Strategies for Managing Challenging Behaviors in Mental Illness

This essay addresses the critical issue of managing challenging behaviors, particularly aggression, in individuals with mental illness. It begins by highlighting the prevalence of mental illness and the associated behavioral changes, emphasizing the emotional and psychological distress experienced by patients. The essay explores various risk factors contributing to aggressive behavior, including comorbid substance use, past trauma, and non-compliance with treatment. It then delves into effective management strategies, such as de-escalation techniques, cognitive behavioral therapy, patient-centered communication, and medication management. The role of nurses in providing care is emphasized, including interventions like environmental changes and medication. Furthermore, the essay acknowledges barriers to effective management, such as physical harm to staff and patient non-compliance. The conclusion underscores the importance of a comprehensive approach, including assessing the causes of aggression, applying effective communication, and using CBT to develop coping strategies for improved patient outcomes.

Running head: MANAGING CHALLENGING BEHAVIOURS
MANAGING CHALLENGING BEHAVIOURS
Name of Student:
Name of University:
Author’s Note:

1MANAGING CHALLENGING BEHAVIOURS
The study will elaborate the assessment, prevention and management of aggressive
behavior among the individual suffering from mental illness. The patient with mental illness
often exhibit some severe behavioral changes that might result in adverse health complications.
The different risk factors are also exhibited in the study that is responsible for the onset of
aggressive behavior among the mentally ill patient (Duxbury & Whittington, 2005). The
individual with mental illness and aggressive behavior experience huge emotional and
psychological distress and also go through various negative thoughts in their life that is
responsible for further deteriorating their health condition. De-escalation of physical restrain and
cognitive behavioral therapy are the best practice approaches for managing the patient suffering
from mental illness (Cowin et al., 2003). Patient-centered communication and medication
management will be used by the nurse to manage and reduce the complexity of the mental illness
in the patient. Physical harm, aggressive behavior and lack of communication are the few
barriers that will inhibit the nurse to properly manage the patient (Kontio et al., 2014).
The individual suffering from mental illness exhibit few challenging behaviors like
aggression or anxiety. Aggression is considered as the significant clinical issue for the individual
suffering from mental illness and is also used by psychiatrist to identify that the individual is
suffering from any severe mental illness (Kunimatsu & Marsee, 2012). Based on the survey
conducted by the Australian Institute of Health and Welfare, approximately 3.9 million of
Australian population have exhibited the condition of mental illness associated with the
behavioral changes. The prevalence of mental illness among the Australian population is
increasing day by day and it is estimated that every 1 in 5 individual are under the risk of
obtaining mental illness that is associated with behavioral change. The behavioral change tend to

2MANAGING CHALLENGING BEHAVIOURS
have more severe negative consequence on the individual suffering from mental illness (Cutcliffe
& Riahi, 2013). The aggressive behavior is largely exhibited by the individual suffering from
mental illness which can lead to different emotional or physical harm to the patient. The rate of
mental illness is very prevalent for the adult age group that can arise due to various risk factors.
The patient cam exhibit any type of aggressive behavior depending on the severity of the mental
illness that includes reactive-expressive aggression, reactive-inexpressive aggression and
proactive-relationship aggression (Bowers, 2003).
The individual suffering from any mental illness might exhibit severe aggressive
behavior that can be caused due to the existence of different comorbid substance exploitation or
past family history of aggression. Some people exhibit the condition of aggressive behavior due
to the presence of any mental illness associated with other risk factors. The past history of non-
compliant with the treatment that can be the major risk factor that might enhance the aggressive
behavior of the patient (Sutton et al., 2013). The inadequate access to the treatment facilities or
exposure towards stress can also result in escalated mental illness with severe behavioral
changes. The condition of aggressive behavior or behavioral change is exhibited largely by the
individual suffering from mental illness and also have a past medical history of trauma. The
individual suffering from mental illness can be due to any specific circumstances and it is very
important to note the pattern of aggression in order to identify the risk factors that is accountable
for the bad mental health condition of the individual (Citrome & Volavka, 2011). The other
associated risk factors can be a past history of substance abuse, criminal records or history,
personality disorder, unemployment, relationship loss and self-injury.
The individual suffering mental illness often exhibit either minimum behavioral change
or exhibit severe behavioural change that can be due to various factors. The individual often

3MANAGING CHALLENGING BEHAVIOURS
experience from emotional and mental distress dealing with their aggressive behavior. They tend
to assume all the negative thoughts related to their life and the people who are closely related to
them (Price et al., 2018). The individual suffering mental illness are often susceptible towards
the physical violence or any other kind of aggressive behavior. They also tend to experience
from social isolation can directly affect their mental health and due to the exclusion their
negative behavior also increases that further influences their behavior and attitude. There are
huge behavioral changes that is suffered by the individual suffering from mental illness and they
must overcome from the negative thoughts or else the severity of the condition increases and
they tend to be more reactive and negative towards their life and often suffer from adverse health
consequences. The aggressive behavior is also responsible for developing the aspect of extreme
behavioral changes through which the individual fail to identify any positive aspect of their life
and even develop additional health risk such as depression or anxiety (Cutcliffe & Riahi, 2013).
Aggressive behaviour of the mental ill patient are the key concern in the growing
population of Australia. It can be identified by the mean of communication and observing the
attitude. It is evident from the study of McCann et al. (2014) that the best practice approach to
manage the aggressive behaviour of the mental ill patient depend on the intensity of the situation
and attitude displayed by the patient. The method of de-escalation is one of the practice that is
intended to manage the challenging behaviour. It consist of verbal communication where the
health care nurse try to give their undivided attention and be non-judgemental in their action.
This practice helps to prevent the turning of aggressive and violent situation of the patient. The
other nursing approach to manage the mental illness is the use of cognitive behavioural therapy
(Sugden et al., 2016). The approach to CBT help to change the behaviour of the patient by the
mean of effective communication. Range of question is asked with the patient in order to assess

4MANAGING CHALLENGING BEHAVIOURS
the cause of aggressive behaviour. Once the root cause is known, the behaviour is managed by
encouraging, counselling and establishing exercise like gardening or physical activity. This will
help in teaching them to control their aggressive behaviour and way to self-manage it. From the
study of Dickens, Piccirillo & Alderman (2013) it is inferred that physical restraint is the other
approach to manage the aggressive behaviour, however it should be done by those staffs who are
specially trained in it. Physical intervention and restraint is generally performed, where the initial
intervention fails. However, consideration should be paid in time period of intervention, as long
restraint may cause damage to brain.
The role of nurse in managing the aggressive behaviour of the mental ill patient is crucial
as they are responsible to provide effective care. The nurse can implement various types of
intervention to prevent and manage the challenging behaviour of the mental ill patient. The nurse
can provide patient care centred and give respect to the decision and desire of the patient. The
nurse will try to communicate with the patient and assess the care need. Communicating in
humble and respectful manner can help to create trust in the care plan. It will help to change the
behaviour of the patient by conveying coping strategies to them. The nurse can provide
education to the patient about the harm associated with the aggressive behaviour. This will also
help the patient to be self –aware and able to manage their aggressive behaviour. It is evident
from the study of Humble and Berk (2003) that nursing intervention to manage the challenging
behaviour can be done by mean of anticipatory strategies for example environmental change, use
of medication and behavioural intervention. The nurse can change the living atmosphere of the
patient by shifting them to cool and peace environment. Moreover, in situation when the
aggressive behaviour of the mental ill patient is not controllable, the nurse can provide sedative
medications, which make the patient calm (Hahn et al., 2006).

5MANAGING CHALLENGING BEHAVIOURS
Managing the challenging behaviour of the mental ill patient by the nurse may encounter
various barrier. It is noted in the study of Lavelle et al. (2016) that aggressive behaviour of the
mental ill patient has the potential to cause physical harm to the nurse and other staffs. It is the
major barrier that can constrain nurses from providing effective care. There is the probability
that, mental ill patient do not respond to the nurse or show their desire in the care plan, due to
which a nurse cannot assess the main cause of aggressive behaviour. They can become
aggressive or show disinterest towards the intervention. In the interference of providing effective
medication, the patient may not give their consent and can cause physical harm to the nurse
(Price et al., 2015).
Lastly, from the above discussion, it can be said that challenging behaviour of the mental
ill patient is the psychological issue where the person can develop at any point of time. The
aggressive behaviour among the mental ill patient have the potential to cause self-harm and lead
to poor physical health. There are many risk factors associated with aggressive behaviour like
suicidal thought or poor care by the nurse and family. In order to provide effective care, nurse
need to assess the cause and apply effective communication or CBT to develop coping strategies
among the mental ill patient. It can help to improve the behaviour of the people and lead to good
health.

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