Mental Health and Social Service Needs
What the exam expects you to know
Residents bring grief, depression, anxiety, fear, anger, cultural beliefs, religious practices, and sexual needs into the facility. You are expected to know basic psychosocial care: treat the resident as a whole person, respect culture and religion, protect privacy during intimate moments, and communicate with open-ended questions, active listening, silence, and empathy. Know the difference between normal grief, which comes in waves and eases with support, and depression, which is persistent sadness, withdrawal, poor appetite, sleep changes, and hopelessness that should be reported. Recognize defense mechanisms such as denial, anger, and regression as coping, not misbehavior.
Traps built into questions
Trap answers include telling a crying resident not to cry, promising to keep a secret, giving personal advice about money or family, arguing about religious beliefs, and labeling a resident as difficult or attention-seeking. The biggest trap is missing a safety statement. Any talk of being better off dead, of not wanting to live, or of giving away possessions must be taken seriously: stay with the resident, do not leave them alone, and notify the nurse immediately. Report changes in behavior, appetite, sleep, and social contact.
Worked example
A resident says, Nobody would care if I died. You do not reply that everyone gets down sometimes. You stay with the resident, say something like That sounds very painful, I am glad you told me, notify the nurse right away, and document the exact words used.