Nursing Strategies for Adolescent Mental Health and Social Inclusion

This essay explores the barriers to mental health inclusion faced by adolescents in New Zealand, highlighting the high rates of psychological distress and suicide among this age group. It examines the impact of stigma, social deprivation, and low socioeconomic status on access to mental health services. The essay then discusses the Strength Model as a recovery-oriented approach, emphasizing the importance of focusing on adolescents' strengths rather than vulnerabilities. Furthermore, it evaluates New Zealand's strategies for encouraging social inclusion, such as improving awareness and building trust between healthcare professionals and young people. The essay concludes by assessing the crucial role of mental health nurses in facilitating recovery and social inclusion through effective communication, knowledge of mental health issues, and empowerment of adolescents to contribute positively to their communities. Desklib offers a wealth of similar academic resources and study tools for students.

Running head: BACHELOR OF NURSING
Bachelor of nursing
Name of the Student
Name of the University
Author note

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Although, adolescents lead a healthy and happy life in New Zealand (NZ), however,
according to a 2012 survey, many students experience some form of mental health concern.
According to 2013-2014 NZ Health Survey, among the adolescents aged 15 to 24 years, about
10% males and 5% females reported high rates of psychological distress experiencing sleep
problems, anxiety and depression (Best Practice Advocacy Centre New Zealand, 2015).
Similarly, high rates of youth suicides occur in NZ and among 32 The Organisation for
Economic Co-operation and Development (OECD) countries, males and females of the age 15-
19 years commit highest number of suicides (Best Practice Advocacy Centre New Zealand,
2015). In the same 2012 survey, there were reports of self-harm where 18% males and 29%
females reported deliberate harm in NZ (Mental Health Foundation Research Report, 2014).
These statistics illustrates that there are mental health issues among adolescents in NZ having
risk factors such as childhood trauma, sexual or physical abuse, social deprivation and poverty.
In NZ, Pacific people and Maori are at the highest risks for mental health who committed highest
suicides. Despite of the fact, that there is high level of mental health issues experienced by
adolescents in NZ, there are barriers to mental health opportunities, access and treatment faced
by them. There are long waiting times and lack of focus on the adolescents’ emotional literacy
and early intervention that is creating barriers to mental health access by them. Therefore, the
fowling essay will focus on the barriers to mental health inclusion, NZ strategies or initiatives in
encouraging inclusion for adolescents with mental illness (MI) followed by identification and
evaluation of role of nurses in facilitating their recovery and social inclusion.
In NZ, adolescents face maximum barriers to mental health access diagnosed with MI.
The mental health among adolescents can be explained through lifespan or developmental theory
among adolescents. Despite this increase in mental health issues, a dearth of literature examines

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development of mental illness among adolescents. Adolescence is a period of psychological and
physical maturation where there are changing social roles and away from childhood towards
responsibility and independence. This transition from childhood may affect them with increasing
exposure to risky behaviours like alcohol and substance abuse, worries about relationships, body
image, education achievements and peer pressure. The incidence of mental health issues
increases from puberty including anxiety, psychosis, depression and suicidal ideation. In primary
care, clinicians are at the unique position to help adolescents while they navigate this life
transition. During this transition from childhood to adulthood, adolescents go through many
internal changes and in the course of developing their own sense of view and identity about
themselves and the world; they may experience conflict between their expectations and growing
sense of identity (Mental Health Foundation of New Zealand, 2014).
During this phase of MI, they require mental health support; however, they have poor
access to primary mental health care due to stigmatization, social deprivation, and low socio-
economic status. There is stigma associated with the MI that is leading to discrimination against
adolescents with experience of MI. In addition, stigmatization hinders recovery as stigma within
the communities, lack of knowledge within primary health services and limited relevance of
services greatly acts as barriers for the access to mental health services by adolescents in NZ.
There is long waiting hours and about one in ten young people across NZ have to wait for more
than two months to see a mental health specialist for support across NZ. In 2016, about 15,400
adolescents under the age of 19 years were missing mental health care in NZ (Ministry of Health,
2012). The stigmatization is affecting the quality of care and treatment outcomes received by
young people with MI.

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Low socio-economic status and financial issues also affects young people with MI.
There is significant financial disadvantage among young people with MI as compared to the
general population. Young people with mental illness belonging to families having income lower
than average are unable to manage the symptoms of MI. They are discriminated and overall
impact of financial disadvantage hampers their mental health treatment. They face cost barriers
in the establishment and maintenance of healthy lifestyles and medical services that creates a
dual barrier in accessing mental health services (Moses, 2010).
Stigmatization and financial disadvantage also acts as barriers in community inclusion.
A large number of adolescents with MI drop out from schools or stop attending mental health
counselling, as there are negative attitudes against them. This greatly affects their recovery and
makes them leave treatment affecting their overall quality of life. Moreover, behaviour and daily
operations of mental health staffs also contribute to factors that make teenagers leave their
treatment. Therefore, the above discussion revealed perceived barriers to adolescent participation
in access to mental health services and treatment (Andrade et al., 2014).
A recovery focused model can be used that can have positive benefits and in promoting
mental health and wellbeing of adolescents. A period of despair follows mental illness diagnosis
and associated community stereotypes and negative expectations among adolescents. During this
phase, there is a shattering world of their dreams and hopes. There is frozen inactivity and
extreme social withdrawal that affect their recovery (Tew et al., 2012). To promote mental health
and wellbeing among adolescents, Strength Model can be used as a recovery-oriented approach
towards mental health services helpful in young people participation with MI in the NZ
community. The model explains that when the strengths of young people with MI like skills,
passions and interests are presented instead of vulnerabilities, it promotes better recovery among

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them (Keyes & Simoes, 2012). For example, every individual have the capacity to recover and
transform his or her lives. If the mental health practitioners focus on the strengths of adolescents
rather than their deficits, there is better recovery among them. Another example is focusing on
the positive aspects as their capacities can be helpful in normalizing their mental health
experiences and promote recovery (Ryan, Ramon & Greacen, 2012). The stimulation of positive
energy of adolescents can be promoted through act of belief. The individual, family and
community is mired deeply in the complexities of trouble believe that there are no resources that
can help to resolve the MI issue among adolescents. In this situation, strength model can be used
where professionals can communicate that through the empowering of inner strength of
adolescents and resourcefulness of family or community, there can be better recovery and
promotion of health and wellbeing restoring faith in them and their capacity in shaping their own
lives (Slade, Adams & O'Hagan, 2012).
The model explains that community is “an oasis of resources” that can provide mental
health support to the adolescents (Clement et al., 2015). For example, the community can
provide the adolescents with care, support and opportunities that are necessary for their
successful living. When the community provides mental health resources to adolescents with MI
through community collaboration, there is social inclusion and identification of individual
strengths promoting wellbeing and recovery. The model also outlines the fact that an individual
is a product of their life experiences and inhabiting environment, therefore appreciating the
strengths and aspirations of young people can be helpful for them while living with MI. This
model can be useful for promoting wellbeing among young people with MI by helping them
identify and achieve important and meaningful life goals. Most importantly, strength model
provides a robust vision of facilitating recovery-oriented partnership between practitioner and

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client. This in turn promotes mental health recovery that is a dominant paradigm in the mental
health services (Gehart, 2012). This model provides a framework for the mental health
professionals who are working with clients with MI to move beyond the negative and disabling
effects of MI to a life that is filled with purpose, meaning and identity for the adolescents during
their transition period from childhood towards adulthood. Therefore, strength model can be used
as an approach for recovery and wellbeing among adolescents in NZ diagnosed with MI.
NZ has developed many strategies that have encouraged social inclusion of adolescents
with MI. As reported by NZ Health Survey, against backdrop of mental health issues, there is
need for opportunities so that there is maximization of young people engagement in primary
care. There is need for improvement of awareness by reaching out to clinics and education
sessions in schools through presentations. This can be helpful in breakdown of barriers to access
for adolescents and participation in service delivery workshops and youth awareness can help to
provide an experience that is welcoming and positive for the young people. The local youth
health services need to be dedicated and sensitive towards the adolescents that can be helpful in
community participation (Best Practice Advocacy Centre New Zealand, 2015).
Another strategy is to help adolescents be engaged and accessed to the mental health
practice. There is a need for increase in appointments through emailing or calling the clinic that
can be helpful in reducing the long waiting hours. There should also be non-judgmental staffs as
it is an important aspect of their experiences with the mental healthcare providers. The mental
health clinics should be youth-friendly having posters, magazines and health information in the
waiting area to make them feel valued and included (World Health Organization, 2014). There is
need for building of trust that underpins engagement of young people with the mental health
professionals. There should be maintenance of privacy and confidentiality as it is the way to

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openness and honesty with healthcare professionals. The mental health professionals should
explain to the adolescents about privacy that sharing of information would only take place during
medical decisions.
The mental health services should acknowledge adolescents as an individual. They need
to be reassured that their health is important for them. There should be building of transition
periods into consultations that can be helpful in encouraging them for follow-ups and attend
appointments at regular intervals (World Health Organization, 2016). For this strategy,
communication is important between healthcare professionals and young people. There should
be empathetic communication where adolescents should feel that they are listened, heard and
understood. The healthcare providers should give health information to them in a straightforward
way and work in partnership in addressing their health concerns. Therapeutic communication is
important where the healthcare professionals should provide care to young people who are in
need for intervention. Interpersonal communication skills are essential in building trust, rapport
with adolescents so that they feel socially included, listen and perceive each other and
simultaneously, engage in the creation of meaningful relationships while focusing on their issues
and assisting them in learning to live with MI (Jorm, 2012).
From a critical analysis perspective, these strategies are not successful in facilitating
social inclusion for adolescents with MI. The barriers of stigma and low socioeconomic status
have hindered access to mental health services. NZ has adopted recovery-based approach that
focuses on personal journeys of individuals towards mental health and wellbeing while
community participation is a broader concept that focuses on reduction of social exclusion and
stigmatization towards MI. The mental health services of NZ have not yet embraced the mental
health needs of individuals with MI. The concept of social inclusion and recovery concept are

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not yet fully understood and as a result, the mental health services in NZ are in the phase of
renewal and growth. The country is trying to acknowledge the importance of increase in social
inclusion for improving mental health services for the adolescents with MI (Mariu et al., 2012).
Mental health nurses need to understand the concept of social inclusion that means
adolescents who experience MI should be empowered to make a positive contribution to the
community as individuals and citizens. The nurses need to possess the communication skills and
good knowledge of various mental health conditions along with engaging and warming attitude.
There should be demonstration of real empathy and interpersonal communication skills with the
adolescents in addressing their needs and empowering them to lead a quality life (Townsend,
2013). Effective communication skills need to be adopted by mental health nurses so that the
clients feel satisfied and adhere to treatment and counselling. This also helps in building rapport
that is necessary for the clients in gaining confidence and feel included in treatment regimens.
Therapeutic communication skills like giving recognition, accepting, active listening and
working in collaboration with clients can be helpful in successful social inclusion and recovery.
The nurse should be able to gain trust of service users through effective communication so that
they feel valued and socially included. This social inclusion is important for recovery as the
mental health nurses can directly assess the young people with MI in addressing their needs and
in offering the best services to them. In this way, mental health nurses can address recovery
access, acceptance and inclusion to life opportunities (Shives, 2011).
Mental health counselling by nurses not only empowers the service users, but also helps
them to manage their own mental conditions being a key factor for reducing burden on mental
health services. Self-empowerment recovery by mental health nurses can be helpful in gaining
full independence and in contributing to their meaningful and purposeful life. Nurses need to

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collaborate with clients in improving adherence by shared decision-making while actively
engaging them in their course of treatment and counselling (Stuart, 2014). In the wider context,
mental health nursing is the application of knowledge and prevention of mental illness while
promoting and maintaining the mental health of individuals. The early diagnosis, care,
rehabilitation and referrals are important for the mentally ill individuals. The nurses need to
develop and perform individual plans of care for the clients entrusted to care. Mental health
nurses need to play an important role in facilitating recovery through support and assistance.
Recovery-based approach is important for rebuilding their meaningful life while living with their
mental problems. This approach emphasizes on hope that is important for sustain of motivation
and supporting the expectations of clients for a fulfilled and rich life (Mental Health
Commission, 2011).
From the above discussion, it can be concluded that there are perceived barriers
experienced by adolescents in NZ who are suffering from MI. In NZ, young people experience
mental health issues that greatly affect their quality of life. They are unable to get access to
mental health services due to stigmatization, social deprivation and financial barriers. There is
poor community participation and fewer opportunities for young people with MI as they are
socially deprived from the mainstream mental health services. In this context, the strength model
can be used as a recovery-based approach that affects the health and wellbeing of the young
people. The model explains that mental health professionals should focus on the strengths of the
individuals rather than vulnerabilities. This can be helpful in making them socially included and
promote better recovery. Moreover, this model is helpful in guiding mental health professionals
where they should emphasize and support the potentials of clients in empowering them. The

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strength model outlines that strengths like skills, passion and relationships need to be encouraged
by practitioners so that they can lead a quality life.

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