Mental Health Act or Mental Capacity

Discuss about the Mental Health Act or Mental Capacity.

Depression and suicide are one of the most common causes of high mortality rates worldwide. It has been found that depression is the third highest reason for the burden of different types of diseases prevalent in Australia, i.e., about 13.3% and also globally. Depression is found to have a high prevalence throughout the life and about one in seven individuals will experience this disease in their lifetime in Australia. As  per The World Health Organisation estimation, depression will be the utmost concern of health in both the developing and countries by 2030 (“Facts and figures about mental health and mood disorders”, 2012). According to the National Survey of Mental Health and Wellbeing, 2007, around 3 million of total Australians are having anxiety or depression. On an average, males are more prone to have depression in comparison females with about 1 in 5 females and about 1 in 8 males will experience depression to some extent in his/her lifetime. Further, as per the survey only around 35 % of the Australians having depression or anxiety access the proper treatment. Further, it is observed that about 1 million of the adults in Australia have depression and on an average, it is estimated that 1 in 6 Australian will experience depression in his/her lifetime. The long-standing studies have suggested that one in five adolescent is prone to experience depression till they attain 18 years of age. Depression is observed to affect the young people more and about one in seven youngsters between the age 16 and 24 are found to experience depression each year (“beyondblue Depression and Anxiety”, 2016). Moreover, suicide is also found to be the prominent health concern and in the past five years from the year 2010 to 2014, the average deaths due to suicide were 2,577 every year. The age group that was found to be at peak for suicide was 85 plus age group in the males and 35-39 years in the case of females. Studies have shown that suicide rate is more common amongst men as compared to the women, with about 2.8% of suicide deaths in men and about 0.9% of suicide in women in the year 2014. Individuals having a previous history of suicidal attempts are at a greater risk of suicide. Moreover, the mental conditions like psychotic illness and depression increase the risk of suicide.  Individuals having substance or drug abuse are also at an increased risk of suicide attempt. The other specific risk groups for depression and suicide are individuals belonging to the LGBT community and Aboriginal Torres Strait Islanders (“Facts and figures about mental health and mood disorders”, 2012). However, in comparison to the deaths due to suicide, where men rates were markedly higher in comparison to the women rates, women were found to have higher rates of hospitalization, because of intentional self-harm in comparison to men across almost all the age groups (“Suicide and hospitalised self-harm in Australia”, 2014). Further, in the case of depression also males were found less likely seeking help in comparison to females, with about 1 in 4 males who experienced depression or anxiety accessing treatment (“Facts and figures about mental health and mood disorders”, 2012).

Sol 2: Mr. Edward, a 62-year-old male, is referred by his GP because of his mental health condition and risks of self-harming. The basic factors that have led to the presentation of the client and his mental health concerns and risks are the number of life events that have made him vulnerable towards the development of the mental health problems (Alaszewski, 2013). As his past social history reveals that he was unable to attend the funeral of his father and his mother, he always felt guilty and distressed about it. As Edward was unable to cope up with this stressor and has not adapted himself to this stress, it led to the development of psychiatric symptoms. Moreover, the recent death of his youngest son 15 months ago contributed to the development of mental health problems. Since his youngest son has died, Edward has a feeling that his family is not as close as it used to be, which makes him sad and tearful. Edward feels depressed after his youngest son death and didn’t want to go to his farm and work as he used to do earlier. Moreover, as his elder son also moved to Sydney, there is no one in the family to look after his work as he feels tired for the past few months and is not able to give sufficient time and energy that is required. Due to these reasons, he also incurred a loss in his business. All these events in his life in the past few months have affected Edward mentally and he has lost any kind of hope for future. The inability of Edward to adapt to these challenging and stressful incidences led to his current mental conditions and hence is presented in the clinic. The thoughts of self-harming and suicide, state of being depressed and distressed all the time are the main reasons why his GP has referred to the clinic. His past life events of staying away from his family and not able to attend the funeral of his father and mother have always been distressful for him.  Moreover, the recent death of his youngest son exacerbated his mental health condition.

Sol 3: A therapeutic relationship between the health practitioner and the patient is the one that enables nurses and health practitioners to apply their skills, professional knowledge, experiences, and abilities towards meeting the goals and health requirements of the patient. This therapeutic relationship is goal-oriented, dynamic, and patient-centered as it is designed and developed to meet the requirements of the patient (Stromberg, Backlund, Johansson, & Lofvander, 2013). Irrespective of the length or context of the interaction, the therapeutic relationship existing between the nurse and the client patient should always protect the client’s dignity, privacy, and autonomy and should focus on the development of respect and trust. However, confidentiality is the major area that is surrounded by the ethical issues. The health practitioner should safeguard the confidentiality and privacy of the patient within the norms of the law. The term confidentiality includes the ethical duty of the health practitioner not to disclose any kind of information related to the patient without his/her prior consent or authorization. Hence, the ethical issue that can arise in the above scenario is the maintenance of the confidentiality of the client. To discuss the case of Edward with any other person or a member of the department without his prior consent is against the rule of ethics and can raise an ethical dilemma (McElroy, 2011). The mental health act establishes the substitute framework for decision making for the individuals having mental illness and who due to their illness are incapable of making own assessment, as well as, treatment decisions but at the same time requires treatment and care plan to prevent any kind of harm to the safety of their own health or safety of others (Jones, 2014). However, various legal issues can arise during the provision of care and treatment plan in case of the mental health disorder. One of the legal issues that may arise in the case scenario is the failure to protect the client’s safety (Flaskerud, 2012). As client admits having suicidal ideation, there are chances that the patient may harm himself or can attempt to suicide. Hence, the main duty, in this case, is to provide a safe environment to the patient and legal concept can arise if the patient is not left safely in the hands of other health practitioners by the nurse before discontinuing the treatment (Canady, 2015).

Sol 4: Mental well-being is necessary to make an integral part of the individual’s life and his/her capacity of leading a fulfilling life, involving the individual’s ability to develop relationships, work, study, pursue leisure activities or interests, and to in decision making and to make day-to-day choices. Risks to the mental health of an individual manifest at all the stages of life. Individual having a mental disorder tends to have the set of risks and vulnerabilities, involving increased chances of experiencing premature mortality and disability, discrimination and stigma, social exclusion, as well as, impoverishment (“Risks To Mental Health: An Overview Of Vulnerabilities And Risk Factors”, 2012). Hence, in the above case scenario, the biggest nursing concern is the mental health status of the client and the associated risks with his mental condition. The potential risk in the client is social isolation as he does not feel like going to work and feels depressed all the time. Feelings of isolation are also the potential risk that can occur due to the death of his youngest son and because of having a feeling that his family is not as close as it used to be. The other potential risk that can develop due to his mental condition is impoverishment that can occur due to the difficulties of the client to maintain his work and income properly. Moreover, the major concern linked with the client’s mental health is the chances of the client to get involve in the fatal events like self-harming or suicide (Ojio, Nishida, Shimodera, Togo, & Sasaki, 2016). As disturbances to the client mental well-being could adversely compromise his choices and capacities, causing not only the decreased functioning and activity  at the individual level but can also lead to the welfare losses both at the societal and household level, thus considering these as the major concerns (“Risks To Mental Health: An Overview Of Vulnerabilities And Risk Factors”, 2012).

Sol 5: Since the number of risks associated with the mental health is very large, responses to overcome them requires to be multi-sectoral and multi-layered. Broad strategies that may be involved in dealing with mental disorder consists of nurturing the core attributes in the individual like resilience and self-esteem, early recognition, as well as, prevention of behavioral and emotional problems, provision of working and living conditions that allows self-determination and psychosocial development especially amongst the vulnerable individuals, promoting positive interactions and thoughts within and between the different social groups, promotion of the opportunities, rights, and care of persons having mental disorders (“Risks To Mental Health: An Overview Of Vulnerabilities And Risk Factors”, 2012). As the physical safety of the patient is the main priority, the nursing interventions will include determination of the appropriate level of precautions and preventive measures of suicide for the client. As the client is the participant in his own care, so the intervention will include the explanation of the suicide precautions to the patient. The nursing intervention will also include a close observation of the client’s mood and any changes in his moods will be recorded and reported as the risk of suicide increases with the change in the moods (Dallas, 2015). Moreover, as the patient states that he has ruminating thoughts of suicide, assessment of his behavior can help in the determination of any kind of unusual behavior, which may help in the identification of the times of having increased risk for suicidal ideation (Whiteside, 2014). As the client feels depressed most of the times and has lost hope for future, there is a requirement of the development of skills in the clients which can help him to replace the  self-destructive attitude and behavior is having. Hence, the nursing intervention will be focused on providing the opportunities for the client in order to express his emotions, as well as, to release his tension in the most non–self-destructive ways like discussions, physical exercise, and participation in the recreational activities (Kok, Bockting, Burger, Smit, & Riper, 2014). To treat his mental health condition, the nursing intervention will focus on involving the client to a greater extent in planning his own treatment as participating in his treatment and care plan could help increase his sense of control and responsibility. Further, the client will be encouraged to express his feelings as expressing the feelings may help him to identify, accept, as well as, work through his feelings, even if the feelings are painful or uncomfortable (Schultz & Videbeck, 2013).

References

Alaszewski, A. (2013). Vulnerablity and risk across the life course. Health, Risk & Society, 15(5), 381-389.

beyondblue Depression and Anxiety. (2016). Beyondblue.org.au. Retrieved 22 August 2016, from https://www.beyondblue.org.au/about-us/research-projects/statistics-and-references

Canady, V. (2015). HHS awards Excellence in Mental Health Act planning grants to 24 states. Mental Health Weekly, 25(41), 4-4.

Dallas, H. (2015). How to deal with difficult patients. Dental Nursing, 11(2), 85-87.

Facts and figures about mental health and mood disorders. (2012). Retrieved 22 August 2016, fromhttp://www.blackdoginstitute.org.au/docs/Factsandfiguresaboutmentalhealthandmooddisorders.pdf

Facts and stats about suicide in Australia. (2014). Mindframe-media.info. Retrieved 22 August 2016, from http://www.mindframe-media.info/for-media/reporting-suicide/facts-and-stats

Flaskerud, J. (2012). Mental Health Care and Health Literacy. Issues In Mental Health Nursing, 33(3), 196-198.

Jones, R. (2014). Deprivations of Liberty: Mental Health Act or Mental Capacity Act?. IJMHCL, 1(16), 170.

Kok, G., Bockting, C., Burger, H., Smit, F., & Riper, H. (2014). Mobile Cognitive Therapy: Adherence and acceptability of an online intervention in remitted recurrently depressed patients. Internet Interventions, 1(2), 65-73.

McElroy, A. (2011). Fundamental Aspects of Legal, Ethical and Professional Issues in Nursing – Second editionFundamental Aspects of Legal, Ethical and Professional Issues in Nursing – Second edition. Nursing Standard, 25(42), 28-28.

Ojio, Y., Nishida, A., Shimodera, S., Togo, F., & Sasaki, T. (2016). Sleep Duration Associated with the Lowest Risk of Depression/Anxiety in Adolescents. SLEEP, 39(08), 1555-1562.

Risks to mental health: an overview of vulnerabilities and risk factors. (2012).World Health Organization. Retrieved 22 August 2016, from http://www.who.int/mental_health/mhgap/risks_to_mental_health_EN_27_08_12.pdf

Schultz, J. & Videbeck, S. (2013). Lippincott’s manual of psychiatric nursing care plans. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.

Stromberg, R., Backlund, L., Johansson, S., & Lofvander, M. (2013). Mortality in depressed and non-depressed primary care Swedish patients: a 12-year follow-up cohort study. Family Practice, 30(5), 514-519.

Suicide and hospitalised self-harm in Australia. (2014). Aihw.gov.au. Retrieved 22 August 2016, from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549727

Whiteside, U. (2014). Online Cognitive Behavioral Therapy for Depressed Primary Care Patients: A Pilot Feasibility Project. Permj, 18(2), 21-27.

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