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Question 1. Holistic Nursing Care in Mental Health

Theory of holistic nursing is a combination of knowledge of nursing along with the related theory and personal experience and intuition that helps in building better relationship with the patient that will help in faster healing and promoting goof health. The holistic approach of the nursing aims at faster healing and does not limit just to the treatment of the illness, rather focuses on the overall treatment and wellness. In a nutshell, Holistic Nursing Care is a connection between the body, mind, spirit, emotions, environment, and context, cultural and social relationship. This is an important aspect in the mental health that primarily focuses on the emotional and psychological wellness as the well-being of the entire body depend on the well-being of the mind. Nursing Care in Mental Health is more holistic as it really justifies the interlink between the body, mind, spirit, emotions, environment, and context, cultural and social relationship so that overall well-being of an individual can be achieved. Physical health just focuses on the healing of injury or getting rid of the physical pain but mental wellness is an overall being being of an individual (Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). It involves more focus and attention compared to other nursing discipline.

Question 2. Factors Contributing to Mental Illness

The statement that states that “mentally ill is a vulnerable population and are at a greater risk of developing physical illness and poor health outcomes” is fully justified as mental illness directly impacts the wellness of the entire body (Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). Mind and brain is the element that helps in governing and controlling the whole body and its functioning. Their wellness is much more impact for the overall wellness of an individual. Some of the factors that contributes to the Mental Illness includes,

  • Genetic or Inherited factors – The risk of occurrence of the mental illness is higher if any member of the family already suffering from mental illness. This is because of the inheritance or the passage of the genes that carry the genetic factor that induces the illness.
  • Drug and Alcohol Abuse – Access usage of the drugs induces the manic episode or the psychotic episode. This affects the mental activity.
  • Other Biological Factors – Any imbalance in the hormonal factors affects the stability of the brain thereby inducing mental illness. Change in the hormonal factors also induces the risk of instability of the brain.
  • Early Life Environment – Any kind of negative experience an individual might have encountered at the early childhood also induces mental illness. Even negligence in the care during the childhood affects the mental condition thereby leading to mental instability.
  • Trauma and Stress – Any kind of traumatic events in life like isolation from the society, any kind of domestic violence or breaking down of the relationship leads to many negative experiences in life leading to mental illness.
  • Personality Factors – Some of the personal traits like having the sense of perfectionism or lowering of the self-esteem increases the risk of anxiety and depression. This if not treated in long run would lead to mental instability.

Physical health assessment is an indication of the stability of the mental health (Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., ... & Whitley, R. (2014). If a person shows sudden change in the physical health like drastic weight loss or change in the health condition, clearly indicates the mental imbalance.

Question 3. Assessment of the Mental Health Condition

Mental health is one of the primary elements of an individual and the same should be taken care for overall well-being and wellness. Mind and brain is the element that helps in governing and controlling the whole body and its functioning. Their wellness is much more impact for the overall wellness of an individual. Although mental instability could be identified through the signs and symptoms in general yet there are conditions and cases where identifying the mental condition becomes really difficult and very challenging. This is case where the treatment becomes very difficult and challenging because the specification of the disease is not clear and thus defining the treatment becomes difficult. Diagnosis of exact cause or factor of mental illness is difficult and any delay in the identification would lead to serious outcomes. Most of the mental illness is associated with the sudden change in emotions and this affects the behavioral aspect of an individual. Any kind of negative experience an individual might have encountered at the early childhood also induces mental illness. Even negligence in the care during the childhood affects the mental condition thereby leading to mental instability. The risk of occurrence of the mental illness is higher if any member of the family already suffering from mental illness (Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., ... & Whitley, R. (2014). This is because of the inheritance or the passage of the genes that carry the genetic factor that induces the illness. Some of the personal traits like having the sense of perfectionism or lowering of the self-esteem increases the risk of anxiety and depression. This if not treated in long run would lead to mental instability. In case of Hillary where the exact identification of her mental condition is difficult, it is important that she should undergo certain medical assessment that would clarify her condition in a better and clear manner. Once certain change in the behavioral aspects is seen, it is important that the same should not be neglected and should be assessed for confirmation so that easy treatment could be established and initiated.

Question 4.

The primary job of the registered nurse having specialization in the mental health is to identify between a mentally ill person and a mentally disordered person. This clarification would help her in strategizing the type of care aimed for the patient. Post the above step, she needs to identify the intensity of the harm and the reasons that might lead to prolong or further deterioration of the mental health of the patient. She must also be sensitive while dealing with these kind of special cases as these patients lack mental stability and not aware of the thing going around them. Each patient with mental illness condition is having different medical requirement and if the same is not been handled effectively, might lead to conditions that could worsen their physical as well and emotional conditions. The registered nurses who are accountable of taking care of these patients should have basic required qualification but along with that they need special feature of reasoning and critical thinking so that they could act based on the situation and condition of the patient (Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). Mental wellness is a combination of various aspects including inter-generational dependence, subjective well-being, self-actualization, perceived self-efficacy, competence and autonomy. The realization abilities of an individual along with his ability to cope up with the general stresses of life and having a productive approach is some of the basic features of mental health. A combination or professional skills and practical; assistance would help in supporting Hilary and her family who desperately needs support to improve her mental health condition.

Question 5. Discussion on Sammy’s Schizophrenic Condition

Question 6. Co-morbidity Schizophrenia is a chronic mental disorder that is associated with hallucinations, delusions, issue with thinking and concentrating along with lacking motivation, etc. In this condition a person lose the ability to identify the difference between imagination and reality and is often characterized with lot of mental disturbances including change in personality and behavior. A Schizophrenic patient often experiences a mixture of positive and negative feelings. Role of a nurse in this setting is highly critical and important. Both medication and consultation is important for supporting patient for achieving overall health outcome. Each patient with mental illness condition is having different medical requirement and if the same is not been handled effectively, might lead to conditions that could worsen their physical as well and emotional conditions. Considering the case of Sammy who is diagnosed with Schizophrenia needs support of both medication and mental counseling. The two issues that Lucy needs to address is to analyze the level of the Schizophrenic condition he is facing and second is the most acceptable medication that would be effective for his heath condition. He is feeling highly demotivated and do not have the enthusiasm to even go the office and deal with people around. According to the NMC Code of Professional Conduct, both ethics and compliance are involved in dealing with the patient so as to provide both mental and physical stability to the patients. Psychotic patients are critical to deal with and needs lot of patience and perseverance. One has to keep their feet into their shoes to understand their situation and condition in a better way. Lucy can suggest for cognitive behavioral therapy that would help in recognizing the psychotic episodes periodically (Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). She can also incorporate supportive psychotherapy that will help in managing the episodes effectively and can help in reducing its severity. A psychological therapy like the cognitive therapy is another nursing intervention that would help in dealing with the situation in a better way. Distraction technique is yet another nursing intervention that would support Sammy to recover from his current Schizophrenic condition. In addition to all these, periodic counseling is also recommended for Sammy for attending sustainable recovery.

Effect on a Person’s Mental Health and Well-Being

When a person encounters or suffers with two or more disorder at a time or concurrently, the condition is known as comorbidity. It is also known as the existence of two or more medical conditions. In the current case, Dean is suffering from the mental illness along with intense addition to drinking. Comorbidity affects the fundamental condition of an individual along with affecting his priorities and desires. As a result, compulsive behavior is resulted wherein the ability of control on the body is lost. This if not treated in long run would lead to mental instability (Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). Each patient with mental illness condition is having different medical requirement and if the same is not been handled effectively, might lead to conditions that could worsen their physical as well and emotional conditions.

Some of the common methods that are used for treating comorbidity include,

  • Dialectical behavioral therapy (DBT) – This is designed in such a manner that the self-harming behavior of an individual is reduced like the thought of cutting, suicide attempt, etc.
  • Cognitive behavioral therapy (CBT) – It is a common approach that helps in treating the mental illness largely. It is utilized for monitoring the behavioral change in an individual suffering from mental illness. This is also applicable for the condition that Dean is facing.
  • Therapeutic communities (TC) – It is one of the option that is utilized for long-term treatment of mental illness including comorbidity. This residential treatment is used for “resocialization” of the person.
  • Assertive community treatment (ACT) – This is an approach that is having individualized approach and is outreach to the community.
  • Contingency management (CM) – This is the approach that helps in managing the behavioral aspects of the individual through following healthy practices.

Comorbidity affects the social and personal life of the people to a great extent and these needs to be addressed through one of more options that are listed above.

References

Dieleman, J. L., Baral, R., Birger, M., Bui, A. L., Bulchis, A., Chapin, A., ... & Lavado, R. (2016). US spending on personal health care and public health, 1996-2013. Jama, 316(24), 2627-2646.

Happell, B., & Gaskin, C. J. (2013). The attitudes of undergraduate nursing students towards mental health nursing: a systematic review. Journal of Clinical Nursing, 22(1-2), 148-158.

Leppien, E., Mulcahy, K., Demler, T. L., Trigoboff, E., & Opler, L. (2018). Effects of statins and cholesterol on patient aggression: is there a connection?. Innovations in clinical neuroscience, 15(3-4), 24.

Levett-Jones, T. (Ed.), (2013). Clinical reasoning: Learning to think like a nurse. Sydney, Australia: Pearson Education.

Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary & alternative therapies in nursing. Springer Publishing Company.

Orthwein, W. C. (2017). Psychiatric and mental health nursing: The craft of caring. CRC Press.

Roberts, M., Mogan, C., & Asare, J. B. (2014). An overview of Ghana’s mental health system: results from an assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS). International journal of mental health systems, 8(1), 16.

Robson, D., Haddad, M., Gray, R., & Gournay, K. (2013). Mental health nursing and physical health care: A cross‐sectional study of nurses' attitudes, practice, and perceived training needs for the physical health care of people with severe mental illness. International Journal of Mental Health Nursing, 22(5), 409-417.

Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G., ... & Whitley, R. (2014). Uses and abuses of recovery: implementing recovery‐oriented practices in mental health systems. World Psychiatry, 13(1), 12-20.

Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., ... & Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. The Lancet, 387(10023), 1123-1132.

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