Implement and monitor nursing care for consumers with mental health conditions
There are various negative consequences’ would take place with the untreated mental disorder. It can be lead to suicide, mental trauma, depression, anxiety disorder and bipolar disorder etc. these consequences will affect the human in a badly manner (Goodell et al., 2011). Therefore, it is must to be treating such type of mental condition so that positivity will be spread in society.
Social and cultural have several myths in regards to the mental illness as the society generally believed that mental illness get occur due to bad parenting and awful surrounding which an individual is experiences. Besides that, they also identified that people with mental illnesses are weak and depressed and their behaviour early fluctuate as per the time.
Moreover, there is also a myth that kids can’t have a mental illness like depression, stress and anxiety problem and believed that it is normally find only in the adult and young people (American Psychiatric Association, 2013). Lastly, there is also have an myth that people with extreme poor mental condition don’t recover and they are tend to be unwell forever.
Therapeutic communication is considered as an effective nursing practice which is widely used by the nurses and doctors for the mentally ill patients. In this concept, the face-to-face process of interacting will be undertaken through focusing on the advancing or repairing the physical or wellbeing of the patient (Storrie et al., 2010).
Nurse uses therapeutic communication method with the aim to provide support and collect information about the patient health state. Thus, with the help of this method, therapist could able to examine the communication strategy so that in the best style one thoughts, need and goals to be communicated effectively.
Therapeutic relationship and therapeutic alliances share the common concept as both aims is to develop the healthy relationship between the healthcare professional and in clients/ patients. But their differences can be identified with the associated with better psychotherapy outcome (Karlin et al., 2010).
Duty of care is considered as a legal obligation regarding to provide the reasonable amount of care to the individual in order to avoid any type of harm. It can be stated that doctors and other health professional have a duty of care towards their respective patients.
Six Signs and Symptoms of Aggression
- Depression of flat affect
- Delusion
- Personality Fluctuation
- Anxiety
- Delusion
- Threatening behaviour
There are four strategies that are largely used by the professionals to reduce the aggression and it could be the communication strategy, environmental strategies, cathartic activities and room programme etc (Kobau et al., 2011).
The factors which are undertaken for accessing the challenging behaviour are as follows:-
- Workplace guidelines are the key factor within which individual behaviour is measured.
- Risk factors include the different types of clients such as psychiatric; patients disoriented by drugs, mental illness patients etc.
- Staff support is also a factor which considers in the measuring of the accessing of individual
The common symptoms of the depression are high stress level, feelings of guilt, hopelessness or restlessness etc (Keyes et al., 2010). Besides that, decrease energy and physical pain can also be symptoms of the mental problem which result to depression. Thus, these are the symptoms that make the individual depressed and lethargic
Suicide, self-harm and suicidal ideation defines the common understanding about the harming oneself. In this, suicide is the deliberate act of killing ourselves and it is considered as a non-fatal and inflicted behaviour which result in the end is death. Self-harm does not result in death and suicidal ideation is the thinking process about the committing the suicide.
Six factor of suicide that are as follows:-
- Impulsivity
- Depression
- Anxiety
- Mood disorder
- Antidepressant
- Major depressive disorder
There are two groups which has a higher risk of suicide as per the Australia community. This group are young adult and males have been growing gradually for the past 25 years.
The recovery model states that the main purpose of this principle, its aims to deliver the mental health services in a way that contributes high towards the recovery of mental health consumer in order to get the recognise from the society (Dyrbye et al., 2012).
Negative aspects of the schizophrenia are as follows:-
- Apathy
- Absent
- Lethargy
- Social withdrawn
- Reduction in speech
Five types of hallucination that is experienced by the individual:-
- Visual hallucination
- Auditory hallucination
- Olfactory hallucination
- Gustatory hallucination
- Proprioceptive hallucination
There are six side effects of the antipsychotic medications and it includes the dry mouth, weight gaining, and muscles spasm & unclear vision, sleepiness etc (Westerhof & Keyes, 2010).
Stigma has a deep impact on the individual life when it comes to the serious mental illness as they are struggled with disability which occurs from the disease. Such stigma of the individual influenced the individual capacity in a badly manner. But at the same time, people with mental problem hold up opportunities that define the quality life such as good job, safe housing, satisfactory health and affiliation with different group members etc (Lawrence et al., 2010). Thus such stigma has a positive impact on the individual.
The adverse effect of substances (drug, abuse and addiction) use is as follows:-
The excessive consumption of drug leads to ruin the mental condition of individual. It is finding that the most abused drugs directly or indirectly influences the people mental state and reduces their capacity to take proper decision and affect their ability to think positively. Thus, it can be stated that the substances use can have an extreme bad reaction over the people (Kendler et al., 2010).
First complication that arise with the alcohol withdrawn is the delirium tremens which is characteristic by suffer from hallucination, mental confusion and disorientation etc; another one is that people are more in an awake state.
The major differences between both terminologies are that delirium is caused through acute illness and drug toxicity while dementia is caused through the anatomic changes in brain.
The ECT or TMS both are the tools which is used by the professional to treat depression.TMS is used in the first level treatment while ECT is quite an length process so it is used less by the professionals.
The registered Nurse has a strong role in the multidisciplinary approach as it provides the health care to different individual personalities, families and communities. They offer various services with the aim to promote the health and to prevent illness etc (Scott et al., 2010).
In this case scenario, Lucy suffers from major depression, a condition causing regular feeling of sadness and mood disorder. The implication of Lucy depression includes social, financial and cognitive aspects which are described below:
Social: The social implication is the inability of Lucy to socialize and withdrawal from social interaction. This also leads to increased loneliness due to social isolation. Another social effect can arise in this case is low self-esteem and self-confidence causing feeling of anxiousness and results in decreased performance in managing daily living activities (Rogers and Pilgrim, 2014).
Lucy’s social capacity to function is affected in terms of her relationship with her son and this can lead to family withdrawal and suicide intentions in Lucy.
Financial: The depression in Lucy can have financial implications in terms of inability to manage finances and other monetary decisions (Disner et al., 2011). This can also have a negative impact to afford health care treatments, therapy, counseling etc. and cost of medications.
Cognitive: Lucy cognitive implications of depression are indicated by reduced ability to recall and memorize things.
Thus, the mental ability of Lucy under depression is being affected by poor concentration, sinking mood, and decline in capacity to think (Disner et al., 2011) and answer basic questions such as when Lucy had last eaten (as asked by her son) due to slow processing of information by brain. The cognitive effect in Lucy also indicates loss of interest in life due to her suicidal intentions.
The barrier to develop a therapeutic relation with patient under a major depression is the psychological circumstances, belief and individual attitude about the mental illness and depression. In case of Lucy, the psychological burden is a major barrier identified to develop therapeutic alliance. The negative attitude of Lucy towards life and medication treatment and development of depressing behavior create an obstacle to access and receive quality care.
Thus, the patient resistance due to decline in cognitive state to get treatment care is another barrier as Lucy is has stopped taking her mediations for depression. This is also indicating Lucy belief and attitude towards depression disorder which is also inducing suicidal thoughts.
The suicidal intentions and loss of interest in life due to loss of her husband is also a barrier to develop a therapeutic relationship with Lucy. The stigma of mental illness with feeling of sadness can also affect the patient-nurse relationship in treatment care plan.
In Lucy’s case scenario, the strategies to develop a therapeutic relationship for patient under major depression are:
Active Listening Strategy: The nurse can use this strategy to understand the attitude and belief of Lucy towards life (Haugan et al., 2013), suicidal intentions, and psychological burden in absence of her husband and any other negative thoughts under current state of mental condition. This will be helpful for the nurse to understand the mental state of Lucy to plan for effective treatment care.
Communication strategy: This strategy is useful in Lucy’s case to exchange knowledge related to patient existing condition, to convey the consequences of mental disorder, provide positive feedback or convey improvement in existing condition, to motivate and keep patient cheerful and inform the treatment care plan.
The communication will be useful to provide sound information to Lucy to understand the mental disorder and provide support along for the psychological benefit (Haugan et al., 2013) and to develop an effective therapeutic relationship.
Empowerment therapy: This therapy can be used to reduce the dependency on others and make Lucy independent to take hold of the daily activity of living, mental state and financial control in absence of her husband (Layous et al., 2011). This will help Lucy to cope better with depression disorder.
The nurse using this therapy can help the Lucy capacity to function in personal, self-health management, social and financial aspects to manage things independently. This can help Lucy to regain lost confidence and feel positive about the treatment care leading to effective therapeutic relationship.
Lucy is living alone therefore, the management discharge is vital to ensure her safety. The safety management for Lucy is through discharge instruction for balanced diet and continued medication as per prescription and other antidepressants to cope with mood disorder and to address the risk of Lucy non-compliance with good eating habits and medications.
To ensure Lucy safety the nurse address the risk of self-harm and suicidal thought and instructed to contact health practitioner, her sons and 911 services during negative thoughts or behavior and intention to self-harm. The discharge planning also includes self-management practice such as meditation and yoga, proper sleep and rest and to develop good eating habits along with social connection such as visit to sons place, churches and social gatherings and to keep regular contact with patient physician to improve mental health state.
Lucy is advised to contact the healthcare provider for any side-effects of mediations and if she thinks no improvement is observed in current mental state. Additionally, Lucy can contact physician if she is having any concerns related to general well-being.
Lucy is also referred to seek counseling each week for one hour in aged care to get an opportunity for social connection among same age group or with individual suffering similar mental conditions and to reduce the psychological burden or negative thoughts from the sudden loss of her husband.
The purpose of the Mental Health Act 2014 is guidance to clinicians to access and provide proper treatment to individual with mental illness. It focus on providing least restrictions on patient right, respect and dignity (Mental Health Commission, 2017).
The act also enables the patient or nominated person to take decision regarding treatment and access to other health care system and promotes voluntary treatment thus, safeguard the individual suffering from mental disorders. It also recognizes the role of patient carer such as family, relative or any other nominated person.
The act is in compliance with the law governing to access care and treatment of mental illness individuals for protecting the mental illness patient from self-harm and for community protection. The Mental Health Act 2014 is applicable in Kath scenario as Kath is suffering from mental illness and require mental health treatment to avoid further deterioration of mental condition which can lead to serious self-harm and harm to other individuals in the community.
Kath under mental illness has shown aggressive and argumentative behavior with fellow staff this aggressive can also put her three children in danger that might require protection from Kath. This act also applies to as she was admitted as an involuntary patient due to risk of self-harm and purpose for her children and community protection.
The criteria for admission as an involuntary patient as stated in the Mental Health Act (2014) is through court order, after individual medical examination/certificate of medical health practitioner, request from family members, friends or relatives, request from community and apprehension from police (Smith et al., 2014) requires to take individual with mental illness to mental health practitioner.
The admission of Kath as an involuntary patient was request from community members followed by apprehension from police as Kath appears to suffer from mental illness and requires a medical or mental health practitioner for further examination.
The criteria for treatment as an involuntary patient as stated in the Mental Health Act (2014) is that the individual is verified to have a mental illness, the individual require immediate treatment to avoid further deterioration of existing mental health to prevent from self-harm, harm to other persons and community (Patterson et al., 2016).
Moreover, the patient has mental inability to make any treatment decision or make arrangements for the treatment provisions. The treatment criteria for Kath as an involuntary patient requires Kath to be admitted and restrained in psychiatric unit to access and receive best possible care and proper treatment without any informed consent about the provisions of the mental illness treatment.
The treatment order must be provided such as inpatient treatment order or a community treatment order for immediate treatment without informed consent about the provisions of the treatment being made (Mental Health Commission, 2017) and other related heath related treatment in accordance with the mental health act.
Answer 3:
Kath’s rights under the Mental Health Act (2014) as an involuntary patient admission and treatment are:
Right to participate in decisions related to treatment plan- Kath has right to involve in the decisions and ask questions about the current and future treatment course to make advance statement to the concerned psychiatrist. Right to ask second psychiatric opinion- Kath has right to consult a second psychiatric opinion for her current treatment and future care plan. Right to seek for Legal advice – Kath can seek legal advice for her mental conditions and ongoing treatment.
Kath also has right to compliant about ongoing treatment to mental health commissioner for the treatment and revoke the treatment order by making request to Mental Health Tribunal (Singh et al., 2014). Kath also has right to communicate with her children and other relatives and has right to nominate a person who can be a family member, relative or carer to communicate and take decisions regarding treatment and related provisions.
Under the survey in Australia, it is identified that the Australia population is facing growing mental disorder problem due to increasing rate of diseases and it affects the individual growth. In regards to address such issue, the Australia institute of health and welfare’s presents the report on the mental health service care facilities and characteristics (McGorry et al., 2013).
In addition to this, the report describes the mental health care structure in Australia. In this, it is mention that state and territory government supplies proper funds to the public health care’s, at the same time, specialist team of professionals are hired in this care centres. Besides that in order to treat the mental disorder patients, government also involve in conducting various programs, activities etc. It also provides support of accommodation and social housing program etc.
Moreover, the Australia government also provide support to the nursing care practices through provide funds to a range of public mental health care institution. This can be possible through the Medicare benefits schedule and the pharmaceutical benefits scheme and repatriation pharmaceutical benefits schemes etc.
From the survey which is conducted in the Australia stated that around approx, 45% of Australians who is in between the age of 16-85 will experiences more problem of the mental illness. Likewise, the common cause of the mental illness is the depression, anxiety or a substance use (alcohol, drug addiction) etc.
besides that, it is also find that there are mainly two types of group who has high mental illness issues and these are the young adults and males. Basically, the males and young adults are committing more suicide due to instable mental health situation (Eagar et al., 2010). Thus, in order to reduce its negative effects, there are various initiatives are taken by the Australia government which are mention below:-
From the report of Australia institute of health and welfare’s, it is also estimated that there are several ways are use by the Australia health care centres to impart the mental care services. It involves the following:-
- Hospital based outpatient services
- Patient services in hospital
- Community mental health care services
- Specialized staff and general practitioners
Impact of such initiative on the mental health care:-
These above mention initiative which is taken by the state and territory government are proved to be valuable for the Australia as with the growing mental state ratio in Australia clearly indicate that there is high need to take necessary step for reducing such problem (World Health Organization, 2014). The main cause of growing such problem is the rising burden of work and imbalances of the life cycle of individual.
Thus, these result in high stress level which in-short convert into the disease. So basically, increasing disease is considered as a big cause of high mental illness in Australia. These diseases have a negative impact on the local society. So, there are various recommendation is stated by the Australia government under their policies.
It is mandatory for the workplace owners to provide the flexibility to the individual and provide the personal growth opportunity to them so that they could balance their work life with personal life. Furthermore for the mental health care services centres,
it is suggested that services care should hire the professionals and innovate some unique activities and therapies in order to treat the mental illness more effectively and efficiently. Thus, these above given recommendation contributes high for achieving the stress and mental free environment in Australia (Babitsch et al., 2012).
The mental health service structure in Australia is developed at the great extent. It is because the mental health services in Australia are provided in the different ways. It can be understood by the help of different ways:
- Hospital based outpatient services
· Admitted patient care in hospital and other residential care
· Consultations with both specialists and general practitioners (GPs).
· Community mental health care services
At the same time, the number of the service provider is continuous increasing rapidly because available opportunity in this industry. Additionaly, Australian government, state government and NGOs also play an effective role for the developing the good facility in the mental health service. In this, it has been seen that Australian government always keeps provision for the development of the mental health service sector and also supports to a person how is mentally ill.
In the same concern of this, the state government are also plays its role effective as funding and provision of Australian government (Storrie et al., 2010). They are also responsible for the implement the policies and regulation of the central government. In Australian government mental Health service sector, the main role is played by the Central government regarding the rules, regulation and funding. It initiates on the all the procedures and states government implements them.
In this video, Lisa is a patient of the Hallucination and hearing voice. In this problem, the patient feels some specific that are not really exist outside the mind of the patient like, see something, hear voices, smells, testes something, etc. The mind of the patient commands the body to feel such things and make perception of feeling nervous, paranoid and frightened.
This problem can be start due to mental illness or by the use of illegal drugs or alcohol which highly affect the mind (Pierre, 2010). This mantel illness can also occur due to extreme tiredness in the body and patient has a risk of harm to other and self.
When can informed consent be made?
Answer: The patient can be informed for the consent before the treatment because the patient should be able to take decisions on the basis of own views.
How do patients with mental illness understand their rights?
Answer: The Patients can understand their rights with the mental illness by the use of given statement of rights and he/she can also discuss with the doctor for their care and treatment.
- What is an advanced statement in regard to treatment?
Answer: The patient may make advance statement about their treatment at the time of treatment decision with the authorized Psychiatrist (American Psychiatric Association, 2013).
- How is mental health complaints managed?
Answer: The mental health complaints can be managed by the commissioner through resolution of the compliant. The commissioner can also access and support the complaints for the solution of the mental problems of the patient.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Babitsch, B., Gohl, D., & von Lengerke, T. (2012). Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011. GMS Psycho-Social-Medicine, 9.
Disner, S. G., Beevers, C. G., Haigh, E. A., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature reviews. Neuroscience, 12(8), 467.
Dyrbye, L. N., Harper, W., Moutier, C., Durning, S. J., Power, D. V., Massie, F. S., … & Shanafelt, T. D. (2012). A multi-institutional study exploring the impact of positive mental health on medical students’ professionalism in an era of high burnout. Academic Medicine, 87(8), 1024-1031.
Eagar, K., Watters, P., Currow, D. C., Aoun, S. M., & Yates, P. (2010). The Australian Palliative Care Outcomes Collaboration (PCOC)–measuring the quality and outcomes of palliative care on a routine basis. Australian Health Review, 34(2), 186-192.
Goodell, S., Druss, B. G., Walker, E. R., & MAT, M. (2011). Mental disorders and medical comorbidity. The Synthesis Project.
Haugan, G., Innstrand, S. T., & Moksnes, U. K. (2013). The effect of nurse–patient interaction on anxiety and depression in cognitively intact nursing home patients. Journal of clinical nursing, 22(15-16), 2192-2205.
Karlin, B. E., Ruzek, J. I., Chard, K. M., Eftekhari, A., Monson, C. M., Hembree, E. A., … & Foa, E. B. (2010). Dissemination of evidence‐based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of traumatic stress, 23(6), 663-673.
Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C., & Eaves, L. J. (2010). Stressful life events, genetic liability, and onset of an episode of major depression in women. Focus, 8(3), 459-470.
Keyes, C. L., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100(12), 2366-2371.
Kobau, R., Seligman, M. E., Peterson, C., Diener, E., Zack, M. M., Chapman, D., & Thompson, W. (2011). Mental health promotion in public health: Perspectives and strategies from positive psychology. American journal of public health, 101(8), e1-e9.
Lawrence, D., Kisely, S., & Pais, J. (2010). The epidemiology of excess mortality in people with mental illness. The Canadian Journal of Psychiatry, 55(12), 752-760.
Layous, K., Chancellor, J., Lyubomirsky, S., Wang, L., & Doraiswamy, P. M. (2011). Delivering happiness: Translating positive psychology intervention research for treating major and minor depressive disorders. The Journal of Alternative and Complementary Medicine, 17(8), 675-683.
McGorry, P., Bates, T., & Birchwood, M. (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), s30-s35.
Mental Health Commission (2017). Mental Health Act 2014. Retrieved from: https://www.mhc.wa.gov.au/about-us/acts-and-legislative-changes/mental-health-act-2014/
Patterson, C., Procter, N., & Toffoli, L. (2016). Situation awareness: when nurses decide to admit or not admit a person with mental illness as an involuntary patient. Journal of advanced nursing, 72(9), 2042-2053.
Pierre, J. M. (2010). Hallucinations in nonpsychotic disorders: toward a differential diagnosis of “hearing voices”. Harvard review of psychiatry, 18(1), 22-35.
Rogers, A., & Pilgrim, D. (2014). A sociology of mental health and illness. UK:McGraw-Hill Education.
Scott, A., Sivey, P., Ait Ouakrim, D., Willenberg, L., Naccarella, L., Furler, J., & Young, D. (2010). The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database of Systematic Reviews, 2011(9).
Singh, S. P., Burns, T., Tyrer, P., Islam, Z., Parsons, H., & Crawford, M. J. (2014). Ethnicity as a predictor of detention under the Mental Health Act. Psychological medicine, 44(5), 997-1004.
Smith, D., Roche, E., O’Loughlin, K., Brennan, D., Madigan, K., Lyne, J., & O’Donoghue, B. (2014). Satisfaction with services following voluntary and involuntary admission. Journal of Mental Health, 23(1), 38-45.
Storrie, K., Ahern, K., & Tuckett, A. (2010). A systematic review: students with mental health problems—a growing problem. International journal of nursing practice, 16(1), 1-6.
Westerhof, G. J., & Keyes, C. L. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of adult development, 17(2), 110-119.
World Health Organization. (2014). Social determinants of mental health. World Health Organization.
