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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

http://www.anmc.org.au/http://www.anmc.org.au/http://www.anmc.org.au/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.

http://www.anmc.org.au/http://www.anmc.org.au/

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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.