Mental Health Report: Inpatient and Community Mental Health

This report delves into critical aspects of mental health care, providing an in-depth analysis of recovery-oriented practices, the NSW Mental Health Act (2007), and least restrictive practices. The report begins by exploring the differences between clinical and personal recovery, emphasizing the i...Read More

Running head: MENTAL HEALTH
Name of the Student:
Name of the University:
Author Note:

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Executive Summary:
The purpose of the assignment provides a deep insight into the mental health patients. The first part has
discussed recovery-oriented practice in mental health. The second part has discussed NSW Mental Health
Act (2007). The third part has discussed Least Restrictive Practice and fourth part has discussed nursing
interventions that could be used to promote a person’s personal recovery in the inpatient or community
mental health setting. Lastly it provided a concise conclusion to the readers.

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Table of Contents
Introduction (max 250 words).........................................................................................................................3
Recovery-Oriented Practice in Mental Health (max 500 words)...................................................................3
NSW Mental Health Act (2007) (max 500 words)........................................................................................5
Least Restrictive Practice (max 500 words)...................................................................................................7
Recommendations (max 500 words)..............................................................................................................9
Conclusion (max 250 words)..........................................................................................................................11
References.......................................................................................................................................................11

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Assessment 1 Written Report template (suggested structure)
Introduction (max 250 words)
Internally nurses are subjected to the various experiences in the different clinical areas of practices which
received maximum attention in the recent era; mental health domain is one such the setting (Chester et al.,
2015). Caring for patients with severe mental illness is one of the most crucial responsibilities confronted
by the nurses in their clinical setting (Kidd, Kenny & McKinstry, 2015). Despite the mountain of research
present in the literature, very little evidence has been documented about the lived experiences of nurses
who are dealing with a mentally ill patient in their daily practice. National Survey of Mental Health and
Wellbeing of adults by Australian institute of health and welfare suggested that in Australia, the 12months
or lifetime prevalence of the mental disorders have been experienced by the population aged in between
16 to 85 years (Fletcher et al., 2019). Approximately 45 to 50% of the population of Australia are
experiencing mental health disorders and others will experience mental health illness at some point in
their experience. Meurk et al. (2015), reported that 1 in 5 of the population has experienced common
mental illness such as depression, anxiety or traumatic disorders in the previous 12 months, where phobias
and anxiety disorders are most prevalent. Hence, in order to reduce this high abundance of mental illness,
The Australian Government designed different mental health policies and announced a number of mental
health-related measures in the 2019 Federal budget. This paper will provide Recovery-Oriented Practice
in Mental Health, NSW Mental Health Act (2007) and least restrictive practice in the following
paragraphs.
Recovery-Oriented Practice in Mental Health (max 500 words)
What is the difference between ‘clinical recovery’ and ‘personal recovery’ for people with lived
experience of mental illness?

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Recovery-oriented approaches offer a transformative conceptual framework for the practice where a
person with insight and lived experience of mental illness and their family members are at the centre of
the care process (Sutton et al., 2017). However, many pieces of literature documented the differences
between clinical recovery and personal recovery which influence a person and their journey towards
recovery. Thomas et al. (2016), suggested that clinical recovery is a concept that emerged from the
domain of the mental health professionals where professionals involved in the recovery process of getting
rid of the symptoms of mental illness and restoring normal functions of a healthy life. On the other hand,
personal recovery is a concept that is emerged from the expertise of individuals with lived experiences
(Health.nsw.gov.au (2019). Van Eck et al. (2017) define personal recovery as a unique process of
changing personal and values, feelings, goals and skills for the sake of the mental health recovery. Hence,
recovery-oriented models offer the partnership where the expert is the person who is living with lived
experience and health professionals who are expert in supporting the recovery journey
What is recovery-oriented language in mental health?
to feel valued (Palmer et al., 2016). By emphasizing on the active listening, open-minded behaviour,
autonomy, polite and culturally safe language reflecting hope, optimize and empathy, professionals can
speak a recovery-oriented language which focuses on the self-determination of the patients, support the
recovery journey and celebrate the success story of the patients. Hence, this is the language used by the
professionals to empower patients, boost their self-confidence and facilitate the feeling of safety.
Recovery is an on-going process which assists an individual to improve their mental and physical
wellness and ability to live a satisfying self-directed life (McKenna et al, 2016). The recovery-oriented
mental health services acknowledge this improvement and believe that everyone is an expert in their life.
In this case, recovery-oriented language is the language of hope and optimism that makes a person feel
important and valued (Www1.health.gov.au, 2019). The individuals living with mental illness usually
experience trauma, anxiety, the distress which further affected their quality of life. In this case, involve

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patients in the therapeutic communications according to the social and cultural languages of the
professionals bring positive changes in the values and beliefs of the patients and patients
Why is recovery-oriented language important for a person’s recovery?
Lim, Wynaden and Heslop (2019), highlighted that patients who seek the support of the mental
health professionals are significantly disturbed, vulnerable and mentally ill. Taking a deep insight into
the situation, the patients are expected professionals to be empathetic, compassionate. In this context, the
recovery-oriented language embraces the probability of recovery by recognizing inherent strength, self-
determination, and capacity of the individuals who are living with the mental health issues (Rickwood &
Thomas, 2017). The recovery-oriented language maximizes the self-determination as well as self-
management involves person-centred perspective, acknowledge the diversity of the personal values and
beliefs and promote hope and optimism of living a self-directed satisfied life (Wilson, Hutchinson &
Hurley, 2017). Hence, the recovery-oriented language is one of the most crucial for a person’s recovery.
NSW Mental Health Act (2007) (max 500 words)
What is the purpose of the Mental Health Act?
NSW mental health act 2007 deals with the care and treatment of the patients who are
experiencing severe mental illness in New South Wales (Lamont, Brunero & Sharma, 2016). Each
jurisdiction of Australia has its mental health act which attempts to restore the civil rights and liberties
with the requirement of preventing serious harm. The act proclaimed on 31 August 2015 for the wellbeing
of the mentally ill patients (Health.nsw.gov.au, 2019). The primary aim of the act is to provide the care,
treatment as well as promote the recovery of the patients who are mentally ill or mentally disordered. The
act provides the care to the patients who are impaired temporarily or permanently (Light et al., 2017). In
this context, the health professionals must support the faster recovery of the person exhibiting one of the

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symptoms discussed below (Harvey, 2015). Moreover, the other purposes of the act are to set out a
circumstance in which recovery can happen, provide a framework for the assessment of the mental illness,
ensure the rights of the consumers, dignity, and self-respect and promote the recovery-oriented
approaches (Health.nsw.gov.au, 2019).
Who has rights under the Mental Health Act?
The people with serious mental illness and tend to exhibit the symptoms of mental illness such
as irrational behaviour, frequent mood swings and have a tendency of doing self-harm. Mentally ill and
mental disorders both are the consumers of the rights. Under this act, the rights of the consumer
include right to receive best possible care and treatment in the least restrictive environment, rights to have
legal representation, right to have one designated carer , right to have an interpreter , right to access to the
medical records, right have the respect for dignity and right to apply to be discharged (Health.nsw.gov.au,
2019). Hence, these factors are required to consider while providing the care for the patients who are
suffering from mental illness.
What are the criteria for mental illness under the NSW Mental Health Act 2007?
The New South Wales mental health act gives the court the power to restore the civil rights of the
patients who are suffering from mentally ill patients and promote the recovery of the patients
(Health.nsw.gov.au, 2019). A person is eligible for receiving mental health treatment services under
section 32, only if the person is currently or was cognitively impaired, suffering from mental illness
(Derrick et al., 2015). For the purpose concerning the act, a mental condition includes delusion, frequently

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disturbance of mood m hallucination, frequently irrational behaviours of self-harm (Health.nsw.gov.au,
2019). The patients with diagnosed with serious mental disorders such as anxiety, depression, anti-social
personality, and bipolar disorders according to DSM criteria V are the most suitable candidate for the
mental illness. The self-harm tendency of the person includes physical, emotional, suicide, violence, and
aggression are eligible to be mental health patients (Harvey, 2015). On the other hand, the exclusion
criteria for the mental health act include a person with particular political beliefs, a person with particular
sexual preference, a person with particular philosophical perspective, a person with particular sexual
promiscuity, engaged in immoral and illegal actions, have a tendency of taking drugs (Health.nsw.gov.au,
2019).
Least Restrictive Practice (max 500 words)
Why is the use of seclusion and restraint risky – for the consumer?
Health workers, particularly who work in the mental health units are subjected to the greater risk
of work associated aggression in the other occupations where the majority of the risk of exhibiting
violence and aggression is observed in patients with mental illness. Many health professionals
experienced trauma due to their lived experience in mental health units. In this case, restriction and
seclusion are used in the mental health units as a potential tool for managing the aggressive behaviour of
the mentally ill patients (Www1.health.nsw.gov.au, 2019). The consumers who are subjected to seclusion
include people who are extremely intoxicated, consumers with the history of physical injury, patients with
a history of trauma and detention. However, seclusion and restrain the violet the mental health act as it is
not therapeutic interventions. Wilson, Hutchinson and Hurley (2017), highlighted that seclusion and
restrain subject the patients into the high psychological distress and they tend to feel vulnerable than
before. Consequently, it affects the recovery process of the consumers and involvement of the family
members as well as other health professionals in the process of recovery. The patients failed to obtain
their recovery goals and it threatened the dignity, self-respect and experience physical injury. Fletcher et
al. (2019), highlighted that sudden death is a very common phenomenon for patients who are subjected to

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seclusion. Hence it is seclusion and restraints are risky for the consumers and it is recommended to treat
patients in the less restrictive environment.
Why is the use of seclusion and restraint risky – for staff members?
While seclusion and restraints are risky for the consumers, it equally poses risk to the staffs who are
working in the mental health unit, especially to the staffs who are experiencing mental ill patients. Oster et
al. (2016), highlighted that seclusion and restraints facilitate job burnout and fatigue in the health
professionals because of the lived experience they are subjected to in their daily practice. Moreover,
the health professionals in the seclusion and restraint environment usually failed to engage in the
interactions with other health professionals calmly and respectfully, genuinely engage the consumers and
family members, failed to collaborate with other health professionals and subjected to the more
aggressive behaviours (Jury et al., 2019). Collaborating with the health professionals and family
members assist in identifying the stressors and protective factors for the recovery and facilitate the
appropriate assessment of mental health patients and holistic care to the patients (Hu et al., 2019). Hence,
in the restrains and seclusions, staffs failed to provide holistic care, subjected to the trauma of sudden
death.
What does ‘least restrictive care’ mean in the mental health context?
Least restrictive care is defined as the care process in which a safe and collaborative environment is
created for supporting the wellbeing and personal recovery of the patient while restoring the dignity,
rights, and freedom of the patients (Goulet, Larue & Dumais, 2017). Least restrictive care process in the
context of mental health involves the engagement of the consumers in the treatment; provide them the

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opportunity of self-reflection, employing active listening skills for addressing the concern of the patients
(Jury et al., 2019). Moreover, least restrictive care facilitates the practice of patient-centred care, support
individual goals. Consequently, patients feel empowered, safe and confident and it facilitates faster
recovery
Recommendations (max 500 words)
Describe two (2) nursing interventions that could be used to promote a person’s personal recovery in the
inpatient or community mental health setting. Provide rationales (the aim of the intervention) and
evidence (how do you know it may be effective?) to support your recommendations.
Please note – the interventions must be things that nurses do, not what the organisation does (eg. provide
mandatory training), and referring to another discipline (eg. Social worker, psychologist or GP) is not an
intervention.
While providing the care to the patients, it is crucial to consider the Personal recovery of the patient as the
personal recovery as changing personal and values, feelings, goals, and skills for the sake of the mental
health recovery (Chester et al., 2015). As mentally ill or mentally disordered patients are vulnerable,
appropriate interventions are required to provide to the patients which support the faster recovery of the
patients and provide hope of living a healthy life (Chester et al., 2015). Hence, in this context, the
responsibility of nurses is to design interventions could be used to promote a person’s recovery in the
inpatient or community mental health setting. The two such interventions include engaging the consumer
in physical activity and engaging customers in compassion focused therapy.
Nursing Intervention 1:
Considering engagement in the physical activity, one hypothesis has been proposed by the researchers
that physical activity has beneficial effects on the mental health distractions such as distraction, social

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interactions, and self-efficacy. The intervention aims to reduce the psychological distress in patients.
Rosenbaum et al. (2016), highlighted that medium to intense physical activity improves the mental health
of the patients by reducing the psychological distress such as anxiety, depression and negative mood.
Moreover, exercise also improves the cognitive function of the patients and improves the self-esteem of
the patients. The prime reason behind this is that exercise boost the production of feel-good chemicals
such as serotonin, endorphins (Suetani et al., 2016). The interventions would be effective in the clinical
setting where the evaluation parameter would be the improvement of the sleep, reduced anxiety, and
mood and increase the energy level in patients. Consequently, patients would be able to alter their
thoughts and beliefs. Hence, in this case, physical activity would be the most suitable intervention
(Suetani et al., 2016).
Nursing Intervention 2:
Considering compassion-focused intervention, it is a type of psychotherapy used for supporting the
personal recovery of the patients who are suffering from severe mental illness (Leaviss & Uttley,
2015). The therapy aims to amend the values and beliefs of the patients so that they can be compassionate
towards themselves while they experience any negative incidents in life. Compassion focused therapy is
especially appropriate for the patients who have difficulties in accepting themselves and have a frequent
tendency of involving themselves in the criticism. Compassion focused therapy is broadly built on the
idea of the caring behaviour of the patients towards themselves (Krieger et al., 2019). The purpose of the
intervention is to provide the training to the patients to acquire skills of compassion and transforms the
problematic patterns of the cognition such as anxiety, anger, shame, and self-criticism. This can be
facilitated by developing a positive therapeutic relationship, developing the ability to experience as well
as cultivate the attribute of compassion, developing the attributes of compassion others. Leaviss and
Uttley (2015), suggested that after going through compassion focused therapy, the patients tend to be
compassionate towards themselves and reduced rate of anxiety, anger and mood swings.

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Conclusion (max 250 words)
Thus it can be concluded that mental health emerges as the prime focus around the globe that
increases the global burden of disease. Due to the complexity of the disease, the nurses are often
accompanied by unique challenges which further disrupt the quality of the life of the nurses and their
clinical practice. The nurses are accompanied by health care. The recovery-oriented approach is one of the
most suitable approaches that not improve the quality of the life of patients but also improves the clinical
practice. Recovery-oriented approaches offer a transformative conceptual framework for the practice
where a person with insight and lived experience of mental illness and their family members are at the
centre of the care process. In this case, recovery-oriented language is crucial as this language promote
hope and optimism that facilitate recovery. New South Wales mental health act (2007) is one such act in
Australia that supports the recovery-oriented approach and restores the rights of the mentally ill patients.
The people with serious mental illness and tend to exhibit the symptoms of mental illness such
as irrational behaviour, frequent mood swings and have the tendency of doing self-harm are consumers of
this rights. In this case, patients are required to treat in the least restrain environment as seclusion and
restrains can be harmful to patients and staffs as well. Two nursing intervention must be performed by
nurses such as physical activity and compassion focused therapy that will empower patients and provide
them a perspective of living quality life.
References
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