Terminology

When you first enter into the world of Mental Illness, the amount of new vocabulary can be overwhelming. Added into the stress of caring for a loved one, it is easy to get lost. We’ve compiled a list of the most common terms to get you started.

Acceptance and Commitment Therapy (ACT): A proven talk therapy for depression and anxiety.  ACT helps people overcome their struggles with emotional pain and worries. It helps them learn to recognize, commit to and achieve what’s important to them.

Accessible services: Services that are easily available to those who need them (for example: affordable, located nearby, open during  venings and weekends).

Accrued deficits: Delays or lack of development in emotional, social, academic or behavioral skills that a child or adolescent experiences because of untreated mental illness.

Acetylcholine: Neurotransmitter in the brain, where it helps to regulate memory, and in the peripheral nervous system, where it controls the actions of skeletal and smooth muscles.

Acute: Condition that has rapid onset, marked intensity and short duration.

Addiction: Dependence on a chemical substance to the extent that a physiological and/or psychological need is established.

Adherence: Following the guidelines agreed on by you and the provider, including taking medication as prescribed.

Adjourn: Legal term — To suspend a proceeding to a later time and perhaps different place.

Adrenergic nervous system: The complex set of nerves that use norepinephrine- based messengers and connect extensively with  multiple organs in the body, including the heart, lungs, and hormone-producing glands.

Adjunctive agent: A second drug prescribed to bolster the effectiveness of the first.

Advocacy: Active support for a cause or position. Activities to support individuals with mental illness including rights protection, legal and service assistance and system or policy change.

Affect: Behavior that expresses a subjectively experienced emotion. Affect is responsive to changing emotional states, whereas mood refers to a pervasive and sustained emotion.

Affiant: Legal term — The one who makes an affidavit.

Affidavit: Legal term — Written statement of facts submitted in the course of a legal proceeding.

Agonist: In pharmacology, a substance that stimulates or mimics a receptor mediated biological response by occupying cell receptors.

Agranulocytosis: A dramatic decrease in the number of infection-fighting white blood cells. Agranulocytosis is a very rare side effect of antipsychotic drugs. The ill effects of this disease can be reversed if it is identified early, and the drug discontinued.

Akathisia: Subjective sense of restlessness accompanied by fidgeting of the legs, rocking from foot to foot, pacing, or being unable to sit or stand. Symptoms develop within a few weeks of starting or raising the dose of a conventional antipsychotic medication.

Akinesia: A state of motor inhibition; reduced voluntary movement.

Alogia: Speechlessness. Most commonly used to refer to the lack of spontaneity in speech and diminished flow of conversation that occurs as negative symptoms in schizophrenia.

Americans with Disabilities Act (ADA): Enacted in 1990 and amended in the years following, the purpose of the ADA is to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities; to provide clear, strong, consistent, enforceable standards addressing discrimination against individuals with disabilities; to ensure that the federal government plays a central role in enforcing the standards established in this chapter on behalf of individuals with disabilities; and to invoke the sweep of congressional authority, including the power to enforce the fourteenth amendment and to regulate commerce, in order to address the major areas of discrimination faced day-to-day by people with disabilities.

Amphetamines: Medications that stimulate dopamine release in the central nervous system causing elevated mood and increased wakefulness, alertness, concentration, and physical performance. Clinically used to treat ADHD and narcolepsy. Have a high potential for abuse.

Amygdala: Part of the basal ganglia, it is a structure in the forebrain that is an important component of the limbic system that is involved in the regulation of emotions.

Anhedonia: Inability to experience pleasure from activities that usually produce pleasurable feelings.

Anosognosia: A common symptom of schizophrenia and bipolar disorder with psychotic features. Also called “lack of awareness” or “lack of insight,” it has an anatomical basis that has been confirmed in multiple scientific studies. It
affects approximately 50 percent of individuals with schizophrenia and 40 percent of individuals with bipolar disorder and is the most common reason that individuals with schizophrenia and bipolar do not take their medications. When taking medications, awareness of illness improves in some people.

Antagonist: In pharmacology, a substance that opposes, blocks or neutralized a receptor-mediated biological response (for example a dopamine antagonist competes with dopamine for receptor sites in the brain — this prevents the dopamine from binding and exerting its effect).

Anticholinergic effects: Interference with the action of acetylcholine in the brain and peripheral nervous systems by any drug. In psychiatry, the term generally refers to the side effects of antipsychotic drugs, tricyclic antidepressants and antiparkinsonian medications. Common symptoms of such effects include dry mouth, blurred vision, constipation and decreased ability to urinate.

Anticonvulsant: Drugs most commonly used for the treatment of seizure disorders. Also may be effective in preventing or treating mania and depression in bipolar disorder. Also called mood stabilizers.

Antidepressants: A class of medications used to treat unipolar mood disorders (depressive disorders). Includes 3 types: selective serotonin reuptake inhibitors (SSRIs), monoamineoxidase inhibitors (MAOIs), and tricyclic antidepressants.

Antihistamines: A class of medications that block histamine receptors. Used primarily to treat allergies, also commonly used in psychiatry to treat drug reactions and for their sedative properties.

Antihypertensives: A class of medications used to reduce blood pressure. Also found to be useful for certain psychiatric disorders such as ADHD or Tourette’s syndrome.

Antipsychotic: A medication used to reduce/eliminate disturbances in the perception of reality (psychosis). Also known as neuroleptics.

Anxiolytic: A class of medications that have anti-anxiety effects and are used widely to relieve emotional tension.

Appropriate services: Designed to meet the specific needs of each person and family, usually provided within the person’s community.

Arraignment: Legal term — Early stage in the criminal justice process occurring after an arrest. Defendant is brought before a judge or a magistrate and informed of the charges pending against him or her. Plea is entered. If applicable, bail is set.

Assessment: Professional review of needs that is done when services are first sought from a provider. Includes a review of physical and mental health, intelligence, school performance, family situation and behavior in the community.

Asperger’s syndrome: Also known as Asperger’s disorder (AD) or simply Asperger’s, is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction and nonverbal communication, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. The diagnosis of Asperger’s was eliminated in the 2013 fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and replaced by a diagnosis of autism spectrum disorder on a severity scale.

Atypical antipsychotics: Also known as second generation antipsychotics (SGAs)) are a group of antipsychotic drugs used to treat psychiatric conditions. Some atypical antipsychotics have received regulatory approval (e.g. By the FDA of the US, the TGA of Australia, the MHRA of the UK) for schizophrenia, bipolar disorder, autism, and as an adjunct in major depressive disorder.

Autonomic nervous system: The part of the nervous system that innervates the cardiovascular, digestive, reproductive and respiratory organs. Controls basic life- sustaining functions. Includes the sympathetic and parasympathetic nervous systems.

Avolition: A symptom of mental illness that is particularly common in schizophrenia. This symptom is expressed as extreme apathy and loss of normal drive and interest. A person with avolition often finds it difficult to get started at tasks or, if they begin a task, often gives up before they have finished it.

Axon: Fiber-like extension of a neuron through which the cell sends information to target cells.

Bail: Legal term — Cash or bond posted by a defendant as collateral to ensure that he or she returns to court on a future date.

Basal ganglia: Structures located on both sides of the limbic system, involved in the regulation of movement and in a variety of neuropsychiatric symptoms including dementia, depression and psychosis. Contains the caudate nucleus, the key area of the brain involved in learning and breaking habits.

Behavior modification: The core of behavior therapy. Focuses on negative habits or behaviors and aims to reduce or  eliminate them by the use of reinforcements or rewards.

Behavior therapy: Mode of treatment that focuses on substituting healthier ways of behaving for maladaptive patterns used in the past. Most benefit for individuals who desire to change.

Bench warrant: Legal term — Issued by a judge when an individual fails to appear in court at a specified date and time.

Benzodiazepines: The generic name for a group of drugs that have potent hypnotic, sedative and anxiolytic action. They are also called anxiolytics or antianxiety drugs.

Biological psychiatry: A school of psychiatric thought that emphasizes physical, chemical, genetic and neurological causes of psychiatric illness and treatment approaches.

Blood level: The concentration of a drug in the plasma, serum or blood. In psychiatry the term is most often applied to levels of lithium carbonate, tricyclics and anti- convulsants.

Case manager: Individual who organizes and coordinates services and supports for people with mental health conditions and their families (may also be referred to as service coordinator, advocate, facilitator, etc.).

Catatonia: A marked psychomotor disturbance that may involve stupor or mutism, negativism, rigidity, purposeless excitement and inappropriate or bizarre posturing.

Categorically needy: A term that describes the group of individuals that states are generally required to cover under Medicaid in order to receive federal funds. This groups includes people who receive assistance through Supplemental Security Income (SSI) and other federally assisted income maintenance payments.

Centers for Medicare and Medicaid Services (CMS): The federal agency in the U.S. Department of Health and Human Services (HHS) responsible for the administration of Medicaid, Medicare and State Children’s Health Insurance Program (SCHIP).

Central nervous system: The brain and the spinal cord.

Cerebellum: Large part of the brain concerned with the coordination of muscles and the maintenance of bodily equilibrium.

Cerebral cortex: External layer of gray matter that covers the brain hemispheres. Largest part is composed of neurons which receive and transmit electrical impulses from and to other brain regions.

Cerebrospinal fluid: Fluid manufactured in the brain and contained within
the brain and spinal cord. It circulates in the central nervous system.

Cerebrum: The expanded anterior portion of the brain, which is considered the seat of conscious mental processes.

Certification standards: Administrative requirements with which an agency must comply to be certified. Usually a state or federal agency such as a department of mental health or human services.

Child protective services (CPS): Designed to safeguard the child when abuse, neglect, or abandonment is suspected, or when there is no family to take care of the child.

Cholinergic: Activated or transmitted by acetylcholine, this is the part of the autonomic nervous system that controls life sustaining organs of the body.

Chronic: Refers to a disease or condition that persists over a long period of time or recurs frequently.

Clinical trial: A systematic and scientific evaluation of a new treatment for a disorder.

Civil/involuntary commitment: Legal process to determine if an individual is in need of mental health treatment against their will. Process and criteria vary by state (and often by county). Generally handled through chancery or probate court.

Cognitive: Related to mental process of comprehension, judgment, memory and reasoning.

Cognitive behavioral therapy (CBT): A research-based approach to therapy that is generally short-term and focused on addressing specific thoughts and behavior involved in maintaining an individual’s problems and reducing that behavior.

Cognitive deficits: Impairment of judgment, memory, reasoning and comprehension due to a variety of causes.

Cognitive distortion: Interpreting an event in a distorted way that leads to a faulty conclusion.

Cognitive functions: Activities related to the ability to think — take in and process information, reason, memorize, learn, and communicate.

Cognitive processing therapy (CPT): A proven talk therapy for PTSD that is a type of cognitive behavioral therapy (CBT). CPT helps people learn new patterns of thinking so their memories of trauma do not interfere with their daily lives and may include writing about one’s traumatic experience.

Comorbid/co-occurring: Simultaneous appearance of two or more illnesses, such as the co- occurrence of schizophrenia and substance abuse or alcohol abuse and a depressive disorder. Co- occurrence of the illnesses may be unrelated to any common etiology.

Community support system: System of services that enable an individual with serious mental illness to live successfully in the community. May include medical, psychological, vocational, educational, recreational, social and residential services.

Complainant: Legal term — Person who files a complaint.

Complaint: Legal term — Legal instrument filed by District Attorney that initiates a criminal action. Complaint states the alleged crime of the defendant in legal language.

Confidentiality: The ethical principle that a healthcare provider may not reveal any information disclosed in the course of clinical treatment to anyone other than the patient.

Consistency: Acting or reacting the same way every time, predictably.

Consumer: In mental health, an individual who is using one or more mental health services.

Continuum of care: Term that implies a progression of services that a child moves through, usually one service at a time, also referred to as comprehensive services or wraparound services.

Contraband: Legal term — Goods barred by law. Generally includes specific weapons or drugs prohibited by law.

Controlled substances: Classes of compounds categorized by the US Drug Enforcement Administration as potentially addictive (for example: opiates, narcotics, etc.).

Conviction: Legal term — Disposition of a case in which the defendant is found guilty by trial or plea

Coordinated specialty care (CSC): A team-based, multi-element approach to treating first episode psychosis that has been broadly implemented in Australia, the United Kingdom, Scandinavia, and Canada. Component interventions include assertive case management, individual or group psychotherapy, supported employment and education services, family
education and support, and low doses of select antipsychotic medications.

Co-payment: The portion of the service fee that the patient is responsible for paying with the remainder generally paid by an insurance provider.

Core disorder: The primary or major problem.

Course: What happens to a condition over time.

Covered expenses: Health care expenses eligible for payment by an insurance provider.

Crisis residential treatment services: Short term, round the clock help provided in a non-hospital setting during a crisis. Purpose of this care is to avoid inpatient hospitalization, help stabilize the person and determine the next appropriate step.

CT (Computed Tomography) scan: A detailed, cross-sectional picture of structures in the body and brain made by using x-rays.

Cultural competency: Services that are sensitive and responsive to cultural differences. Also adaptable to fit the needs of the family based on their values and customs.

Day treatment/partial hospitalization: Programs that typically last at least 4 hours per day, working in conjunction with mental health providers. Includes special education, counseling, parent training, vocational training skill building, crisis intervention and recreational therapy.

Deductible: A specified amount of money that must be paid by a consumer before insurance benefits begin.

Defendant: Legal term — Person alleged to have committed the crime.

Defense lawyer: Lawyer representing the defendant in a criminal case. May be private or public defender.

Defense mechanisms: Unconscious intrapsychic processes serving to provide relief from emotional conflict and anxiety).

Deinstitutionalization: Change in locus of mental health care from traditional, institutional settings to community-based services. Sometimes called trans- institutionalization because it often merely shifts people from one institution (the hospital) to another (such as a prison).

Delusion: False belief based on an incorrect inference about external reality. Firmly sustained despite clear evidence to the contrary. Belief is not part of a cultural tradition.

Dementia: Condition of declining mental abilities, especially memory. Individuals with dementia may have trouble doing things they used to do such as keeping the checkbook, driving a car safely or planning a meal. They often have trouble finding the right word and may become confused when given too many things to do at one time. Individuals with dementia may also experience changes in personality, becoming aggressive, paranoid or depressed.

Denial: Defense mechanism, operating unconsciously, used to resolve emotional conflict and allay anxiety by avoiding thoughts, feelings, needs
considered intolerable.

Dendrite: Branch of the nerve cell that receives nerve impulses from the axon of a neighboring nerve. A treelike extension of the neuron cell body. It
receives information along with the cell body from other neurons.

Depersonalization: Feelings of unreality or strangeness concerning the environment, the self, or both. This is characteristic of depersonalization
disorder and may also occur in schizotypal personality disorder, schizophrenia, and in those persons experiencing overwhelming anxiety, stress or fatigue.

Derealization: A feeling of estrangement or detachment from one’s environment. May be accompanied by depersonalization.

Detoxification: The therapeutic process of removing dependence producing substances form the body so that withdrawal symptoms are minimized and physiological function is safely restored. Treatment may include medication, rest, diet, fluids and nursing care.

Dexamethasone-suppression test (DST): A test of hormone function sometimes used as a diagnostic tool in depression. In healthy individuals, the administration of dexamethasone suppresses the concentration of cortisol in the blood. Approximately 40-50 percent of persons diagnosed with major depressive disorder have an abnormal DST in that they do not suppress cortisol in response to dexamethasone.

Diagnosis: The process of determining, through examination and analysis the nature of a patient’s illness.

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5): Book published by the American Psychiatric Association that gives general descriptions and characteristic symptoms of different mental illnesses. Used by physicians and other mental health professionals to
confirm diagnoses of illnesses.

Dialectical Behaviour Therapy (DBT): An evidence-based model of therapy that helps people learn and use new skills and strategies so that they build lives they feel are worth living. Specifically designed for individuals with borderline personality disorder, but is useful in treating a variety of mental health disorders.

Differential diagnosis: The process whereby multiple possible disorders are considered by a clinician to formulate a final diagnosis.

Discharge: Legal term — When a prosecutor decides not to proceed against a defendant.

Discharge plan: Plan developed prior to an individual’s discharge from a treatment facility that outlines the services that will be needed upon discharge and establishes how/where those services will be provided.

Disinhibition: In psychological terms, refers to freedom to act according to one’s inner drives or feelings, with less regard for restraints imposed by cultural norms.

Dismissal: Legal term — When charges against a defendant are removed. Only a judge can dismiss a case.

Disorder: A cluster of symptoms and objective findings that, grouped together, are related to a specific problem.

Disposition: Legal term — When a case has been concluded (conviction by trial or plea, dismissal or acquittal).

Diversion program: Designed to target problem youth and direct them away from the justice system and into a treatment center or program.

DNA (deoxyribonucleic acid): The double-stranded molecule that contains all genetic information in almost all organisms.

Doctor of Osteopathic Medicine (DO): A professional doctoral degree for physicians and surgeons offered by medical schools in the United States. Holders of the D.O. Degree have the ability to become licensed as osteopathic physicians who have equivalent rights, privileges, and responsibilities as
physicians with a Doctor of Medicine degree (M.D.).

Dopamine: Neurotransmitter found in the brain specifically associated with some forms of psychosis and movement disorders.

Drug formulary: A listing of medications developed by an insurance provider identifying which medications they will pay for, and the process of obtaining medications not included in the formulary — usually requires additional work on the part of the physician.

Drug interaction: Effects of two or more drugs taken simultaneously producing an alteration in the usual effects of either drug taken alone. Interacting drugs may have a potentiating or additive effect.

Dual diagnosis: (Also referred to as comorbid, or co-occurring disorders) individuals who are living with more than one disorder at the same time (for
example: mental illness and substance abuse, or mental illness and mental retardation).

Dysfunction: A medical abnormality in the functioning of an organ or other part of system of the body.

Dyskinesia: Any disturbance of movement. It may be induced by medication.

Dystonia: Abnormal positioning or spasm of the muscles of the head, neck, limbs, or trunk; the dystonia develops within a few days of starting or raising the dose of a neuroleptic medication, because of dysfunction of the extrapyramidal system.

Early intervention: Process used to recognize warning signs for mental health problems and to take early action against factors that put individuals at risk.

ECG — Electrocardiogram: A painless procedure that produces a sketch of the electrical activity of the heart (also called an EKG).

ECT — Electroconvulsive Therapy: The passing of an electrical current through one or more hemispheres of the brain for the purpose of treating
illnesses such as a severe depressive disorder.

EEG — Electroencephalogram: Used to measure electrical activity in the brain.

Efficacy: Effectiveness of a drug as a therapeutic agent, particularly over long term use.

Eligibility: Phrase describing Medicaid’s policy of restricting eligibility to members of certain groups or categories, such as children, the aged, and individuals with disabilities. Individuals who fall into approved categories must also satisfy financial eligibility requirements including income.

Emancipated minor: Person younger than 18 years who is considered totally self- supporting. Legal rights afforded at adulthood are typically
extended to an emancipated minor.

Emergency and crisis services: Group of services that are available 24 hours a day, 7 days a week to help during a mental health emergency. Include telephone crisis hotlines, suicide hotlines, crisis counseling, etc.

Endocrine disorders: Disturbances of the function of the ductless glands that may be metabolic in origin and may be associated with or aggravated by emotional factors, producing mental and behavioral disturbances in addition to physical signs.

Enmeshment: Intense emotional bond with another person that is so pervasive it can seem that one’s identify is lost in the other person.

Entitlement programs: In health law, legislatively defined rights to health care.

Epigenetic: An influence other than the structure of DNA that affects inherited traits.

Epilepsy: Neurological disorder characterized by periodic motor and sensory seizures, sometimes accompanied by alterations of consciousness.

Etiology: The biological or psychological cause of a disorder.

Euphoria: Exaggerated feeling of physical and emotional well-being.

Evidence-based practice (EBP): Refers to treatment guidelines that can be supported by quality clinical research.

Executive function deficits: Disturbances in the sequence of mental processes that relate to the ability to plan, initiate, organize, and follow
through on an activity. Includes problems with time management, organization, and prioritizing.

Extrapyramidal symptoms (EPS): A variety of signs and symptoms, including muscular rigidity, tremors, drooling, shuffling gait (parkinsonism);
restlessness (akathisia); peculiar involuntary postures (dystonia); motor inertia (akinesia); and many other neurological disturbances. Results from dysfunction of the extrapyramidal system. May occur as a side effect of certain psychotropic drugs, particularly neuroleptics.

Fail first policies: Requirement that as a prerequisite for authorization of a non- formulary medication that the patient fail on at least one other
medication.

Family centered services: Designed to meet the specific needs of each individual child and family.

Family-driven care: In mental health, a model in which families have a primary decision-making role in the care of their own children. Families also
have a primary role in the policies and procedures governing care for all children in their community. Family involvement includes choosing supports,
services and providers. Setting goals. Designing and implementing programs. Monitoring outcomes. And determining the effectiveness of all efforts to promote the mental health of children and youth.

Family support services: Designed to keep the family together, while coping with mental health problems that affect them.

Family therapy: Psychotherapy in which problems are understood and treated in the family. Requires the cooperation of the entire family to make
changes and find solutions.

Felony: Legal offense in the most serious crime category (for example: robbery, burglary, grand larceny, sale of narcotics, murder).

First episode psychosis: The first time someone experiences psychotic symptoms or a psychotic episode. People experiencing a first episode may not
understand what is happening. The symptoms can be highly disturbing and unfamiliar, leaving the person confused and distressed. Unfortunately negative myths and stereotypes about mental illness and psychosis in particular are still common in the community. A psychotic episode occurs in three phases. The length of each phase varies from person toperson.

First line treatment: The type of treatment tried first for a certain condition or disorder, because it is the most effective and well-tolerated.

Flight of ideas: A nearly continuous flow of accelerated speech with abrupt changes from one topic to another, usually based on understandable
associations, distracting stimuli or playing on words.

Frontal lobe: One of the four divisions of each cerebral hemisphere. Important for controlling movement and associating the functions of other
cortical areas.

GABA (gamma aminobutyric acid): An amino acid and neurotransmitter, found throughout the central nervous system, that has
a vital dampening effect on the excitability of nerve cells.

Generic medication: A nonproprietary name as contrasted to the proprietary “brand” name given to a medication by a pharmaceutical
corporations (generics are cheaper than brand name medications, but effectiveness may vary by individual).

Genes: Located at various points along the chromosomes, genes are bits of DNA that carry the hereditary code, i.e., the instructions for making protein
molecules. It is estimated that the human has approximately 100,000 genes, known collectively as the genome.

Glial cells: Small neurons that are specialized to provide nourishment and support for the command neurons located in gray matter regions such as the cortex and the basal ganglia.

Glutamate: A neurotransmitter; an amino acid governing much of human thought and emotion, regulating systems involved in cognitive and higher
mental functions (memory, learning, sensory reception, information processing). Glutamate serves as the brain’s major excitatory neurotransmitter, causing neurons to “fire” rather than cease firing. Glutamate is also the sole source of GABA, the predominant inhibitory transmitter in the CNS.

Grandiosity: Exaggerated belief or claims of one’s importance, often manifested by delusions of great wealth, power or fame.

Gray matter: The portion of brain tissue that is dark in color. Gray matter consists primarily of nerve cell bodies, dendrites and axon endings.

Grievance: Formal process of filing a complaint with the mental health system, requires a hearing process.

Half-life: The time it takes for half of a drug, once absorbed into the bloodstream, to be eliminated from the body.

Hallucination: A sensory perception in the absence of an actual external stimulus. To be distinguished from an illusion. Hallucinations may involve
any of the senses.

Health Maintenance Organization (HMO): Entity that provides, offers or arranges for coverage of designated health services needed by members for a fixed, prepaid premium.

HIPAA (Health Insurance Portability and Accountability Act of 1996): HIPAA Title I protects health insurance coverage for workers and their families when they change or lose their jobs. HIPAA Title II addresses the security and privacy of health data. It requires the U.S. Department of Health and Human Services to establish national standards for electronic health care transactions, as well as national identifiers for providers, health plans and employers. To comply with HIPAA, systems of care must establish ways to ensure patient privacy as the patients move seamlessly from one agency to another. (For Canada, see PIPEDA)

Hippocampus: A structure that is part of the limbic system. Crucial to learning and long term memory.

Home based services: Provided in a family’s home either for a defined period of time or for as long as it takes to deal with the mental health problem. Includes parent training, counseling and working with family members to provide necessary help. Goal is to prevent placement outside of
the home for the child.

Hypertensive crisis: Sudden and sometimes fatal rise in blood pressure; may occur as a result of combining monoamine oxidase inhibitors and tyramine in food, or over-the- counter medications (e.g., cough remedies, nose drops).

Hypervigilance: Ongoing condition of guardedness generally more so than a situation realistically calls for. Habit of staying prepared for fight or flight.

Hypomania: An episode of increased energy that can last for hours to days but is not characterized by a loss of touch with reality and so is not severe
enough to be categorized as manic.

Hypothalamus: The part of the brain that controls several body functions including feeding, breathing, drinking, temperature and the release of
many hormones.

Iatrogenic: Harmful effects presumed to be caused (inadvertently) by the treatment itself.

Impulsivity: Action that comes out of an immediate desire without thought of the consequences.

Independent living services: Support for a young person living on their own. Include therapeutic group homes, supervised apartment living, job
placement, etc.

Indictment: Legal term — The written statement charging a person with the commission of a crime or other offense.

Individual education plan (IEP): An individual education plan is a written plan that describes special education programs, accommodations and services that a school board will provide for a student. IEP s are based on a thorough assessment of a student’s strengths, needs and ability to learn and demonstrate learning.

Informed consent: Permission by the patient for a medical procedure based on a n understanding the nature of the procedure, the risks involved, the consequences of withholding permission and alternative procedures.

Infraction: Legal term — An offense carrying the lowest sanctions, primary monetary sanctions.

Inpatient hospitalization: Mental health treatment provided in a hospital setting 24 hours a day. Provides short term treatment in cases where a
person is in crisis and diagnosis and treatment when a person cannot be evaluated or treated appropriately in an outpatient setting.

Insight: In this context, the extent of a person’s understanding of the origins, nature and mechanisms of their mental illness.

Interpersonal therapy (IPT): A contemporary approach to the treatment of mood disorders that focuses on current problems, important social
relationships, self- evaluation by the patient with assessment of their own current situation and clarification and modification of maladaptive perceptions and current interpersonal relationships. This therapy strengthens the person’s communication and problem-solving skills.

Intervention: Action taken to treat a disorder.

Juvenile justice facility: Encompasses detention centers, shelters, reception or diagnostic centers, training schools, ranches, forestry camps or farms,
halfway houses, group homes and residential treatment centers for young offenders.

Lability: Rapid mood swings or moodiness.

LCSW: Indicates that the person is a Licensed Clinical Social Worker.

Limbic system: Network of structures in the forebrain that work to regulate human emotions such as fear, anger, depression, excitement, and certain
aspects of movement. Regulates emotion, memory, arousal, cognition. Includes the hippocampus, amygdale, thalamus, hypothalamus.

Looseness of associations: Disturbance of thinking shown in a person’s speech in which an individual shifts from one subject to another subject
that is unrelated or minimally related to the first. Individual gives no indication of being aware of the disconnectedness, contradictions, or illogicality of speech.

Longitudinal: Related to what happens to a disorder over time, as the child grows.

Longitudinal studies: Research design in which the same subjects are studied over the course of a determined period of time (for example: to
study long term effects of medications on children).

LPC: Indicates that the person is a Licensed Professional Counselor.

Maintenance drug therapy: Continuing a therapeutic drug after it has reached its maximum efficacy, and at a minimum effective level to prevent
an early relapse or a later recurrence of illness.

Managed care: A system of health care that combines delivery and payment. Managed care influences use of services by employing management
techniques designed to promote the delivery of cost-effective health care.

Managed health care plan: An arrangement that integrates financing and management with the delivery of health care services to an enrolled
population. A managed health care plan employs or contracts with an organized system of providers that delivers services and frequently shares
financial risks.

MD: Indicates that a person has a doctorate in medicine and is able to prescribe medication. This may include pediatricians, psychiatrists,
neurologists and family practitioners (among many others).

Medicaid: An entitlement program financed jointly by the state and federal governments that provides medical services to people with low incomes.
States must offer certain services (inpatient and outpatient hospital services, physician’s services, clinical lab and x-ray services and ho me health services). Additional coverage of persons with mental illnesses is limited.

Medical necessity: The determination that a specific health care service is medically appropriate, necessary to meet a consumer’s health needs,
consistent with the diagnosis, the most cost-effective option and consistent with clinical standards of care.

Medicare: An entitlement program of health insurance for the elderly and for qualified disabled persons enacted in 1965 in the United States. Part A (hospital insurance) is earned through employment covered by Social Security. Part B (supplementary insurance) is elected and paid for through a heavily subsidized premium.

Medication holiday: A period of time (usually 1-3 months) during which the child’s medication is discontinued. Commonly used over the summer months for ADHD when the primary effect of the illness is on school performance. Medication holidays should not be initiated by caregivers but under the supervision of the treating physician.

Medication trial: A systematic test of a medication in a patient that usually takes 1-3 months.

Mental health intensive case management (MHICM): A team of mental health physicians, psychologists, nurses and social workers that treats
patients in their homes in the community. MHICM helps Veterans experiencing severe mental illness have less need of hospitalization and live better at home and in the community. While most MHICM programs are located in urban areas, in some cases, MHICM teams can serve rural areas as well.

Mental illness: A behavioral or psychological syndrome that causes significant distress or disability or a significantly increased risk of death, pain
or an important loss of freedom. Syndrome is considered to be a manifestation of some behavioral, psychological or biological dysfunction in the person.

Mental retardation: Major group of disorders of infancy, childhood or adolescence characterized by intellectual functioning that is significantly
below average. Manifested before age 18 by impaired adaptive functioning.

Metabolism: Ongoing chemical processes that create or break down compounds/medications.

Metabolite: A compound that results from the chemical breakdown of a neurotransmitter in the space between nerve cells (synapse).

Military sexual trauma (MST): Refers to sexual assault or repeated, threatening sexual harassment experienced by women or men during military
service on or off duty.

Misdemeanor: Legal term — Offenses for which imprisonment up to one year in jail may be imposed (for example: shoplifting, trespassing, vandalism).

Mood reactivity: An excessive response to a typical environmental stimulus or stressor, such as extreme anger at common requests.

Motor functions: Activities related to the ability to move.

MRI — Magnetic Resonance Imaging: A non-radiating imaging technique that produces better resolution (sharper images) and more varied pictures of the structures of the body and brain than CT scans.

MSW: Indicates that the person has a master’s degree in social work.

Neurobiology: The basic science underpinning nerves and the nervous system.

Neurochemical: Referring to the elemental makeup of the messengers of the nervous system.

Neuroleptic: Referring to a specific effect of a pharmacologic agent on the nervous system; specifically, a drug whose principal effect is on
psychomotor activity.

Neurologist: Medical specialist in the medical treatment of disorders of the nervous system, like seizures.

Neuron: The basic unit of the nervous system and functions to conduct electrical stimuli to other cells. Receives multiple inputs from numerous
projections called dendrites and send its outputs by means of a single axon synonym nerve cell.

Neuropsychological: Related to the interface between brain functioning and thinking processes (perception, processing and problem solving).

Neuropsychiatry: Medical specialty that combines neurology and psychiatry emphasizing the somatic substructure on which emotions are
based and the organic disturbances of the central nervous system that give rise to mental disorders.

Neuroscience: The study of brain function, the neural substrates of behavior and how the nervous system is affected by disease.

Neurosis: Older term (no longer used medically) to describe emotional disturbances of all kinds other than psychosis.

Neurotransmitters: Chemical found in the nervous system that facilitates the transmission of impulses across synapses between neurons.

Night terrors: Episodes in which a sleeping person becomes agitated, thrashes around physically, and may cry out. Attempts to wake and/or calm the person only increase the agitation.

Norepinephrine: Neurotransmitter secreted by the adrenal glands in response to arousal-provoking events such as stress. Influences mood,
emotional behavior, alertness, anxiety and tension.

Occipital lobe: One of the four divisions of the cerebral cortex in the brain primarily responsible for vision.

Occupational therapist: Provide services to improve a person’s ability to accomplish everyday tasks associated with a maximum level of safe independence.

Orthostatic hypotension: A drop in blood pressure resulting in a dizzy or faint feeling that is produced after suddenly sitting up or standing up. Many
psychiatric drugs cause orthostatic hypotension. It can be a serious side effect in elderly people.

OTC: Over the counter, medications available without a prescription.

Parasympathetic nervous system: The part of the autonomic nervous system that controls the life sustaining organs of the body under common,
danger-free conditions and is mediated by acetylcholine.

Parent counseling: Therapeutic approach in which parents are educated about the child’s brain disorder and given information and advice on
general issues and on specific problems they may be having with behavior or the child.

Parent training: Systematic goal oriented process in which parents are taught how to manage the behavior of their troubled child by means of
positive and negative reinforcement. Especially appropriate for parents of younger children.

Parietal lobe: Area of the cerebral cortex responsible for the intellectual processing of sensory information (visual, tactile, auditory) and also
responsible for verbal and visual spatial processing.

Parity: In mental health, equivalent benefits and restrictions in insurance coverage for mental health services with other health services.

Parkinsonian effects: Drug-induced side effects resulting from an antipsychotic medication that mirror classical Parkinson’s disease
symptoms, such as reduction in motor abilities and coordination, shuffling gait, drooling, muscle rigidity, and tremors. Ordinarily the effect occurs
within five to 90 days of drug initiation.

Pathophysiology: The actual disturbances in the body organs or brain causing the disorder.

Peptides, neuropeptides: Chemicals, including some hormones that act as messengers in the brain and modulate the activity of many other
neurotransmitters.

Pervasive: Occurring more often than not, in many settings, and for morethan a few months.

Pharmacotherapy: Treatment of a disease through the use of pharmaceutical medications.

PhD: Indicates that a person has a doctoral degree; in the mental health field, this is usually in psychology.

Phobia: Fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immediate anxiety
response or panic attack even though the subject recognizes that the fear is excessive or unreasonable.

Personal Information Protection and Electronic Documents Act (PIPEDA): PIPEDA is Canada’s parallel to the US’s HIPAA. It oversees a broader range of industries including banking, telecommunications, and other industries where personal data can be collected or stored. It ensures that personal information is stored securely and privately, and that an individuals can view and appeal the validity of any information collected.

Placebo: An inactive compound such as sugar pills, used in scientific studies to determine how much of a medication’s positive effect comes from
the medication and how much from other factors.

Plan of care: Treatment plan especially designed for each person, based on individual strengths and needs, developed by the provider with input from the person and family (if involved).

Plea: Legal term — Defendant enters a plea at arraignment.

Plea bargain: Legal term — Coming to terms and conditions of what the plea is going to be.

Polymorphism: Multiple alleles of a gene, usually expressing different phenotypes.

Polytrauma: Two or more injuries to physical regions or organ systems, one of which may be life threatening, resulting in physical, cognitive,
psychological, or psychosocial impairments and functional disability.

Positive effect: A beneficial outcome of a treatment. The anticipated effect for which a medication is prescribed.

Positron emission tomography (PET): An imaging technique for measuring brain function in living subjects be detecting the location and concentration of small amounts of radioactive chemicals.

Postsynaptic: Refers to the area after the synaptic cleft (the receiving neuron).

Posttraumatic stress disorder (PTSD): A disorder that may result when a person experiences a traumatizing or life-threatening event such as combat, natural disasters, serious accidents or violent personal assaults. PTSD symptoms can disrupt daily life. They include re-experiencing the trauma and emotional distancing from other people or feeling emotionally numb. Other symptoms may include being irritable or quick to anger, trouble sleeping, nightmares, fearfulness or losing interest in things.

Poverty of speech: Condition in which speech becomes less spontaneous or forthcoming. Questions are answered briefly with little
unprompted elaboration.

Preliminary hearing: Legal term — In felony cases a preliminary hearing is held before a judge to determine if there is sufficient cause to believe the
defendant committed the crime.

Presynaptic: Refers to the area before the synaptic cleft (the sending neuron).

Pretrial conference: Legal term — In felony cases a pretrial meeting in the presence of a judge between counsel for both sides and sometimes the parties to settle all preliminary questions of pleading and scope of the dispute.

Primary care provider (PCP): The provider that serves as the initial interface between the patient and the health care system. Usually a physician selected by the consumer and coordinates their treatment.

Prodromal phase: Phase during which a deteriorating state of health is recognized that later culminates in full-blown illness. During the deterioration phase, there are subtle warning signs of the impending illness, such as withdrawal, bizarre thoughts, or other behaviors recognized as precursors of a psychotic episode.

Prognosis: The prediction of the future course of a disease.

Prolonged exposure therapy (PE): A proven treatment for PTSD. Prolonged exposure therapy helps people revisit traumatic memories in a safe
environment. Veterans first remember the trauma by retelling it. Then they slowly become more comfortable with sights, sounds, and smells that remind them of the trauma. They learn to face situations in their current lives that they have been avoiding. The memories and situations become less troubling and interfere less with the person’s daily life.

Prophylactic: A treatment or medication used to protect against the onset or recurrence of a disease or disorder.

Psychiatric-mental health nurse practitioner (PMHNP): An advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

Psychiatrist: A medical doctor who specializes in treatment mental diseases by evaluating a person’s mental health along with their physical health. A
psychiatrist can prescribe medications.

  • Child and adolescent psychiatrist: A medical doctor who has completed training as a psychiatrist, plus training in treating children with emotional and behavioral disorders. Can prescribe medication and provide therapy.

Psychiatry: The branch of medicine that deals with identifying, studying and treating mental, emotional and behavioral disorders.

Psychoactive: Affecting the central nervous system resulting in changes in thinking, behavior, or emotion.

Psychologist: A mental health professional who has received specialized training in the study of the mind and emotions. Psychologists usually have
advanced degrees such as a Ph.D.

  • Child psychologist: A psychologist who specializes in children and adolescents.

Psychomotor agitation: Excessive motor activity associated with a feeling of inner tension. The activity is usually nonproductive and repetitious and
consists of behavior such as pacing, wringing of hands and inability to sit still.

Psychopathology: Study of the significant causes and processes in the development of mental disorders. Also the manifestations of mental disorders.

Psychopharmacology: The study of the effects of psychoactive substances son behavior in both animals and people. Includes both the study of drug
effects in patients and the expert use of drugs in the treatment of psychiatric conditions.

Psychotic: Describes someone whose ability to distinguish what is real from what is not real is impaired. Involves hallucinations and/or delusions.

Psychotherapy: Form of treatment in which a person who wishes to relieve symptoms or resolve problems through verbal interaction seeks help from a qualified mental health professional and enters into an implicit or explicit contract to interact in a prescribed way with a therapist.

Psychotropic medications: Refers to any medications that alter psychological functioning and/or mood, thoughts, motor abilities, balance, movement and coordination.

Psychotropics: Agents that affect the central nervous system, resulting in changes in thinking, behavior or emotion.

Rapid cycling: Referring to bipolar disorder in which four or more episodes of mood disturbance (manic, hypomanic or major depressive episode) occur within one year (for adults).

Receptor: A specialized area on a nerve membrane, a blood vessel, or a muscle that receives the chemical stimulation that activates or inhibits the
nerve, blood vessel, or muscle.

Recovery: Process of overcoming a particular life problem, such as gambling, codependency, mental illness, or childhood abuse through inner
change and personal growth.

Recreational therapist: The primary purpose of these treatment services, which are often referred to as recreational therapy, is to restore, remediate or rehabilitate in order to improve functioning and independence, as well as to reduce or eliminate the effects of illness or disability.

Refractory: Non-response to the known therapeutic effect of a drug or course of drug treatment; or, non-response due to increased tolerance to a
drug over time. See treatment resistant.

Rehabilitation: In psychiatry, the methods and techniques used to achieve maximum functioning and optimum adjustment for the patient and to prevent relapses or recurrences of illness.

Relapse: The return of symptoms associated with the present episode of psychiatric illness after the symptoms had been reduced or eliminated for a
brief period.

Remission: A reversal of a disorder, leaving no symptoms.

Residential treatment center: Facilities that provide treatment 24 hours a day and can usually serve more than 12 people at a time. Constant
supervision, care and treatment.

Resilience: An ability to recover from or adjust easily to significant challenges such as misfortune or change.

Respite care: 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. May be provided in home or off site.

Reuptake: Removal of a neurotransmitter from the synapse by the neuron that released it. Reabsorption.

Reuptake inhibitor: Medication or chemical that acts on the presynaptic neuron and inhibits that neuron’s ability to reabsorb the neurotransmitter it
has released.

Risk: The chance or possibility of experiencing harm or loss.

Risk factor: A circumstance or a condition that increases the chances of developing a disease.

Second line treatment: A type of treatment reserved for use when the first line treatment is ineffective or not tolerated.

Sedative: Sleep-producing.

Self-harm/mutilation: Self injury used as a coping mechanism to release or manage overwhelming emotional pain or to express that pain to others
(for example: cutting).

Self-medication: Using alcohol and/or other drugs in an effort to improve one’s own mood and general feeling. People with untreated mental illness
often turn to self- medication for relief.

Serious emotional disturbances: Diagnosable disorders in children and adolescents that severely disrupt their daily functioning in the home, school, or community. May also be referred to as mental illnesses.

Serotonin: The chemical messenger in the nervous system that when decreased or deficient may lead to depression and anxiety.

Side effect: A drug response that accompanies the principal response for which a medication is taken. Most side effects are undesirable yet cause only minor annoyances. Others may cause serious problems.

Social Security Disability Insurance (SSDI): Disability insurance payments to individuals who have retired prematurely due to a disability, but who have contributed to the disability fund through their employment, the children of these retirees, or people who became disabled before age 18 years.

Somatic: Referring to the body, as opposed to the mind.

Stigma: The labeling of a person or group to indicate that something is abnormal. The stigma of mental illness is still strong enough that many
individuals are reluctant or refuse to seek treatment.

Stimulants: A class of medications that increase or enhance central nervous system activity (for example: Ritalin, Dexedrine, Adderall, Cylert,
etc.).

Strength-based treatment: In mental health, a process that builds upon an individual’s strengths to work towards recovery.

Subpoena: Legal term — Mandatory legal notice to appear in court.

Substance use disorder: Impairment in social and occupational functioning resulting from the pathological and compulsive use of a substance.

Substance dependence: Sometimes defined in terms of physiological dependence as evidenced by tolerance or withdrawal. Other times defined in
terms of impairment in social and occupational functioning resulting from the pathological and repeated use of a substance — symptoms of tolerance and/or withdrawal may also be present.

Suicidal ideation: The presence of a suicidal thought or plan.

Supportive psychotherapy: A treatment technique that helps a person reduce stress and cope with their disorder without probing disturbing
thoughts or emotions.

Sympathetic nervous system: Part of the autonomic nervous system that responds to dangerous or threatening situations by preparing a person
physiologically for “fight or flight.”

Symptom: A specific manifestation of a condition indicative of an abnormal physical or mental state. Subjective perception of an illness.

Synapse: The space between the membrane of one nerve cell and the membrane of another. The synapse is the space through which the nerve impulse is passed, chemically or electrically, from one nerve to another.

Syndrome: A configuration of symptoms that occur together and constitute a recognizable condition.

System of care: A partnership of mental health, education, child welfare and juvenile justice agencies as well as teachers, children with serious emotional disturbances and their families and other caregivers. These agencies and individuals work together to ensure children with mental, emotional and behavioral problems and their families have access to the services and supports they need to succeed. Together, this team creates an individualized
service plan that builds on the unique strengths of each child and each family. The plan is then implemented in a way that is consistent with the family’s culture and language.

Tachycardia: Unusually rapid heartbeat (greater than 100 beats per minute) that may result from the side effects of antidepressants acting on the
autonomic nervous system. It is a form of heart arrhythmia.

Tapering: The process of slowly decreasing the dose of medication over several days or weeks until the medication is completely discontinued. This
is done to reduce or avoid withdrawal symptoms.

Tardive dyskinesia: A side-effect of traditional antipsychotic drugs. Involves abnormal involuntary movements of the face, tongue, mouth, fingers, upper and lower limbs, and occasionally the entire body. Usually appears after taking the drug for some time and occurs in at least a mild form in 25 to 40 percent of people taking antipsychotic medications. Tardive dyskinesia may be severe or irreversible in 5 to 10 percent of cases.

Telemedicine or telemental health: Technology that allows a clinical provider to care for a patient from a remote location, using a camera and special video monitor that allows the patient and provider to see and hear one another. Telemental health can be used to perform assessments and conduct individual or group psychotherapy and medication management.

Temperament: A set of character traits an infant is born with. Sometimes thought of as a person’s inherent disposition and the foundation of their
personality.

Temporal lobe: One of the four major subdivisions of the cerebral cortex of the brain. Involved with speech and with auditory and complex visual
perceptions.

Thalamus: Brain structure which relays the information from the brainstem to the cerebral cortex. Seems to act as a filter for sensory information
flowing into the brain.

Therapeutic foster care: Foster care services where the caregivers have received specialized training in working and living with children with SED
diagnoses.

Thought disorder: Disturbance of speech, communication, or content of thought, such as delusions, ideas of reference, poverty of thought, etc.. Term
thought disorder is often used synonymously with the term psychosis.

Titration: Process of determining the exact dose of medication needed for a person with a brain disorder by evaluating their response to the medication.

Tolerance: Characteristic of substance dependence that may be shown by (1) the need for increased amounts of the substance to achieve intoxication or the desired effect, (1) by markedly diminished effect with continued use of the same amounts, or (3) by adequate functioning despite does or blood levels of the substance that would be expected to produce significant impairment in a casual user.

Toxicity: The capacity of a drug to damage body tissue or seriously impair body functions.

Transdermal: Absorbed through the skin.

Transition services: Activities needed by students with disabilities to promote movement from school to post-school activities.

Trauma: An event, injury or emotional shock that has a negative effect on a person’s psychological state of mind.

Traumatic brain injury (TBI): Occurs when an external force traumatically injures the brain. Individuals who sustain a TBI may experience a variety of effects, such as an inability to concentrate, an alteration of the senses (hearing, vision, smell, taste, and touch), difficulty speaking, and emotional and behavioral changes. Whether the TBI is mild, moderate, or severe, persistent symptoms can have a profound impact on the injured survivor and those who serve as caregivers.

Treatment resistant: Lack of response to a specific therapy that would ordinarily be expected to be effective.

Ventricle: One of the cavities or spaces in the brain that are filled with cerebrospinal fluid.

Vesicle: A membranous sac within an axon terminal that stores and releases neurotransmitters.

Warrant: Legal term — Judicial writ authorizing an office to execute a search, seizure or arrest.

White matter: The brain’s long-distance connections, composed of myelinated axons that connect various gray matter areas of the brain to each
other and carry messages.

Withdrawal: A pathological retreat from people or the world of reality, often seen in schizophrenia. Also, the cessation or significant reduction of use of a chemical substance in a person with a pattern of heavy or prolonged use of that substance, often accompanied by withdrawal symptoms.

Withdrawal symptoms: Symptoms and signs that develop within a short period of time (usually hours) after stopping use of a substance. Withdrawal symptoms are specific to the substance.

Wrap around services: A process in which families with children who have severe emotional disturbance are able to address their needs through a
strengths-based, family-driven team approach. A “wraparound facilitator” helps link families of children with severe emotional disturbances with needed services and supports. All members of the family are served through a partnership with the facilitator and other service professionals. The family can choose others they want to have as a part of the team, including friends, church members and relatives. Wraparound helps develop creative strategies to meet the needs of each person that may include both traditional and non-traditional approaches and supports.

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