HNN222: Mental Health and Illness WEEK 1
Seminar 1: Intro to HNN222
Define mental health and illness:
Mental health: a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and can make a contribution to his or her community
Mental illness: a health problem that significantly affects how a person feels, thinks, behaves, and interacts with other people
OR a diagnosable illness that significantly interferes with an individual’s cognitive, emotional or social abilities;
a condition in which an individual cannot cope & function as they did previously, causing considerable personal, social and financial distress
Discuss the impacts of stigma and stereotyping on people experiencing mental health difficulties:
Stigma: mark of disgrace associated with a particular circumstance, quality, or person Stigmas around mental health:
• Fake because you can’t see it
• Excuse to get out of things
• A sign of weakness
• They’re violent Impacts:
• Causes barriers to a client seeking help
• Causes mental health clients from feeling disconnected Describe the key elements of mental health nursing practice:
• Value and facilitate the personal recovery of all individuals
• Promoting their personal agency, connectedness and social inclusion
• Self-determination and their active participation in society
• How they can negotiate the range of resources they need to remain active citizens in the community of their choice, even during periods of mental distress
As nurses in mental health it is important that we:
• Listen / empower people to achieve goals
• Get to know our clients
• Being our patients advocates
• Plan care for our patients
• Effective communication
• Psychoeducation
• Administer medication
• Physical assessments
• Form a therapeutic relationship o Trust/ empathy
o Terminates once goals have been achieved o Encouragement
o Non-judgemental approach
o Validating “I hear you and can see your upset and I am here to help”
o Maintain boundaries
Discuss the concepts of person-centred care and therapeutic communication as they apply to mental health nursing
Technique Definition
Empathy The helper becomes keenly attuned to the patients feelings while maintaining a sense of one’s separateness
Open ended questions Questions structured to encourage the patient to share information and feelings
Close ended questions Information gathering that requires one word/ brief answer
Active listening Accepting what the speaker has said, analysing it and reflecting back your understanding of what was heard
Clarification Increasing the understanding of what the patient is trying to say
Supported confrontation Making a direct statement that challenges a patients behaviour or beliefs Silence Allowing time for a patient to gather thoughts and ponder a topic without
interruption (this can communicate acceptance and concern)
Reflection Verbally giving back the feeling part of the patient’s communication to help focus on the feeling tone
Non verbal communication Overt behaviour that indicates listening and attention
Congruent communication Body language, facial expression and verbal content all expressing the same thing
Reassurance Providing support by giving attention to matters that are important to the patient e.g. locking house or securing pets before proceeding with interview
Define biopsychosocial model of care as it relates to mental health nursing:
• The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery.
• Bio: genetics, physical health
• Psychological: thought, behaviours, mood, stress
• Social: support systems, community, culture
• This model allows more of a patient centred care and ask the consumer what they want in their care. This is important as it promotes holistic care model- looking at a person as a whole not just their mental health.
Develop understanding of the concept of recovery including its definition, enablers and barriers to recovery
• Recovery is defined as being able to create and live a meaningful and contributing life in a community of choice with or without the presence of mental health issues
• Recovery is a person’s personal journey based on their experiences. It is not defined by someone’s symptoms
• Barriers
- Social disadvantage - Social isolation
- Difficulty getting back into mainstream society
- Difficulty finding accommodation, obtaining meaningful work, having meaningful connections with others, achieving an adequate income and feeling safe
• In mental health, recovery is not just focused on recovery from illness, but involves many factors including:
- Finding and maintaining hope - Autonomy and self determination
- Collaboration between consumers and mental health professionals
- Involvement of family and important support networks - Citizenship and social inclusion
- Finding purpose and meaning in life - Provision of holistic care
- Focusing on the person's strengths.
Develop beginning understanding of trauma and its impact on mental wellbeing; reflect on the role of the nurse in delivering trauma-informed practice.
• Acknowledge the trauma the consumer has experienced and to not cause any more trauma
• Trauma informed practice recognises the impact of trauma and the interplay between trauma and mental health. A key aspect of trauma informed practice is providing a safe environment for people who have a history of trauma.
• Role of the nurse in trauma-informed practice:
- Take a universal approach, assume all people who seek mental healthcare may have experienced trauma
- Early assessment of trauma history
- Help the person lower their distressing emotions (sitting, listening, walking, basic relaxation techniques, calm environment)
- Build trust, understand how trauma and abuse may have shaped difficulties in relationships and impact on therapeutic relationships
- Recognise the person’s strengths and support them to develop care plans that affirm their preferences for care and how they can manage distress
- Maintain dignity and individual rights of the person at all times
- Provide services in ways that are flexible, individualised, culturally competent, respectful and based on best practice
- Develop an understanding of presenting behaviour and symptoms in the context of past experiences Develop beginning understanding of psychopathology & psychopharmacology:
Psychopathology: the scientific study of mental disorders
Psychopharmacology: the scientific study of the effect of drugs have on mood, thoughts, feelings and sensations.
Seminar 2: Legal & ethical issues
Reflect on ethical principles that are relevant to mental health care covered earlier in your course:
Ethical principles:
• Justice
• Non maleficent
• Autonomy
• Truthfulness/ confidentiality
• Beneficence
Relate ethical principles to mental health care
Develop understanding of legislation in mental health care
Develop beginning understanding of the Mental Health Act (2014) and the core concepts of rights of the mental health consumer, privacy and confidentiality, consent, advanced statements and supported decision making
Using a case study, navigate key sections of the Mental Health Act (2014)
Developing understanding of the role of the nurse in caring for patients under Compulsory Treatment Orders in the mental health setting and the community
Pharmacology: Basics
Demonstrate the role of the nurse in planning and delivering least restrictive care for people with mental illness.
Demonstrate a beginning understanding of the pathophysiology associated with mental illness;
Define psychotropic medication: medications used to treat mental illness o Pathophysiology of psychotropics:
• Neuron = basic functional unit of the brain and the CNS
• All communication in the brain involves neurons communicating across synapses at receptors (receptors = targets for the neurotransmitters/ chemical messengers necessary for communication between neurons)
• Neurotransmitters (acetylcholine, noradrenaline, dopamine, serotonin/ 5HT & GABA/ gamma- aminobutyric acid) are implicated in the development of mental illness
• Psychotropic medications alter communication among the neurons in the CNS
- They alter the way neurotransmitters work at the synapse by modifying reuptake of
neurotransmitters into the presynaptic neuron, activating/ inhibiting postsynaptic receptors, or inhibiting enzyme activity
• Major psychotropic medications are believed to act by altering the activities of the receptors, enzymes, ion channels and chemical transporter systems involved in these processes
Identify the main groups and types of drugs used to treat mental illness:
• Antipsychotics (neuroleptics)
• Antidepressants
• Mood stabilisers
• Anxiolytics
• Anti- anxiety (benzodiazepine)
• Atypical
• Sedative- hypnotic
Identify common side effects associated with psychotropic drugs
• Benzodiazepine: drowsiness, dizziness, feelings of detachment, dependency
• Antidepressants: sedation, dry mouth, constipation, blurred vision, seizures, urinary retention
• Antipsychotics: movement disorders, sedation, seizures, neuroleptic malignant syndrome (NMS) Discuss the nursing role in the administration of medication:
• Promoting adherence
• Educating consumers about medications
• Nurses must be aware of the issues surrounding the administration of the medications
• Assessing and intervening in relation to side effects from psychotropic drugs
• Develop a comprehensive understanding of the medications and the impact on an individual
• Understand the supportive and therapeutic nursing interventions that support medication adherence Discuss common barriers to maintaining a prescribed therapeutic medication regimen:
• Medication side effects
• Lack of insight on the illness
• Personal preference
• Fail to see the connections between medication and their health Discuss relapse prevention:
• a number of steps: establishment of a therapeutic relationship & ongoing education, identifying early signs of relapse, monitoring for signs of relapse, intervening early when the signs are observed, engage the person/ their family/ supports in the process, have a positive relationship to ensure accuracy and honesty
