This report explores the importance of mental health in nursing practice and discusses the biopsychosocial factors that contribute to mental health issues. It includes case studies, interventions, and ethical considerations.
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Mental Health Nursing Practice
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Table of Contents INTRODUCTION...........................................................................................................................1
INTRODUCTION Mental health refers to emotional, psychological and social well-being. It is an important health factor which is necessary to manage stress and make decisions. Different elements are there which affect the mental health for which social care units have been developed in order to help the patients for recovering completely from any sort of mental issue. Problems related to mental health should be diagnosed as early as possible otherwise it could affect the overall health of the body. This report comprises of three different case studies depicting the biopsychosocial problems, factor related to biological, psychological and social, three individual interventions relating to the cases and ethicolegal implications for each such cases. MAIN BODY As per Evans, Nizetter & O'Brien, “assessment is one of the important and fundamental skills of the mental health nurse. Through assessment we develop an understanding of the consumers, formulate a plan of care and contribute to the decision making of multidisciplinary teams”. On decoding this definition, it can be said that mental health is important for maintaining the overall physical and mental health. Biopsychosocial model of assessment forms a nexus between biology, psychology and socio-environmental factors. These factors contribute to development of a human. This model was developed by Engel in the year 1977 to conduct an examination for understanding thoughts and feelings which may affect the physical condition of an individual. This assessment is applied for carrying a medical examination as a step in clinical practice. There are variety of biopsychosocial factors responsible for the development of types of disorders which have significant impact on the lives of people suffering from such disorders. In the first case study, it has been observed that Steve was going through the phase of depression at the age of 21 years. Due to this, he lost interest in his life and was disconnected with social life. The biopsychosocial a person gets into depression from endocrine which is related to hormone, immune and neurotransmitter system built in our body. With regard to psychological factors, depression may occur from negative thinking patterns, intolerance level, decision making issues, and impaired emotional intelligence. Steve is a 21-year-old young boy who has been diagnosed with schizophrenia due to which he has been acting in a weird way. The factors for mental problem may range from genetic, malnourishment, size of the brain or issues relating to chemical 1
present in the brain. In the case of Steve, changes in the chemical present in the brain is the prime factor which forced him to suffer from schizophrenia. Psychosocialmodelofassessmentisdividedintothreepartsviz.Biological, psychological and social. It is important to understand the importance of each of them so that better examination can be conducted for ascertaining the actual issue.Biological aspectis that part which deals with the issues regarding age, genetic or physical features. Age of a person is related with the physical fitness of a person. When an individual is a kid, there is no kind of stress or bad habits but as the child grow and face the real world in which there are many challenges which contribute to a lot of mental issues. The mental situation of a person gets changed with the time. In the context of nursing practice, the staff in the health care units and hospital should show enhanced care towards a kid and young person as they are more vulnerable to mental health. This affect their body which gives them negative thoughts about the life. Psychological aspectis related with the mental status, thoughts, behaviours, feelings, emotions and history of trauma or abuse in the life of a person. These have director connection with the mental health of a person and affect significantly the well being of an individual. This impact the strengths and weaknesses in a major way. Lets take the factor feelings. It can be good or bad depending on the fulfilment of the desires. It is connected with the brain of a person which may have long lasting effect. Furthermore, feelings can affect the behaviour and attitude of a human being. If these are positive then a person feel motivated and encouraged to do things on the other hand, if feelings are negative then individual starts to act negatively leading to depression. Hence, in every situation feelings should be positive in order to keep the brain healthy so that good mental status can be maintained. The last aspect of psychosocial model of assessment issocial aspect. This aspect is about looking into the factors related to social and cultural which are an essential part of a person's life. These influence hugely to the mental health as no individual wish to be left isolated. Some of the factors covered in this aspect are past and current family relationships, friendships and social support, workplace stress, quality of marriage, community involvement, religion, finances and many such things. Lets consider the factor family relationships, the members of a family are the pillars of strength who provide support to a person all the time. Without a family, the survival become difficult also, an individual starts to feel alone and lose interest in life. It is a portion of community in which people live and every human being search for support from the members of 2
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the family. Furthermore, every individual goes through the phase which may leave a positive or negative impact depending on the experience. In such situations, a person feel the need of the family to share happiness as well sorrows so that peace of mind can be achieved. Along with this, the opinions of the family members are taken in making decisions. Interventions refer to the actions taken for improving the situations of people suffering from issues of mental health. Every disease is required to to be diagnosed by conducting a detail examination so that proper treatment can be provided. Every organizations engaged in providing medical services follow certain fixed procedures and processes for making the mental health better as quickly as possible. The case is about Steve who has been diagnosed with schizophrenia following which he was admitted to an acute psychotic unit in order to observe the mental status of Steve. His parents started to keep him away from his younger brother so that the peaceful environment is not spoiled. The doctor who has been handling the case of Steve, has prescribed anti-psychotic medication for taking his health under-control. These interventions have bee made for making his health better. However, he is reluctant to continue the medication because his weight has beenputonwhichchangedhismindsetnegativealso,isolatedhimfromthefriends. Intervention is important to find a solution for treating the disease so that person can lead a healthy and peaceful life without any illness or weakness. The doctor prescribed Steve with certain medicines to be taken on time so that quick results can be attained. Steve refuse to take the medicine and believe that he was getting some weird sound which was stopping him to take the medicine. It is a kind of hallucination which how to stop doing every kind of activities making them lazy and dizzy all the time. This caused the situation was because of which he was admitted to the hospital. The staff engaged in nursing health practice are required to abide by laws and ethical considerationsinordertocarrytheactivitieslawfully.Thisenhancestransparencyand accountability so that negligence so that incidents of negligence can be reduced. Therefore, the ethical principles which are to be followed comprises of autonomy which refers to the right of the patient to retain control over his or her body. Health care staff has the authority to give suggestions only but cannot persuade the patient to make a particular decision. It is up to the patient what decisions he or she is making. Beneficence is the principle which emphasizes on nursing staff to carry activities with the intention to create benefits for the patients. This means 3
that procedures and treatments should be done with the motive to good. This requires good amount of knowledge with adequate training so that right treatment can be given to the patient seeking medical services. Non-maleficence in literal sense means not to do harm. It is based on a greater context which takes into account the society as a whole. The ultimate goal of staff who are involved in providing medical services should act in a a way which does not harm the society or community. This is based on providing benefits to large number of people. The last principle being justice which focused on maintaining fairness in the decisions which are to be applicable. In other words, the resources should be divided and allocated in equal amount by looking at the scarcity of the resources. Furthermore, the medical practitioners should follow the laws and legislations. In the case of Steve, the major principles which can be applied are autonomy and beneficence. According to the ethical principle of autonomy, it is up to Steve to take the medicines or not or go to the hospital for advanced treatment. Nobody can force Steve to go for medical treatment if he does not want to. However, when a person goes through the face of depression, the failed to make appropriate decisions for themselves because of not being in the right mental condition. Hence it is not correct to let them make the decision but still their choices regarding going for medical treatment should be considered. Also a person feel very weak in this stage of depression, so extra care should be given by the family for encouraging the depressed person to have medicines on time. The other ethical principle can be beneficence. As per this principle, the staff of the health Care unit where Steve is seeking medical treatment should be aware about the condition of the patient in order to provide all the necessary services without any delay. Furthermore, the staff allotted with the activities of taking care of the patient should have adequate training so that they can act diligently. All the policies and activities should focus on providing the maximum benefits to the Steve for making him better with the time. Also, negligence and similar acts should be avoided so that recovery can be made faster. Apart from this, there are legislations regarding mental help in which should be followed withoutmakinganybreachorcontraventioninthelegalprovisionsofvariousactsas implemented by the government of Australia. Laws are formed to govern activities of hospitals and healthcare units for mitigating the incidence of negligence. 4
From the above report, it has been concluded that mental health is important for the well- being of overall body. It should be given attention by every person so that it never gets two face depression fordisorders like bipolar disorder. These are the issues which are creation of poor mental health and should be treated with right solution as soon as possible. Biopsychosocial factors Provide a model assessment tool which is used for or assessing be exact problem that a person is facing. It provides number of elements which are responsible and should be analysed to form a connection and find out the reason for mental health issues. In addition to this, various legislations and principles of ethics should be followed by this staff taking care of patients so that legality can be maintained. 5
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