Multidisciplinary, Ethical Mental Health Illness Nursing Care

This essay examines the crucial role of multidisciplinary, ethical, person-centered, and holistic nursing care in managing mental health illnesses, specifically addressing violent and aggressive behaviors. It begins by defining mental health and illness, highlighting the prevalence of conditions like depression, anxiety, and substance abuse, and their links to aggression. The essay then explores risk factors for aggression, including substance abuse, mental health disorders, and social factors. It contrasts traditional medical models with recovery-based approaches, emphasizing patient perspectives and lived experiences. The essay also discusses best practice approaches, such as cognitive behavioral therapy (CBT) and psychodynamic therapies, alongside the importance of multidisciplinary interventions, including exercise and nutrition. The registered mental health nurse's role is defined, stressing the need for comprehensive assessments and adherence to ethical standards. Cultural barriers and patient isolation are acknowledged, with recommendations for culturally competent and family-centered approaches. The essay concludes by reiterating the importance of recovery-oriented and strengths-based approaches in mental health care.

Running head: MENTAL HEALTH AND ILLNESS
MENTAL HEALTH AND ILLNESS
Name of the Student:
Name of the University:
Author note:

1MENTAL HEALTH AND ILLNESS
Introduction
As postulated by the World Health Organization, an optimum condition of mental health
is one where an individual enjoys a condition of wellbeing and the ability to manage normal life
stresses, engage in fruitful and productive work and contribute positively to the societal or
community expectations. When such a state of wellbeing and optimum societal as well as
personal functioning is lost, an individual experiences mental illness (Parliament of Australia,
2019).
While a number of mental health disorders exist, mental health conditions with violence
and aggressive behaviors are often difficult to manage and require comprehensive efforts by the
individual, his or her family as well as the concerned health professionals for ensuring
prevention of any personal or public harm. Caring for individuals with aggressive or violent
behaviors can often be sensitive and raise ethical dilemmas. It is hence, recommended that a
recovery based approach be administered where the nurse, actively involves the patient in the
care-plan decision making process where all needs are addressed in a holistic or comprehensive
manner (Katz, 2015).
Thesis Statement: The following essay will hence argue in support of the importance of
a multidisciplinary, ethical, person centered and holistic nursing care interventions for
management of mental health illness in patients, with respect to violent and aggressive
behaviors.

2MENTAL HEALTH AND ILLNESS
Discussion
Prevalence of Aggression
According to the Department of Health, the most common prevalent health illnesses
existing in Australia are disorders associate with depression and anxiety, which are prevalent
across 6 to 14% of the population, respectively. Additional mental health disorders affecting the
Australian population include post-traumatic stress disorder, obsessive compulsive disorder, and
bipolar disorder (Department of Health, 2019).
It must be noted that the above mental illnesses are often linked to self-harming and
suicidal behaviors across inflicted individuals, which when promptly mitigated by health
professionals, often result in violence and aggression. Additionally, certain mental health
conditions are associated with higher susceptibility of violence and aggression across
individuals. These include disorders related to alcohol consumption and illicit substance usage,
which are prevalent across approximately 16% of Australians aged 12 to 17 years and one out of
five individuals aged between 16 to 85 years as reported by the National Drug Strategy and
Household Survey 2016 (National Drug and Alcohol Research Centre, 2019). An additional key
mental health disorder which is associated with high prevalence of aggression and violence are
bipolar disorders and psychotic disorders like schizophrenia which have been estimated by the
Department of Health to affect approximately 50% of the population (Department of Health,
2019).
Risk Factors for Aggression
The Department of Health and the Australian Institute of Criminology has estimated
numerous risk factors which are associated with violent and aggressive behavior across

3MENTAL HEALTH AND ILLNESS
individuals. Individuals who are male, engaging in excessive alcohol consumption or abuse are
more at risk of demonstrating aggressive and violent behaviors. Additionally, individuals who
are at higher susceptibility of demonstrating aggression and violence including those with
substance abuse of illicit drug usage disorders especially methamphetamine and cocaine
(Australian Institute of Criminology, 2019).
In criticism of the above, as researched by Levenson, Willis and Prescott (2016), alcohol
and substance abuse disorders are not always the sole contributors of violence and aggression. In
addition to the substance abuse disorders, patients with mental health illnesses such as anxiety
and anxiety associate disorders which are linked with traumatic life events or lived experiences
of child abuse or domestic violence are also at risk of demonstrating violence and aggressive
behavior. Additionally, organizational factors may also fuel violent and aggressive behaviors
across individuals. Patients under the influence of alcohol or illicit substances, when met with
restraints, especially violence at healthcare units are also prone to demonstrating violent and
aggressive behaviors (Ashton, Morris & Smith, 2018).
Further, in criticism of the above, as researched by Gerber et al., (2018), a person’s social
and cultural status may also cotrnibte to violent and aggressive behaviors. Social factors like
stigma and stereotype may also contribute to violence and aggressive behavior in individuals and
are prevalently observed in Aboriginal and Torres Strait Islander Communities, which shall be
elaborated upon in the following sections.
Consumer’s Perspectives/Lived Experiences
Traditionally, as researched by Tremblay, Vitaro and Côté (2018), a medical model had
been the preferred mode of treatment with mental health disorders characterized by violence and

4MENTAL HEALTH AND ILLNESS
aggression postulated to be linked solely to the biological functioning of individuals.
Perspectives or experiences of consumers were largely disregarded and associated with insanity
which is why, traditional interventions of placing restraints or isolation of such patient were
further met with viscous cycle of violence and aggression across patient. A disregard to the
opinions of the patient’s families, especially across Indigenous and culturally diverse
communities were prevalent further resulting in consumers perceiving the mental healthcare
system to be inhuman and disrespectful.
In criticism of the medical model, as researched by Hegarty, Tarzia, Hooker and Taft
(2016), it has been largely postulated than an individual’s mental health is an amalgamation of
his or her social, familial, interpersonal and emotional factors. This has hence resulted in a
growing emphasis on usage of a recovery based model n collaboration of strengths based
approach to mental health management. A recovery approach is characterized by a person
centered approach to treatment where the concerned individual is encouraged to share his or her
lived experiences which may have contributed to current aggressive and violent behaviors along
with sharing his or her hopes, dreams and goals for the future. According to Kewley (2017), a
strengths based approach is characterized by the patient and the health professional to
collaboratively work with each other to identify his or her strengths and design interventions to
enhance the same as efforts to mitigate mental symptoms and associated harmful behaviors. The
collective usage of such approaches hence result in the individual feeling empowered,
encouraged and motivated and instills perceptions that his or her lived experiences are being
emphasized upon, respected and empathized with.

5MENTAL HEALTH AND ILLNESS
Best Practice Approaches
According to Kolko, Herschell, Baumann, Hart and Wisniewski (2018), a number of
psychotherapeutic approaches can be considered to address the violent and aggressive behavior
across individuals. Behavioral interventions such as cognitive behavioral therapy (CBT) has been
evidenced to be an effective intervention in the regulation of violent and aggressive behaviors. In
CBT, a psychotherapist works in close interaction with the affected individual in the
identification of the stimuli or external factors which may trigger such harmful behaviors and
work towards management of the same.
In criticism to the behavior interventions of CBT, as researched by Taubner, Fonagy,
Bateman and Rabung (2017), however, as discussed, behavior, violence and aggression are
prevalent in individuals with lived experiences of trauma, abuse and violence which may are
often unnoticed and suppressed. Hence, in alignment of the same, psychodynamic approaches
are also an effective approach where the therapist encourages the individual to share hidden
feelings and experiences of guilt, shame and abuse which may have contributed to the violent
and aggressive behaviors.
At present, as researched by Scarth, O'toole and Richman (2016), health professionals are
requested to adhere to the needs of the patient in a comprehensive and holistic manner. It has
been evidenced that a multidisciplinary approach to mental health illness management must be
considered, where alternative treatments like exercise and nutrition are emerging as interesting
options. Dietary and exercise interventions such a nutritionally balanced diet and mild exercises
like stretching are recommended to be administered in congruence with psychotherapy. Recently
creative arts therapies like music, dance, art and drama therapies are being explored as
alternatives to traditional pharmacological interventions.

6MENTAL HEALTH AND ILLNESS
Mental Health Nurse’s Role/Interventions
The registered mental health nurse must comply to standard 1 of the Nursing and Midwifery
Board of Australia (2016) and hence, practice assessments which are comprehensive, holistic and
evidence based. The biopscyhosocial needs of the patient with violence and aggression must
hence be assessed using a HEEADSS tool for screening of Home status, employment and
education, exercise and eating, peers relationships and activities, drug or alcohol use, sexuality,
symptoms of depression and suicide and safety or spirituality factors. Additional assessments
include the Kessler Distress Scale and Warwick-Edinburgh Mental Well-being Scale for
evaluation of mental state and wellbeing (New South Wales Government, 2019).
Additionally, while it is beyond the scope of the nurse to engage in psychiatric
interventions, he or she must adhere to patient centered care as per NMBA standards of practice
and encourage direct patient participation in decision-making. Additionally, the mental health
nurse must adhere to Standard 3 of the NMBA Codes and work in collaboration with the
psychotherapist and other health professionals to deliver multidisciplinary care to the patient
(Nursing and Midwifery Board of Australia, 2016)
Barriers
Cultural barriers are one of the major obstacles to treatment where an patient’s diverse
ethnicity and family traditions may not be complaint of treatment interventions suggested by the
nurse or health care professionals. Additionally, in order to ensure staff and patient protection,
violent and aggressive patients may often be isolated resulting patient dissatisfaction. In criticism
of patient isolation practices, it has been evidenced that isolating may further aggravate violent
behaviors. Additionally instilling paternalistic principles may further disrespect cultural and
family values resulting in progression of mental health symptoms (Williston, Taft &

7MENTAL HEALTH AND ILLNESS
VanHaasteren, 2015). Health professionals like nurses are hence advised to adhere to the
National Practice Standards for the Mental Health Workforce. Hence, nurses must first adhere to
Standards 2, 3 and 4 which involves cultural competence and family centered approaches
involving family therapy or involvement of the patient’s family. The nurse must also adhere to
standard 1 and respect the patient’s preferences prior to any intervention and obtain consent with
utmost diligence (Department of Health, 2019).
Conclusion
Hence, this paper demonstrates the widespread prevalence of mental health illnesses in
Australia. Despite notable improvements in terms of prevalence and reported incidences,
violence and aggression across individuals with mental health illnesses, especially violence and
aggressive behaviors, continue to prevail in organizations dealing with mental healthcare in
Australia. At present, a recovery oriented or strengths based approach, in comparison to medical
model are the preferred approaches which nurses are recommended to administer and ensure
holistic and comprehensive management and assessment of mental health issues with violence
and aggression. For conforming to ethical modes of practices, nursing interventions must be
centered around patient centered and family centered approaches along with the certified
standards of practice.

8MENTAL HEALTH AND ILLNESS
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