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Mental Health Nursing 1
Week 1Revised 7/2011 by Sue Willis
Introduction to Mental Health &
Mental Health Nursing
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Objectives
Define mental health & mental illness Explore historical perspectives on mental health
Clarification of myths/values/attitudes related tomental illness
Discuss the major hypotheses in relation to bio-psycho-socio-physiological theories as an explanationof emotions and behavior
Discuss the classification systems most commonlyused in mental health services in Australia.
Discuss the role of the mental health nurse Develop a beginning understanding of the standards
of practice for mental health nursing in Australia
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What is mental illness?
Mental illness is a general term for a group ofillnesses that affect the mind or brain: and then
inturn effect, mood, behaviour and thought.
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Type of Common Mental
Disorder
Male
%
Female
%
Persons
%
Anxiety Disorder
10.8% 17.9% 14.4%
Affective Disorder 5.3% 7.1% 6.2%Substance Use Disorder 7.0% 3.3% 5.1%
Any Common MentalDisorder
17.6% 22.3% 20.0%
*Source: National Survey Mental Health Wellbeing 2 (NSMHWB), 2007Another 1% of the Australian population will have the low prevalence mental disorder of
Psychosis in one year.
PERCENTAGE OF AUSTRALIANS AGED 16-85 WITHA MENTAL DISORDER IN LAST 12 MONTHS*
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Historical Background - beliefs
Mental illness was viewed as punishment from Gods/God
Superstition, magic, witchcraft
Possession
Mental ill people were:
Punished harshly, condemned, burned, restrained locked up
and treated as criminals in detention with criminals, peoplewith leprosy
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Historical Background Cont
The de-institutionalisation movement - Started
in the 1950s
Mid 20th Century - The introduction of neuro-
leptic drugs
Specialised mental health nursing educationwas not introduced not until after 1910 in
Australia. The first training for psychiatricnurses began in 1882 at the McLean Asylum inBoston .
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Societal attitudes towards people with
mental illness
People in society has a negative attitudes towardspeople with mental illness and this is due to theirlack of knowledge about mental illness and theimpact of the media in the way they portray the
person with mental illness (SANE Australia, 2000)
Language used to describe individuals with mentalillness can be harmful, stigmatising and discrimitory
Eg. Those people, Maddies, Cookhoos and Crazy people
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Misconceptions about mental illness
All people with mental illness are violent and
aggressive
People who with mental illness have an intellectual
disability
People with mental illness will never recover
People with mental illness should be locked up andkept away from society
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The Mental Health Act
Governs the care,
treatment and
control of mentally ill
and mentally
disordered persons in
NSW 2007
2007
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Legal Definition of Mental Illness
Mental illness for the purposes of the MH Act means a
condition that seriously impairs either temporarily orpermanently, the mental functioning of a person and ischaracterised by the presence of any one or more of the
following symptoms: Delusions
Hallucinations
Serious disorder of thought form
Severe disturbances of mood Sustained or repeated irrational behaviour indicating the
symptoms mentioned above.
Mental Health Act Guide Book (2003, p3)
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Theories on mental illness
Chemical imbalances (serotonin, dopamine, acetylcholine,others)
Anatomical abnormalities of brain (eg. Enlarged ventricles inschizophrenia)
Biological factors genetics/hereditary (when both parents
are with schizophrenia, 50% chance of having a child withschizophrenia)
Substance or drug abuse (e.g., drug induced psychosis)drugs alter chemicals in brain
Sociocultural Stressors
Mental illness is caused by the interrelationshipbetween some or all of the above factors
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Sociocultural Stressors DisadvantagementThe lack of socioeconomic resources
that are basic to adaptation
StereotypeA depersonalized conception of individuals withina group
IntoleranceUnwillingness to accept different opinions orbeliefs from people of different backgrounds
StigmaAn attribute or trait deemed by the person's socialenvironment as unfavorable
PrejudiceA preconceived, unfavorable belief aboutindividuals or groups that disregards knowledge, thought, orreason
DiscriminationDifferential treatment of individuals or groupsthat is not based on actual merit
RacismThe belief that inherent differences among the racesdetermine individual achievement and that one race is superior
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What is Mental Health Nursing
A specialised field of nursing that focuses on
meeting the mental health needs of the person,
in partnership with family, significant others,
and the community in any setting.
It is a specialised interpersonal process,
embodying a concept of caring, which is
designed to be therapeutic.
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Mental Health Nursing
is provided in a variety of settings:
In-patient/hospital (adult, child & adolescent units)
Emergency mental health services
Community mental health services
- triage & assessment
- case management
- crisis intervention
- early intervention & first episode psychosis
- rehabilitation
- accommodation
- peri & post natal depression clinics
- anxiety & depression clinics- court Liaison
- G.P/Mental Health Liaison
Corrections health mental health services
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Classification systems in MH Care
ICD-10 AM Diagnostic categories for seriousmental illness ( International classification of
diseases ; WHO generated documented; basis
of diagnosis with the clinical documentationtools , used globally )
DSM IVTR ( Diagnositic and Statistical Manual
of Mental Disorders version 4, revised usedprimarily in the US and some mental health
personnel use it in Australia
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Global Assessment of Functioning (GAF)
Axis System of diagnosis NSW Mental Health Clinical Documentation;
is a set of standardised documentation used
throughout NSW public hospitals. MH Documents include a set ofOutcome
Measurement Tools for each age group to be
used by staff, patients and carers eg. HoNOS,RUG ADL, LSP16, K10 etc
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References
American Psychiatric Association. (2000). Diagnostic and statistical manual
of mental disorders: DSM-IV-TR. (4th ed.). Washington: American
Psychiatric Association Publishers. Available online via STATRef
Australian Bureau of Statistics (ABS). (2006). Mental health in Australia: A
snapshot, 2004-05. 4824.0.55.001. Australia 2006. Canberra: AGPS.
Available online via ABS website
Australian Nursing & Midwifery Council. (ANMC) (2006). Code of
professional conduct for nurses in Australia. Dickson, ACT: ANMC. Or
accessed via: http://www.anmc.org.au
Australian Nursing & Midwifery Council. (ANMC) (2008). Code of ethics for
nurses in Australia. Dickson, ACT: ANMC. Or accessed via:
http://www.anmc.org.au
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References cont.
Australian Nursing & Midwifery Council. (ANMC) (2006). National
competency standards for the registered nurse (4th ed.). Dickson,
ACT: ANMC. Or accessed via: http://www.anmc.org.au
Boyd, M. A. (2008). Psychiatric nursing: Contemporary practice (4th ed.).
Philadelphia: Lippincott Williams & Wilkins.
Council of Australian Governments (COAG). (2006). National action plan
on mental health 2006-2011. Canberra: National Printing Office.
Fontaine, K. (2009). Mental health nursing (6th ed.). New Jersey: Prentice
Hall.
Horsfall, J. (1994). Social constructions in women's mental health.Armidale, Australia: University of New England Press.
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References cont.
Horsfall, J. Stuhlmiller, & Champ, S. (2000). Interpersonal nursing formental health. Sydney: MacLennan & Petty.
Kneisl, C. & Trigoboff, E. (2009). Contemporary psychiatric-mental healthnursing (2nd ed.). New Jersey: Prentice Hall.
NSW Health. (2008). Mental health clinical documentation. PD2005_358.
Sydney: NSW Health.
Patton, G. C., Coffey, C., Carlin, J. B., Degenhardt, L., Lynskey, M., & Hall, W.
(2002). Cannabis use and mental health in young people: a cohort
study. British Medical Journal, 325, 1195-1198.
Stuart, G. W., & Laraia, M.T. (2005). Principles and practice of psychiatric
nursing (8th ed.). St Louis: Mosby.
Varcarolis E.M. (Ed.). (2002) .Foundations of psychiatric mental health
nursing (4th ed). Philadelphia: WB Saunders.