Nrsg210 Mental Health Nursing: Case Assessment Answers

Answers:

1.

The wellbeing of Justin might be affected to a great extent by his recent life event especially stress and social exclusion. He had been suffering from clinical depression. He had been diagnosed with Type 2 Diabetes Mellitus. He feels sad and is directionless after leaving school. These feelings have intensified over the years and loss of a close person has left an impact on him. He do not have friends and constantly thinks about his future. He knows that his future is bleak and he has no opportunities for job. He knows that he might develop the complications of Type 2 Diabetes like his father. Studies have shown that people who have diabetes are at a greater risk of having depression than those who do not have depression. Diabetes is also the breeding ground for anxiousness and anger (American Diabetes Association, 2015). As Justin is suffering from diabetes, his depression that is caused by several other factors, is aggravated. Loneliness is the main cause of depression in people. If a person has friends and is sociable, he is not into depression. As Justin does not have any friends, his life is bound to be in depression and loneliness. Social wellbeing is affected by this. As his father has been suffering from Diabetes and is not being able to treat himself, Justin can be mentally affected as he does not see any hope of getting treated of Diabetes either. He has been suffering from weight loss. This can affect his health and he may become weak.

2.

The topic of mental health is in a large section of questions regarding cultural difference, social change, historical events and coping. There are different ways of defining and fostering the quality of life. There are also differences in determination, explanation and dealing of mental illness. Questions arise on the impact of social and cultural change affecting health and the interpretation of it (Parker, 2015). There are many cultural differences in such Aboriginal people that effect mental health. One such type of difference is the casual attribution biases. People understand events and the contingencies as external forces and causes. Some may think them to be internal attributes and having control over the life events.  Another difference that occur is the response to abnormality. Different notions of culture affecting mental health are also found (www.healthinfonet.ecu.edu.au, 2015). These attributes may be found in Justin in relation to mental health’s cultural interpretation. He may consider his mental illness as a result of external factors like loneliness and death of close person. 

3.

Attitudes and values tell the way how mental health related services and communication takes place. Every person has his own set of beliefs and values. The patients need to be heard with patience and treated with respect and dignity. They must have their privacy. Through communication, the patient as well as his family must be taken care of with full sympathy. Diversity among the patients with respect to religion, culture, gender and class must not affect the communication with the patient. Effective and full participation is needed towards the individual. The principles of health practise related to recovery of mental health have to be abided by. Through effective communication, positive and authentic relations must be fostered. Tensions arising in patients are one of the focuses of the person dealing with the patient these are to be resolved. Quality service care is provided by effective working relations. Attitudes shown to patients are the way of thinking and feeling. While interacting with the patient, positive attitudes are to be shown. It helps in taking care of all kind of situations that may arise from mental health conditions of the patient. Carer has to be respectful, ethical, professional, hopeful and encouraging (Health.gov.au, 2015). These beliefs and attitudes may influence communication with Justin.

4.

Effective partnership with patients prevent the patient from getting sicker and heal without going into further complications (Denham, 2015). Family members can also be made part of the caregiving team by building up partnership with them. It then becomes legitimised. Health professional have to give support and encouragement for achieving the objective of self-efficacy. Adequate education of the family members is needed for fulfilment of the goal.  Health care professionals have to consider the family as true partner in giving care and must consider themselves as educators rather than experts who teach the families to solve patient problems.  Families too can build up skills for problem solving. The way the professional are getting knowledge on this concept influences the outcome (Euromedinfo.eu, 2015). Patient himself can be an essential partner for improving the quality of life he is leading. Active participation is needed from the patient’s side. This can be incorporated by the carer by educating the patient. Robust and effective efforts are to be given by the carer to engage the patients in all aspects of patient care. Patients need to be handled with great care and sympathy in order to make them have faith in the health partnership. Patience needs to be maintained for achieving desired outcomes expected from patient and family partnership (Mezey, 2002).

5.

Certain points have to be looked after for ensuring culturally safe care for Justin when he is hospitalised. Health professionals must understand the background of the patient and the culture to which he belongs. There should be an understanding of cultural competencies, cultural awareness, cultural humility and cultural safety. They must understand that the patients may have some different perspective of culturally safe care. The carers must be aware of any ongoing debate that may be of importance to the patient. Acknowledging the role of the patient in treatment needs to be done and is seen as a good sign (Baunach et al., 2015). Unbiased health care services is the key to effective care for the patient. The professionals must try not to hurt the feeling and emotions of the patients with respect to their own believes and values. They must enquire about the patient’s use of any traditional medicine before taking any step against it. Also, personal thoughts and believes must not be imposed on the patients and proper justified explanations are to be given for any action taken that may go against the culture of the patient according to him (Douglas et al., 2014).

6.

Justin is suffering from depression and is concerned about the social withdrawal over a year. He is reluctant to speak and when he speaks he shares his thoughts about the death of his uncle. Assessment stated that he was not in the risk for alcohol and drug use but was in risk for emotional wellbeing. The main area of concern is depression.  This needs to be treated with proper care plan. A young person may have depression due to various factors. The impact of it is in the way he behaves and leads in life. It may cause difficulties at home as well as in relations with others. There may be other factors that cause decline in the mental condition, like any disease. Together, they can affect the person’s life. Suicide is the thought coming to many people’s mind. If the illness continues for long, more harm will be created and it is likely that treatment at later stages will not be very effective (Thapar et al., 2012). So the main area of focus and concern for Justin’s care plan has to be depression.

7.

Different strategies allow health professional to talk to the patient in a culturally safe manner. The help from traditional healer can be a relief to the patient and he may feel safe. Also, identification of resources that are culturally safe to the patient and reflection of this thought in communication is very effective in proper communication. Sympathy and patience is needed to make a patient feel culturally safe (Baker and Giles, 2012). The cultural believes are to be identified and respected in order to gain the patient’s faith on the health care professional. Cultural sensitivity is to be applied in communication. Through communication, a mutual respect, willingness to listen and openness needs to be imparted. Shared understanding along with acknowledgment of the typical identity of patients makes the patient feel safe. Through the communication the healthcare professional must reflect that he is familiar with the values, belief and history of the ethnic groups.  There must be no assault, denial of the patient’s identity or any challenge (Skellett, 2015). These strategies are applied by the health care professional for talking to Justin in culturally safe manner.

8.

Significant measures are to be taken for providing Justin with support for maintaining his well-being after he returns to the community.  The family must facilitate his re-engagement with certain culture laws. For long term treatment of the patient’s condition, the family must get involved and it is their duty to make necessary decisions. Help and emotional support from family forms the basis for effective care plan for mental patients (Hermann and Palmer, 2002). Love and sympathy is what they need. This driving force for enhancing the wellbeing usually comes from the family who are the closest to the patient (Leggatt, 2002). Also, for proper management and treatment of depression, the problems causing such depression needs to be solved. Justin is socially separated and does not have any friends. He must be encouraged to be socially active and make new friends. Unemployment is a vital cause for his depression. Help can be extended for finding a suitable job for him. If his problems are resolved, he will be able to get back a healthy life devoid of depression.   

9.

I would like to reflect on my experience I had with Justin and what I learnt from them. This experience gave me knowledge on how to communicate and treat people coming from different cultural background. Healthcare professional face numerous problems while providing care to patients who have different ailments as their values and believes often differ from that of the health care professional (Elwyn et al., 2014). I have learnt that health care can be considered as a very complex issue, especially if it is a mental problem in the patient. Cultural and language barriers can complicate the situation further. Health care professional need to lay emphasis on the cultural backgrounds of the patient before taking any further step in effective care planning. Communication with the patient is crucial and I have learnt this vital matter from my experience. If the patient is safe and feels comfortable with the health care professional, he will be able to recover soon. I will try to keep this point in mind and will implement this in my future practices. Another important aspect that I learnt was that different ethnic groups have different principles related to health care. Along with modern medicines, they rely on their traditional healers for wellbeing. The patient must not be hurt on this ground and respect and dignity of the patient must be maintained. All the aspects that I have learnt from my experience with Justin will help me immensely in the future.  

10.

Some additional aspects are needed for learning in order to provide culturally safe healthcare in future. People who need culturally safe health services are to be given care earlier in course of the mental illness. They must be taken into ease and must be empowered. Details of healthcare are to be shared with them. It is to be understood that cultural safety makes a critical component of appropriate patient outcome. Learning of different cultures and peoples would lead to cultural safety. Proper knowledge has to be gained in this regard. Methods are to be implemented for adherence to intervention plan by the patient and it will only take place if the patient finds culturally safe environment. One fundamental point of culturally safe care is the disadvantages given to recipients by the imposition of own cultural beliefs acknowledged by the health carer. Meaningful pathways are to be provided for self-determination of the patients (Richardson and Williams, 2007). All these points are to be learnt for giving a culturally safe environment for patients in the future.

References:

American Diabetes Association, (2015). Mental Health. [online] Available at: https://www.diabetes.org/living-with-diabetes/complications/mental-health/?referrer=https://www.google.co.in/ [Accessed 2 Sep. 2015].

Baker, A. and Giles, A. (2012). Main content area Cultural Safety: A Framework for Interactions between Aboriginal Patients and Canadian Family Medicine Practitioners. Journal of Aboriginal Health, 9(1), pp.15-22.

Baunach, E., Lines, D., Pedwel, B., Lange, F., Cooney, R. and Taylor, H. (2015). Aboriginal and Islander Health Worker Journal - The development of culturally safe and relevant health promotion resources for effective trachoma elimination in remote aboriginal communities (Indigenous Collection) - Informit. Aboriginal and Islander Health Worker Journal, [online] 36(2), p.9. Available at: https://search.informit.com.au/documentSummary;dn=851236900698958;res=IELIND [Accessed 3 Sep. 2015].

Denham, C. (2015). Partnership with Patients. [online] Safetyleaders.org. Available at: https://www.safetyleaders.org/partnershipWithPatients/ [Accessed 3 Sep. 2015].

Douglas, M., Rosenkoetter, M., Pacquiao, D., Callister, L. and Purnell, L. (2014). Guidelines for Implementing Culturally Competent Nursing Care. [online] Available at: https://tcn.sagepub.com/content/early/2014/02/14/1043659614520998.extract [Accessed 3 Sep. 2015].

Elwyn, G., Dehlendorf, C., Epstein, R., Marrin, K., White, J. and Frosch, D. (2014). Shared Decision Making and Motivational Interviewing: Achieving Patient-Centered Care Across the Spectrum of Health Care Problems. The Annals of Family Medicine, 12(3), pp.270-275.

Euromedinfo.eu, (2015). Developing a partnership with the family. [online] Available at: https://www.euromedinfo.eu/developing-a-partnership-with-the-family.html/ [Accessed 3 Sep. 2015].

Health.gov.au, (2015). Department of Health | Part 2: Values and attitudes. [online] Available at: https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-wkstd13-toc~mental-pubs-n-wkstd13-2 [Accessed 3 Sep. 2015].

Hermann, R. and Palmer, H. (2002). Common Ground: A Framework for Selecting Core Quality Measures for Mental Health and Substance Abuse Care: Psychiatric Services: Vol 53, No 3.Psychiatric Services, [online] 53(3), pp.281-287. Available at: https://ps.psychiatryonline.org/doi/10.1176/appi.ps.53.3.281 [Accessed 3 Sep. 2015].

Leggatt, M. (2002). Families and mental health workers: the need for partnership. World Psychiatry, 1(1), pp.52-54.

Mezey, M. (2002). Ethical patient care. Baltimore: Johns Hopkins University Press.

Parker, R. (2015). [online] Available at: https://www.nt.gov.au/lant/parliamentary-business/committees/ctc/youth-suicides/Submissions/Sub%20No.%2008,%20Robert%20Parker,%20Top%20End%20Mental%20Health,%20Part%202,%2029%20Sept%202011.pdf [Accessed 3 Sep. 2015].

Richardson, S. and Williams, T. (2007). Why is cultural safety essential in health care?. Med Law, 24(6), pp.699-707.

Skellett, L. (2015). Cultural awareness and cultural safety. [online] www.psa.org.au. Available at: https://www.psa.org.au/download/Cultural%20awareness%20and%20cultural%20safety.pdf [Accessed 3 Sep. 2015].

Thapar, A., Collishaw, S., Pine, D. and Thapar, A. (2012). Depression in adolescence. The Lancet, 379(9820), pp.1056–1067.

www.healthinfonet.ecu.edu.au, (2015). [online] Available at: https://www.healthinfonet.ecu.edu.au/uploads/resources/10270_reser_chapter-6_pg_218-291.pdf [Accessed 2 Sep. 2015].