In view of the strict confidentiality requirements for patient records, particularly in cases involving mental health and illness, both mental health patients and the general public were assured in accordance with the nursing and midwifery council code of conduct (NMC 2008), to respect and observe mental patients rights to confidentiality. Furthermore any information obtained about them as part of this research was not shared or disclosed with/ to any third party without their ultimate permission been given (Mental health and learning disabilities 1998).
WHAT IS MENTAL HEALTH
There have been so many attempts by writers and authors to define what mental health is? So many different definitions have been given and for the purposes of this research only two of them were mentioned. According to The World Health Organisation (2001) health is the state of being complete mentally, emotionally, socially, physically, psychologically fit and not just a mere absence of sickness. But Keyes (2002) pointed out that mental health does not refer to a single instance of an individual’s state of mind, but rather, it covers a broad spectrum and describes a collective sequence of behaviour over time. It may be generally explained and the argument is that diverse bodies, environments and settings use dissimilar means of conceptualizing the term. In other words what constitutes mental health in one profession or community might not necessarily mean the same in another. It could be classified as the disturbing toughness which allows individuals to take pleasure in their existence and endure pain, distress and depression which can also be said to be a good signal for individual`s interests and a fundamental idea in our personal, and other’s (Weare 2000). In some cases stating what mental health is? can include a broad scope of capacities which emphasises our potential in growth, change and also social nature (Department of Health 1995a) There are a many of mental health situations that could result to a disability, such as nervousness, sadness, as well as schizophrenia (web 1). In a report issued by the World Health Organisation (2003) it indicated how secretive and covered the shame and favouritism associated with mental health have been and emphasised the need to uncover and bring to the public domain. The extent of agony and challenge with regards to disability and spending for people, relatives and communities are overwhelming. The world has now recognised in the last few years the huge trouble and the probable danger associated with the illness.
The discovery here indicated astonishing figures all over the world on the epidemic with it seriousness been sometimes overlooked. Surprisingly more than 450 million individuals go through mental or disorders in behaviour. Almost one million individuals do kill themselves each year and due to neuropsychiatric disorders (depression, alcohol-consumption disorders, schizophrenia and bipolar disorder), four of the six leading causes of years lived with disability. Mental disorder can at least be found in every four families and relatives are normally the main care providers for persons with mental health problems. The degree of the challenge on relatives as a result of the complications to measure and as a result often uncared for. Nevertheless, the considerable effect on their relatives` quality of life has always been negative. People affected by mental illness incur both social costs and mental health costs and is victims of discrimination, human rights abuse, stigmatisation and both internal and external dejection (WHO 2003).
WHAT IS MENTAL ILLNESS
This is where the functioning of the mind becomes affected due to the series of signs and experiences of conditions, such as phobias, schizophrenia, depression, anxiety, mania and substance misuse disorders (Carol and ASH 2004, health welfare 1998, Trent 1999, Tudor 1996). Due to how rampant and common mental illnesses have become in recent years, in the course of an average person’s life, it is possible that they will either develop a mental health problem themselves, or have close contact with someone who does (Kitchener and Jorm 2002). In a research conducted in Scotland, it concluded that one in every four adults will experience mental health problems at some stage in their lives (Scottish Association for Mental Health (2003a). Weiss et al (2001) advocated that mental illnesses have been stigmatized in several nations and cultures. Current findings have proved the attempt in some countries to minimise the degree of stigmatisation through scientific approach and educational efforts (Rahman et al 1998). But notwithstanding these efforts, the disgrace and panic attached to mental illness remains a considerable barrier to finding assistance to identify and to treat. The association of stigmatization on mental illness has caused disparities, as oppose to other forms of illnesses, and its` further violation human rights abuse regarding people having these disorders. Even though mental health and mental illness are not the same but they are inter- related and so sometimes used interchangeably (World Health Organization 2003). Mental health is how individuals think, feel, and behave as they cope with daily life. It assists in deciding how people cope with stress, relate to others, and make choices. On the other hand, Mental illness is a collective term for a broad range of mental disorders and the mental disorders are medical conditions that disrupt how a person thinks, feels, and/ or behave, resulting in distress and/or impaired functioning (Austin 2010).
CHALLENGES OF MENTAL HEALTH PATIENTS WELLBEING
Patients with mental disabilities have problems and the range of the challenges encountered in their everyday life are numerous and involves for example reactions to adjustments (external situations normal responses); either short or longer-term disability connected to signs of hopelessness and nervousness (and psychiatrically linked with diagnoses such as gloominess, but may be generally constructed); bipolar disorder, schizophrenia (with a obvious genetics root, more simply clear by its signs but also with important the general public meaning and penalty). There may be coexist between each other, and also with problems linked to the drinking of alcohol or drugs, and with problems ensuing from complications traits and personality types (The Royal College of General Practitioners 2007). The case study below attempted to explain Ms. Catherine who suffers from postpartum depression.
CASE SENARIO – Ms Catherine suffers from `postpartum depression`
“Postpartum” depression is a type of depression that happens to women after they give birth and they are of two different categories which are postpartum or maternity “blues,” a calm frame of mind problem of minimum period and “postpartum chief depression”, a painful and likely life damaging illness of a longer duration. The Postpartum blues affect between 50%-80% of new mothers after labour and symptoms are normally begin from 3 to 4 days after delivery, getting worse by days 5 upwards, and may be likely to leave the mother away by the 12 day. The new mother could have atmosphere swings with period of feeling weeping, irritable, interspersed and nervous or with situations of feeling well; and she may have difficulty sleeping. If the signs continue more than 2 weeks, it is essential to look for medical assistance (Moline et al 2001). On the other hand, the starting of “Postpartum major depression” could be at any period in the initial periods after given birth and is extreme intense than postpartum blues. It is the changes in the brain chemistry that causes it and lead to mood disorder; a genetic illness which does not happen by the fault of the mothers or the consequence of a “weak” or unsound personality. Medically there are professional treatments since it is treatable and curable. The postpartum depression has major symptoms such as dejected atmosphere throughout the day, almost every time, for not less than 2 weeks and leading to loss of activities that were interesting or enjoying before. Other signs involve tiredness, feeling fidgety or slowed losing, a common sense guilt or insignificance, complicatedness in concentration, sleeplessness, and persistent belief of death or suicide (Moline et al 2001).
Detailed Analysis- Ms Catherine`s story
Ms Catherine story started one day when she came home from the hospital with her beautiful baby daughter after delivery, but her world began to fall apart. She was hit by intense nausea, vomiting, diarrhoea, dehydration, and fainting. Breast feeding her baby became out of question. Every time she held her baby to her breast, she needed to quickly lay her back down so she could run to the bathroom. In the course of the first 3 months of her daughter’s life, she was hospitalized twice, removed from her children including the newly born. She was completely changed from a very strong, vibrant, healthy and physically active person to something else, unable to carry out even the simplest daily responsibilities. She became devastated and a failure as a mom and couldn’t even get out of bed where she even wanted to die. During her second hospital stay, a nurse gently suggested that she might have postpartum depression but was stunned. How could the horrible gastrointestinal symptoms she was experiencing be caused by depression? She however understood how she could be depressed because of the sickness she was suffering from, but not the other way around. And she had never heard of `postpartum depression`. But she took the suggestion to heart and quickly sought a diagnosis information, and help. In the process started taking an antidepressant and also immediately began seeing a psychologist for therapy. Ms Catherine showed sign of recovery but has always wanted someone around her to assist her in her daily routine duties.
My Encounter with Ms Catherine
I found it difficult in interacting with and responding to Ms Catherine initially because little did I know about mothers suffering from postpartum depression after given birth. But later on I realised that it is a common mental illness problem that affect most women after child birth. Immediately afterwards my attitude and behaviour towards her changed and begin to interact with her freely. The instance recognition of Ms Catherine ill health changed my thoughts, attitude, belief and perception of people with mental disability and the need to assist them to cope with their everyday life. Ms Catherine behavioural practices are sometimes strange than normal with her consistence ineffectiveness couple with her cold attitude and responsiveness regarding what ought to be routinely practices. It is therefore imperative that patients with mental disability are treated and dealt with according to their specific circumstances since this helps in addressing their individual concerns effectively. One of the weaknesses I have was to getting closer to people who suffer from mental related illnesses but I now come to realise that my fear of not wanting to approach people with mental disability because of how they can be aggressive sometimes has changed drastically. As a consequence I have now been able to build on my strengths in terms of always given a helping hand to patients and more on to people whose mental wellbeing has been challenged.
ENGAGING WITH AND ASSISTING MENTAL HEALTH PATIENTS
The responsibility of assisting, caring and engaging people with mental health disabilities and challenges does not rest with or depend on only one person but rather on every single individual, the society as well as organisations. As depicted in the figure 1 below, the interest and the desire to demonstrate the willingness to help manage the challenges of the mental health patients` wellbeing cat across every angle and borders.
MENTAL HEALTH PROFESSIONALS
Figure 1: A diagrammatical representation of different identifiable individuals and groups who are to assist in mental health patients’ wellbeing challenges.
Source: Adapted from World Health Organization 2003
But for the purposes of this study the concentration was narrowed down to the role of different health and social care professionals in mental health promotion. Their roles are numerous involving supporting them to keep on with their medication as this will guard against the harmful effects that can cause further breakdowns, try to minimise additional pressure by supporting them to amend to the effects of the illness. Also work with their relatives and the community to support the patient, support them to sort out any difficulties they may face that are causing them stress. Assisting them again to stay away from becoming annoyed or violent of them and avoid being too protective and not to treat them like children (Mental Health Training n. d). The National Mental Health Act of 1946 acknowledged psychiatric nursing as one of four core areas for the provision of psychiatric care and treatment, along with psychiatry, psychology and social work. Since Nurses played an important role in the treatment of increasing demand for psychiatric services resulting from mental health issues in order to meet the rising demands (Bigbee and Amidi-Nouri 2000). As a mental health nurse I may see patients who are living in the society, normally in the patient`s own home or in a clinical based. As a nurse providing support to mental health patients through difficult periods of their illness is significant. I will see patients who are currently well to ensure everything is going on well with them and be the first point of contact if the patients begin to experience any unusual signs of additional ill conditions. I will also be helping patients with their medication and make sure that the patient understands what they should be taking and when, since that is very important at this stage of their lives. I will provide information to the patient’s immediate family on the need to understand and cope with their relative’s ill condition (s) and not to neglect or reject them. I may also be involved in cases where the patient’s transition from hospital back into the community is carried out (Web 2). Within the continuum of mental health interventions, prevention and promotion have become practical and proofing based, backed by a fast increasing body of knowledge from areas as divergent as developmental psychopathology, psychobiology prevention, and health promotion sciences (WHO, 2002). Rutz et al (1992) indicated how the preventive measures and promoting programmes have also been shown to result in substantial cost-effective savings to the public since that stops any occurrences of any mental illness. The mental health professionals have different identifiable roles in the promotion of quality mental health. The World health organisation declared and has set aside a day in the whole world as the world mental health day after recognising the need to promote good mental practices. WHO indicated that the process of assisting mental health patients and the general public to gain increase awareness and control over their own health and better it is essentially worth noting (WHO 1986). As shown in figure 1 above these health and social care professionals are all involve in the daily promotion and sensitization of the challenge. The practices of improving the quality standard of life and the possible good living are interlinked, rather than only an amelioration of symptoms (Secker 1998). Psychosocial issues persuade a number of health behaviours (e.g. proper diet, adequate exercise, and avoiding cigarettes, drugs, excessive alcohol and risky sexual practices) that have a wide-ranging negative effect on the domain of health (WHO 2002).
The strategy to improve upon my information technology (IT) strengths will be done through the consistent usage of the IT. With particular attention given to the micro soft excel to improve on my numerical strength with the engagement of an IT professional for additional tuition. My literacy strengths will be enhanced by the regular practice of using the micro soft word with the selling options becoming the dominant material for improvement.
It however became evidenced that mental health illnesses pose a serious threat and damage to our daily lives. It is no doubt mental illnesses are of different kinds and levels of severity. Some of the major types discovered included depression, anxiety, schizophrenia, bipolar mood disorder, personality disorders, and eating disorders. But the main frequent mental illnesses are anxiety and depressive disorders and so it was not surprising when the case study above was on postpartum depression. Even though most people go through feelings of strong tension, panic, or depression sometimes, but a mental illness is observe only when these symptoms turn out to be so worrying and devastating that individuals experience immense complicatedness enjoying their normal routine activities, for example work, enjoying relaxation time, and maintaining associations. More attention needs to be devoted to the sickness since failure to over look its existence could result to a potential disaster and further deaths. The decision by the world health organisation to declare a day as “world mental health day” is important and must be observe by all but having regard to the enormous benefits it will yield to us. The cost of treating and caring for mental ill patients increases as the days goes by as oppose to the amount involve in prevent the condition from occurring. The contributions of health and social care professionals over the years have been incredible and therefore ought to continue in order to prevent, reduce and even a further eradication of the epidemic. It must however be noted that the sickness is preventable and even treatable so do not die in silence since “the problem shared, is the problem solved”.
Austin, (2010) Psychiatric and mental health nursing for Canadian practice, Medicine series; Lippincott Williams & Wilkins, edition 2 revised, ISBN 0781795931, 9780781795937
Bigbee, J. L. and Amidi-Nouri, A. (2000) History and evolution of advanced nursing practice, advanced nursing practice an integrated approach (3rd ed.). Philadelphia, W.B. Saunders, pp. 3-32.
Brug, J., Lechner, L., De Vries, H. (1995a) “Psychosocial Determinants of fruit and vegetable consumption”, Appetite, Vol. 25 No.3, pp.285-96.
Carol, B. and ASH, S. (2004) Tobacco and Mental Health, Scotland; available at http://www.ashscotland.org.uk/ash/files/tobacco%20and%20mental%20health.pdf
Centre for Health Promotion (1997) Proceedings from the International Workshop on Mental Health Promotion; 1997 Toronto, University of Toronto.
Keyes, C. L. M. (2002) “From languishing to flourishing in life” The mental health continuum: “, Journal of Health and Social Behavior No 43.
Kitchener, B. and Jorm, A. (2002) Mental Health First Aid Manual Centre for Mental Health Research, The Australian National University.
Mental Health and Learning Disabilities (1998) a guide to working with vulnerable clients, Guidelines for mental health and learning disabilities nursing, Kingdom Central Council for Nursing, Midwifery and Health Visiting.
Mental Health Training (n. d) A Mental Health Training Programme for Community Health Workers, Helping People with Mental Illness, University of Manchester.
Ministry of Supply and Services (1988) Mental health for Canadians, Health and Welfare Canada: striking a balance. Ottawa: Canada.
Moline, L. M., David, A. K., Ruth, W. R., Lori, L. A. and Lee, S. C. (2001) Postpartum Depression: A Guide for Patients and Families, A Postgraduate Medicine Special report, Expert Consensus Guideline Series. Available at http://www.psychguides.com/DinW%20postpartum.pdf.
Rahman, A., Mubbashar, M., Gater, R. and Goldberg, D. (1998) “Randomised Trial of Impact of School Mental Health Programme in Rural Rawalpindi, Pakistan.” Lancet 352 (9133): 1022-25.
Royal College of General Practitioners (2007) Care of People with Mental Health Problems, Curriculum Statement 13
Rutz W et al (1992) Cost-benefit analysis of an educational program for general practitioners given by the Swedish Committee for Prevention and Treatment of Depression; Acta Psychiatrica Scandinavica, 85: 457-464.
Scottish Executive (2004a) Health in Scotland Edinburgh: Scottish Executive Available at http://www.scotland.gov.uk/library5/health/his03-03.asp.
Secker, J. (1998) Current conceptualizations of mental health and mental health promotion Health Education Research, 13: 57-66
Trent, D. (1992) The promotion of mental health fallacies of current thinking, Promotion of mental health; 2:562.
Tudor, K. (1996) paradigms and practice, Mental health promotion: London: Rout ledge.
Weare, K. (2000) A whole school approach, Promoting mental, emotional and social health:. London: RoutledgeFalmer.
Weiss, M. G., Jadhav, S., Raguram, S., Vounatsou, P. and Littlewood, R. (2001) Anthropology and Medicine, “Psychiatric Stigma across Cultures: Local Validation in Bangalore and London” 8 (1): 71-87.
World Health Organisation (2003) Investing in mental health, Department of Mental Health and Substance Dependence, Avenue Appia 20, 1211 Geneva 27, Switzerland.
World Health Organization (1975) Sixteenth Report of the WHO Expert Committee on Mental Health, Organization of Mental Health Services in Developing Countries: Technical Report Series 564, WHO, Geneva.
World Health Organization (1986) Ottawa Charter for Health Promotion. Geneva.
World Health Organization (2002) Mental Health Policy and Service Guidance Package: Workplace Mental Health Policies and Programmes, Draft document; Geneva, WHO, Mental Health Department and Substance Dependence (unpublished document).
Web 1= (www.mind.org.uk) Accessed 21- 05-2010
Web 2= http://www.cmha.ca/bins/content_page.asp?cid=3-86-87-88 Accessed on the 15-08-2010.
Web3= http://www.netdoctor.co.uk/diseases/depression/mentalhealthprofessionals_000358.htm Accessed 12- 06- 2010