Essay On Mental Health Nursing

This paper aims to examine the formulation of schizophrenia with the help of biopsychosocial model of health that would provide information on how biological, social, and psychological factors have associated with the development of schizophrenia. It also includes the role of the mental health nurse, and interventions according to the biological, social, and psychological factors to improve the health of service user. Schizophrenia is a serious mental health disorder in the United Kingdom with approximately 14.5 per 1000 people. Although it does not affect a huge population like any other mental health condition; however, it is a severe neurological condition have more negative consequences (Simeone et al., 2015). According to Fromer et al. (2016), schizophrenia makes people to interpret reality by causing symptoms such as delusions, visual or auditory hallucinations, and extreme disordered thinking that reflect in the mood and behaviour of people. This paper focuses on the case of Peter, and the patient has been referred to as Peter in the entire case scenario to maintain confidentiality and protecting the patient’s details as per the NMC guidelines. Furthermore, patient consent and approval from my supervisor have been taken earlier before using this case as part of nursing education.

 

I have provided support to various mental patients in the past including peter who has been a drug and alcohol addict and has aggressive behaviour. During the care of Peter, I found that Peter’s habit of drugs and alcohol, and non-adherence to medications have increased his mental health condition. Part from this there are various biological, social, and psychological factors that triggered the problem. Some critical symptoms have observed in Peter including self-harm, attempts of suicide, delusion, and hallucinations. These symptoms and mental health condition of Peter were the major barriers to trust and relationship which was essential to obtain consent from patient. Peter has been once treated under the MHA 2007 act and detained in a rehabilitation centre due to suicide attempts. According to the biopsychosocial model of health, social, biological, and psychological factors are associated with the formation of an illness including mental disorder Bolton, and Gillett (2019). The biopsychosocial model of health is widely accepted and followed in NHS to understand the development of an illness which also helps the professionals, and nurses to understand the factors associated with the health condition of the patients; for example, by using this model, a nurse would be able to observe clients’ background, family history, education, social life, and living environment, and can identify the link between these factors and health of a patient. Furthermore, the biopsychosocial model of health allows the experts to understand the behaviour patterns of mental patients (Frazier, 2020).

 

Environmental and social factors that were associated with their mental health of Peter include his way of living, isolation, drug, and alcohol addiction, and the death of his grandmother (Trenoweth, and Moone, 2017). Peter who used to live with his parent and sister was in a close relationship with his grandmother. He has been involved in drugs, and cannabis for a long time; however, he has increased intake of this substance after the death of his grandmother which has also deteriorated his mental condition. Lifestyle and other environmental factors include eating habit, Peter did not have a routine for eating, and used to take unhealthy diets which caused nutrition problems. Environmental triggers such as isolation were also involved in the development of schizophrenia. Peter’s habit of alcohol and substance use deteriorated his mental condition. His audit score also revealed possible dependence with the use of 6 to 8 strong lager can that contain more than 9% alcohol including 6 to 8 cannabis joints per day, and four rocks crack of cocaine in 3 days (Chamber, 2017).

 

According to McCutcheon, and Marques (2020), living environment, and psychological factors can trigger schizophrenia, and individuals with a history of illness such as depression or stress are more vulnerable to having this problem. During the assessment, I have found that biopsychosocial triggers were involved in the development of schizophrenia. Many other signs have been observed in their behaviour of Peter; for example, he had manic episodes, sudden mood changes, fewer needs for sleep, low motivation, depression, and hallucinations. van Rooijen et al. (2019) explained that individuals with schizophrenia may have depression or episodes of depression, and during these depressive episodes they try to attempt suicide or involve in other self-harm activities. Similarly, they also have negative thoughts and mood swings problems. Therefore, our priority was to focus on each symptom separately and to make a comprehensive care plan for Peter. The biopsychosocial model of health provided a detailed analysis of Peter’s health condition which also made it easier to apply suitable and appropriate interventions. Through the mental health assessment, I have observed a wide scope of side effects of substance use, and symptoms of schizophrenia such as mood swings, aggressive behaviour, delusion, hallucinations, and thoughts are different from the real world. Furthermore, mental health assessment and CIWA-AR revealed his alcohol dependency which was the reason behind his hallucination (Walker, 2017). In response, people develop aggressive behaviour and feelings. Schizophrenia may affect one’s ability of thinking, by misleading them from reality, furthermore, it can affect patients’ relationships with society, family, and friends, and make the person isolated (Trenoweth, and Moone, 2017).

 

Miklowitz et al. (2021) argue that combinations of pharmaceutical and therapeutic interventions would be more effective for the treatment of schizophrenia that includes both medication and therapies, Medication focuses on symptoms related to the biological and psychological factors, and provide short-term relief; such as mood changer, relief from depression, while therapies are effective for long-term treatment that health to improve behaviour and prevent the risk of self-harm. Patient with Schizophrenia has dual symptoms which is known as positive and negative symptoms. Positive symptoms include hallucination, delusion, and change in mood and behaviour, while negative symptoms include isolation, withdrawal, trouble in speech, and lethargy (Bugarski-Kirola et al., 2017). Therapies could be used to improve the positive symptoms, and medicines can reduce the negative symptoms of schizophrenia. Active participation from patients requires to treat this mental disorder. Freeman et al. (2019), argue that patients’ participation in the treatment is necessary to improve the patients’ outcomes. During the intervention, the priority was to focus on health and behaviour of Peter, and reduce other risks; for example, Archibald et al. (2019) explained that people with schizophrenia who are addicted to alcohol have a higher risk of developing chronic illnesses. The priority is to reduce the risk of hypertension, diabetes, and heart problems. Therefore, the participation of Peter in the treatment was necessary to educate him and improve both his mental and physical health.

 

According to Emul, and Kalelioglu (2015), the physical need of mental health patients’ needs to be focused on during the care as people with schizophrenia have physical health issues due to fatigue, lack of sleep, and nutrition deficiencies. In addition, schizophrenia is group of positive and negative symptoms which require holistic care. Peter’s holistic assessment was completed with the help of multidisciplinary team. Multidisciplinary support is essential in schizophrenia care that include addressing both physical and mental needs with the help of different professionals (Baruth et al., 2021). Therapist and physicians in the multidisciplinary team have decided to apply Cognitive Behavioural Therapy (CBT), while regular medicines were provided to control negative symptoms. I was also the part of this multidisciplinary team, and as a nurse it was my responsibility to develop a therapeutic relationship with and communicate effectively with team. Prior to beginning the CBT intercession, Peter's mental health was surveyed through a psychological wellness assessment where he has rated his mood 6 out of 10. Besides, it has been seen that he was in hurry, his discourse was quick, and making discussion with focused and was certain as he was trying to ensure that people believe his hallucinations (Baruth et al., 2021).

 

Aside from the non-pharmaceutical interventions, Peter has additionally been given drugs to oversee other basic side effects; for instance, mood-stabilizing medications are useful to control hyper episodes. Peter has been given Lithium (Lithobid), this medicine has helped peter control low and high moods during the psychotic episodes. Furthermore, chlordiazepoxide was given to relieve anxiety, and intramuscular pabrinex to meet the requirements of Vitamin B and C. Considering the NICE guidelines (2015), Peter has been taught about the use of drugs and conceivable side effects he might have because of the impact of medications (Healy, 2016). Peter has been given the most ideal intercession in the mental health unit that upholds the patients through a commitment to their own medical care. Psychoeducation has been furnished alongside the consideration that has upheld his to deal with the side effects at home. Peter has been directed to utilize CBT at home which has helped him in the drawn-out treatment of hyper episodes. The collaborative approach with the evidence-based intervention was successful for Peter's psychological well-being improvement (Foster et al., 2016).

 

Nurses in the mental health unit are expected to have competencies in both physical and mental health assessment and have abilities to communicate with other professionals. French et al. (2010), suggest that mental health nurse in a multidisciplinary group is associated with the consideration need to have fundamental abilities and offer holistic help. Giving comprehensive consideration is additionally the critical capacity of a multidisciplinary group, considering the way that Peter is at the risk of creating persistent medical problems, a multidisciplinary group has been adjusted who has done the holistic assessment to ensure that no physical requirement for the client would stay unattended. To expand the interest of Peter in the care, we have requested parents to take participation in the care. The contribution of Pater’s parents has permitted us to acquire consent from him; therefore, a cooperative choice was made to observe the NMC rules to guarantee great care (NMC, 2015).

 

The effectiveness of care provided to Peter can be evaluated by applying the evaluation frameworks and by looking at the overall outcome of the multidisciplinary interventions (Marsilio, Torbica, and Villa, 2017). The CBT intervention that we have used to treat Peter was effective that has improved his behaviour and mood. Kennerley, Kirk, and Westbrook (2016), explained that CBT treatment replaces pessimistic thoughts that change the feelings and behaviour of people as it plans to lay out brain connections by brain thinking. People with discouragement and emotional well-being issues, for example, bipolar or schizophrenia have pessimistic contemplations that influence their way of behaving or lead to self-hurt, and increase aggression; Similarly, in the case of Peter, CBT helped to develop pessimistic considerations and allowed him to supplant the contemplations accordingly response or conduct moves along. Also, when CBT intercession was applied in Peter’s treatment, he revealed how negative thoughts used to develop in his mind and how he responds to the sentiments; however, CBT has allowed him to supplant the negative thoughts with positive ones, which changed his way of behaving. Individuals' way of behaving relies upon how they arrive at a circumstance; likewise, Peter has figured out how to supplant those negative thoughts (Miklowitz et al., 2021).

 

 

A blend of mediation utilizing CBT and drugs has worked for Peter and we have figured out how to decrease both positive and negative symptoms of schizophrenia (Kennerley, Kirk, and Westbrook, 2016). The contribution of peter and his family in the treatment has enabled effective support that has improved the result of care. In this way, focusing on the NICE rules comprehensive support was given to Peter that has to meet his mental, and physical requirements (NICE, 2015). As per Kitwood, and Brooker (2019), social help is viable in psychological well-being treatment as an organization of social help works on people's capacities to adapt to pressure, and offer enthusiastic help; for instance, when people are related to loved ones with whom they share what is going on and examine the issue that alleviation the pressure, likewise, they give substitute ways or answers for their concerns, and pay attention to them that reduce the burden of people. Peter was advised to meet with his friends and family to build a network of social support that can help him to improve his psychological wellbeing.

 

Patient consent and confidentiality are the major ethical and legal issues in mental health care. Obtaining consent was challenging as in starting he was not ready for treatment. It was the responsibility of our team to keep his identity secure while providing him care. Mental Health Act 2007 highlights three key ethical issues like rights of the patient when receiving treatment, their rights to dignity and liberty, and the protection of the public (Hem et al., 2018). Due to the severe symptoms of schizophrenia Peter has shown aggression and tried to harm others. It was necessary to treat Peter to protect him and others; therefore, we gave him medications to improve his mood. In the multidisciplinary team, there was a conflict of interest when I raised denied support by other physicians. They were about to detain Peter in a room; while I supported the medication over isolation. There were few unmet needs for Peter including biological requirements; for instance, because of the absence of rest, lack of sleep, and unhealthy diet, he created nutrition inadequacy, and become frail which was an ideal justification behind his weakness; subsequently, he required adequate eating with adequate liquids intake. However, our has assessed the issue and provided a comprehensive diet plan to improve nutrient and fluid level.

 

In conclusion, Peter has suffered from positive and negative symptoms of schizophrenia. According to the biopsychosocial framework, peter’s habit of consuming alcohol, and drugs, living environment, isolation, and history of mental health problems were the major triggers. It has been found that people with this disorder are confused with reality as they believe that their hallucinations are true. A similar situation has been observed with Pete who was involved in attempting to hurt himself and others. Peter has been treated with the multidisciplinary approach that has supported and assisted him to recover from schizophrenia. Both negative and positive symptoms were treated with medications and therapeutic interventions; however, basic needs such as rest, and nutrition rearmament were not addressed. In addition, conflict of interest in a multidisciplinary team was a major ethical concern during the treatment of Peter.

 

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