A Reflection on the Key Concepts Impacting on People with Mental Health Issues and their Support

Introduction

Mental illness presents a patient with severe disorders of thoughts and/or behavior which results in the inability of the individual to cope with the ordinary demands and routines of life. Mental health nursing specializes in caring for those with mental diseases. The mental health nurse promotes and supports the recovery of the patient. As a mental health student nurse and health assistant, I have developed in the profession that calls for the importance of making a difference, flexibility and achieving excellence. There are various theories that have been used to explain the cause of mental illness. The aim of this essay is to provide a reflection on an experience as a student nurse and health assistant on the various concepts that impact on people with mental health issues and their support. The experience will be related to a selected critical appraisal theory (OREM's theory) in mental health nursing. The rationale, history of mental illness and the OREM's theory will guide the explanation of my understanding of diagnosis, the importance of good mental health nursing attitude, ethical standards and compassionate outlook as a mental health student nurse and health assistant.

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Rationale

The understanding of the various concepts that impact people with mental illnesses and their support applies differently to the student nurse and when working as a health assistant. As a student nurse, I understood these concepts based on the theory learned in the classroom. However, when working as a health assistant in the hospital, I realized that the application of these concepts in the clinical setting is a bit challenging and requires the student nurse to develop practical skills needed when handling people with mental disorders.

As a student nurse, I learned that people with mental health issues and their support are impacted by different concepts such as diagnosis, nursing attitude, moral standards, and compassionate outlook. However, when working as a health assistant in mental health nursing, it is crucial to understand the applicability of the diagnosis of mental health illnesses. I learned the criteria for diagnosing different mental disorders using the DSM V. As a health assistant in the hospital, I needed to have a clear understanding of the diagnosis particular mental illness by learning the major signs and symptoms that a doctor tries to establish in order to conclude about the mental disorder. Therefore, my learning about the different mental health problems in the classroom was useful in knowing that these illness present differing symptoms. The DSM V criteria provide the major signs that a mental health professional should check to establish the proper diagnosis based on the presented results of the assessment (Townsend, 2015).

Patients suffering from mental health problems require the necessary support from mental health nurses and caregivers. As a student nurse, I learned that these patients can access treatment from specialist mental health services including community mental health teams, crisis intervention, social care, residential care, and hospital treatment. During the hospital treatment services, the mental health nurse plays a huge role in ensuring the general well-being of the patient (Goodrich, Kilbourne, Nord & Bauer, 2013). While working as a health assistant, I realized that the attitude of the mental health nurse is important in helping the mentally ill patient to recover quickly. It is necessary to adapt to a positive attitude towards the illness and the patient at the same time. Resilient is an attribute that helps student nurses and health assistant in the mental health field to support patients with psychological disorders to accept their condition, treatment and go through the process of full recovery (Khanlou & Pilkington, 2015). Therefore, adhering to the set moral standards in mental health nursing is crucial to ensure the patients receive ethical treatment and care.

A compassionate outlook of mental illnesses is important for a mental health nurse and prepares one to handle any challenge on the way when caring for the patients (Townsend, 2015). As a student nurse, I learned that by being compassionate, the mental health nurse can cope with irritable patients who may have a different perspective of the care they are getting. Therefore, a compassionate outlook is useful in coping with challenging behavior and staying understanding to the mentally ill patients always.

History

As a mental health student nurse, I have developed my understanding of the diagnosis of mental illness from different perspectives. Initially, I understood mental diseases as caused by some form of the trigger in the mind and an abnormal behavior in a person would be an indicator of a mental health problem. The history of mental illness guided my thinking on the causes and diagnosis of mental health illnesses. In the classroom, I learned that mental illness has a recorded history of cyclical evolution (Farreras, 2018). In the past, any person with an abnormal behavior deviating from the sociocultural norms was regarded as mentally ill. The diagnosis was based on cultural and supernatural beliefs. I realized that Supernatural, somatogenic and psychogenic theories were used to describe the cause of mental diseases. These three approaches provide different explanations for the causes of mental disorders and their methods of treatment and care.

I learned that the supernatural view of mental diseases explained that the person must have been possessed by demonic spirits, curses, an attack from displeased gods, sin, eclipses, and planetary gravitation. However, the somatogenic theories argue that mental illnesses result from genetics, brain imbalance or a certain illness. The different causes of mental illness would determine the type of treatment that the patient would be given (Farreras, 2018).

While learning about the history of mental illnesses, I recognized that the medical explanation of mental illness was established around 400 BC after separating superstition and religion from medicine (Wallace, 2010). The explanation for these findings was that insufficient bodily fluids including bile, phlegm, black, blood and yellow bile were the causes of a mental illness. Care for mentally ill patients was done at home by the family members. Psychological stress was also an associated cause of abnormal behaviors. Therefore, I concluded that the history of mental illness provides a useful background that a student nurse can use to understand the changes that have been occurring in the diagnosis, care, and treatment of people with mental illness.

The history of mental illness in the UK presents a differing view of how people with the disorders were identified and cared. In the UK, the history of mental illness can be traced back in the year 1774 with the passing of the first law, The Madhouses Act 1774, to address mental health problems in the country (Revolvy, 2018). As a student nurse, I learned that throughout the 19th Century, lunatic asylums were established to house the mentally ill people. It shows that moral and compassionate aspects of care for the mentally ill was practiced in the UK from the past years. The law recognized the need to treat the mentally ill with dignity by providing the needed care. The County Asylums Act 1808 allowed pauper lunatics to be removed from prisons and workhouses and housed them in places of care (Revolvy, 2018). The establishment of the Commissioners in Lunacy through the Lunacy Act 1845 ensured the building of lunatic asylums to care for those with mental disorders. These practices coincided with the need to punish madness in the asylum and imprison the mentally ill in a moral world (Foucault, 2001). Care and treatment for the remaining mentally ill people in the UK were left to the relatives. The building mental institutions started in the year 1890 with the passing of the Lunacy Act 1890 and the patients would now start getting treatment from the local authority mental hospitals. With improvement made to the mental institutions over the years, the people with mental diseases started receiving long-term treatment in the hospitals from the 20th century onwards. Turner, Hayward, Angel, Fulford, Hall, Millard and Thomson, (2015) state that the historical narrative of mental illness in the UK concentrated on structuring the care around the rights of the individual to obtain health and liberty. Basically, the history of mental illness in the UK helped me to understand that family care was the main help that the law promoted in looking after those mentally ill. Mental institutions and hospitals was an initiative that was later implemented in the late 19th century and early 20th century.

Orem's Theory of Mental Health Nursing

Orem's theory of nursing is based on three major parts including self-care, self-care deficit and nursing system (Masters, 2012). These three parts are theories within one general theory developed by Orem. In this theory, Orem's assumptions were that people must be self-reliant and take responsibility for their personal care and others who need care within the family. Based on this general theory, individuals are different and nursing should consider this aspect when interacting with each person (Seed & Torkelson, 2012). To successfully meet all the needs of a patient and develop their self-care needs is a critical element in primary care prevention and management of a disease. Having knowledge of an on the possible health problems in useful for the promotion of self-care behaviors among individuals. Further, learning self-care and dependent care behavior mostly occurs within a socio-cultural context.

The self-care theory supports that people should practice activities that promote personal health and well-being. The self-care deficit theory specifies when nursing care is required and in this case, the adult cannot effectively maintain continuous self-care. The nurse can help the patient through guidance, support, acting for, ensuring an environment of personal development and teach. The nursing systems theory describes ways in which the nurse meets the self-care needs of the patient or the need for both. In that case, the nursing system can either be wholly compensatory, partly compensatory or supportive educative system (Masters, 2013).

World Health Organization (WHO) Global Policy

The WHO global policy on mental health nursing considers mental health as an important part of well-being for all nations, individuals and societies (WHO, 2007). A person must have the capacity to cope with the normal stressors of life, work productively and contribute to society. Mental health nurses play a huge role in the treatment and care for people with mental illness. As a student, the WHO global policy reminds me of the importance of mental health nurses in providing mental health care services. The education of a mental health nurse must be adequate and their role in mental health developed while studying nursing education. Psychiatric nurses promote, prevent and treat mental disorders.

Recovery

According to the Mental Health Foundation UK (2018), recovery is a process, a framework and guiding principle in the treatment of mental illnesses. For a full recovery, treatment and care for mental illness should focus on the individual and not merely the symptoms. As a student and a health assistant, I understand that the recovery model should involve the entire process of treating a mental disorder. Putting the process into action means that the health assistant should build resilience and support those with mental illness. Treating or managing th...