• Subject Name : Nursing

Importance of Knowledge Regarding Mental Health for The Nurses

Whatever the clinical setting is, mental health education plays an important role in each one of it and it is important for nurses to be aware of mental health education. In the given case scenario, Janice and Samprit are looking forward to work in their preferred units after they complete their about mental health with respect to their preferred health units. Now a days, it has been seen that chronic health conditions often makes the patient feel depressed because of his health status and there are so many cases of comorbidity where along with physical health issues, psychological disorders later on develops and in such cases the health care professional must be aware of the mental health education and its concepts. This will help in dealing with the patient positively and will also help the patient in receiving optimal care (Snoek, 2018).

Comorbidity can be defined as the presence of more than one additional health issues that co-occurs with the primary condition. Psychological disorders are often the secondary health issues that co-occur with the primary health condition most of the times (Snoek, 2018). This essay is going to discuss that why having knowledge regarding the mental health and illness is important for nurses irrespective of the type of clinical settings.

The comorbidity of both physical and psychological disorders has been seen and considered as the most common occurrence among the patients in the healthcare system, as well as in the population. The chronic physical illnesses often leads to depression and anxiety disorders and is termed as comorbidity with physical illnesses. The anxiety disorders and depression in the people with chronic pain conditions results in increasing the risk of chronicity, additive work-loss, disability, mortality, and poorer quality of life. Not only this but, more healthcare utilization is done and still reduced success in the treatment is achieved (Plana-Ripoll et al. 2019). As, Janice wants to work in the care unit and Samprit wants to work in emergency ward, there will be times where Janice will deal with the patients in the care unit who comes into depression or deals with any mental disorder and Samprit might face patients panicking and getting anxiety attacks in the emergency ward. In both of such situations it is the duty of the nurse to show some compassion and handle the patient with care and support and calm them down. This is where; their knowledge for mental health will be used.

If both of the students will not have understanding and knowledge regarding mental health and illness then, they will overlook to their physical disease and it has been seen that it is not considered to be good, when one of the comorbid disorders is overlooked. Healthcare professionals that are in disciplines other than the psychiatry or are general practitioners usually avoid the diagnosis of mental illness and the reason for this might be the uncertainty regarding the diagnosis of the psychiatric disorders and appropriate treatment that should be given for the psychiatric disorders and partly (Catala-Lopez et al., 2018). They often avoid the apparent stigmatization of their patients that happens when they are tagged as 'mentally ill'. Poor physical health can potentially result into a high risk of mounting mental health problems. Likewise, poor psychological health could negatively impact the physical health of an individual, leading to an increased risk of some conditions. Lack of knowledge of mental health will create hindrances in getting the desired health outcome of the patient even if you are providing quality care. This is why, knowledge of mental health and mental illness will help in the provision of patient-centered care and in achieving the optimal health outcomes of the patients (Lake & Turner, 2017).

However, it is important for all the nurses to understand the recovery model of care by the mental health services in order to enhance their practice. It helps in enhancing their practice as the recovery model of care give emphasis to supporting the patient's potential for recovery. In recovery model of care, recovery is considered as a journey rather than the outcome. This involves the developing the hope, a safe foundation and the sense of self, empowering the patients, social inclusion, supportive relationships, and coping skills (McLafferty et al., 2017). The main significance of this recovery model in nursing practice is that it does not only help the people with some mental illness to recover but along with this it also helps the nurses to work in odd situations or with vulnerable populations. This is so because recovery model of care entails five elements and the learning outcomes from these five elements helps the nurses to enhance their practice. These five elements is often collectively abbreviated as CHIME. Chime means connectedness, hope, identity, meaning & rationale and empowerment (Frost et al., 2017).

This will help Janice and Samprit in developing supportive relationships with patients and such relationships will lead in fostering the hope in patient. Both of them from this will enable themselves to play their role of connecting the recovering patients to the care services that the recovering patients might have had limited access to. Implementing the recovery model of care also helps in interpersonal acceptance, sense of social belonging, and mutuality (Davidson, 2016). Janice and Samprit will also be able to develop personal coping strategies and this is considered as an important element. Developing the sense for coping strategies and problem solving abilities will help in organizing the individual traits along with their problem issues which could or could not be symptomatic. In addition to this, the nurses will also be able to empower the patients by building a secure foundation as a result of implementing this recovery model of care. This will lead to a mutually supportive relationship between the care providers and the patients and identification of the patient's existing strengths. All of these things will not only help the nurse in getting the patient mentally recover but also will help him to respond to his treatment for physical illness and will help in getting the optimal patient health outcome (O’Keeffe et al. 2018).

However, mental state examination is an assessment that gives insights to the patient’s thinking. It is a structured evaluation of a patient's cognitive as well as behavioral functioning. It comprises of the descriptions of patient's appearance and his behavior; motor and speech activity, level of consciousness and attentiveness, mood and affect, attitude and insight, thought and perception, and finally, his higher cognitive abilities (Rocha Neto et al. 2019). The mental state examination is important for the nurses to undertake a comprehensive examination because it helps the nurses to get the snapshot of patient's emotions, behavior, and thoughts at the time of observation. Through this, it will help them in identifying the presence of a wide range of mental health conditions, the severity of that condition, and the potential risk a patient can have on him or on the people around him. In this way it would help the nurses in prioritizing the delivery of care (Norris Clark & Shipley, 2016).

For assessing the patient’s mental status in an appropriate manner, it is very important to develop an understanding of the patient’s cultural, educational, and social background. This is so because what seems abnormal to someone with more rational ability might seem normal to the other with less rational ability. The nurses often face patients that are dealing with some physical disorders but look cognitively intact. This is where; the mental state examination becomes important to be performed in patients because the mental status observations are considered to be a key tool for the psychiatry professional. Polishing the observational skills with the help of informal assessment along with formal exams helps to make the clinician be aware to restrain aspects of affect, behavior, and speech particularly as they transform during the period of meetings. However, subtle variations are essential sources of information all the way through the treatment. Learning to identify the subtleties is a critical element of learning in order to become a skilled clinician.

There are certain nursing interventions that could be taken by the Janice and Samprit in order to engage and support their patients. In context to this empowering the patient is considered as an important factor as it helps in engaging the patient and also showing them that their healthcare professionals are supporting them well (Bombard et al., 2018). Empowering the patients can be defined as a process in which the nurses enables the patients to do and decide as per the preferences of the patient. Empowering the patient with mental illness will help the patients in taking the control to their lives as well as their environment. It is the amalgamation of the freedom with power. Empowering them with respect to the context of healthcare means the encouragement of autonomous self-regulation for maximizing the potential of the individuals with mental illness regarding their health and wellness (Norris Clark & Shipley, 2016).

The steps involve in this can be initiated with informing and educating the patients regarding their illness, and to let them actively take part in participating in their treatment related decisions. The registered nurses have the expertise in clinical assessment, critical thinking, care coordination, leadership, and clinical decision-making and these are considered to be an important aspect in supporting and empowering the patient with mental illness.

The nurses working with mentally ill patient require special skills for understanding different mental, social and physiological aspects of the patient’s health in order to improve the provision of care (de Jacq et al., 2016). The nurses are the ones who are directly involved in assisting the patients in complicated scenarios. Having a mental illness along with the physical health issue i.e., comorbidity makes the patient find themselves a difficult one to deal with. For this, the nurse should use a holistic approach in order to address the various issues that are faced by the patients with mental disorders. There are certain complications that increase the issues for the nurse to deal with such patients and there they can utilize their interpersonal skills. Utilization of interpersonal skills will help in improving the provision of (Rodrigues, 2014). In a study by Naah et al. (2020) it has been seen that some of the issues faced by mentally ill patients are often because of the unfit physical environment, social determinants, stigmatization, lack of health care services, and lack of emotional support. The nurses are supposed to improve the patient’s power that is concerned with the health management and this will help in improving the autonomy.

Another aspect to this is therapeutic communication. It is the relationship between health professionals and patients that helps in creating a positive partnership with the patients by manifesting compassion, empathy, warmth, care, and respect. An effective therapeutic communication is considered as a key to the patient-centered care in the healthcare system (Younis, Mabrouk & Kamal 2015).

From the essay it can be concluded that irrespective of the clinical setting, nurses must have some knowledge for the mental health. Specifically, in case of cormorbidity which has been seen in most of the people, nurse’s knowledge regarding the mental health plays an important role. Along with this nurses must have a clear understanding regarding the recovery model of care by the mental health services in order to enhance their practice. As it helps in enhancing the nursing clinical practice because the recovery model of care give emphasis to supporting the patient's potential for recovery. In addition to this, nurses should also learn about the mental state examination as it is considered as way to get insights to the patient’s thinking helps in evaluating a patient's cognitive ability. However, if the nurses implement certain nursing interventions for engaging and supporting the patients then, this would help in the provision of optimal care and patient satisfaction.

References for Implications for Mental Health Care

Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., Onate, K., Denis, J. L., & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science : IS13(1), 98. https://doi.org/10.1186/s13012-018-0784-z

Catala-Lopez, F., Alonso-Arroyo, A., Page, M. .J, Hutton, B., Tabares-Seisdedos, R., Aleixandre-Benavent, R. (2018) Mapping of global scientific research in comorbidity and multimorbidity: A cross-sectional analysis. PLoS ONE 13(1): e0189091. https://doi.org/10.1371/journal.pone.0189091

Davidson, L. (2016). The recovery movement: Implications for mental health care and enabling people to participate fully in life. Health Affairs, 35(6). https://doi.org/10.1377/hlthaff.2016.0153

de Jacq, K., Norful, A. A., & Larson, E. (2016). The Variability of Nursing Attitudes Toward Mental Illness: An Integrative Review. Archives of psychiatric nursing, 30(6), 788–796. https://doi.org/10.1016/j.apnu.2016.07.004

Frost, B.G., et al. (2017). An integrated recovery-oriented model (IRM) for mental health services: Evolution and challenges. BMC Psychiatry 1722. https://doi.org/10.1186/s12888-016-1164-3

Lake, J., & Turner, M. S. (2017). Urgent need for improved mental health care and a more collaborative model of care. The Permanente Journal21, 17–024. https://doi.org/10.7812/TPP/17-024

McLafferty, M., et al. (2017) Mental health, behavioural problems and treatment seeking among students commencing university in Northern Ireland. PLoS ONE, 12(12): e0188785. https://doi.org/10.1371/journal.pone.0188785

Naah, F. L., Njong, A. M., & Kimengsi, J. N. (2020). Determinants of active and healthy ageing in sub-saharanafrica: Evidence from cameroon. International Journal of Environmental Research and Public Health, 17(9), 3038. https://doi.org/10.3390/ijerph17093038

Norris, D., Clark, M. S., & Shipley, S. (2016). The mental status examination. American Family Physician94(8), 635–641.

O’Keeffe, D. et al. (2018). ‘Recovery’ in the real world: Service user experiences of mental health service use and recommendations for change 20 years on from a first episode psychosis. Administration and Policy in Mental Health and Mental Health Services Research, 45,635–648.

Plana-Ripoll, O. et al. (2019). Exploring comorbidity within mental disorders among a Danish national population. JAMA Psychiatry, 76(3), 259–270. doi:10.1001/jamapsychiatry.2018.3658

Rocha Neto, H. G., Estellita-Lins, C. E., Lessa, J., & Cavalcanti, M. T. (2019). Mental state examination and its procedures-Narrative review of Brazilian descriptive psychopathology. Frontiers in Psychiatry10, 77. https://doi.org/10.3389/fpsyt.2019.00077

Rodrigues R. A. (2014). Contributions of nursing in elderly care. Revistalatino-americana de Enfermagem22(3), 353–354.https://doi.org/10.1590/0104-1169.0000.2423

Snoek, F. (2018). The challenge of treating comorbid mental health problems in patients with a somatic illness. The Lancet Psychiatry, 5(6). https://doi.org/10.1016/S2215-0366(18)30130-5

Younis, J. R., Mabrouk, S. M. & Kamal, F. F. (2015). Effect of the planned therapeutic communication skills of pediatric nurses. Journal of Nursing Education and Practice, 5(8), pp. 109. doi:10.5430/jnep.v5n8p109

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