Mental Health Nursing: Trauma, Schizophrenia, and Patient Care Plans

This assignment provides a comprehensive overview of various aspects of mental health nursing. It addresses the impact of transgenerational trauma on indigenous populations and explores the differences and similarities between schizophrenia and bipolar disorder, including pharmacological treatments. The assignment also discusses least restrictive practices in Victoria, psychoeducation for patients taking clozapine, and nursing actions for alcohol withdrawal. Furthermore, it outlines the processes for voluntary and involuntary admissions, non-pharmacological therapies for anxiety, and assessment questions for depressive disorders. The assignment concludes with nursing priorities for a patient with mania and the impact of stigma on individuals with mental illness and their families. Desklib offers a range of resources, including solved assignments and past papers, to support students in their studies.

Mental Health

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
1. Role of transgenerational trauma and mental illness for indigenous people...........................3
2 differences and 2 similarities between schizophrenia and bipolar disorder along with 1
pharmacological treatment...........................................................................................................3
3. Least restrictive practice in Victoria........................................................................................4
4. Psychoeducation that nurse provide to people with clozapine along with its side effects,
indication, monitoring and consumer education..........................................................................4
5.a. Nursing actions for alcohol withdrawal for consumer admitted to an inpatient mental
health unit....................................................................................................................................5
5. b. Signs that need to be considered for alcohol withdrawal....................................................6
Some signs and symptoms that need to be considered by nurses for alcohol withdrawal
include: depression, nervousness, mood swings, shakiness and nightmares. All these happen
when people start quitting alcohol and drugs but nurses need to consider this and they need to
take actions accordingly..............................................................................................................6
6. Process for voluntary/non-compulsory and involuntary/compulsory admission to psychotic
patient..........................................................................................................................................6
7. Two non-pharmacological therapies that can be used in anxiety disorder treatment..............6
8. Questions that can be asked for assessing mood with depressive disorder clients..................7
9. Five nursing priorities that need to be implemented for Raj who is admitted on the acute
inpatient unit................................................................................................................................7
10. Two impact of mental illness stigma for consumer as well as their families........................8
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................1

INTRODUCTION
When patient is emotionally, psychologically and socially well-being then it is known as
improved mental health (Greenberg, 2020). This study is going to discuss impact of
transgerational trauma on indigeneous people. Further, it will discuss importance of roles of
nurses and case managers in improving mental health problem.
MAIN BODY
1. Role of transgenerational trauma and mental illness for indigenous people
In regard to intergenerational trauma, it can be said that it is a concept that helps out in
understanding years of generational challenges, faced by families. In other words, it can be said
that when experience of parents and their actions affect the development of their children and
grandchildren then it is known as transgenerational trauma. Some causes of this trauma include:
sexual abuse, extreme poverty, sexual abuse and genocide (Isobel and et.al., 2021). It is found
that indigenous people often suffer from transgenerational trauma because they have lack access
to healthcare and other basic services. Extreme poverty and discrimination with such people are
some main reasons of this problem.
International concept of mental health can be discussed as emotional, social and logical
well-being. Poor mental health affects the way people think, act and feel.
There are number of cultural and bio psychological factors that affect mental health and
become reason of transgenerational trauma among indigenous people include: land
dispossession, forced relocation, loss of spiritual practices and culture.
2 differences and 2 similarities between schizophrenia and bipolar disorder along with 1
pharmacological treatment
Similarity 1: One of the main similarity between bipolar disorder and schizophrenia is both can
be characterised as psychiatric disorder as per the mental disorders fifth edition.
Similarity 2: Both require high utilisation of healthcare system (Lomholt and et.al., 2019).
Difference 1: Difference can be identified with its causes and symptoms. In regard to bipolar
disorder, it can be said that it causes extreme mood swings with one episode of mania and
schizophrenia causes hallucination.
Difference 2: Bipolar disorder has cyclical outcome and schizophrenia has poor outcomes.

Pharmacological treatment for bipolar disorder: lithium carbonate and valproic acid are
commonly prescribed mood stabilizing drugs.
Pharmacological treatment for schizophrenia: Aripiprazole and asenapine are common
medicines used in treating schizophrenia. Social skill training, cognitive therapy and family
psychoeducation are some other effective treatments (Cea-Canas and et.al., 2020).
3. Least restrictive practice in Victoria
In regard to least restrictive, it can be said that it is an application of model of care that increases
an older person’s autonomy, dignity and respect their rights.
Disability act 2006: It is the legislation where there is need to use least restrictive practice. As
per this act, if restrictive practices are being used then healthcare practitioners require using
behavioural support plan and it should be developed by an NDIS registered behaviour support
practitioner. Some steps that need to be followed for this practice include: registering with NDIS
quality of service providers, appointing an authorised program officer, development of NDIS
support plan, authorising the use of restrictive practice by authorised program officer and
approvement by Victorian senior practitioner (Morrice‐West and et.al., 2020).
The main aim of using this practice in this field is to encourage everyone to treat others in a fair
manner and engaging patients in treatment process. Protecting rights of older people and make
sure that they are living with freedom and respect.
4. Psychoeducation that nurse provide to people with clozapine along with its side effects,
indication, monitoring and consumer education
In regard to clozapine, it can be said that it is a psychiatric medication that is being given to
patient with mental illness or schizophrenia. It can help people in decreasing suicidal thoughts.
Nurses need to provide education to patient in this context so that they can take it in a prescribed
and effective manner otherwise, it may increase severe negative impacts. Some information that
nurses need to provide to patients who take clozapine include:
Side effects: Drowsiness, dry mouth, dizziness, headache, increased salivation and restlessness.
If patient do not take it in a prescribed manner or if it is being taken overdose, then it may lead
severe side effects such as: fainting, nausea, difficulty in urination, confusion, unusual bleeding
and yellowing of the skin (Gogos and et.al., 2019).

Indications: Primary indication for this medicine is schizophrenia and schizophrenia disorders
who have taken other medicines but did not have great impact. In severity of this problem¸
nurses suggest this medicine.
Monitoring: Blood monitoring is important as it is important for patients to test WBC and
neutrophil count weekly for 18 weeks and every 28 days thereafter.
By collecting all these information, patients can protect themselves from negative and side
effects of this medicine.
5.a. Nursing actions for alcohol withdrawal for consumer admitted to an inpatient mental health
unit
In regard to Tess, it is known that he is suffering from depression for many years and recently he
lost his partner and in order to cope up with this problem and depression, he increased her
alcohol intake. It is important for nurse to take immediate and effective actions so that Tess can
be protected from severe complications of depression. Some actions that can be taken by nurse
include:
Treatment initiation: It is responsibility of nurse to encourage patient for participation in drug
rehab programme. In this program, they influence in a manner as people start thinking about
giving up drugs (Joseph, Plummer and Cross, 2022). It changes out attitude and this is the most
important thing that can motivate Tess for decreasing alcohol consumption.
Early abstinence: If patient agrees to decrease alcohol consumption and giving up drugs that
she needs to enter in this tough stage. Cravings, personal and social factors can make difficult for
patient but nurse needs to encourage patient for active participation in healthy activities and self-
help group.
This encouragement and education can make able to Tess in giving up alcohol and it can have
positive impact on her health.

5. b. Signs that need to be considered for alcohol withdrawal
Some signs and symptoms that need to be considered by nurses for alcohol withdrawal include:
depression, nervousness, mood swings, shakiness and nightmares. All these happen when people
start quitting alcohol and drugs but nurses need to consider this and they need to take actions
accordingly.
6. Process for voluntary/non-compulsory and involuntary/compulsory admission to psychotic
patient
In Victoria state, there is a criteria according to which nurses and case manager can get hospital
admission done of patients involuntary and compulsory such as: patient has dangerous
behaviour, if he becomes unable to perform his daily routine activities and there is danger of
essential harm. In regard to Hong, it is found that he is under the care for schizophrenia and from
some days behaving strange and stopped taking medicines. It can increase risk to their family
members and himself as well. So, in this condition, case manager has right to get his admission
done involuntary and compulsory. In this involuntary process, community assessment order last
for maximum of 24 hours (Tinland and et.al., 2019).
Non-compulsory and voluntary refers those treatments that patient himself ask for. In the
case of Hong, it is known that he is unable to take his own decision but his parents are concerned
and it is the reason, they called case manager. On the basis of concern of parent, this admission
can be considered as voluntary but patient is mentally ill and he needs to be get admitted so, it
can also be considered as compulsory and non-voluntary.
7. Two non-pharmacological therapies that can be used in anxiety disorder treatment
Anxiety is a feeling of fear as well as uneasiness. It can have negative impacts on mental health.
There are both pharmacological as well as non-pharmacological therapies that are being provided
to patients in order to protect them from stress and other complex mental problems. Some
effective non-pharmacological therapies include:
Cognitive behavioural: It is an effective psychotherapy in most patients with anxiety disorder.
This theory changes behaviour and the way patient think at the time of anxiety and fear. The

main aim of this therapy is to change worried thoughts that lead anxiety (Wright and et.al.,
2019).
Along with this therapy, client can be encouraged to quit alcohol and drugs, caffeine intake,
maintaining a balanced diet, drinking water, taking regular sleep, getting regular exercise and
living around positive behaviour of people (Pompoli and et.al., 2018).
8. Questions that can be asked for assessing mood with depressive disorder clients
As it is known that Perry is suffering from major depressive disorder and it is important for
nurses and health care providers to ask some questions that can help them out in assessing their
mood. By evaluating answers of questions, healthcare providers can take actions accordingly.
1. Do you feel discomfort when you are around your family members and close friends?
Interpretation: One of the main reason of asking this question is to know reason of his
mental health and depressive disorder problem. In many of the cases, it has been seen
when clients become depressive when they are around members to whom they do not
like. So, knowing whether domestic violence is the reason of his condition, this question
will be asked.
2. What is the main thing that bother you to the great extent?
Interpretation: Again the main reason of asking this question is knowing reasons that
are increasing his mental condition ill (Timulak and et.al., 2018). It can help out
healthcare professionals in selectin treatment so that patient can be treated in a timely and
effective manner.
3. How do you feel most of the time? Happy? satisfied? Sad? Anxious?
Interpretation: Answer of this question can help out in knowing behaviour of client and
his mood swings.
4. What do you do in your free time?
Interpretation: It can help out in knowing interesting field of client so that strategies can
be developed accordingly.

9. Five nursing priorities that need to be implemented for Raj who is admitted on the acute
inpatient unit
As it is known that Raj is mania and has stopped taking medicines of it. He is sexually
provocative and this behaviour can affect others so, it is important for nurse to focus on this
problem and take actions immediately (Kortelainen and et.al., 2022). Main nursing priorities
include:
Psychotherapy: CBT is the main therapy in which Raj can be encouraged for participation. It
can change his behaviour and ways of thinking.
Mood stabilizer: By giving lithium drug after prescribing by healthcare professionals, his manic
episode problem can be solved.
Therapeutic communication: Patients with mania often have short attention spans so, for
engaging and increasing their focus, nurse can use clear, short sentence (Luostarinen and et.al.,
2020).
Engagement in interesting activity: After knowing interesting field, nurse can engage patient in
such activities. It can make busy to Raj and can improve his sexual behaviour.
Education: Proper education and sexual behaviour and ways of communicating with others, he
can be treated.
10. Two impact of mental illness stigma for consumer as well as their families
Stigma is when people see themselves and others in a negative way because of distinguishing
characteristics (Chang and et.al., 2018). Having negative thoughts for people who have mental
illness can have negative impacts on well-being and overall health of patients. Some negative
impacts that it can have on families and consumers include:
Fewer opportunities for employment: People who are suffering from mental health stigma or
when they are not being treated in a positive manner then it makes them feel de-motivated. It
lowers their morale and they find difficulties in finding employment opportunity. IT creates
problem for their families as well. It becomes difficult for them to live in a society.
Feeling of hopelessness: When people start bullying such people then it has negative impact on
them. They become hopeless and they start living along. Families also become bound to be
isolated from society that affect their knowledge and overall health.

CONCLUSION
It has been summarised from the above study that mental illness has negative impact on
patients and their families as well. It has discussed effectiveness of nursing intervention and
ways in which it can treat people with mania and severe mental ill people. Cognitive behaviour
therapy helps out in changing behaviour of patients with mental illness.

REFERENCES
Books and journals
Cea-Canas, B. and et.al., 2020. Connectivity strength of the EEG functional network in
schizophrenia and bipolar disorder. Progress in Neuro-Psychopharmacology and
Biological Psychiatry, 98, p.109801.
Chang, C.C. and et.al., 2018. Perceived stigma of caregivers: Psychometric evaluation for
Devaluation of Consumer Families Scale. International journal of clinical and health
psychology, 18(2), pp.170-178.
Gogos, A. and et.al., 2019. Sex differences in schizophrenia, bipolar disorder, and post‐traumatic
stress disorder: Are gonadal hormones the link?. British Journal of
Pharmacology, 176(21), pp.4119-4135.
Greenberg, N., 2020. Mental health of health-care workers in the COVID-19 era. Nature
Reviews Nephrology, 16(8), pp.425-426.
Isobel, S. and et.al., 2021. Intergenerational trauma and its relationship to mental health care: A
qualitative inquiry. Community mental health journal, 57(4), pp.631-643.
Joseph, B., Plummer, V. and Cross, W., 2022. Mental health nurses perceptions of missed
nursing care in acute inpatient units: A multi‐method approach. International Journal of
Mental Health Nursing.
Kortelainen, S. and et.al., 2022. Acute ischemic stroke in a university hospital intensive care
unit: 1‐year costs and outcome. Acta Anaesthesiologica Scandinavica, 66(4), pp.516-
525.
Lomholt, L.H. and et.al., 2019. Mortality rate trends in patients diagnosed with schizophrenia or
bipolar disorder: a nationwide study with 20 years of follow-up. International journal of
bipolar disorders, 7(1), pp.1-8.
Morrice‐West, A.V. and et.al., 2020. Training practices, speed and distances undertaken by
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Wright, J.H. and et.al., 2019. Computer-assisted cognitive-behavior therapy and mobile apps for
depression and anxiety. Current psychiatry reports, 21(7), pp.1-9.
Tinland, A. and et.al., 2019. Psychiatric advance directives for people living with schizophrenia,
bipolar I disorders, or schizoaffective disorders: study protocol for a randomized
controlled trial–DAiP study. BMC psychiatry, 19(1), pp.1-13.
Pompoli, A. and et.al., 2018. Dismantling cognitive-behaviour therapy for panic disorder: a
systematic review and component network meta-analysis. Psychological
medicine, 48(12), pp.1945-1953.
Timulak, L. and et.al., 2018. A comparison of emotion-focused therapy and cognitive-
behavioural therapy in the treatment of generalised anxiety disorder: study protocol for
a randomised controlled trial. Trials, 19(1), pp.1-11.
Luostarinen, T. and et.al., 2020. Intensive care of traumatic brain injury and aneurysmal
subarachnoid hemorrhage in Helsinki during the Covid-19 pandemic. Acta
neurochirurgica, 162(11), pp.2715-2724.
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