Mental Health Nursing

Question:

Write an essay on Mental Health Nursing.

Answer:

Mental health nursing is a crucial part of nursing profession. It is because nurses have to deal every patient with having a unique problem. Therefore, mental health professionals should have appropriate skills and knowledge about dealing and working with different, unique vulnerable group of psychiatric patients. In this context, here the age group which would be discussed is the age group within 20-40 years, adult people who are able to be included in the community and social works. However, while having mental illness, it becomes difficult to include people of this age group to be included in the community (Bird et al., 2014). Therefore, national and state government should focus upon undertaking some strategies which would be helpful for mental health patients belonging from the mentioned age group to be included in the community work. 

In addition, the mental health illness also enhances the health care cost as most of the mental health treatments take long period of recovery. However, recovery is an important aspect in the case of mental health people. The young people and middle age people experience different mental health conditions. Addressing these mental health conditions and providing adequate care for eliminating those symptoms is very important for including these people in the community. From the annual health report, it has been revealed that in 2012-2013, one in six New Zealand adult has been diagnosed to have a common mental disorder at a stage of their life cycle. 16% or 582000 adults were diagnosed to experience mental disorder (Schmied et al., 2013). In this context, they revealed that it has been found that women are more likely to suffer from mental health problems. Mental health disorders have been found to be the third leading cause of health loss in New Zealand. The main mental health disorders include anxiety, depression, alcohol abuse and schizophrenia. This assignment would discuss a recovery model for will being of these people and its impact. The initiatives undertaken by New Zealand for encouraging inclusion of psychiatric patient and the role of nurse in facilitating recovery and social inclusion would be discussed (Kidd, Kenny & McKinstry, 2014).

Barriers for inclusion of adult mental health patient into the community

The social inclusion refers to the inclusion of a person who is healthy and fit, both physically and mentally, in the social work. Including mentally or physically unfit people in the social work can have negative outcomes which might affect the well being of the entire community. Thus, the concept of social inclusion is very much important to be understood. In New Zealand, adults with mental health problems are said to be a significant group that is excluded from the society.  However, social exclusion affects person’s ability to function and enjoy in community and explore their abilities for staying well (Bowen, 2013).

There are a number of barriers against the social inclusion of adults with mental disorders. Stigma and discrimination against people with mental health problems is persistent through the society. Many people fear to disclose their condition to others due to discrimination. Organizations are likely to exclude people with mental disorder to the fear of their low productivity and conflicts in office premises. Another barrier of social inclusion of mental patients is lack of clear responsibility to promote vocational and social outcomes for the people with mental health problems. Another barrier is lack of ongoing support for enabling mentally disordered adults to work. Sometimes, people receiving benefits; believe that they will end up financially better off if they attempt to go for work (McAndrew et al., 2014). Barriers also include struggling for access of basic services including housing and transport. Sometimes, education, sports, arts and leisure providers are unaware of benefits of their services to the people with mental health disorder and how these services could be more accessible to that group. Social exclusion is multi dimensional and it affects different domains of people’s life including poor housing, isolation and low income. On the other hand, social inclusion is dynamic where the participation of people varies over time. Other barriers of social inclusion of this age group mental health patient include effect of mental impairment, lack of support and self-stigma prejudices (Kidd, Kenny & McKinstry, 2015). 

Social inclusion of these people in the community also has several benefits. Social inclusion of mentally disable adult can give the person a financial and emotional support which might promote the mental and physical wellbeing of the people. Social inclusion give the person the opportunity to engage or participate in different aspects of life which would be agreed by the society as significant factor for the person’s happiness, well being and improve quality of life. Social inclusion give them the opportunity to have their rights of citizenship through the right based approaches of social inclusion which helps people from this group to think that they are also valuable for the society, thereby enhancing their self-esteem and promoting well being (Stuart, 2014). 

Recovery model and its impacts on person’s wellbeing

The Tidal model of recovery has been selected for discussing the mental health promotion. This mental health recovery model was established by Professor Phil Barker, poppy Buchanan-Barker and their colleagues. The model concentrates upon the simultaneous process of change inherent in people (Happell et al., 2014). This model attempts to empower people with mental problem to lead their self-recovery in spite of being directed by the mental health professionals. This mid-range theory of nursing focuses upon helping individual and making their own voyage of discovery. The core philosophical metaphor of this model has been drawn from the chaos theory, “the unpredictable, yet bounded nature of human behavior and experience is compared to the dynamic flow and power of water and tides of the sea” (Sklar et al., 2013). The model includes six key philosophical assumptions. 

1. A belief in the virtue of curiosity

2. Respect towards people’s wishes in spite of being paternalistic

3. Identification of the power of resourcefulness in spite of concentrating upon deficit, issues or weaknesses

4. Acceptance of crisis paradox as the opportunity

5. Acknowledgement of goals belonging to the person

6. The virtue of following elegance- the simplest way should be required

The process of mentally disable people’s engagement occurs in three different domains. With the help of this model, the mental health practitioners’ uses these dimensions for being aware of the situation and to decide what should be done now. In the self domain, people feel their experience world. The mental health practitioners emphasize on giving a secure environment feeling and develop a Security plan for the people to decrease threats to people. In another domain, the world domain, people hold their story. The model is used in a specific form of inquiry for exploring the story in a collaborative manner, thereby revealing the hidden meaning, participant’s resources and to characterize what should be done for assisting his recovery. Others domain symbolize other relationships of the person along with other members of the health care team assisting the person (Slade et al., 2014). 

The model includes ten commitments. These are:

Value the voice

Respect the language

Reveal personal wisdom

Develop genuine curiosity

Be transparent

Become the apprentice

Use the available toolkit

Give the gift of time

Craft the step beyond

Know that change is constant

These commitments of the Tidal model depict the fact that nurses should concentrate upon the exact and specific needs of the people, thereby emphasizing on “doing what should be done”, thereby helping to avoid encouraging dependence. To become a successful health care practitioner following and implementing the Tidal model, they should have twenty competencies. In 2000, this tidal model was first implemented in Newcastle in an adult mental health program involving nine acute admission wards. Around 100 different Tidal model projects were developed in different nations and adopted broadly (Janca et al., 2015). The model uses the power of metaphor and seeks to reveal the meaning of patient’s experiences, thereby emphasizing the significance of their voice and wisdom. 

The use of Tidal model in the recovery of mentally disable people showed positive impact upon the recovery of the patient. The implementation of this model showed that nursing as ‘caring with’ approach enhanced the development of partnership within client and care giver. With the application of tidal model of recovery, the mentally disable people can learn to value their voice and can enhance their self-esteem which would encourage them to participate in the social work and be able to play their social roles, thereby leading to social inclusion (Hepworth & McGowan, 2013). 

Initiatives or strategies of New Zealand for encouraging inclusion for consumers

Social inclusion includes people’s journey to recovery and in broader concept, it focuses to challenge the societal norms by removing barriers for part6icipation in community. In New Zealand, social inclusion and participation are the key terms characterizing the New Zealand government’s approach for improving the status of social disadvantage and poverty (Hennessy & Hughes, 2014). The New Zealand government has developed a social inclusion and participation work group (SIP) and the major function of this group is to monitor a number of key policies and portfolio areas. These areas include the officer for the community and voluntary sector, the officer for disability issues, the officer for senior citizens and the GLBTI policy team (Clement et al., 2015). The current government priorities include the economic transformation balancing social and economic policy, ensuring that young and old people are able to access security processes and gain the opportunity to reach their full potential and establishing a strong sense of pride and national identity. The SIP team has undertaken all their activities according to this theme. In addition, the New Zealand government has adopted the pragmatic approach for improving social outcomes in spite of theory driven rationale for their policies and interventions related to the social inclusion of people (Happell et al., 2014).  

The Government has undertaken a holistic approach for taking in the overall level and distribution of well being in society for ensuring that:

All mentally disable people would have opportunities to develop their potential

All people would gain a basic level of well being including disadvantage reduction

Social well being is improving on an average while compared to other developing countries 

New Zealand society is cohesive as a whole and expresses a unique national identity

The outcomes between groups has a similar distribution

A comprehensive society is endorsed by the New Zealand Positive Ageing Strategy, the New Zealand disability strategy, the Youth Development Strategy Aotearoa and New Zealand’s Agenda for Children, and their associated activities. In 2004, $62 m through four years has been provided by the government for assisting the incorporation of current refugees, migrants and their relatives in the community. It has been found that mental health disorder is more in migrants than in the non migrants, thus this policy is significant for improving the status. Sometimes, language becomes the barrier for social inclusion; the “Language Line” telephone represents 35 different languages as the agent of 6 government agencies (Storm & Edwards, 2013). In addition, to explore creative domain in the mental disable people for encouraging them, the government promoted the local participation in arts through Creative Communities Scheme within creative New Zealand and 74 other local authorities which permits the participation of clients from health, justice, disability or social service sector for creating art and learn about how to integrate within the community positively (Manuel & Crowe, 2014). The Physical Activity Planning Service which has been made by the partnership within the New Zealand recreation Association and Sport and recreation New Zealand, gives the specialized planning actions for the people with mental or physical disabilities to the territorial local authorities. All of these activities encourages the social inclusion and enhance recovery of mentally disable adults.

Evaluation of nurse’s role to facilitate recovery and social inclusion of clients

The mental health nurses should support people to contribute positively to their community and it is the key role of the mental health nurse to understand what are the services by which the care user feels satisfied and what are the needs of individual. The nurses should be able to relate patient’s social needs with the treatment needs and thereby undertaking a holistic program for fulfilling patient’s needs. Nurses shave to follow the twenty competencies provided in the tidal model of recovery. It would help them to understand how to support mentally disable adults for encouraging them in social inclusion. One of the crucial aspects of nurse’s role is to believe in the capacity of people to recover, patient’s ability to make choices and ability to achieve goals set for them. At the same time, based on the Tidal recovery model, they should encourage the care users to enhance their self esteem and understand how to manage themselves by their own without the assistance of the care giver (Robson et al., 2013). It would help to promote the recovery process. In addition, the mental health nurse should go out into the community for gaining intimate knowledge about the available networks and resource with the community groups facilitating education, employment along with the leisure activities. While dealing with mentally disable adults, the nurses should support their autonomy and rights in their person-centered care intervention which would help them to establish a partnership within service providers and service users, thereby promoting faster well being and recovery of the individual which would promote social inclusion further (Swain, Gale & Greenwood2014). 

Conclusion

Recovery models are very helpful to evaluate the outcomes of treatments of mentally disable patients. These recovery models have guided the mental health nurses and other professionals to help patients in the right way for their recovery. This essay included the impact of Tidal recovery model upon patient’s health and well being.  It has been revealed that, mental health illness is such a problem which not only affects the patient’s physical and mental status, rather it also affects family and social involvement of the patient and their family. In this context, this essay has been focused upon exploring the barriers and opportunities of the adult people having mental health problem in New Zealand and the initiative strategies and policies undertaken by the New Zealand government to enhance the social inclusion of this group of people. Social inclusion of mentally disable adults is a key initiative of New Zealand government and it has been shown significant positive results. After discussing the recovery model of mental disability and social inclusion along with the initiatives of New Zealand government about social inclusion of mental health people, the role of nurse for promoting recovery and social inclusion of mentallydisable people in the community of New Zealand.

Reference List

Bird, V., Leamy, M., Tew, J., Le Boutillier, C., Williams, J., & Slade, M. (2014). Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers. Australian and New Zealand journal of psychiatry, 0004867413520046.

Bowen, M. (2013). Borderline personality disorder: clinicians’ accounts of good practice. Journal of psychiatric and mental health nursing, 20(6), 491-498.

Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., … & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological medicine, 45(01), 11-27.

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.

Happell, B., Scott, D., Platania‐Phung, C., & Nankivell, J. (2012). Should we or shouldn’t we? Mental health nurses’ views on physical health care of mental health consumers. International journal of mental health nursing,21(3), 202-210.

Happell, B., Stanton, R., Hoey, W., & Scott, D. (2014). Cardiometabolic health nursing to improve health and primary care access in community mental health consumers: Protocol for a randomised controlled trial.International journal of nursing studies, 51(2), 236-242.

Hennessy, J. L., & Hughes, F. (2014). Appreciative inquiry: A research tool for mental health services. Journal of psychosocial nursing and mental health services, 52(6), 34-40.

Hepworth, I., & McGowan, L. (2013). Do mental health professionals enquire about childhood sexual abuse during routine mental health assessment in acute mental health settings? A substantive literature review. Journal of psychiatric and mental health nursing, 20(6), 473-483.

Janca, A., Lillee, A., Sng, A., & Cooper, J. (2015). Continuity of Life Interview: Development and Evaluation of a Novel Instrument for the Assessment of Recovery from Mental Illness. International Journal of Person Centered Medicine, 4(4), 239-243.

Kidd, S., Kenny, A., & McKinstry, C. (2014). From experience to action in recovery-oriented mental health practice: A first person inquiry. Action Research, 12(4), 357-373.

Kidd, S., Kenny, A., & McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of advanced nursing, 71(1), 181-192.

Manuel, J., & Crowe, M. (2014). Clinical responsibility, accountability, and risk aversion in mental health nursing: A descriptive, qualitative study.International journal of mental health nursing, 23(4), 336-343.

McAndrew, S., Chambers, M., Nolan, F., Thomas, B., & Watts, P. (2014). Measuring the evidence: Reviewing the literature of the measurement of therapeutic engagement in acute mental health inpatient wards. International journal of mental health nursing, 23(3), 212-220.

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.

Schmied, V., Johnson, M., Naidoo, N., Austin, M. P., Matthey, S., Kemp, L., … & Yeo, A. (2013). Maternal mental health in Australia and New Zealand: A review of longitudinal studies. Women and Birth, 26(3), 167-178.

Sklar, M., Groessl, E. J., O’Connell, M., Davidson, L., & Aarons, G. A. (2013). Instruments for measuring mental health recovery: a systematic review. Clinical psychology review, 33(8), 1082-1095.

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.

Storm, M., & Edwards, A. (2013). Models of user involvement in the mental health context: intentions and implementation challenges. Psychiatric Quarterly, 84(3), 313-327.

Stuart, G. W. (2014). Principles and practice of psychiatric nursing. Elsevier Health Sciences.

Swain, N., Gale, C., & Greenwood, R. (2014). Patient aggression experienced by staff in a New Zealand public hospital setting. The New Zealand Medical Journal (Online), 127(1394).

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