Mental Health Promotion - Essay Example

?Order 533974 MENTAL HEALTH PROMOTION The primary objective of this essay is to present the mental health promotion study carried out on a patient inthe acute psychiatric assessment ward. A discussion on the concept of mental health and mental promotion is presented at the beginning of the paper followed by an assessment of the mental health of the patient identified in the ward. The patient is the subject for the mental health promotion strategic interventions used in application of published research and studies on mental health promotion. The efficiency of the mental promotion strategies and tools used in the assessment of the patient’s mental health is then evaluated. CONCEPT OF MENTAL HEALTH There has been various concepts and approaches to mental health. According to the Department of Health, some of the factors that greatly influenced mental health are family traditions, beliefs, and cultural practices. The World Health Organisation (WHO) defines health, as a state of being physically, mentally and socially fit. Being healthy does not just mean the absence of sickness or physical incapacity. Mental health is therefore a fundamental indicator of the overall health and well being of a person. However, many other sources simply view mental health merely as the absence of disease or illness. This view is supported in the biomedical model of health as mentioned by Seedhouse (2002). On the other hand, Seeker (2005) indicated in his study that to get the best result from caregiver’s intervention approach, there is a need to focus on the diagnosis and interpretations of a disease in pathological terms. There is a big disparity between one who is diagnosed with mental illness in contrast to another condition where there is no medical diagnosis, in terms of access to medical care and health services. Persons diagnosed of mental illness that gets access to healthcare and social services developed some sense of emotional security from the support and should cope better with the challenge. In contrast, a person who is not diagnosed of being mentally ill may not get the needed support and attention from caregivers resulting to negative feelings of being neglected. A more comprehensive definition of mental health was coined by the Health Education Authority (HEA) in 1997. The agency’s definition of mental health put emphasis on the spiritual and emotional ability of the person to endure and recover from painful experiences or sufferings in life. This resilience will enable a mentally healthy person to move on and enjoy life after a suffering some form of pain (Squire 2002, Wagnild & Collins 2009). In 2004, the World Health Organization pronounced an insightful definition of mental health giving emphasis to normal aspects of living. It is a state of well-being in which the individual is conscious of his social ties and can cope up with the day to day stresses of life. A mentally healthy person should therefore be able to work productively and to offer something positive to their community. Such productivity and positive contribution promotes inner satisfaction and greatly reinforces overall health. Nations all over the globe are looking into mental health promotion with renewed interest. Mental health is essentially the condition that dictates the total well-being and productivity of a person. Intervention through health promotion is far more effective in safeguarding mental health than treatments and medicinal therapies at the on stage of a fully diagnosed mental illness. This latter approach is rather expensive and yet less effective as presented in the following research and studies. CONCEPT OF MENTAL HEALTH PROMOTION Activities that promote the mental health of individuals has a positive effect in preventing and reducing mental illness (Barry & Jenkins 2007) and in the fast recovery of mentally afflicted individuals (Friedli 2009). In 2001, the Department of Health introduced mental health promotion as any action or activity that enhances or supports the mental well-being of a person, family, association, or community. In 1999, the DOH established the National Service Framework (NSF) for Mental Health, a ten year framework setting out high standards of care for the mentally afflicted. The first and primary standard on this framework is focused on the significance of mental health promotion for all individuals in the community. The New Horizons published the new mental health vision and pronounced mental health promotion as a strategy that would improve the mental and emotional fitness of the population (DOH 2009). This Quality Framework for mental health promotion (Health Education Authority 1997) is being adopted in this study to come up with the most appropriate mental health promotion programme for the chosen patient. The programme intends to address mental health risks on three ways: by the elimination or reduction of structural barriers, by strengthening support groups or communities, and by reinforcing resilience of the patient. The first course of action can be realised by introducing new learning experiences, or by taking out all forms of discrimination or indifference. The second course of action would entail activities that can improve or strengthen social ties through self help network or community contacts. By engaging in activities that will foster strong relationship and strengthen self-concept, the patient can become more resilient and withstand crisis (DH 2001, HEA 1997) PATIENT PROFILE The patient’s right to confidentiality and privacy is protected by law (Nursing and Midwifery Council [NMC] 2008). It is therefore reasonable to hide the true name of the patient chosen in this study. A fictitious name, Mr. John Miller is used to represent the patient who is thirty five years old, married and work as a bursar in college. This paper choose a middle-aged man from the working class as subject of the study in an attempt to present that men are also vulnerable to mental illness and that mental health promotion should not be confined more on women but equally to men as well. Men also faced varying degrees of stresses in the family and in the workplace. Traditionally they carry the burden of supporting the daily needs of the family. This alone is a stress factor more so today when almost all nations all over the globe are on the verge of a financial crisis. There are unexpressed needs hidden in silence, and because of this silence men’s health tend to be overlooked as in the case of our subject. Miller lives with his wife of more than ten years and a pet dog that he has owned for the last thirteen years. He has one adopted son whom he has a close relationship with but was recently offered a scholarship and studied abroad. He has no sibling and both his parents died when he was yet ten years old. Before his illness, Mr. Miller worked as bursar at the local college. His wife became increasingly worried when her husband spent weekend days in bed and refused to eat anything. His doctor had seen her two weeks previously and had prescribed some anti-depressants. However his wife reported to have found the medicine in his dresser with the pack still intact. In the ward, the following observations were noted on Mr. Miller. He had poor appetite, looked depressed, unmotivated, cannot concentrate, and restless. He also isolated himself and refused to participate in any activities initiated by the staffs in the ward. The first Multi-Disciplinary Team review [MDT] conducted on Mr. Miller pointed to the urgent need to put him into a stable state; physically mentally, and emotionally. He was closely observed and the observations are duly recorded for documentation. His caregiver was given instruction to ensure Mr. Miller’s safety and to make sure that he takes on time all his prescribed medicines. Furthermore, Mr. Miller was scheduled on a one on one session with the nursing staff to give him the opportunity to open up his troubles while building therapeutic atmosphere. This one on one sessions builds up a nurse and client relationship wherein the circumstances and feelings that lead to the patient’s condition can be interpreted as the healthcare professional closely observes actuations of the patient, tactfully asks questions to draw relevant information, and carefully listens as patient expresses his feelings (Rigby and Alexandra 2008). Established therapeutic relationship essentially influences positive health outcomes among mental patients, according to Reynolds (2009). With this in mind, the staff designed a non- intrusive mental health program that is tailored to Mr. Miller’s status based on recorded observations and findings during the initial MDT. Important findings that called for the cooperation from Mr. Miller’s wife were noted. The wife was educated to the importance of his role in the therapeutic mental health promotion programmed for his husband. Mr. Millers’ wife vowed to fully support the programme and this strengthened the intimacy between husband and wife. NEEDS ASSESSMENT A detailed assessment was then conducted on Mr. Miller’s health promotion needs, and this was done based on the concept on “needs-led” assessment of the NHS and Community Care Act of 1990 (DH 1999). To make sure that scarce services and resources are wisely allocated to satisfactorily meet the identified needs of the patient, systematic structure to assess Mr. Miller’s health promotion needs was carefully put into place (Parry-Jones and Soulsby 2001). Informal interviews with Mr. Miller helped establish and understand difficult experience and fears that he expressed (Barker 2009). For instance, he felt that his lack of motivation to care for himself and the loss of interest in walking his dog and other pleasurable activities was a feature of an illness, worsened by a negative impact on his relations with his wife. Helpful information was revealed during the informal interviews conducted with Mr. Miller. This helped point out the painful experiences and fears that led to his present condition (Barker 2009). It was found out that one of the contributing factor was the feeling that his lost of interest to walk his dog every morning and to perform other enjoyable activities was an illness, and this was aggravated by the negative impact of this sick feeling on his marital relations with his wife. Another factor that came into light was his appearance. The executive look is gone. Being a bursar at the local college, Mr. Miller, he has always been smart-looking, projected what he called an ‘executive’ appearance and now he’s disturbed by the great change in his appearance. He has always been socially active and enjoyed interacting with people in the community. Information from his wife provided a better picture of Mr. Miller before his admission and this helped the staff examined the contributory factors to Mr. Miller’s present health condition. With the above information, the MDT instituted a mental health promotion program that is best suited to the needs of Mr. Miller. The objective of the program is not merely to prevent the symptoms of a mental illness but rather to restore and support his total well-being (Barry and Jenkins 2007). It is worth noting that Mr. Miller was very cooperative with the programme. He revealed that staying physically active is important to him as it has contributed to his mental and physical well-being in the past. This revelation validates the Department of Health’s recommendation in 2001 which was to include physical exercise in all health and social services to help prevent or treat health problems. Another literature study, appreciated the immense support of the promotion of physical activity in relation to mental health (Cripps 2008). Although the role of physical activity was positively acknowledged, there are those who feel that physical exercise is just use as a distraction strategy in some cases, while others think that it is just a matter of a lifestyle choice and most found it difficult to find the perfect link between physical and mental health (Faulkner and Biddle 2002). However, some reports noted that as individuals suffer different symptoms that impact mental health, it is difficult to determine which exercise is most favorable as there is limited evidence to exactly distinguish the benefits on the patient of the different forms of physical exercise. A part of Mr. Miller’s health promotion program requires him to perform physical exercise. The staff studied an appropriate physical activity that he could do in the ward. His exercise program is divided into four phases to help him gradually develop and maintain physical activity: The following are the four phases of the exercise program: 1. Mr. Miller is required to attend and observe the exercise session. 2. Mr. Miller needs to participate in the exercise session for as long as possible to check on his capability. 3. Mr. Miller needs to complete the entire session. 4. Mr. Miller needs to perform the exercise session independently and be able to discuss how he feels during the exercise. The first exercise introduced to Mr. Miller was the chair-based session which is run twice a week in the ward. The staff supported and encouraged him to participate as much as he could. He cooperated willfully and was tasked to note his daily achievements. The strategy intends to help him regain self-control and understand the value of physical exercise to his mental health. Several studies have confirmed the relationship between physical exercise and mental well being. Earlier literature review suggested that physical exercise can improve aminergic synaptic transmission in the nervous system by increasing the 5-HT neural transmitter which is also known as serotonin (Ransford 1982). Another study noted that, a high concentration of serotonin on the post synaptic 5-HT receptor, an excitory neurotransmitter, have a good effect on the total disposition of a person (Greenwood et al 2005 as cited by Cripps 2008). However, Colbridge cautioned practitioners and supporters to be fully aware that the hypothesis was derived from animal study models and not on human beings. Meta-analytic reviews on the impact of exercise on depression indicated that there were notable changes in the psychosocial aspects of the patient (North et al as cited in Callaghan 2004). One of the factors that contribute to this positive change is the opportunity to meet other people during the exercise session which provides occasions for social interaction. Other factors that can help promote mental health are a happy marriage and reliable social support. The Social Exclusion Unit (2009) research findings revealed that married couples appeared to fare better than their unmarried counterparts. In addition, authors Hedelin and Svenssion affirmed the importance of social support in positive mental health, in that, timely motivation from a trusted friend or relative can successfully inspire an individual to participate in exercise activities. Healthcare professionals at the ward fully informed Mr. Miller of the details of his therapeutic programme and he was commendably supportive. However Mr. Miller confessed that he needed more positive input from his wife. He felt that the presence of his wife will inspire him to perform better during the exercise programs. Staff conveyed Mr. Miller’s concerns to his wife and he was reassured of his wife’s full support. Soon he became more enthusiastic and wholeheartedly participative of the exercise program. Not long after that, he informed the staff that he felt that he is now ready to explore a more challenging physical programme that is outside the ward. Reports of positive developments from Mr. Miller and the noticeable improvement of his physical appearance demonstrated an improved self-concept (Mann 2004). This evidence proved that poor social support contributes to poor self-esteem which is can lead to mental health problems as suggested by a study reported by authors Brown et al in1990 and cited by Mann in 2004. EVALUATION Clinical observations, and all qualitative and quantitative data confirmed the fact that mental health promotion programmes can effectively help in restoring and preserving the total well-being a person as proven by this study on the case of Mr. Miller. The subject’s acceptance of his condition, the fostered therapeutic relationship, and the loving support of his wife are also key factors that made the mental health programme worked successfully on his case. Although Mr. Miller’s response to the strategy was at first disappointing, continuous support in terms of subtle encouragement from the staff moved him to cooperate. His closest friend, who in this case is the wife, is very crucial to his finally accepting the programmed that was specially designed to help him get back into his normal day to day affairs. He regained control of himself and of his total well-being. Being able to get back to doing things he enjoyed doing most like walking his dog and socially interacting with people around him greatly helped Mr. Miller’s restoration back to a healthy life. Now he is in full control of himself again and his medication has been reduced. He voluntarily enrolls in a fitness program in his locality. This renewed consciousness on the impact of physical exercise, social interaction, and other mental health promotion programme including the support that he could get from healthcare professionals can prevent future relapse. As in this case of Mr. Miller, he accepted and appreciated the value of physical exercise and the value of stable social relations as key factors in promoting mental health and emotional well-being. He was grateful for the timely intervention and the mental health promotion programmes initiated by healthcare professionals. He was also very careful for the loving and untiring support from his wife. There is a strong proof that supported the relevance of mental health promotion programmes (WHO 2004). This study proves the importance of promoting mental health not only among men in the working class but all through the life ages, young and old, men and women alike. Timely access to healthcare services from healthcare professionals and the commencement of non-intrusive interventions as in the case of Mr. Miller protected and saved the mental health of the subject. This proves the point that medicines alone cannot effectively heal mental illness, and that timely intervention through mental health promotion can save patients from mental incapacity. Mental health promotion coupled with social support, marital intimacy and close family ties largely promote mental health. The study also presented the value of a stable marriage and love in the family circle while allowing freedom to interact with one’s social circle. A set of wholesome exercise activities in the family and in the workplace help in promoting mental wellness as suggested by the different studies presented in this paper. Mental health promotional activities and programmes in the home and in the workplace contribute to the total well-being and to becoming an active contributor in the family and in the community. Such non-intrusive intervention effectively helped mentally challenged patients as presented in this paper. 2) References • Age Concern. (2006). UK Inquiry into Mental Health and Well-being. London: Age Concern. • Audit Commission. (2004). Older People : Independence and well-being. The Challenge for Public Services. London: Audit Commission. • Barker, P.. (2009). Assessment- The Foundation of Practice. In P. Barker, Psychiatric and Mental Health Nursing. The Craft of Caring. London: Arnold. • Barry, M. & Jenkins, R. (2009). Implementing Mental Health Promotion. Philadelphia: Churchill. • Callaghan, P. (2004). Exercise: A Neglected intervention in Mental Health Care. Journal of Psychiatric and Mental health Nursing. • Colbridge, M. (2005) Management of SSRI and Related Drug Overdose. 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