o Wellbeing is multi-dimensional + requires a combination of subjective and objective outcome measures, personal characteristics (predisposition), external context factors + the relationship between these o Influenced by range of factors → biomedical, psychological, social, economic, environmental o E.g. hard to have a positive wellbeing if your mental health is struggling

• Considers:

o How we see and feel about ourselves

o How we interact with others and the world around us o Personal growth and development

• Includes:

o Being able to work productively and contribute to community life

o Interact with others and the environment in ways that promote subjective wellbeing and optimize development and use of mental abilities

Aspects of Mental Health

• 4 major components of mental health (Kittleson) → mental health more than absence of symptoms of mental illness

o High self-esteem (you have a solid sense of who you are and you feel okay about it) o Effective decision making (capacity to make decisions)

o Value awareness (if you don't have any means you don't really care) o Expressive communication skills

• Contextual and social issues (Raphael) → social forces and personal qualities contribute to mental health o E.g. workplace, education, resilience

What is mental illness?

• Mental health problem = diminished cognitive, emotional or social abilities BUT not to the extent that the criteria for a mental illness are met

o Not necessarily a diagnosis

o E.g. can’t get out of bed, getting out of relationship

• Mental illness = disorder diagnosed by a medical professional that significantly interferes with an individual's cognitive, emotional or social abilities

o Encompasses wide variety of signs, symptoms, experiences and disorders o E.g. mood disorders, psychotic disorders, eating disorders, personality disorders

• Diagnosis generally made according to Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) → made by psychiatrists

o Each disorder has diagnostic criteria that must be present for diagnosis of the condition o ADDITIONALLY INCLUDES: epidemiology, prognosis, age of onset

o Can cause harm → stigma (labels stick which causes judgement)

Models of Human Behavior

• Range of models have been developed to explain human behavior/mental illness

(4)

4

• Used to suggest:

o Reasons for observed behavior + causes of abnormal behavior o Models of prevention and treatment strategies

o Appropriate roles for patient and therapist

• Biological Model = view emotional and behavioral disturbances like any other physical disease o Person considered sick + suffering an illness

o Normal behavior = equilibrium in body

o Focus → classify (diagnose) + cure/treat illness by physical treatments

o E.g. structural brain changes, endocrine dysfunction (hormones), nervous system disorders (neurotransmitters), genetic transmission

o Suggests cure is possible

o Decreases stigma + assists with research and real science

• Psychoanalytic Model = mental illness results from fixation at a particular developmental stage or conflict that has not been resolved

o Human behaviors determined by → unconscious forces, developmental factors, family relationships o Defense mechanisms are unconscious ways of reducing anxiety

• E.g. repression, regression, displacement, projection

• Behavioral Model = objective study of observable human behavior VS examining the mind o Basic assumptions:

• Personality determined by prior learning

• Human behavior is changeable across life span

• Behavior changes are caused by environmental changes

• Cognitive Model = people are active participants in the environment and interpret their environment cognitively

→ take in information, process and respond to it

o Behavior results from interplay of external (stimuli) and internal events (perception)

• Sociological/Social Model Model = focus is on the person but in the context of their society as a whole o E.g. social situations, economic, environmental inequality

• Biopsychosocial Approach = mind, body, and environment interact in to cause health and illness o Biology, genetics, pathogens precipitate and contribute to illness

o Psychological and behavioral components cause health problems

• e.g. poor self-control, inadequate stress management

o Socioeconomic status, culture, poverty, technology, relationships, religion/spirituality can influence health

Mental Health Nursing

• A specialized field of nursing that supports people experiencing mental illness or distress

• Work in partnership with and consider the consumers' physical, psychological, social, and spiritual needs in the context of their lived experience

• Work in partnership with consumers' family and significant others

• Provide information and education on mental health maintenance restoration, coordinate care and provide talking therapy

• Embodies the concepts of caring and compassion by supporting consumers who are unable to maintain mental, social or physical functioning of themselves

• Empowers consumer to take on active role in self advocacy + self-care

• Therapeutic relationships + communication

• Recognize and understand how a persons' lived experience informs/influences their health and well-being

• Help individuals discover and ascribe meaning to their experiences

• Tasks: assessment, risk management, education, support, physical/pharma logical interventions

• Practice underpinned by:

o Therapeutic relationship o Holistic approach

o Integrated care practices/biopsychosocial framework o Person centered framework

o Recovery focused care

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