Introduction To Mental Health

In this essay, I will be describing how I have been developing my understanding of Mental Health Nursing over the course of the module Introduction to Mental Health, by discussing the different topics I have been researching and learning throughout this module to achieve my level of understanding. The key points I will be discussing are, the history of mental health, the definition of mental health and illness, the roles and responsibilities of the Mental Health Nurse, the quality skills of the Mental Health Nurse, different models of mental health and illness, recovery, and the stepped care model.

I am developing an understanding of Mental Health Nursing within this module by learning what mental health and mental illness are defined as, the history of mental health , the diverse range of roles and responsibilities of the Mental Health Nurse and the qualities required to fulfil these roles effectively, the process of recovery that considers the variety of models of mental health and illness that are used to achieve individual recovery, and the stepped care delivery model.

The history of mental health began with the term keeper and attendants of the insane whose role it was to control and maintain the order of the inmates within the institutions that had been built to house them, to then the term nurse slowly being introduced. Asylums were then slowly becoming phased out largely due to overcrowding, with some of the patients being incarcerated due to lack of wealth or social status. Mental health then progressed to defining mental health as an actual illness, they then slowly started closing the institutes. As the institutes began to close, patients were then discharged back into the community, and home-based support was more widely introduced. (Nolan, 1993)

Mental illness is defined as a range of mental health conditions that may affect someone’s thoughts, emotions, moods and ability to relate to others and function daily. People with the same diagnosis will each have different experiences of the condition. (Bolton, 2008)

With consideration to the fact each individual may have a different experience of their condition, the recovery process for each person will vary, therefore the roles and responsibilities of the Mental Health Nurse will vary within the recovery process, as each individual has a different perception of what recovery may mean for them. The roles may be that of a carer, educator, custodian, therapist, advocate, role model, inspirer of hope, milieu manager, leader, researcher, assessor, advocate, supporter, listener, risk-taker or care coordinator. (Egan, 2010)

In order to fulfil these roles effectively, the Mental Health Nurse must have the professional quality skills to be able to assist within the recovery by having good listening skills, good communication, be professional, be understanding, show kindness, empathy, adaptability, sincerity, calmness, and the ability to think critically and creatively, good skills and knowledge, humour, to be a rational thinker, problem solver and many more. (Clifton et al., 2017)

The notion of recovery from mental health problems considers a variety of different models of mental health and illness, while some of these models don’t speak of recovery, they help us to better understand mental distress to aid in individual recovery.

The Humanistic model, that is also known as person-centred care, is where the practitioner works with the client to determine a better understanding of the issue, to help support the individual in finding what they believe the problem and solution maybe, rather than make assumptions of the individual. The person-centred approach is underpinned by the core values of empathy, unconditional positive regard and congruence (Clifton et al., 2017)

The Biopsychosocial model investigates the biological, cognitive, psychological and social factors that may have an impact on an individual’s wellbeing, such as physical health, metabolic disorders and emotions, coping skills and social skills, peer groups, interpersonal relationships, trauma, grief and perceptions. These factors highlight the effects all these interactions may have on an individual’s health and wellbeing, rather than assume only one factor may be the cause. (Clifton et al., 2017)

The Stress Diathesis model outlines that stress levels, and each individual’s level of ability to cope with stress, may contribute or cause mental illness, which explains why some people may be exposed to the same level of stress but react differently to those stressors, and it is the Mental Health Nurses responsibility to try and help them find better ways to manage and cope with these stresses to aid in the recovery process. (Zubin and Spring, 1977)

The main principles within the recovery process are hope, and the ability to learn to understand their condition to be able to take back control of their lives, whether that be building resilience or social inclusion such as finding local support groups to be able to flourish rather than merely survive. (Repper and Perkins, 2003)

In order to structure and deliver these models and principles within mental health, we use the stepped care model, this is a model of service delivery, this is a system of delivering the care to the patient using the least resources but with the maximum effect and reach to patients, with the main principles of delivering the best care with minimum impact on the individual, and detecting the need for more or less intensive treatment, allowing them to step up, step down or step out of treatment if an alternative treatment may be more beneficial for them, step up could be a referral from a primary care team to the secondary care team, with each successive step up process being a more intensive treatment, step down such as from speciality care team to a secondary care team or to step off to self-care, telephone appointments or social inclusion interventions. (Firth, Barkham and Kellett, 2015)

In conclusion, mental health has advanced significantly over the history of nursing to achieve a diverse range of professional support, particularly advances towards support within the community, and that mental illness is defined as a range of mental health conditions. That everyone’s experience of mental health conditions will differ, even with the same diagnosis. To be able to support and treat those mental health conditions, the Mental Health Nurse has a variety of roles and responsibilities to fulfil and have the right professional qualities to achieve support and recovery. Recovery is individual, each person has a different perception of what recovery means for them and the way to achieve this. Mental Health Nurses must apply a variety of models to mental health conditions and illnesses, that looks at a person centred approach, the biology of the individual and the stress vulnerability of the individual, to discover the impact that these may have on their wellbeing, to support them towards their recovery process, and be able to take back control of their lives. A service delivery model, the stepped care model, is used to direct an individual to the right level of care within healthcare, where they can step up, step down or step out of the intensity of the care, with minimal impact on their lives.

I will take this learning forward in my nursing practice by maintaining a person-centred approach, and by applying the models of mental health and illness to everyone I am supporting to be able to achieve the best outcomes of recovery, and by remembering that each person has a different perception of what term recovery may mean for them.

References

1. Bolton, D. (2008). What is Mental Disorder: An Essay in Philosophy, Science and Values. United States: Oxford Press, p.Chapter 1.
2. Clifton, A., Hemingway, S., Felton, A. and Stacey, G. (2017). Fundamentals of Mental Health Nursing. John Wiley & Sons, Incorporated, p.Chapter 1.
3. Clifton, A., Hemingway, S., Felton, A. and Stacey, G. (2017). Fundamentals of Mental Health Nursing. John Wiley & Sons, Incorporated, p.Chapter 3.
4. Egan, G. (2010). The Skilled Helper. 9th ed. Linda Schreiber: Cengage, p.chapter 1.
5. Firth, N., Barkham, M. and Kellett, S. (2015). The clinical effectiveness of stepped care sysyems. Journal of Affective Disorders, [online] (170), pp.119-130. Available at: http://www.elsevier.com/locate/jad
6. Medlineplus.gov. (2019). Mental Disorders: MedlinePlus. [online] Available at: https://medlineplus.gov/mentaldisorders.html
7. Nolan, P. (1993). A History of Mental Health Nursing. London: Stanley Thomas, pp.chapter 1, 1.2.
8. Repper, J. and Perkins, R. (2003). Social inclusion and recovery. Edinburgh: Baillière Tindall, pp.1-63.
9. Zubin, J. and Spring, B. (1977). Vulnerability- A new view of schizophrenia. Journal of Abnormal Psychology, 86(2), pp.103-126.
10. Linzi Morgan 1904643