Essentials of Mental Health Nursing

This document discusses the essentials of mental health nursing, focusing on the importance of therapeutic relationships, evidence-based care planning, mental health assessment strategies, and risk management. It explores the case of Kevin, who is suffering from schizophrenic and type 1 diabetes due to domestic violence.

Essentials of mental Health Nursing

Table of Contents
INTRODUCTION...........................................................................................................................2
MAIN BODY...................................................................................................................................2
LO 1.................................................................................................................................................2
Therapeutic relationship.........................................................................................................2
LO 2.................................................................................................................................................3
Evidence base required to care for and support people with acute mental health condition..3
LO3..................................................................................................................................................6
Identify the wide range of mental health assessment strategies and tools which applicable
them in relevant practice settings...........................................................................................6
LO4..................................................................................................................................................7
Principle of risk assessment, risk management that reflect on the positive risk taking into
mental health care...................................................................................................................7
LO5..................................................................................................................................................9
Legal and Ethical issues while delivering and evaluating care..............................................9
CONCLUSION..............................................................................................................................13
REFERENCES..............................................................................................................................14
1

INTRODUCTION
Mental health can be defined as a behavioural, cognitive as well as emotional well-being.
It is the way of thinking, behaving, responding and feeling. This present study is based on a case
of Kevin who is suffering from schizophrenic and type 1diabetes due to domestic violence. This
present study is going to show importance of therapeutic relation in the case of Kevin as how this
relation can improve his health. Further, it will show evidence based care planning relevant to
the case which includes: cognitive behavioural therapy, family based approach, Individualised
recovery focused plan approach and others which allow therapists to improve health of the
patient. It will also discuss mental health assessment strategies along with principles of risk
assessment which can help patient in improving his mental health. Lastly, it shows legal as well
as ethical issues which can occur while delivering healthcare so, it is important to focus on all
legal and codes of ethics.
MAIN BODY
LO 1
Therapeutic relationship
In the case of Kevin who is 27 year old man has severe schizophrenic and type 1
diabetes. Aggression, depression is one of the main problem through he is going. So, it is
important to provide better healthcare services to him. There are several steps by which the
patient can be treated in an efficient manner.
Therapeutic relationship: It is one of the main step of treating patient with having
severe mental health problems and depression. It refers a relation between healthcare provider
and the client or the patient. For providing better healthcare services it is important for therapists
and healthcare provider to make an effective relation with the client in order to make him believe
that all processes will be done for his better health Mössler & et.al. (2019). In the case of Kevin,
it is important to build a trust, respectful and caring agreement and relationship because his
problems of mental health are severe. It is also stated that the patient denies taking insulin at the
time of periods of depression but agrees to take medications of schizophrenia.
2

Person centred care: In the case of Kevin, Patient centre care will be the best therapy
because it can fill his emotional needs or gap because it is stated that due to ineffective relation
and domestic violence he is suffering from this problem. In this care or therapy one of the main
aim of therapist is to focus on the person not the problem. It is important for therapist to make
the patent believe that he will not be judged and can share anything whatever he wants. In this
case, it can allow the patient to better cope with current and future problems which he may face
by talking much with therapist Delaney, (2018).
Communication theory: A Communication skill is vital and must which a therapist and
healthcare provider has. It is the key of the success. Therapists have to deal with all types of
patient and being calm, making use of active listening, talking in a polite manner is important in
order to make the patient feel comfortable and valued. In this case it can be said that interactive
model of communication can help therapists to solve current problems of the patient and make
him feel better as well as influencing him to take insulin. With the help of this model, therapist
tries to influence the patient to share his feelings and for that therapist also tell the patient about
himself for treating him as a friend.
Developing trust, empathy: After using communication model, it can also be said that
trust and empathy in healthcare plays an important role. This skill and behaviour builds patient
trust makes him able to be calm and depressed free. In this context, authors have proved that
empathy is one of the main skill and key which is associated with better adherence to
medications, decrease chances of mistakes in healthcare processes and the most important is
increasing patient satisfaction Omura & et.al. (2018).
So, from the above discussed steps, it can be said that therapeutic relation plays an
important role in healthcare and especially in cases of schizophrenic, mental illness, depression
and anxiety. So, in the case of Kevin who has all these problems with type 1diabetes due to
domestic violence can improve his health.
LO 2
Evidence base required to care for and support people with acute mental health condition
Evidence based care planning: Mental health or schizophrenic is one of the main
diseases which need to solve at early stage in an efficient manner. Some evidence based care
planning in the case of Kevin includes: medications, family based services and cognitive
3

behavioural therapy. All ways and evidence based care are being discussed below in a detailed
manner Pilgrim, (2019).
Ways of engaging: Before using therapy for the patient it is important to engage with the
patient in order to have an active participation of the patient in the process of healthcare. It can
be said that by creating accountability, making all informations clear, using effective
communication skills, therapists can engage himself with the patient.
Setting goals: Setting goals is one of the main step on which basis further steps can be
performed. It works as a base for therapist. Therapy is a long process and for accomplishing the
main aim, therapist needs to develop some objectives through which he can improve health of
the patient. Some objectives of this case include:
 To make the patient influence to take insulin within 10 days.
 To make the patient able to take participation in social activities within 20 days.
 To make the patient able to take care of himself and interact with family members in 15-
20 days.
Cognitive behavioural theory: It is one of the best and effective evidence based care planning.
It is the best talking therapy which can be beneficial in the case of Kevin who has schizophrenic
and type 1diabetes. With the help of this therapy, counsellor or therapists try to talk to the patient
continuously after making him feel comfortable and it allows him to manage problems and
changing the way of thinking of the patient. It is one of the best strategy or therapy which is
mainly being developed for treating patient with anxiety, depression, schizophrenic and other
mental health problems. By attending a limited but effective number of sessions, patient can
improve his health Smithson, (2019). It is beneficial for Kevin because with the help of this
therapy and its features, he can make himself aware about negative thinking which is creating
problems in his life.
In addition, it can also be said that as per the nature and intensity of the problem which
the patient is suffering from, counsellor can make use of other therapies along with this therapy.
Using more than 2 therapies at a time can give better results to therapists and patient as well.
After attending some sessions, patient become able to control themselves without having need of
counsellor as they learn that how to manage stressful situations in a better way at their own.
Individualised recovery focused plan: It is other main effective strength based approach in
which counsellor focuses on both symptoms of the main disease and resilience. It is also mainly
4

developed for treating and dealing with people suffering from mental health problem. With the
help of this approach, counsellor can make Kevin or the patient able to take participation in
activities as well as relationship that are meaningful and suitable with the problem. There are
main 5 core elements which make this approach successful and allow counsellor to improve
health of the patient as well as accomplish the main goal. It includes; Self direction,
empowerment, non-linear, strength based and respect. In the context of respect it can be said that
it is one of the main element by which counsellor can make the patient feel valued.
Interventions: Interventions means all those ways by which the current problem or
disease of the patient can be treated and cured. It refers an action or a process of intervening or
action which is being taken to improve medical disorder. In the case of Kevin, some medications
can be suggested as interventions which can help him out in improving health and removing
schizophrenic and type1 diabetes. Aripiprazole, Brexpiprazole and Clozapie can be the best
medicines which can improve his health and protect him against depression and anxiety.
Rather, these medicines, family therapy can also be suggested to the patient. Because it is
stated that due to anxiety he does not interact with his family members and one of the reason is
domestic violence and family based therapy can allow the patient and family members to interact
with each other’s by sharing their feelings. Family therapy for schizophrenia include: stress
reduction, education, structural problem solving and emotional processing Rathod & et.al.
(2017). In this approach all members work in a group for accomplishing the main goal of
improving relation and protecting the patient against the problem from which he is suffering.
So, from the above discussed evidence based care planning and interventions, it can be
said that health of Kevin can be improved.
LO3
Identify the wide range of mental health assessment strategies and tools which applicable them in
relevant practice settings.
According to case, Kevin who is 27 year old man has severe schizophrenic and type 1
diabetes. He was suffering from the Aggression, depression. These are common one problem or
issue through he is going. In this way, it is important to provide better healthcare services to him
by using mental health assessment strategies and tools. As diagnosis of mental disorder which
initially appears relatively straight forward (Dickens, Ion and Everett, 2019). Kelvin present with
5

symptoms, visible sign of illness and health professional which make diagnoses based on the
primarily signs. However, it despite a dramatic expression of knowledge about the mental
disorder.
Having a mental health assessment that gives medical professional to identify the
problem or issue with patient’s health condition. As per case study, it has identified that mental
test assess emotional wellbeing through series of questions, examine physical condition
(Marchette, Thomassin and Weisz, 2019). Furthermore, there are different ways to examine the
mental health assessment strategies and tools.
Through case study, it can be analysed that medical test which is mainly prescribed by
doctor to Kelvin for identifying the body condition. Medical professional may send kelvin into
lab for tests such as blood, urine test. If in case suspect a certain cause and then quickly provide
better treatment (Eisman and et.al., 2020). The test might be related the diabetes and also used
other technology such as Computed tomography scan, electroencephalogram. These are
consideration as tool or platform that provide the better facilities to Kelvin. When they can easily
identify the cause of schizophrenic and type 1 diabetes. Sometimes, it is very difficult to improve
health condition if person is not responding proper manner. These type of advanced tool or
platform will support for purpose of identification.
On the other hand, Kelvin approach the medical professional that will be used advanced
techniques for mental health assessment. In some situation, it’s hard to diagnose where GP is not
able to find the cause of symptoms (Marchette, Thomassin and Weisz, 2019). Even specialists
also told Kelvin where they can quickly start their treatment. On regular basis, it would be
required to test which help for identifying the mental health condition. It may refer as mental
health specialist that might use any number of test in order to measure cognitive impairment.
Mental health assessment and screening are vital early step in taking the charge of one mental
health and wellbeing. In order to collaborate with client for identifying illness symptoms and
their level of disruption (Marchette, Thomassin and Weisz, 2019). Medical professional do not
diagnose mental disorder but identifying the powerful tool for understand the mental health. In
additional, mental health screening test allows for people to identify the causes of mental health
before they can spiral down, out of control.
Mental health assessment can be formal, informal and standardized. It concluded that any
stage of counselling processes. For instance, there are lot of people to understand what
6

happening related to mental health and their scope. It should be considered the different
strategies and tools.
Observation is the most common strategy that mainly used by medical professional,
counsellor. When they can directly interact with Kelvin. In order to examine their nature,
behaviour. Afterwards, it can reach to the final decision.
Interview is another strategy whereas medical professional consult with Kelvin and discuss
about the mental illness symptoms. They will be paying attention to how they can speak, mood
to see if this provide any clues (Coffey, Hannigan and Simpson, 2019). Furthermore, it is moving
towards the personal history of patient related the family history, work history and other current
social situation. In this way, professional will examine the experience about their childhood and
any issue with drugs.
Standardized tests and other screening tool that provide facility to identify the presence of
certain problem. Generally, it is mainly provided the checklist, questionnaire format. These may
be broader in scope to examine the mental health condition of Kelvin.
LO4
Principle of risk assessment, risk management that reflect on the positive risk taking into mental
health care.
Risk assessment is one of most concept that help for planning highest profile task of mental
health condition (Marchette, Thomassin and Weisz, 2019). It is to be considered as central
components of mental health in today’s case study scenario. The risk can be assessed and assured
in mental health condition which mainly concern about the Kelvin. Sometimes, it also
coordinated with the family members, practitioners, policy makers. It is important for
considerations of quality and safety of kelvin. There are various principles of risk assessment and
safety planning.
Medical professional should be actively participate in the assessment and consult with the
Kelvin for providing better self-examine approach. If the risk assessment and safety plan is based
on the person-centred that involvement of service users. It must ensure that accurate assessment
of risk and vulnerabilities.
7

It has been building the relationship between medical professional and kelvin, whereas
doctor involved in providing the better care (Coffey, Hannigan and Simpson, 2019). As rooted in
therapeutic dialogue and involve getting to know the individual rather than process of checklist.
A comprehensive risk assessment which require the non-judgemental as well as positive
attitude towards the service user. In order to engage with discussion related the risk where how
kelvin can experience by other medical professionals (Coffey, Hannigan and Simpson, 2019).
The behaviour held by professional towards patient at certain risk, together with their own
knowledge, skill which likely to influence their working relationship.
Risk assessment is consider as an integral part of kelvin overall mental health assessment and
implement recovery plan. The safety plan cam be developed on the basis of risk assessment
process (Marchette, Thomassin and Weisz, 2019). Sometimes, it should be aligned and closely
related the kelvin wellbeing and recovery. It is important to understand the interrelationship with
mental health risk and ongoing recovery. It always support for continuously improve the mental
health condition of kelvin.
Risk management in mental health assessment
It has been recognised the interdependencies of risks, relatively providing better
treatment facility which always encouraging kelvin to improve their current mental status. Risk
management is based on the process which consists set of standards to recognise the risks
(Coffey, Hannigan and Simpson, 2019). There are different ways to manage the risk related
mental health.
Initially, it has taken first part of risk management is to determine the overall internal as
well as external drivers. According to case study, the expectation of Kelvin is high to the service
provider because they will give the best treatment in order to identify the cause of problem
(Potter, O'Keeffe and Dollard, 2019). It is an essential part for examining the risk in quickly
otherwise it is directly negative impact on the patient. In some situation, it will be improved the
patient environment and maintain the safety planning.
In first step is that when identifying the risk due to diabetic. It is mainly used the various sources,
methods for identifying the risk (Coffey, Hannigan and Simpson, 2019). It often kelvin always
focused on the incident reporting and although find out accurate information or data. In some
areas, it may be perceived as being entirely clinical management. It becomes useful for providing
local clinical and management team to conduct initial work in determining the significant risks
8

(Gomez, Mejia-Neacsu and Martin, 2019). On the other hand, it is an essential for integrated
with system at some point and develop the comprehensive, risk register.
In another step is that when assess the risk which mainly involved both analysis as well
as evaluation of identified risk. It is all about related to develop understanding towards risk,
therefore it can be easily analysed (Coffey, Hannigan and Simpson, 2019). Moreover, it assess
the extent of potential impact of mental health condition.
It is subjecting a risk to analysis and essential that account is taken of existing measurement.
it can be putting the value on risk and implication which have been subjected but important to
assess current status of mental health status. As per case study, medical professional have been
used the risk assessment tool for purpose of risk identification (Coffey, Hannigan and Simpson,
2019). Therefore, it can easily examine the mental status of kelvin. Afterwards, it has been
planned to develop the risk management for providing the better health care services.
As per discussion, it has been concluded that evaluation of risk which has made decision
based on the result or outcome (Coffey, Hannigan and Simpson, 2019). Sometimes, it is taking
positive risk toward mental health service and involve the decision to accept the risk, give
treatment of Kelvin in step by step manner. However, it is also reflecting the positive risk that
should be consistent with internal, external and risk management strategies which are taking
account of service goal and objective.
LO5
Legal and Ethical issues while delivering and evaluating care
This case includes Kevin and Kevin is the person being treated with mental difficulties.
While giving care and treatment it is very important that some legal and ethical considerations
are followed. This is because Kevin might not be able to safeguard his rights and this is why
legal regulations are required to be followed while giving care to Kevin, this will ensure that
Kevin do not face any discrimination and all the rights of Kevin remain safe.
People with mental health difficulties are required to be deal and treated with proper care
and this is important that they are treated according to legislative guidance. People with mental
health difficulties are not able to take care of their health and well being. Ethical consideration in
this is also important as ethical consideration, ethical consideration is that people who are
involved in care of people with mental health difficulties understand their responsibility for the
9

care and health of such people (Griffiths, 2019). Regarding this some of the legislation provides
guidance about taking care of the people with mental difficulties. Mental Health Act, 2007
consist of regulations for reception, care and treatment of mentally disordered people this also
covers management and protection of their property and other related matters. In this legislation
are covered for people diagnosed with mental disorders so that they can be detained in hospital
and in police custody.
Another act which provides legal ground for treatment of people is Mental Capacity Act.
This is the act which provides legal framework for acting on the behalf of those who cannot
make decision by themselves. In such condition this act provides framework for care of the act
and taking decision on the behalf of such people about how they should be treated. This can be
regarding decision of their physical health as well as their mental health. This act interprets that
only person who has been established to be unable to take their own decisions can be made
decision on their behalf. This way only after unsuccessful practices to ensure that person can take
their decision has been made mental health practitioner can take decision on behalf of the person
who is mentally challenged.
Equality act, 2010 should also be considered while treating person with mental difficulties. This
act saves person with mental difficulties for any type of discrimination on the ground on
disability. This act protects people with disability from any type of discrimination, harassment or
victimization (Cheung and et.al., 2020). Major consideration is to save people with mental
difficulties from any type of ill treatment and misbehaviour.
Legal framework should also be considered that vulnerable adults should also be treated
properly and their safeguarding is also responsibility of health care people until they are being
treated and they should also not be discriminated and should be saved from any type of
mistreatment. Legal framework for this also includes that children with mental difficulties are
also treated with care and their rights also remain safe and they are also safe from other criminal
acts. Deprivation of liberty is also important to consider while treatment and evaluation of people
with mental difficulties. This act safeguards those who cannot take decision for themselves and it
becomes important to deprive their liberty to take decision. Children act 2004 should also be
considered when person being treated with mental difficulties comes under the category of
children. This act provides regulations for safeguarding of the children and promotes their
welfare.
10

Regarding consent of the child under the age of 16 Gillick competency should be considered it is
used in mental law to determine whether the child is able to consent for their treatment without
the need for parental permission or knowledge (Scholten and Gather, 2018). According to gillick
competence parental right on the decision of children terminates for the medical treatment of
their child when the child achieves sufficient understanding about what is proposed for their
treatment. In case of mental difficulty of the person under age of 16 their parents can take
decision for the person.
Delivering and evaluating care of person with mental difficulties also requires some
ethical consideration. This means that person with mental health difficulties should be treated in
proper professional manner as other patients are treated and their evaluation should also be
carried out in ethical manner. Professional treatment means that professional code of conduct
which are followed in treatment of other patients should be followed while treatment of person
with mental difficulties. This includes that any action for the person with mental difficulties and
decisions which are taken for such person should be for their welfare. Justice is also a part of
ethical consideration as justice of the person with mental difficulties should be safeguarded and
their justice should not be compromised on the ground of their mental health (Holland, Fistein
and Walsh, 2018). It should be considered that when mentally challenged patients cannot
safeguard their rights and cannot fight for their justice other are required to safeguard and give
justified treatment and safeguard their rights. Above all that their right should not be
compromised willingly. Autonomy of the person with mental difficulties should also be
safeguarded and it should not be compromised because of their mental health. in case of Kelvin
his rights should be taken care and he is liable to be treated in proper ethical way and treatment
in such form should be provided to Kelvin.
CONCLUSION
From the above case of Jenny it has been summarized that this report includes that Kevin
who is a 27 year old man and has severe and type 1 diabetes. Kevin is going the mental issues
which are known as aggression and depression and this requires to be treated properly. This is
why first step for the treatment of Kevin includes Therapeutic relationship this is the relationship
between are provider and the patient and this allows patient to trust on the person giving care.
Person centred care, communication theory, developing trust and empathy are some of the parts
11

and ways in which mental health care can be provided. Later the report discussed about evidence
based care and this includes that person being treated should be given care in a well planned
manner at the early stage of the mental issue. Mental assessment strategies and tools were also
discussed in this report and they play a significant role in complete and efficient care of the
patient. Mental health care also includes that risk involved in mental health care is properly
identified and diagnosed before starting the care to ensure that all the precautions to ensure
safety can be taken in advance. Lastly, legal and ethical consideration while treating mental
challenged person were discussed. It is very important as there are times and situation when they
are not able to take decision and stand for their treatment and rights.
12

REFERENCES
Books & Journal
Cheung, D and et.al., 2020. Articulating future directions of law reform for compulsory mental
health admission and treatment in Hong Kong. International Journal of Law and
Psychiatry. 68. p.101513.
Coffey, M., Hannigan, B. and Simpson, A., 2019. Recovery-focused mental health care planning
and co-ordination in acute inpatient mental health settings: a cross national comparative
mixed methods study. BMC psychiatry. 19(1). p.115.
Delaney, L. J. (2018). Patient-centred care as an approach to improving health care in
Australia. Collegian. 25(1). 119-123.
Dickens, G.L., Ion, R. and Everett, B., 2019. Mental health nurses’ attitudes, experience, and
knowledge regarding routine physical healthcare: systematic, integrative review of
studies involving 7,549 nurses working in mental health settings. BMC nursing. 18(1).
p.16.
Eisman, A.B. and et.al., 2020. Economic evaluation in implementation science: Making the
business case for implementation strategies. Psychiatry research. 283.
Gomez-Mejia, L.R., Neacsu, I. and Martin, G., 2019. CEO risk-taking and socioemotional
wealth: The behavioral agency model, family control, and CEO option wealth. Journal of
Management. 45(4). pp.1713-1738.
Griffiths, D., 2019. What Works: Ethical Considerations When Treating Offenders with
Intellectual and Developmental Disabilities. The Wiley Handbook on What Works for
Offenders with Intellectual and Developmental Disabilities: An Evidence
‐Based
Approach to Theory, Assessment, and Treatment. pp.17-39.
Holland, A., Fistein, E. and Walsh, C., 2018. Mental Health Law. A Medic's Guide to Essential
Legal Matters. p.127.
Marchette, L.K., Thomassin, K. and Weisz, J.R., 2019. Community mental health settings as a
context for evidence-based practice. The oxford handbook of clinical child and
adolescent psychology. pp.623-639.
Mössler, K. & et.al. (2019). The therapeutic relationship as predictor of change in music therapy
with young children with autism spectrum disorder. Journal of autism and
developmental disorders. 49(7). 2795-2809.
Omura, M. & et.al. (2018). Exploring Japanese nurses' perceptions of the relevance and use of
assertive communication in healthcare: A qualitative study informed by the Theory of
Planned Behaviour. Nurse education today. 67. 100-107.
Pilgrim, D. (2019). Key concepts in mental health. SAGE Publications Limited.
Potter, R., O'Keeffe, V. and Dollard, M., 2019. Analytical review of the Australian policy
context for work-related psychological health and psychosocial risks. Safety science. 111.
pp.37-48.
Rathod, S. & et.al. (2017). Mental health service provision in low-and middle-income
countries. Health services insights. 10. 1178632917694350.
Scholten, M. and Gather, J., 2018. Adverse consequences of article 12 of the UN Convention on
the Rights of Persons with Disabilities for persons with mental disabilities and an
alternative way forward. Journal of medical ethics. 44(4). pp.226-233.
13

Smithson, J. S. (2019). Efficacy of mental health crisis houses compared with acute mental
health wards: a literature review. Mental Health Practice.
14

15