Hallucinations are types of sensory experiences appearing to be true and indeed are not. People suffering from hallucinations creates such experiences that appear to be real but are born in their minds and affects senses and false perceptions of sensory responses (Pardede, 2019). There are growing needs for mental health nurses and clinicians for addressing the issue of cultural safety and sensitivity to consumers of mental health intervention and clinical support. In this direction, considering the speciality and diversity regarding traits and vastness of the Aboriginal Australian cultural facets, special cultural consideration shall be contemplated (McKenna, 2020). The main objective of cultural safety concerning the Aboriginal Australians concerning mental health consumers from the community shall be dealt with acute care and concern (Sommer et al., 2018). The paper will discuss a brief overview of culturally safe nursing intervention for mental health consumes from the Aboriginal Australian community with psychotic illness. Moreover, the paper will also provide with evidence-based psychoeducation strategy that can be properly utilized in this context that purposefully suits the interests of people of the Aboriginal Australian community with psychotic illness.
A culturally safe nursing intervention for a consumer with a psychotic illness
The case is about a mental health consumer, Joe Tzu who belongs to the Australian Aboriginal Community. He is a 25 year old adult admitted to a hospital in the NSW health district for exacerbated conditions of his allergic dyspnoea. He was also recently diagnosed with hallucinations as per the GP who was treating him. Staffs of the room has reported that they found Joe was talking with the wall as if it was someone close to him. After repeated searches, the staff found no one else in the room apart from Joe. Hence, the GP was requested to reconsider this case as the staff indicated that the case of Joe was not merely a case of a common allergic asthma but of hallucinations associated with schizophrenia.
Hallucinations are forms of sensory experiences that happen in the absence of a real and actual origin causing stimulation or sensation (Sommer, Kleijer & Hugdahl, 2018). It is also found for people suffering from hallucinations to perceive an altered state of mind due to virtual sensory response in the absence of a real stimulus and when no one else experiences such kind of validating experiences. It is often misjudged as illusions which is indeed not true. Illusion is nothing more than a misconception and misinterpretation of a valid and traceable external stimuli (Sabucedo et al., 2021). An example of illusion is the misinterpretation of a suit that is hanging on a door as a person of the same height and physical stature. A survey carried out by the Queensland Government’s Health Department revealed that three in every 100 person perceives experiences of psychosis that lose touch with reality via hallucinations, disorganized thoughts and imaginations, and/or delusions (health.qld.gov.au, 2022). Hence, hallucinations can be termed as a psychotic illness which happens due to severe mental disorders causing abnormal perceptions and thinking. In this direction of psychotic illness, two diseases are very closely related among people that suffer from psychosis such as hallucinations and delusions. For example, if a person is suffering from hallucinations, is engaged with false perceptions like feeling, seeing or hearing something that does not exist in reality (McKenna, 2020). For the latter, there are unfounded and false beliefs regarding someone is intriguing and plotting against the mental health consumer that is the people affected with delusions (Curtis et al., 2019).
The major directives for a mental health nurse in the care setting entitled to look after Joe shall be very aware about certain culturally safe practices that support Joe’s background. Culture is very crucial for a person as it is the main precursor element of a person’s life so far including the setting where they are brought up and reached a certain age dwelling on the same culture (McGough et al., 2018). This background of a person entails scope of influencing one’s psychotic and mental health symptoms in many ways, especially in the way they are understood and expressed. In terms of formulation and exercising the care plans and diagnosis, culture requires special attention and rigour (Badcock et al., 2020). The “Australian Institute of Health and Welfare (AIHW)”, has defined cultural safety comprehensively for delivering special needs of the people of the Australian Aboriginal Community. The “Cultural Respect Framework 2016-2026” has emphasised more on the services perspectives from clients or consumers’ point-of-view (aihw.gov.au, 2020). Hence, the culturally safe practice for the case of Joe is centred on understanding his unique cultural considering the community he belongs to. Nurses shall specifically cater to the acknowledgement of differences of Joe’s community and cultural uniqueness concerning the distinct features of Aboriginal vibrant cultural rites, rituals, and practices (McGough et al., 2018). The nursing professional shall be very diligent in catering to the person and respecting his distinct culture and background. Hence, respect and mindfulness regarding the Aboriginal culture are the most comprehensive features of the best strategy involving the culturally safe nursing intervention for a consumer with a psychotic illness applicable in this case (McKenna, 2020). The nurse is also expect to know the dark history of British colonization of Australia and atrocities and oppression of the Aboriginal Australians since then which is often not covered by the media (Curtis et al., 2019). Moreover, practices of the institutionalized racism in Australia is another major challenge to the concerns of the community which shall be dealt with care. Hence, providing a flow of informed power relations, mutual trust, acceptance, sympathy, and dignity for Joe’s culture are the way forwards for the cultural intervention plan (Sommer et al., 2018).
A evidence-based psychoeducation strategy which can be adopted when working with someone who has a psychotic illness
Evidence-based practices (EBP) are ways to the future medical services involving informed problem-solving and decision making practices involving the best research-oriented practices, patinet preferences, clinical expertise, and their conscientious use (O’Brien et al., 2020). In the context of health care and nursing practices for psychotic illness, EBP involves a distinct strategy of pshyoeducation for purposefully solving the condition of a consumer seeking mental health intervention in psychotic ailments like schizophrenia, delusions, and even hallucinations. As per, Turkington et al. (2018), EBP in case of hallucinations shall involve the judicious use of reducing the stress generated form hearing unusual voices (Hayward, 2018). Even if, the EBP is into practice over the years, still the scholars of Cambridge professed in its favour. Primary support shall be extended to the patient, Joe in this case regarding coping mechanisms for elevating his conditions. The natural EBP-based coping strategy shall include a three-layered approach involving psychological, cognitive, and behavioural coping strategies (Hayward, 2018). Major functions of the strategies will be centred on naturally occurring coping strategies. In behavioural strategy, Joe shall be involved in doing something out a chore. In the cognitive strategy, approach of addressing the treatment shall involve empowerment of Joe to think differently (Pardede, 2019). The main goal of the cognitive therapy is to focus one not to worry on self-conditions of Joe and ensuring him not to worry. Psychological strategy involves changing his sensations such as by regular shower twice or thrice for refreshing the mind and keeping the utmost level of hygiene (Froján-Parga et al., 2019). In addition to that, the EBP takes into consideration of rational responding involving combination of the two best EBP practices such as standing up for Joe by presenting new information to the voices he hears and fusing it with ‘playing detective’ by promoting information before re-evaluating accuracy of the belief system that Joe perceives about the voices he hears (Carter & Wells, 2018). However, nursing professionals shall redress the issue of confirmation bias which can restrict information that support his beliefs (Lincoln & Peters,, 2019). Truthfulness of voices, control, and power regarding of the voices Joe hears shall be addressed careful with real and evidence-based examples of what actually may the reality of what is heard by Joe from the walls of the room he is in. In addition to that, whenever, Joe will speak of disconfirmatory information such as he has different view that can be assertively expressed by employing voices in role-play (Turner et al., 2020). Avatar therapy is also a major example in this direction which involves the use of coaching patients by responding to assertive visual deportation on screens of a computer (Thomas et al., 2019). The role play involves the smart and pragmatic use of therapy for articulating views respectfully and calmly. Thus, the EBP can be used purposefully to serve the case of psychotic illness which was well-depicted taking the case of Joe (Sabucedo et al., 2021).
Conclusion
The paper discussed and provided a brief overview of culturally safe nursing intervention for mental health consumes from the Aboriginal Australian community with psychotic illness. Moreover, the paper showed evidence-based psychoeducation strategy that can be properly utilized in this context that purposefully suits the interests of people of the Aboriginal Australian community with psychotic illness. Hallucinations are forms of sensory experiences that happen in the absence of a real and actual origin causing stimulation or sensation. It is also found for people suffering from hallucinations to perceive an altered state of mind due to virtual sensory response in the absence of a real stimulus and when no one else experiences such kind of validating experiences. The paper took the case of a 25 year Aboriginal Adult of Australia, Joe and laid frameworks for proper culturally safe nursing intervention for him. It was found that a flow of informed power relations, mutual trust, acceptance, sympathy, and dignity for Joe’s culture are the way forwards for the cultural intervention plan. Additionally, in the context of health care and nursing practices for psychotic illness, EBP involves a distinct strategy of pshyoeducation for purposefully solving the condition of a consumer seeking mental health intervention in psychotic ailments like schizophrenia, delusions, and even hallucinations. As per, Turkington et al. (2018), EBP in case of hallucinations shall involve the judicious use of reducing the stress generated form hearing unusual voices. Moreover, use of Avatar therapy is also a major example in this direction which involves the use of coaching patients by responding to assertive visual deportation on screens of a computer. Further, role play involving smart and pragmatic use of therapy for articulating views respectfully and calmly. Thus, the EBP can be used purposefully to serve the case of psychotic illness which was well-depicted taking the case of Joe.
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