Developing Mental Health Nursing: Formulation, Interventions, and Ethical Issues

This report explains the biopsychosocial model and 5Ps in Mental Health Formulation for depression patients, and evaluates the social, biological, and psychological interventions for patient care planning and risk management. It also analyzes legal and ethical issues and unmet needs in mental health nursing, and discusses effective care interventions for depression patients. Subject: Mental Health Nursing, Course Code: NURSXXX, College/University: [Name]

Developing mental health
nursing

Table of Content.
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Formulation of mental health.......................................................................................................1
Evaluate the social, biological and psychological intervention for patient.................................3
Effectiveness of care....................................................................................................................4
Analysis of legal and ethical issues and unmet needs and process of addressing them .............5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Mental health nurses working in a assortment of setting as well as support and treat the
patients who are diagnosis with condition of mental illness. Nurses can promote mental health by
building good relationship with patients, encouraging healthy behaviours as well as recognising
and treating symptoms early. The mental health nursing is a process which are considers the
problem-solving approaches intended to facilitate as well as identify the suitable and safe
culturally competent, developmentally relevant and quality care for patients, families, group and
social groups (Lempp and et. al., 2018). This report explains a case scenario which are associated
with John who is 55-year-old men. John is suffering from depression which is a mental disorder
and it is cause the persistent feeling of sadness and and loss of interest and can cause fear and
loss of sleep. He is faces anxiety, restlessness, slowed thinking, speaking or body movements,
feeling hopelessness and unexplained physical problems. The report is also considering the a
biopsychosocial model and 5Ps in Mental Health Formulation. This is including the biological,
psychological and the social intervention which are associated with the patient care planning as
well as risk management of patients (Capuco and et. al., 2020).
MAIN BODY
Formulation of mental health
Mental health formulation is a structured approaches to understanding the factors
underlaying distressing states in such a manner that it gives the knowledges about the changes
required and mechanism and treatment for such change to occurs. There is biopsychosocial
model is used for the identification of the causative factors of the patient which are facing mental
health problem. The biopsychosocial model is formulated by cardiologist Dr. George Engel.
which are widely use by the mental health professionals. This model is associated with the
biological, psychological as well as social factors which have interrelation between them. These
are play a significant role in the promote health and causing disease.
5Ps Explanation
Predisposing The main risk factor of depression is genetics,
biochemical factors, illness, personality style,
ageing as well as long-term pressure such as
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abusive relationship, bullying and work stress.
Depression is also found in those with low
self-esteem, who have poor outlook and who
feel overwhelmed by stress. These can be
cause by the chronic stress and medication or
abusive substances use.
Precipitating Depression is caused by the long term changes
to the brain specially in hippocampus. These
can affect the thinking and feeling as well as
acting. The depression is so hard to treat in the
some patients. This is also has a potential to
affect the physical structure of the brain
(Santomauro and et. al., 2021).
Presenting The current problem of depression is
associated with the physical ache or pain,
fatigue, loss of appetite, sleep problem and loss
of interest and also caused by a medical
condition or medication. These are also
includes faulty mood regulation by the brain,
genetic vulnerability as well as stressful life
events. This is common in the old age and
person which are having the anxiety as well as
mental disorder.
Perpetuating There are some internal and external factors
which are associated with the keeping the
problem going for depression. The internal
factors are including the biochemical
predisposition, life events or trauma can serves
as trigger, anxiety as well as the genetic
factors. These are also includes an inability to
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enjoy normally pleasurable things,
worthlessness and guilt. The external factors
are associated with the stressful external events
or situation such as loosing a job, diagnosis
with the medical issues.
Protective There is need to plan activities for patient who
are suffering from depression enjoys and can
do. There are some activities such as
gardening, video playing which can be fun.
These are assisting in connecting with their
loved one and also help to loved one to focus
on what they can still do. There is need to
establish night time rituals because behaviours
is often worse at night times.
Evaluate the social, biological and psychological intervention for patient
Biological interventions: The biological factors are those which are consist of anything
physical that can cause adverse effect on the patient's mental health. There is need to treat mental
disorders that attempts to alter physiological functioning using drug therapies, electroconvulsive
therapy and psychosurgery. These are collectively called as biomedical therapy. The biological
interventions used in the trails included social skills training, participant modelling, social
problem followed by assertiveness. The other biological treatments are includes
electroconvulsive therapies as well as sleep deprivation. This assertiveness followed by social
problem solving, traditional psychotherapy and CBT. These are associated with the improving
symptoms, functioning, quality of life and social inclusion when used in treatment of people with
mental health situation. These are mainly aimed on the increase the sense of safety, calming,
self-effacing and social connectedness(Davenport and et. al., 2018).
Psychological intervention: The psychological interventions are referring as non-
pharmacological intervention which are mainly aimed on the psychological and social factors.
These interventions is associated with the increasing the cognitive abilities, cognitive
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stimulation, enhancing emotional well-being, decreasing behaviours symptoms and promote
everyday working and functioning. Psychological interventions can be done by the structured
counselling, motivational enhancement, case management, care-coordination, psychotherapy and
relapse prevention. The structured counselling is a short term, solution focusing counselling
which is a brief therapy model and within the confines of an allotted six session and each session
is includes the maximum 50 minutes. These actions are performed to bring about changes in the
patients and these are the wide range of strategies exist and they are directed towards different
types of issues. These activities used to modify behaviours, emotional state and feelings.
Social intervention: The social interventions is an action which is associated with the
deliberate intervention of patients into social affairs for the purpose of changing them. The social
intervention is required for the exercise for the brain and can slow symptoms considering loss of
sleep and hopefulness. The patients staying socially engaged with friends and family has been
associated with boost self-esteem which for people with depression means better eating habits,
more exercise and better sleep. There is also help to try get a families attention before speaking
and reducing backgrounds distractions like TV. There is socializing outside of family can be
valuable as well. There is need to encourage the patient which is based on their stage of illness.
These are including the simple sentences a speaking in a slow deliberate manner. The social
intervention is needed to improve health as well as reduce avoidable costs principally by
increasing (Sharma, Gonda and Tarazi, 2018).
Effectiveness of care
The nursing staff is providing treatment, care and support for people with mental health
problems and depression. The nurses are giving the advice for carers in ways of improving health
and quality of life. The effective nursing care interventions for the depression patient generally
involves such as providing support the caregivers about the reorientation of the patients. In this,
the care nursing can know the perspective that how to effectively orient the patient to time, place,
person as well as the circumstances as needed. the care nurses can be responsible for the proper
safety of the patients after they get discharge from the healthcare organization. In addition to
this, there are some another intervention available such as pharmacological and non-
pharmacological interventions. Its effectiveness involves as it is used within the care treatment as
well as providing support to the vulnerable patient with depression can be both the
pharmacological and non-pharmacological. Within this, the latter involve both the behavioural
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and environmental alterations. While talking about the effectiveness of pharmacological
interventions, there is generally no cure for the depression patients no there are illness altering
medications which are available to cope the depression as well as its associated disorders. In
context with non-pharmacological interventions, there is provided a cognitive stimulation
therapy to the depression patient. The therapy is generally a form of effective intervention and is
used to encourage the people who are diagnosed with mild depression. It is determined by the
cognitive stimulation therapy that a patient with depression, they can effectively able to enhance
their thinking, the performance at work. In this, the care providers can also experience the
improved communication as well as interaction with the depression patient which they actually
care for. Promoting a cognitive stimulation can give the people with depression with specific
effective activities mainly intended to progress the thinking, social interaction as well as memory
also to delay the worsening of the depression symptoms (Myers, 2022).
Another effectiveness of care intervention mainly involves the physical exercise. It has
been determined by performing effective physical activities among depression patients, it can
positively benefit their well-being. It has been seen as an advantageous non-pharmacological
therapy in the prevention as well as the management of depression among vulnerable patients. It
can aid the depression patients to boost the brain activities not only by maintaining the flow of
blood but can also by enhancing the chemical which can effectively protects their brain. In
addition to this, performing physical activity can also tend to counter some of its natural decrease
within the brain connections which generally occurs with ageing. With help of effective nursing
care interventions, they can enable the patient with depression to perform adequate amount of
physical exercise as it can make them feel much better and improve their conditions further
(Ghari Saadati, Ghorban Shiroudi and Khalatbari, 2022).
Analysis of legal and ethical issues and unmet needs and process of addressing them
There are various legal and ethical issues which are associated with the unmet the needs if
the depression patients. These are explained as:
Involvement of older age group: This is the one of the main ethical issue which are
associated with the depression patient. There are some possible barriers are present such as
physical as well as cognitive impairment, lack of transport, changes in patient’s routine and
negative beliefs about medication. These aspects may affect the risk-benefit ratio for
participation (Schaffler and et. al., 2019).
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Respect patient’s autonomy: this aspect is associated with the allowing as well as
enabling patients to make their personal decisions about which health care interventions they will
receive or will not receive. These are can be difficult in PwDs patients on account of impaired
cognition.
Carer involvement: These issues are associated with the receiving information,
participation in decisions about care and discharge as well as receiving emotional support by
nursing care staff.
Equity and Fairness: These issues are related with the patients have opportunities based
on their requirements. These are also associated with every patients receive the same standard,
while health equity issues are related with the patient’s personal care to bring them to same level
of the health care.
These issues can be addressed by the nursing staff when dealing with the depression
patient. These nurses are prepared to commit time, energy as resources to investigating the
ethical issues and their impact on the patient care service. There are nurses are need to
understand the uniqueness if the ethical as well as legal issues. There are every patient who is
come for care are surrounded by many circumstances. The patient may have religious beliefs to
which they comply and those beliefs interfere with suitable care. The nursing care staff is need to
follow the ethical guidelines and best practices to follow the honesty, integrity and
professionalism. These official standards are assisting in the providing the fair and equal
treatment to every patient. There are also a need to reach out to professional organization or
association which are refer to advance a specific profession, support the interest of patients
working in that profession as well as serve the public good (Werner, Tur-Sinai and AboJabel,
2021) .
CONCLUSION
From the above discussion, it has been concluded that the mental health nursing is a
specialized field of nursing practice that involves the care of patients with mental health
disorders to assist them and increase their quality of life. The health care professional whose
field of nursing involves care for patients dealing with a mental health disorder. The nursing is
such a healthy and massive field mental health nursing is an important speciality within it. The
mental health nursing is associated with the intervention, prevention, treatment as well as nursing
care of patients of all ages who are suffering from mental illness and its effects. This also
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includes the psychological, social as well as biological interventions which are associated with
the risk management and care planning of the depression patients. These are also consider the
legal as well as ethical issues which are associated with the care of the patients. The effective
team working as well as practices of person centred care have to developed to increase the future
practices.
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REFERENCES
Books and Journals:
Capuco, A. and et. al., 2020. Gut microbiome dysbiosis and depression: A comprehensive
review. Current pain and headache reports, 24(7), pp.1-14.
Davenport, M.H. and et. al., 2018. Impact of prenatal exercise on both prenatal and postnatal
anxiety and depressive symptoms: a systematic review and meta-analysis. British journal
of sports medicine, 52(21), pp.1376-1385.
Ghari Saadati, L., Ghorban Shiroudi, S. and Khalatbari, J., 2022. Comparison of the
Effectiveness of Solution-Focused Brief Therapy and Compassion-Focused Therapy on
Interpersonal Relationships between Couples with Depression. Avicenna Journal of
Nursing and Midwifery Care, 30(1), pp.30-41.
Lempp, H. and et. al., 2018. Service user and caregiver involvement in mental health system
strengthening in low-and middle-income countries: a cross-country qualitative
study. Epidemiology and Psychiatric Sciences, 27(1), pp.29-39.
Myers, M., 2022. Impacts of Psychoeducation Programs and Moderators on Effectiveness for
Depression: A Systematic Review.
Santomauro, D.F. and et. al., 2021. Global prevalence and burden of depressive and anxiety
disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The
Lancet, 398(10312), pp.1700-1712.
Schaffler, J.L. and et. al., 2019. Developing education materials for caregivers of culturally and
linguistically diverse patients: Insights from a qualitative analysis of caregivers' needs,
access and understanding of information. Health Expectations, 22(3), pp.444-456.
Sharma, S.R., Gonda, X. and Tarazi, F.I., 2018. Autism spectrum disorder: classification,
diagnosis and therapy. Pharmacology & therapeutics, 190, pp.91-104.
Werner, P., Tur-Sinai, A. and AboJabel, H., 2021. Examining dementia family caregivers’
forgone care for general practitioners and medical specialists during a COVID-19
lockdown. International Journal of Environmental Research and Public Health, 18(7),
p.3688.
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