood disorder which may be characterized by extreme elation, impulsivity, irritability, rapid speech, nervousness, distractibility, and/or poor judgment.
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.
Mental health clients to whom some services were reimbursable through Medicaid.
Medical group practice
A number of physicians working in a systematic association with the joint use of equipment and technical personnel and with centralized administration and financial organization.
Medical review criteria
Screening criteria used by third-party payers and review organizations as the underlying basis for reviewing the quality and appropriateness of care provided to selected cases.
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 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.
Prescription, administration, assessment of drug effectiveness, and monitoring of potential side effects of psycho-tropic medications.
MediGap plans are supplements to Medicare insurance. MediGap plans vary from State to State; standardized MediGap plans also may be known as Medicare Select plans.
Another term used for mental health problems.
Refers to how a person thinks, feels, and acts when faced with life's situations. It is how people look at themselves, their lives, and the other people in their lives; evaluate the challenges and the problems; and explore choices. This includes handling stress, relating to other people, and making decisions.
Mental Health Parity (Act)
Mental health parity refers to providing the same insurance coverage for mental health treatment as that offered for medical and surgical treatments. The Mental Health Parity Act was passed in 1996 and established parity in lifetime benefit limits and annual limits.
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, and conduct disorder.
This term is usually used to refer to severe mental health problems in adults.
Activities related to the planning, organization, management, funding, and oversight of direct services.
MI and MR/DD services
Services designed to address the needs of people with both psychiatric illness and mental retardation or developmental disabilities.
Mobile Treatment Team
Provides assertive outreach, crisis intervention, and independent-living assistance with linkage to necessary support services in the client's/patient's own environment. This includes PACT, CTTP, or other continuous treatment team programs.
The system of participating providers and institutions in a managed care plan.
Many States have laws defining network adequacy, the number and distribution of health care providers required to operate a health plan. Also known as provider adequacy of a network.
New Generation Medications
Anti-psychotic medications which are new and atypical.
A facility that provides mental health services, but not on a residential basis, other than an inpatient facility or nursing home.
Services other than those funded by Medicaid.
Nurse Practitioner (NP)
A nurse practitioner is a registered nurse who works in an expanded role and manages patients' medical conditions.
An establishment that provides living quarters and care for the elderly and the chronically ill. This includes assisted living outside a nursing home.
Obsessive-Compulsive Disorder (OCD)
Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.
Orthorexia nervosa is an eating disorder characterized by a fixation on the consumption of healthy foods and the avoidance of those perceived to be unhealthy. Those who have this condition may experience physical and emotional health issues, social isolation, and other issues as a result of their desire to maintain a pure diet.
The results of a specific health care service or benefit package.
Studies that measure the effects of care or services.
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.
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.
Pastoral counselors are counselors working within traditional faith communities to incorporate psychotherapy, and/or medication, with prayer and spirituality to effectively help some people with mental disorders. Some people prefer to seek help for mental health problems from their pastor, rabbi, or priest, rather than from therapists who are not affiliated with a religious community.
Pharmacy Benefit Manager (PBM)
PBMs are third party administrators of prescription drug benefits.
Irrational fears that lead people to altogether avoid specific things or situations that trigger intense anxiety.
A physician assistant is a trained professional who provides health care services under the supervision of a licensed physician.
Pica is an eating disorder characterized by the desire to eat non-food substances such as paper, dirt, or hair. Because temporary periods of eating inappropriate objects are common in childhood, symptoms must be present for more than a month and must not be developmentally appropriate. A one-year-old who occasionally eats dirt, for example, does not qualify for a diagnosis of pica
Plan of care
A treatment plan especially designed for each child and family, based on individual strengths and needs. The caregiver(s) develop(s) the plan with input from the family. The plan establishes goals and details appropriate treatment and services to meet the special needs of the child and family.
Geared toward young children, play therapy uses a variety of activities-such as painting, puppets, and dioramas-to establish communication with the therapist and resolve problems. Play allows the child to express emotions and problems that would be too difficult to discuss with another person.
Postpartum depression affects women after childbirth, typically within the first year. Mild and major depression is estimated to affect more than 19% of women in the first few months after childbirth. Symptoms of depression often go unrecognized, though, because women experience dramatic shifts in hormones during pregnancy and postpartum. Most new moms are likely to show signs of fatigue, for example, along with changes in appetite and sleep patterns, as they adjust to caring for a new baby.
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 cause can interfere with a person's ability to hold a job or to develop intimate relationships with others.
A medical condition that is excluded from coverage by an insurance company because the condition was believed to exist prior to the individual obtaining a policy from the insurance company. Many insurance companies now impose waiting periods for coverage of pre-existing conditions. Insurers will cover the condition after the waiting period (of no more than 12 months) has expired.
The approval a provider must obtain from an insurer or other entity before furnishing certain health services, particularly inpatient hospital care, in order for the service to be covered under the plan.
Psychiatric Emergency Walk- in
A planned program to provide psychiatric care in emergency situations with staff specifically assigned for this purpose. Includes crisis intervention, which enables the individual, family members and friends to cope with the emergency while maintaining the individual's status as a functioning community member to the greatest extent possible and is open for a patient to walk-in.
A psychiatrist is a professional who completed both medical school and training in psychiatry and is a specialist in diagnosing and treating mental illness.
Psychoanalysis focuses on past conflicts as the underpinnings to current emotional and behavioral problems. In this long-term and intensive therapy, an individual meets with a psychoanalyst three to five times a week, using "free association" to explore unconscious motivations and earlier, unproductive patterns of resolving issues.
Based on the principles of psychoanalysis, this therapy is less intense, tends to occur once or twice a week, and spans a shorter time. It is based on the premise that human behavior is determined by one's past experiences, genetic factors, and current situation. This approach recognizes the significant influence that emotions and unconscious motivation can have on human behavior.
Therapeutic activities or interventions provided individually or in groups that may include development and maintenance of daily and community-living skills, self-care, skills training includes grooming, bodily care, feeding, social skills training, and development of basic language skills.
A process by which people who have a mental illness are able to work, learn and participate fully in their communities. For some individuals, recovery is the ability to live a fulfilling and productive life despite a disability. For others, recovery implies the reduction or complete remission of symptoms.
Relapse occurs when a previous medical or mental health issue returns.
An accounting of the quality of services, compared among providers over time. The report card grades providers on predetermined, measurable quality and outcome indicators. Generally, consumers use report cards to choose a health plan or provider, while policy makers may use report card results to determine overall program effectiveness, efficiency, and financial stability.
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 young people at a time. Children with serious emotional disturbances receive constant supervision and care. Treatment may include individual, group, and 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.
Individual ability to face stressful or traumatic events and to re-organise one’s life in a positive manner in the face of difficulties.
A service that provides a break for parents who have a child with a serious emotional disturbance. Trained parents or counselors take care of the child for a brief period of time to give families relief from the strain of caring for the child. This type of care can be provided in the home or in another location. Some parents may need this help every week.
Respite Residential Services
Provision of periodic relief to the usual family members and friends who care for the clients/patients.
Possibility that revenues of the insurer will not be sufficient to cover expenditures incurred in the delivery of contractual services. A managed care provider is at risk if actual expenses exceed the payment amount.
The adjustment of premiums to compensate health plans for the risks associated with individuals who are more likely to require costly treatment. Risk adjustment takes into account the health status and risk profile of patients.
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.
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.
Section 1115 Waiver
A statutory provision that allows a State to operate its system of care for Medicaid enrollees in a manner different from that proscribed by the Centers for Medicare and Medicaid Services (CMS), in an attempt to demonstrate the efficacy and cost- effectiveness of an alternative delivery system through research and evaluation.
Section 1915(b) Waiver
A statutory provision that allows a State to partially limit the choice of providers for Medicaid enrollees; for example, under the waiver, a State can limit the number of times per year that enrollees can choose to drop out of an HMO.
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
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.
Serious Mental Illness
Pursuant to section 1912(c) of the Public Health Service Act, adults with serious mental illness SMI are persons: (1) age 18 and over and (2) 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. (3) That has resulted in functional impairment, which substantially interferes with or limits one or more major life activities. Federal Register Volume 58 No. 96 published Thursday May 20, 1993 pages 29422 through 29425.
Sexuality refers to a person’s habits and preferences in terms of sexual behavior and desire. There are as many individual expressions of sexuality as there are individual preferences for dress or music. Some people may experience confusion or distress regarding some aspects of their sexual behavior or desired sexual behavior and seek help from a licensed mental health professional.
The consolidation of multiple sources of funding into a single stream. This is a key approach used in progressive mental health systems to ensure that "funds follow consumers."
Social anxiety, also known as social phobia, can be described as a fear of social situations or of interacting with people other than one’s close friends and family. When social anxiety is persistent or has a detrimental effect on one's daily life, therapy may be helpful in addressing this issue and exploring treatment and coping methods.
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. SCHIPs operate as part of a State's Medicaid program (Centers for Medicare and Medicaid Services, 2002).
The total unduplicated count of mental health patients/clients served through State programs, exclusive of Medicaid and Other Coverage.
A publicly funded inpatient facility for persons with mental illness.
State Mental Health Authority or Agency
State government agency charged with administering and funding its State's public mental health services.
Stress is primarily a physical response. When stressed, the body thinks it is under attack and switches to ‘fight or flight’ mode, releasing a complex mix of hormones and chemicals such as adrenaline, cortisol and norepinephrine to prepare the body for physical action. This causes a number of reactions, from blood being diverted to muscles to shutting down unnecessary bodily functions such as digestion. Mild levels of stress are beneficial, however, excessive stress can have negative mental and physical health consequences.
A successful or unsuccessful attempt to intentionally kill oneself. Suicide is the result of actions taken to deal with intolerable mental anguish and pain, fear or despair that overwhelms an individual’s value for living and hope in life. While there is a well established link between suicide and depression, each suicide occurs in a unique mix of complex interconnected factors, individual, environmental, biological, psychological, social, cultural, historical, political and spiritual, including psychological trauma (both developmental and intergenerational).
Supportive services that include assisting individuals in finding work; assessing individuals' skills, attitudes, behaviors, and interest relevant to work; providing vocational rehabilitation and/or other training; and providing work opportunities. Includes transitional and supported employment services.
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.
System of Care
A system of care is a method of addressing children's mental health needs. It is developed on the premise that the mental health needs of children, adolescents, and their families can be met within their home, school, and community environments. These systems are also developed around the principles of being child-centered, family- driven, strength-based, and culturally competent and involving interagency collaboration.
A dedicated telephone line that is advertised and may be operated as a crisis hotline for emergency counseling, or as a referral resource for callers with mental health problems.
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 nurturant family home.
Third party payer
A public or private organization that is responsible for the health care expenses of another entity.
Trichotillomania, sometimes referred to as hair-pulling disorder, TTM, or just trich, is a state in which a person has powerful, compulsive urges to pull out hair from the body. The location on the body can vary, as can the severity and the way a person responds to treatment. Treatment options for trichotillomania typically include forms of behavioral therapy. In some cases, a qualified professional may also recommend medication.
A trigger in psychology is a stimulus such as a smell, sound, or sight that triggers feelings of trauma. People typically use this term when describing posttraumatic stress (PTSD).
Unable to Work
This on-line forum was created especially for the nation's jobless and underemployed workers. This resource is available to help the unemployed learn more about the unemployment system, to share their experiences and concerns, and to participate in the national debate over aid to the jobless.
The review of prospective or renewing cases to determine their risk and their potential costs.
Identified treatment needs of the people that are not being met as well as those receiving treatment that is inappropriate or not optimal.
The level of use of a particular service over time.
The risk that actual service utilization might differ from utilization projections.
A practice of selling off health plan subsidiaries or provider activities. Vertical disintegration was a trend in the late 1990s.
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.
Withdrawal is a psychological and biochemical process that occurs when a person stops using a chemical substance—such as some prescription medications, illegal drugs, alcohol, or nicotine—or stops an addictive behavior.
The information on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified mental health provider with any questions you may have regarding a medical condition. We do not recommend or endorse any specific tests, mental health providers, products, procedures, opinions, or other information that may be mentioned on this site. Reliance on any information provided herein is solely at your own risk.