What are the 4 values that nurses integrate into practice?
- Person centred and holistic healthcare
- Culturally safe health care
- Recovery oriented mental health care
- Trauma informed care
What is mental health?
Mental health is a level of psychological well-being or an absence of mental illness. It is the “psychological state of someone who is functioning at a satisfactory level of emotional and behavioural adjustment”.
What is mental illness?
A wide range of conditions that affect mood, thinking and behaviour.
What is the aetiology of mental illness?
- Generally a combination of environmental factors, psychological and biological.
- Stress vulnerability
- Biopsychosocial model of causation
- Neurochemical
- Social and environmental
- Genetic predisposition
- Biochemical differences
How prevalent are mental health disorders during any 12 month period?
20% of Australians or 1/5 [AIHW 2018]
What are some examples of protective factors of MHI?
- Resilience
- Socio economic status
- Social determinants of health and illness
- Good physical health
- Social support
- Strong family relationships
- Problem solving skills
- Mindfulness skills/stress management skills
- Sense of belonging
- Internal locus of control [we think things but don’t act on them]
- Little or no community violence
[More on pg 502 of textbook]
What are the 5 primary areas of the contemporary MH nursing practice?
- Person centred
- Recovery orientated
- Trauma informed
- Culturally safe
- Strengths focused
How and do individuals with a MHI get treated diffently (negatively)?
Yes, they are typically stigmatized, stereotyped, and labelled. Frequently receive negative attitudes, shaming & discrimination from others.
How is MH recovery defined?
Personal 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 MH issues.
The concept of recovery was conceived by and for people with MH issues to describe their own experiences and journeys and to affirm personal identity beyond the constraints of diagnosis.
What do nurses contribute to a persons recovery journey?
- Hope - the belief that change and a better way of life is not only possible, but also attainable.
- Personal Responsibility - not counting on others to solve one’s problems or cure the disorder, but relying on one’s self with help from others.
- Self-determination - re-establish control over one’s personal life, rights and responsibilities.
- Relationships - assistance from friends, family and professional health/mental health care givers.
- Understanding - learning about the disorder, one’s self, what can be done, what is available to help.
- Identity - developing a sense of beyond a diagnostic label.
How is recovery put into practice?
- Professionals do not hold the key to recovery, people with MI’s do. The task of professionals is to facilitate recovery while the task of people who are unwell, is to recover.
- Recovery changes the frequency and duration of symptoms. Symptoms interfere with functioning less often and for briefer periods of time.
- Recovery from the consequences of the illness is sometimes more difficult than recovering from the illness itself (e.g. stigma and discrimination)
Can recovery occur even though symptoms reoccur?
Yes, the episodic nature of severe MI does not prevent recovery.
The recovery process is systematic and planned - T/F
False ! Recovery involves growths and setbacks, periods of rapid change and little change.
How is trauma informed care & practice different for MH PT’s?
- Understanding that people who have MH problems most likely have a background experience of trauma
- What happened to you? vs What’s wrong with you?
- Current service delivery can be re-traumatising for people.
- TICP is a universal precaution to provide care centred around 5 principles of safety, trustworthiness, choice, collaboration, and empowerment.
Why is it important to focus on a MH PT’s strengths?
- There is more to people than their illness or problems
- Promotes resilience, aspirations, talents and uniqueness
- Build strengths to overcome challenges
- Be curious about what works for people, how they feel, gently and kindly explore without invalidating.
- Hold hope for people, reframe pessimism to optimism.
What is the definition for Cultural Safety?
The effective nursing of a person/family … by a nurse who has undertaken a process of reflection on own cultural identity and recognizes the impact of the nurse’s culture on own nursing practice.
What are the steps to cultural safety?
- Cultural (self) awareness
- Cultural sensitivity
- Cultural safety
Produces - an environment where people can be themselves and have their needs met without being challenged or insulted. Notice how similar cultural safety is to the goals of therapeutic relationships and the therapeutic use of self. All of these are dependent on increasing self-awareness.
The therapeutic relationship is irrelevant - T/F
False ! It is the single most significant predictor of positive outcomes in MH is the quality of this relationship irrespective of therapeutic modality.
What are the Core Conditions of a relationship?
- Empathic understanding
- Genuineness
- Non judgmental approach
- Unconditional positive regard
- Confidentiality
- Warmth and respect
What hinders the therapeutic relationship?
- Factors in the nurse
- Factors in the Pt
- Organisational factors
- Social factors
What are key attitudes and qualities for nurses to have in MH?
- Being open
- The ability to set aside preconceived notions
- The ability to know and deal with personal issues
- Having good emotional health
- Being aware of your own theory of intervening and helping in MH as applied to the best evidenced practice.
What are key things to understand of ourselves in developing self awareness, which helps us to understand others?
- Knowing how you respond (emotionally)
- Understanding who you are (identity)
- Acknowledging your own worth or value (self esteem)
- Appreciating your effect on others
Why is professional self awareness important?
Essential for =
- Reflective practice
- Critical thinking
- Being authentic
What is Transference in MH?
The clients’ feelings towards the nurse may be a replay of feelings towards significant others in their past.
Replayed in the therapeutic relationship.
