The treatment of mental disorders

Running Head: Mental Health 1
Psychotropic Treatment and Impacts of Restrictive and Coercive Measures
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Introduction
Globally, the incidence and burden of mental illness are significant (Vos et al., 2017).
According to the Mental Health Services in Australia (MHSA) (2020), is that "about 45% of
Australians aged 16 to 85 years will experience a mental disorder in their life.” Mental
illnesses encompass conditions with low prevalence and those with severe consequences that
range from eating disorders to psychotic illness (DoHA 2013). Psychotic illness includes
Schizophrenia, Delusional disorder, Bipolar disorder, and Schizoaffective disorder. The
illnesses are characterized by fundamental thinking distortions, emotional responses, and
distorted perception (Morgan et al., 2011). The treatment of mental disorders varies based on
the type and severity of the illness. Psychotropic medications such as sedatives are used in
managing psychiatric patients through restrictive measures to reduce aggressive behavior that
may hinder treatment. The coercive measures can be achieved by hiding the sedatives in
food or drinks (Latha, 2010). Such practice has its impact, which also touches on the legal
and ethical principles of the patient, as discussed in this paper. This paper intends to discuss
the challenges faced by registered nurses in recovery-oriented mental illness treatment as well
as the impacts of coercive and restrictive measures.
The psychotropic medication exerts its effect by influencing the chemical makeup of
the nervous system and the brain (Roberts, 2019). The use of psychoactive drugs such as
sedatives has several advantages as well as disadvantages. The medication is not always the
first option in treatment but is always required to ensure the staff and patient safety. Mental
ill patients might show challenging behavior such as punching, grabbing, biting, or cause
self-injury, which can limit the safe delivery of excellent care (Parker, 2015). Psychotropics
have disadvantages such as extrapyramidal effects, psychomotor slowing, sexual dysfunction,
and physical health complaints, among others (Ferreira et al., 2017). According to
Stephenson and others (2013), controversy exists in the use of psychotropic medications in

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the management of mental illnesses. For instance, the use of sedatives without the knowledge
of patients is against medical principles such as self-consent and is therefore ethically
inappropriate. Nurses in mental health care in Australia face several challenges while
implementing recovery-oriented practices. According to the Australian Health Ministers'
Advisory Council (AHMAC) (2013), Recovery-oriented mental health practices are centered
around the needs of the patient. Therefore, it is imperative to have the necessary measures in
place to address the challenges faced by nurses in practice.
The controversy of the Use of Sedatives in Coercive Measures
Several controversies exist in the use of psychotropics to treat psychiatric patients. A
major concern is an ethical dilemma faced by nurses, for instance, the administration of
treatment through coercion. According to Latha (2019), Psychotic patients may present non-
adherence during treatment, which may prompt the use of covert medications by the nurses.
Ethically hiding psychotropic medication such as sedatives to reduce the patient's non-
adherence breaches contemporary ethical practices by the health staff and family members
that approve the practice. Such a practice contravenes the paramount ethical principle of
informed consent. Quality recovery-oriented mental health practices involve delivering
trauma-informed, consumer-centered, recovery-focused, and that ensures safety for everyone
(Butterworth and Faugier, 2013). Therefore, nurses must follow the necessary procedure of
administering psychotropics to patients who can't give consent.
Other controversies of psychotropics center around the long-term side effects of the
medications. According to Stroup and Gray (2018), the side effects range from mild issues
such as dry mouth to most severe such as sexual dysfunction, acute dystonia, and life-
threatening conditions such as myocarditis agranulocytosis. The side effects vary from one
psychotropic medication to the other. Electroconvulsive Therapy (ECT) is a psychiatric
treatment that remains controversial though effective (Luty, 2017). The side effects of such

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treatments are highly emotive and tend to be viewed negatively by the politicians and the
general public. Such negative views may result in the demotion of some applications of the
antipsychotics, which can affect the delivery of quality mental health care. Psychotropic,
treatments such as the use of coercive measures have more benefits compared to
shortcomings that result in controversies.
Recovery-Oriented Mental Health Care
This approach offers the transformative conceptual context of service-delivery,
practice, and culture in mental health care. The framework is built around the lived
experiences of the mentally ill patient and their families. The approach helps to map the
experience and journey of the patients, which helps in affirming their identity beyond the
restraints of the diagnosis. Recovery-oriented care challenges the traditional notions whereby
professional power is used to contain the mental issue. This is because the approach
combines the expertise of professionals with the patient's values, which helps in breaking
down demarcation between the staff and the consumer (AHMAC, 2013). Focusing on the
needs of the patients in recovery-oriented practice may be essential in reducing the use of
restrictive and coercive measures in mental health care.
Impact of Restrictive and Coercive Measures
Coercive measures in mental health treatment include restraint, seclusion, and forced
medication. The measures might have positive and negative outcomes. International
guidelines outline that coercive measures should only be used when other, less restrictive
procedures fail (Fiorillo et al., 2011). Advantages of coercive measures include safety to
nurses and the patient as well as other facility users and easier delivery of services. According
to the Victorian Government Department of Health (2013), restrictive measures have
negative consequences. They include the re-traumatization of patients with existing trauma
histories and damaging of therapeutic relationships between the nurses and the consumers.