NRS222 Essential Nursing Care : Mental Health Nursing

Introduction:

The mental health sector has advanced drastically in the past decade, the changes in the healthcare industry with respect to the different assessment and diagnostic features, innovative pharmacological and non-pharmacological treatment options and recovery-oriented care planning (Slade et al., 2014). With the advancements in the system of mental health care sector, there have been innovations in the care approach taken by the health care providers to the mentally ill patients as well. One of the greatest changes that have been brought forward by the mental health sector had been the integration of the patient centred care planning (Van Manen, 2016). Patient centred care is an approach of care is an approach of care that recognizes and respects the uniqueness of each patient and the individuality that they represent, even in the triggers of mental health deterioration and the different clinical manifestation. This essay will attempt to discuss the aspects of patient centred care in mental health nursing and how lived experiences encountering a mentally ill individual can inform the person-centred care in mental health care.

Discussion:

Lived experience can be defined as the real-life experiences that the individuals have attained while either dealing with mental illness themselves or have witnessed someone close go through any mental disorder themselves. As mentioned by the Jacob, Munro and Taylor (2015), lived experience provides a varied array of different factors associated with the recovery of a patient with mental illness and the exact manner the experience should be aligned to the recovery-oriented care so that their recovery process can be facilitated effectively.  It has to be mentioned in this context that each and every individual has a very different psyche and even in the state of mental illness, the triggers and the protective factors among the different mentally ill individuals differ from one person to another. The lived experience allows the mental health professionals to be able to understand how decision making and personal involvement in the context of care planning and implementation can improve the care outcomes for the patients.

As per the recent improvements in the mental health sector, the care practice scenario is recovery focussed, as a result the need for the mental health care providers to acquaint themselves with the exact need of the mentally ill, the triggers that provoke deteriorations in the mental state of the individuals (Qmhc.qld.gov.au, 2018). The real-life experience of a mental health worker such as a nurse or a peer worker of either going through mental illness or having watched a close one go through the mental illness provides the skills and knowledge of understanding the pain and suffering the mentally ill have to undergo (Van Manen, 2016). Along with that, mental illness and the therapeutic treatment management associated with the recovery planning is needed to focus on achievable goals for the patients (Pierre, 2017). The benefit of lived experience allows the care providers have a clear understanding of the goals that can seem achievable by the mentally ill. The nurses that have had the chance to go through the recovery journey along with the patient with a mental illness recognize the protective factors and risk factors effectively so that achievable goals can be set (Gunasekara et al., 2014). Risk factors are characterised as the increased the likelihood of poor mental health. Individual risk factors may include the genetic predisposition and sometimes the addiction to alcohol or exposure to alcohol. Cognitive immaturity or emotional immaturity, low self-esteem is the individual attributes of mental illness can be recognized through the lived experiences (Coates, Livermore & Green, 2018). Social circumstances where individuals experience loneliness, family conflict, exposure to mental and physical violence give rise to the mental illness. A study by Banfield et al. (2018), suggested that lived experience reported the environmental attributes such as poor access to the basic services, injustice or discrimination in the workplace, school or colleges, social and gender inequality as the risk factors for mental illness (Happell et al., 2015). Therefore, lived experience provides the insight of recognising risk factors and helps nurses to offer superior patient-centric c Lived experiences also contribute recognising the protective which can be enhanced to provide the care during mental illness recovery (Yanos et al., 2015). A study by Petros et al. (2016), suggested that social family support of the patients along with good family interactions acts as the most significant protective factor for improvement of mental illness.  Effective communication skills, economic security, success at work can be by identified as the protective factors for recovery of mental illness of the patient (Morán-Sánchez,  et al. 2016). Since every individual has the different mindset, the lived experiences provide the care provider with the clear understanding of risk factors that need to be eliminated for recovery of mental illness and protective factors to be enhanced for recovery (Bocking et al., 2018). Moreover, understanding each patient’s situation or lived experiences provide nurses to asses each patient’s authentic self.

Peer workers role is being introduced in the mental health recovery and to support the individuals in the mental health recovery (Bocking et al., 2018).. Narrative studies suggested that recovery provide evidence of the importance of individuals who had similar experiences. Peer workers tend to realise specific enhancement in the feeling of empowerment, and therefore they aid in increasing the level of self-esteem, install hope, confidence and positive attitudes (Slade et al., 2014). Peer worker often has an improved ability to incorporate individualised coping strategies for different patients concerning their lived experience (Slade et al., 2014). Studies of peer support services highlighted that they are more relation focused and consequently, evidence of acceptance for patients who received the peer-provided services. However, despite the substantial benefits of lived experiences observed in patient-centric care of mental health recovery, it has the specific drawback that hinders the care procedure (Happell et al., 2015). Nurses who have witnessed someone close go through any mental disorder themselves; tend to be more emotionally vulnerable which in turn affect their delivery of care. Moreover, nurses tend to be more biased when providing the attention to the patient and decision making in the clinical setting for the particular patient.

The lived experience can be incorporated into my nursing practices for providing the patient-centric care in collaboration with the peer workers.  One of the identified aspects that require development is effective communications skills that would help me to the area of concern of patient and address the risk factors, protective factors for delivery of superior patient-centric care. Effective communication requires active listening skills and patience to understand the problem of the patient (Van Manen, 2016). The aspect of effective communication can be developed by arranging the session in clinical setting where peer workers and the patient can share their personal experiences (Slade et al., 2014). Since mental illness unique to every patient, the intervention plans can be designed by effective communication with each patient and in collaboration with the peer workers who undergone the same experiences (Van Manen, 2016). Therefore, I would arrange the session in a different time interval to effectively communicate with them so that they will be able to narrate their lived experiences or any experiences that disrupt their mental peace. Sometimes the mental illness arises due to weak interaction with family members and communication requires extra effort in that cases (Qmhc.qld.gov.au, 2018).. Lack of communication causes people to withdraw the social cues, and effective communication serves as the preventive maintenance, reassuring the family members the recovery by focusing on the personal relationship. Therefore, the session can be arranged involving each close family members of the patient along with the peer workers who are giving support to the patient (Dugdale et al., 2018). Family members can negotiate their time and their narratives which would provide me with a better understanding of the particular patient and recognise the risk factors of the mental illness for the sake of offering a healthy mental state (Van Manen, 2016). The communication would be empathetic, compassionate and more emotionally connected with both peer workers and patient so that both can enhance their coping mechanism (Bocking et al., 2018). A feedback session can be arranged after a communication session where every participant of the course will provide feedback on the communication session which in turn will help to recover the mental illness.

Conclusion:

Thus it can be concluded that mental health important aspect of human being which require the attention of every health professional to reduce the illness. However, with the advancements in the system of mental health care sector, there have been innovations in the care approach taken by the health care providers to the mentally ill patients as well. Lived experience provides a varied array of different factors associated with mental illness which contribute nurses with an insight of the disease to deliver patient-centric care. The benefit of lived experience allows the care providers have a clear understanding of the goals that can seem achievable. Mental illness and the treatment management associated with the recovery planning is needed to focus on achievable goals for the patients. The communication is the only essential aspect which needs to develop for patient-centric care (Banfield et al., 2018).

References:

Banfield, M., Randall, R., O’Brien, M., Hope, S., Gulliver, A., Forbes, O., … & Griffiths, K. (2018). Lived experience researchers partnering with consumers and carers to improve mental health research: Reflections from an Australian initiative. International journal of mental health nursing. 42(3), pp.348-355.

Bocking, J., Happell, B., Scholz, B., & Platania-Phung, C. (2018). Beyond a textbook: Using lived experience of recovery from mental illness as a teaching tool. Australian Nursing and Midwifery Journal, 26(1), 38-38.

Coates, D., Livermore, P., & Green, R. (2018). The unique contribution of older people with a lived experience of mental illness to the peer workforce: observations from older peer workers. European Journal for Person Centered Healthcare, 6(1), 78-87.

Dugdale, S., Elison-Davies, S., Davies, G., Ward, J., & Jones, M. (2018). An exploration of lived experience in a digital world: How technology is revolutionising substance misuse recovery. In Doing Research In and On the Digital (pp. 47-65). Routledge.

Gunasekara, I., Pentland, T., Rodgers, T., & Patterson, S. (2014). What makes an excellent mental health nurse? A pragmatic inquiry initiated and conducted by people with lived experience of service use. International Journal of Mental Health Nursing, 23(2), 101-109.

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Morán-Sánchez, I., Luna, A., Pérez-Cárceles, M. D., Sederer, L. I., Derman, M., Carruthers, J., & Wall, M. (2016). Peers (ie people with lived experience of mental illness and/or addictions) are being hired in large numbers to offer support for people with serious mental illnesses, but little is known about how peer providers are viewed. The goal of this study was to measure reactions towards actors posed as peer providers. Half of study participants interacted with an actor portraying a psychiatrist and half… Psychiatric Quarterly, 87(1), 203-210.

Petros, R., Solomon, P., Linz, S., DeCesaris, M., & Hanrahan, N. P. (2016). Autovideography: The lived experience of recovery for adults with serious mental illness. Psychiatric Quarterly, 87(3), 417-426.

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Qmhc.qld.gov.au. (2018). Promoting Lived Experience Perspective: Discussion paper prepared for the Queensland Mental Health Commission. [online] Available at: https://www.qmhc.qld.gov.au/sites/default/files/wp-content/uploads/2017/02/Promoting-Lived-Experience-Perspective_Discussion-paper.pdf [Accessed 6 Oct. 2018].

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Van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy. Routledge.

Yanos, P. T., Lucksted, A., Drapalski, A. L., Roe, D., & Lysaker, P. (2015). Interventions targeting mental health self-stigma: A review and comparison. Psychiatric rehabilitation journal, 38(2), 171