Discuss about the Mental Health Nursing for Schizophrenia.
One of the key domain of the nursing profession is the mental health nursing. This domain is specialized for the mental health, which provides the care service to the people of all ages (Videbeck, 2013). Mental health nursing includes those who have mental illness with the mild symptoms such as anxiety as well as diseases like schizophrenia, dementia, bipolar disorder and substance abuse. The mental health nurses need to work with the patients, who have mental health problems. However, Andersson et al. (2012) mentioned that different patients of mental health illness may have different symptoms. Hence, the mental health issues diagnosis is difficult. In this context, Beck (2011) stated that the mental health nurses need to have additional skills to handle the patients and provide effective and efficient care. The care nurses need to support them and provide empathy to build a therapeutic relationship. Establishment of the therapeutic relationship with the patients is important.
The key concern of the essay is Angelina, 18 years old teenager, who is suffering from depression. Angelina faces difficulties to concentrate on her studies and cannot lead a normal life due to depressive symptoms. This affects the future of Angelina.
The assignment focuses on the discussion of the therapeutic engagement of Angelina. The discussion states about the implementation of therapeutic modalities for Angelina. For the improvement of Angelina, more than one therapeutic modality can be applied that is discussed.
In case of Angelina, the mental health nurse can provide the mental health service that will help her to get back in normal life. Angelina has started her first year class in the Melbourne University. She is the student of nursing. However, it is necessary to mention that there is no family history of mental health illness in Angelina’s family. She was a high achieving student and enjoyed sports. She has strong social networks of friends. However, since the past two weeks, the friends of Angelina noticed that Angelina has the symptoms of mental illness. The symptoms are hopeless feeling, depressed mood worthlessness, weight loss (8 kg), fatigue, psychomotor retardation, insomnia, less interest in her subject, less attendance, less concentration and reduced attention. Moreover, she had the thoughts of suicide. In such context, Angelina is not able to continue her studies and attend her university classes and examination. Angelina’s parents brought her for the mental health review at the emergency department. In such condition, the mental health nurse has some priorities that she needs to follow.
Hence, the mental health nurse needs to make a strong and positive relationship with Angelina. It is the initial step to set up the strong relationship in mental health care provision (Shea, 2016). As Angelina is suffering from depression, she can feel uncomfortable and may not share her problems with the mental health nurse. As Angelina has no past family history, it is difficult to relate her life consequence with the mental health symptoms. In this situation, the mental health nurse can implement few key interventions relating to the therapeutic process.
It is the duty of the mental health nurse to build the trust during dealing with Angelina. She has symptoms of depression. Moreover, she is being isolated from the society therefore; it can assume that she would not share her feelings with the nurse. She may feel helpless and more depressed in the therapeutic environment. Therefore, the nurse needs to build a strong and reliable relationship with Angelina so that she can share her feelings with the mental health nurse and give the important information about her. This information can help the mental health nurse I the therapeutic procedure. The nurse-client relationship is not possible without the strong relationship (Beck, 2011). The nurse can face problem in the intervention procedure. The mental health nurse needs to make some key strategies like friendly behavior, honesty, suggesting some options and good listening skills.
The nurse needs to genuineness that is she needs to be honest, open-minded and sincere. She should have the active involvement with the patient (Chibanda et al., 2011). Keltner (2013) mentioned that genuineness is the alternative of self-alienation. This can make Angelina feel safe and secure in therapeutic surrounding. This can influence the trust development towards the mental health nurse and the health care system. If the nurse does not have this attribute, then the patient would not able to be free and cannot be able to express her self-acceptance, strong relationship. The negative attribute of the mental health nurse can make the patient feel unable and unsafe to share the concern and needs for the therapeutic purpose. The nurse can win the trust of the patient by the honesty and open mindedness.
Empathy refers to the ability to enter in the life of other person, communicate properly to understand the needs and feelings of the client. Proper empathy can involve the attempts of the patients with sensitivity by the verbal communication and interaction. The nurse should communicate in such language that the patient and her family members could understand. As Angelina has depressive and isolative symptoms therefore, the nurse may face problems to understand the requirements of Angelina. In such condition, the empathy can help the mental health nurse and influence the changes and constructive learning. The problems of Angelina can be diminished by making her social. Therefore, she needs to motivation from the mental health nurse. Fortinash and Worret (2014) suggested that the nurse needs to show empathy rather than sympathy. The patient May feel uncomfortable to express herself if the nurse shows sympathy. In this case, the nurse needs to show empathy so that Angelina can show her feelings and talk freely with the mental health nurse.
When the patient like Angelina stated to show the unconditional affirmative regards, the patients begins to feel importance. This can influence the patients in expressing her feelings and recent health requirements. Therefore, it is necessary to shoe the unconditional affirmative regards to maximize the involvement of Angelina in therapeutic practice. The following points can be applied in case of Angelia that is suitable for the therapeutic treatment:
In the case scenario, it is seen that Angelina is suffering from depression with psychomotor retardation, lack of concentration, insomnia, weight loss and suicidal thoughts. Hence, only CBT cannot modify Angelina’s problems. In such context, she needs antidepressant medication to decrease the psychological symptoms of Angelina. Both the psychological and psychomotor treatment can reduce the problems of Angelina as both have various significant outcomes. Psychologist may suggest Angelina one of the medication or combination of anti psychotic drugs, antidepressant and mood stabilizers. As mentioned by Fortinash and Worret (2014), the psychologist needs to confirm the type, dosage and routes. The antidepressant can help Angelina to feel better, which cannot change Angelina’s personality. Therefore, the combination is important for eliminating the roots of the depression (D’Zurilla & Nezu, 2010). However, there may be some side effects, about which the MHN should be careful. MHN should motivate her and teach her about the therapeutic procedure. She needs to provide mediation on time and positively encourage her. The MHN needs to notice the improvements in Angelina and note down that will help to reduce the depression.
The second intervention is the support and rehabilitation. It is another process that can improve the condition of Angelina. In view of Keltner (2013), the mental health nurse can provide referral of the support groups. In such condition, Angelina can get opportunity to be social and make connection with others. There she can meet with people who are similar to her and went through same condition. They can motivate her by sharing their struggle. This can reduce her isolative mentality and improve her condition by developing her feelings. If Angelina begins to feel valued and important then she will be able to understand the key challenges of life. This can have positive impact on Angelina. In this context, the nurse needs tom involve the family members and friends of Angelina for providing the support and encourage her. When Angelina will be able to understand the importance of wellbeing, it will be easier for her to improve herself by motivating own self. The mental health nurse can arrange rehabilitation for the patient that will help her to be well soon (Sadock & Sadock, 2011). This can motivate Angelina to get well soon and gain back the previous confidence to make high scores in study to secure the future. In such context the mental health nurse needs to aware about the affordability of the patient (Townsend, 2014).
Cognitive behavioral therapy refers to the evidence based psychological treatment, which can recognize behavioral and cognition attributes of the patients.CBT is one of the evidences, which is the most effective treatment of depression. However, Videbeck (2013) mentioned that it depends on various factors like age, which includes children, adults, adolescents and old age people. In therapeutic modality, nurses can assist psychotherapists for identifying behavior patterns (Chibanda et al., 2011). This can make Angelina feel good and free of depression. Hence, in such condition, client centered and team based approaches are the best that the therapist and mental health nurse can choose to understand reasons of depression and reduce the psychological problems. If the professionals can identify the reasons of the depression, then it will help them to change the behavior of Angelina by providing knowledge and skills so that she can think rationally and avoid the negative thinking. In view of Townsend (2014), the motto of the therapy is to bring the positive thinking in the patient. This theory will help her to modify her behavior and come to the normal life again by avoiding depression with the gain of positive thoughts.
With the above mentioned key modalities that is pharmacotherapy and psychotherapy for the treatment of Angelina, there are some alternation. These alternatives can help Angelina to get rid of her problems and provide better outcomes. One of these alternatives is relaxing training and one of the outcomes is the self-management (Andersson et al., 2012). Therefore, health promotion sessions can be arranged for Angelina that will help to improve the self-management skill. This session will create awareness in Angelina and promote her ability to manage her situation by improving the self-management. In addition, she can try yoga and medication that will help her as the relaxing training. Moreover, she can listen music to reduce her stress. This will act as the conventional technique. Music has the power to reduce stress and can bring the positive thinking by reducing stress and negative thinking (Stuart, 2014). Moreover, the mental health nurse can arrange music therapy for Angelina that will motivate her to be positive. Music will reveal her stress and tiredness and provide energy to perform the daily works. The mental health nurse needs to help her by teaching the relaxing training and explaining about the importance of self-management and relaxing training. Only the mental health nurse can help her in such context. Moreover, the mental health nurse needs to monitor Angelina to check her improvement during the conventional therapeutic approaches.
After the discussion, it can be stated that the key focus Angelina can improve her own self and have a positive lifestyle and can decrease the depressive signs and symptoms via therapeutic treatment and continuous support. In such condition, therapeutic engagement depends on the key attributes of mental health nursing. This can include the pharmacotherapy, self-management, CBT, social support, referrals and relaxing techniques. However, the observance of Angelina with the therapeutic procedures is the main determinant of therapeutic outcomes. Only the mental health nurse can ensure this via the positive and the trustworthy relationship. This relationship can be built strong with the motivation. It can be expected that the mentioned interventions and therapeutic procedure develop the condition of Angelina and she will be able to back in her normal life like previously.
References
Andersson, G., Paxling, B., Wiwe, M., Vernmark, K., Felix, C. B., Lundborg, L., … & Carlbring, P. (2012). Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder. Behaviour Research and Therapy, 50(9), 544-550.
Beck, J. S. (2011). Cognitive-behavioral therapy. Clinical textbook of addictive disorders, 474-501.
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A. (2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC public health, 11(1), 828.
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A. (2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC public health, 11(1), 828.
D’Zurilla, T. J., & Nezu, A. M. (2010). Problem-solving therapy. Handbook of cognitive-behavioral therapies, 3, 197-225.
Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric mental health nursing. Elsevier Health Sciences.
Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
Sadock, B. J., & Sadock, V. A. (2011). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Lippincott Williams & Wilkins.
Shea, S. C. (2016). Psychiatric interviewing: the art of understanding: a practical guide for psychiatrists, psychologists, counselors, social workers, nurses, and other mental health professionals. Elsevier Health Sciences.
Stuart, G. W. (2014). Principles and practice of psychiatric nursing. Elsevier Health Sciences.
Townsend, M. C. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.
Videbeck, S. (2013). Psychiatric-mental health nursing. Lippincott Williams & Wilkins.
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