Mental Health and Illness - Essay Example

PERSPECTIVES OF MENTAL HEALTH AND ILLNESS Introduction Continuing research in to the nature of human psychology and mental health is now providing health care professional more insights to develop treatment, therapy and rehabilitation that is more sensitive to the needs of patients but also considers more the reality of patients' lives. Developments in technology and health care services are changing the field of mental health nursing (Morris, Bloom and Kang, 2006). Post World War II, health services have begun to realize the need to revolutionize the treatment of mental illness. Concurrent researches in the fields of psychology and sociology have revealed the importance of mental health and the programs that promote and support those (Perraud et al, 2006). These developments have considered more factors of the state of human condition and the realities that they contend with (Arendt, 1958). Today, these trends have continued to emphasize the importance of creating rehabilitative mental health programs that encourage re-socialization and empowerment of mental health patients. Simultaneously, the nursing profession is seen the need to be more active in mental health care (Simpson, 2005). The nature of nursing itself is a great foundation for developing mental health programs that follows closely patients' progress. In the United States, the Diagnostic and Statistical Manual of Mental Disorders recognizes this role and prescribes the role or nursing professionals as well as their potential for the field (American Psychiatric Association [APA], 1994). The Nature of Being Human But what does the human condition encompass Socrates, Aristotle and Plato were among the first to begin ordered discourses and studies regarding what constitutes man's humanity. Though their efforts were significantly limited, these first conjectures are the foundations form where modern psychology is built on today (Atkinson et al, 1993, p. 9-13). Following its establishment as a science in the later half of the 1800's, psychology has sought to understand the human psyche and its consequence to his condition. More recent in development like the establishment of Freud's psychoanalytic school and Jung's analytic psychology have both emphasized the people are more than what they readily appear to be. Both schools are the most prevalent precepts of current therapeutic methods (p. 534). According to prevailing theories, the human condition encompasses the person and the environment by which he exists and how it affects him. Studies conducted by the King's College's Institute of Psychiatry in London have shown that there is patient-centered programs that recognize and consider the quality of life of mental health patients have gained popularity. There are further studies being conducted to assess the effectiveness of these types of programs: existing data is not yet considered conclusive to judge the effectiveness of the programs. However, the consideration alone of the significance of life-conditions, impact of mental illness to the patient and close associations and access to life-opportunities should already be considered as progress from the older views regarding mental illness (Perraud et al, 2006). Similarly, studies in the University of Southampton have shown that there is a significant relationship between mental health and the positivist manner by which researchers regarding it are now being conducted. This attitude has manifested itself not just in the fields of research but also has allowed the general public access to literature regarding mental health conditions (Weare and Markham, 2005). This has contributed to the earlier detection of conditions and subsequent care as well improved investigations in the field. This has had an overall positive effect on the condition and quality of life of not only those who have mental conditions but the whole of society as well. Thus, to be able to understand and address the human condition, the person and his environment and their interaction together has to be considered. In line with this, mental health program should be able to address both these factors if they are to be able to truly to treat mental health illness. Psychological Normality Psychological normality is the average or ideal or the state of a person. It reflects behavior that is considered typical or common among a group of people. Psychological normality can also by definition only and may not actual reflect the norms of behavior (APA, 2000). The concept of normality is arbitrary and changeable (Wilson, 1993). Take for example the case of homosexuality. For years, it was considered a disorder. Today, it has been taken off the list of psychological disorders (Atkinson et al, 1993, p. 400-404). It has been even able to gain general acceptance (Hebding and Glick, 1992, p. 173). Normality is more significant as a standard or appoint of reference rather as a definition. It is important in making preliminary diagnoses. It is also an important factor in evaluating patient problems, expected outcomes of mental illnesses and the needed nursing instructions for rehabilitation and treatment (Charleston and Happell, 2005). The definition of normality depends significantly on the perspective by which it is defined. Normality is a state of psychological state that is associated with the prevailing social norms. The problem of defining normalcy is because it is so closely associated with conformity that it becomes difficult to universalize considering differences in norms (Bouch, 2003). An important utilization of normality is in theorizing the cause of mental disorders. Aside from creating serving as standard to measure deviation, it can also be used to establish statistical characteristics and tendencies for the population. These information are used not only in the field of medicine and social science but have also been used in business and government policies. The identification of a mean or a tendency is used to indicate a standard for psychological normality. Whereas before, normality was solely dependent on popular concurrence of experts in the filed, today normality is being supported by statistical analysis more. Though the establishment of essential patterns in behavior and variable factors such as culture still requires the valuation through expert opinion, statistical normalcy is gaining greater weight in establishing psychological normality (APA, 2000). The examination of historical information of mental disease assessments done through nursing diagnoses has yielded greatest insight, if not greater volume in information, to support or dispel notions of .psychological normality (Katon et al, 2006). The structure of nursing diagnoses that consider medical, risk, syndrome and social factors have also served as important elements in the foundation of the revolutionization of mental health practices. There has been some critique regarding the accuracy of these observations considering the lack of specialization of nurses in mental health disciplines in general (Morris, Bloom and Kang, 2006). However, it has been outweighed by the need for information in establishing a clearer status of current mental health conditions today. Psychological Development A person is product of his self and the manner by which his environment affects him. In all theoretical models regarding the development of a personality, the conscious person is supposed to be motivated by internal interactions within his person. These two levels of personality interact with his environment and affect him individualistically developing his unique personality and psychological identity (Atkinson et al, 1993, pp. 455-462). In line with this, psychological development is closely related to social theories. Social theories are used to are used to understand and explain the tendencies, patterns or movement of both individuals and society based on the context of the the social order they occur in. (Hebding and Glick, 1992, p. 12). Socials only are able to explain aspects of behavior and may be difficult to apply in a universally. A person's psychological development may follow psychological models or social behavior models but will vary greatly based on the history, anthropology, economics, politics, theology and biology of the person (Adams, Bert and Sydie, 2001). The common factor of all theories regarding psychological development is that the person is central figure. The key elements that are prevalent along all the theories are the importance of cognitive development and perceptions and behavioral orientation (Atkinson et al, 1993, pp. 75-76). Critical periods for psychological developmental have been identified as early childhood and adolescence (Bandura, 1975). However, there has been recent debate regarding the development of the psychology of a person into stages. Like the concept of normalcy, the stages of psychological development are now being studied whether they are to be used as standards or guidelines. One contention is that psychological development which encompasses the person: his biology, orientation and perception; and the world he moves in: the social structure, norms, traditions, perceptions and environments. In this view, psychological development is considered a lifetime interactive process that continues and perpetuates itself during the lifetime of a person (p. 122). Biomedical Model The biomedical model was developed in the 1800's and has been the standard for medical diagnoses. The model is focuses on standard performance or characteristics of the different physical process of the body, for example its chemistry and pathology, to determine deviations (Mino and Lert, 2005). In the context of mental health diagnoses, it utilizes elevation or deficiencies in the nervous system that contribute to aberrant behavior. For example, if the biomedical model is to be used to in understanding epileptic episodes, the focus would be on the synaptic storms in the brain that characterizes epileptic episodes. The biomedical model has been tested means of identifying disorders became it utilizes a very ordered standard of reference. the biomedical model is popular in psychiatry and has been utilized particularly in the standards of medication prescriptions. Since the biomedical model considers the human body chemistry significantly, it is considered as effective model to utilize in developing drugs or treatments (McGuire-Snieckus et al, 2006). There has also been some critique regarding the biomedical model. The model has tendency to emphasize that natural science is the most compelling knowledge approach (Mino and Lert, 2005). The main contention against the model is that it diminishes societal and non-biological psychology. Critics of the model believe that this representation isolates the person. However, there is no denying that the biomedical model provides standards of diagnoses that are backed by significant and collaborative information. It is essential in creating nursing standards and helps in the formulation of nursing scenarios (McGuire-Snieckus et al, 2006). A new model, the biopsychosocial, model that has been developed based on the principles of the biomedical model. The biopsychosocial model adopts the same foundations of the biomedical model but also now includes psychological and social factors. This has allowed the biomedical model to also include factors external to the biology of the individual and also has increased its application to social integrations nursing programs. Cognitive Behavior Cognitive behavior theory focuses on the emotions and behavior. They are dominantly used in psychology and are used only mainly as observational tools in medical fields (Department of Health, 1999). Cognitive behavior theories are embedded in the field of psychotherapy and are used to gain insight into the emotions psychopathology of the individual (Kipling et al, 1999). It also is widely applied in the study of learning. This developed later into the formulation of the theory. The inclusion of cognitive elements to the theory brings into the theory biological elements but to differentiate its approach in cognition to that of the biomedical model, its focus is on how the psychology or emotion of the person contributes to the learning process (Whitfield and Williams, 2003). Cognitive behavior has been able to scientifically establish the inclusion of abstracts elements such as emotions into the diagnoses and treatment of mental health illness. It has also been able to concretize the link between cognition and behavior: establish that perception is not just about information but that the process of perception is also an important factor (Williams et al, 1997). However there have been also critiques regarding the theories. One of the main contentions of against the theory is that it involves more arbitrary standards that create discrepancies in diagnoses and treatment. Another reservation about the cognitive behavior is that it is now being used to provide basis for self-help books that may mead to misconceptions about the nature of psychological wellness (Mino and Lert, 2005). The value of cognitive behavior theories can not be diminished by its flexibility and fluidity, despite its less standardized view; it still is able to support its core theories conclusively. Its prevalent use in popular culture is an indication of its acceptance and understanding by the public. New developments in therapy methods using its theories have been able to address control concerns of treatment (Williams and Garland, 2002). This has raised its reliability and effectiveness in mental disorders; particularly those that can not be treated effectively with drugs or in patients that may have other conditions that contradict other health problems (Department of Health, 2001). Abnormal Behavior Abnormal behavior is the deviation form the norm of accepted behavior. The list of deviations has greatly been reduced in the course of developing research in psychology and sociology. Abnormal psychology, which focuses on psychological disorders, view that abnormal behavior can range form the manner of a person's feelings, thoughts, speech and behavior (Hebding and Glick, 1992). Most of the knowledge regarding the field is derived from clinical settings from the results of intelligence tests, experiments, and case studies (Atkinson et al, 2003, p. 197). In establishing treatment for identified conditions, nomothetic studies are conducted that focus on thought and behavior patterns common to patients suffering from the specific condition. Abnormal behavior can either have a biological, psychological, social or behavioral cause. Thorough nomothetic observations, possible causes of the disease for the individuals are considered to correspond with the treatment to be used (Craighead et al, 1985). Definitions of Abnormal Behavior To eliminate the subjectivity of defining abnormality, psychologists uses standardized tools to delineate their normalcy and deviations. Though these methods are based on scientific methods, it is not able to eliminate the impact cultural or social norms. The definitions of abnormality can be defined by (Davison and Neale, 1994): Statistical deviation Abnormality is defined by deviations form the mean of the population, regardless of norms Abnormality is either below are above the central tendencies with no differentiation whether the deviation have positive or negative effects to personality or behavior It relies on standard deviation analyses, bell curves and other measures of central tendency Violation Social Norms Abnormality is defined by any behavior that is not part of the prescribed accepted behavior regardless of the prevalence of the behavior Social norms can be explicit or implicit in nature Relies on social orientation and learning to transmitted and uses censure to control deviations Maladaptive behavior Any situation that deters a person from reaching goals or the presence of social behavior that deters social group functioning. The main element in the defining abnormality is the inability of acting in way that deters development or function Personal distress Abnormality is closely linked to conditions that create anxiety for the person and others The central theory is that if it produced stress than it can be considered a mental illness and will need treatment Medical disorder Abnormality exists in coincidence with physical condition that is indicative of a physiological disorder Follows closely fundamental biomedical models In this model, a healthy person, or the healthy biogenic entity, is different from the afflicted disease. Classifications of Abnormal Behavior Abnormal behaviors can either develop singly or in combinations. They range in severity as well. Mental disorders can be indicative and consequents of other diseases as well (Merskey et al, 1985). These factors create a great range of treatments and patient needs. At the same time, it also creates a wide range of possible treatment outcomes and interventions. Below is a general classification of the mental health conditions that are encountered in general mental health nursing as listed in the Diagnostic and Statistical Manual of the American Psychiatric Association (APA, 2000): Axis I - Particular clinical syndromes Axis II - Permanent Problems (Personality Disorders, Mental Retardation) Axis III - General medical conditions Axis IV - Psychosocial/environmental problems Axis V - Global assessment of functioning (GAF) The International Classification of Diseases' 10th revision (ICD-10) was published to create a standard international classification of mental conditions and to create the basis for universal treatments. Among the main proponents of the ICD-10 are the World Health Organization (WHO) and the APA1. The major classifications of the conditions are as follows (APA, 2000): F00-F09 - Organic, including symptomatic, mental disorders F10-F19 - Mental and behavioral disorders due to psychoactive substance use F20-F29 - Schizophrenia, schizotypal and delusional disorders F30-F39 - Mood disorders F40-F48 - Neurotic, stress-related and somatoform disorders F50-F59 - Behavioral syndromes associated with physiological disturbances and physical factors F60-F69 - Disorders of adult personality and behavior F70-F79 - Mental retardation F80-F89 - Disorders of psychological development F90-F98 - Behavioral and emotional disorders with onset usually occurring in childhood and adolescence F99 - Unspecified mental disorder The importance of adequate nursing services for mental illness patients is critical so that new development in the treatment of diseases can be truly be effective and maximized (Edd and Burns, 2005). Therefore, nursing and treatment procedures should involve more community and family in programs. These actions can prove not only to increase the affectivity of programs but also help alleviate pressures on nursing staff (Happell and Platania-Phung, 2005). Survey conducted among nursing students have indicated that they realize the importance of revolutionizing health care systems so that it can respond better to psychiatric needs just as they do for medical needs. However, the same surveys have shown that most nursing students do not believe that their education has sufficiently oriented them to deal with mental illness scenarios (Simpson, 2005). Institutions, regardless of their specialization should make an effort in orienting and educating nursing staff with developing knowledge regarding mental health conditions (Hayman-White and Happell, 2005). Conclusion A comprehensive understanding of the fundamental principles of mental health diagnoses, illness and treatment is a knowledge base that all medical professionals should have. Current trends in nursing have indicated that nurses are dealing more with mental health conditions than before (Roth and Kroll, 1986). This development maybe because of advances in mental health that have allowed better detection of mental illnesses but it can also be indicative of increasing mental health illness prevalence. Regardless of whether the increasing trend is because of positive or negative reasons, the reality is greater demand for mental health care. Though definitions regarding mental abnormality remain problematic and require more research, they provide medical professional a means of determining who needed mental health care. Mental health care now also induces resocialization. Whereas before when mental health patients were forever separated form society, recent researchers have shown that there is actually greater benefit in eliciting the support of family and the community in the rehabilitation of patients (Simpson, 2005). These new researches have now figured prominently in improving wellness diagnoses and have influenced current trend in nursing care. They have also been able to dramatically improve nursing outcomes for mental illness patient in clinical and social settings (Charleston and Happell, 2005). It is undeniable that mental health nursing has to deal with pressures within the medical systems as well as external pressure form the public (Morris, Bloom and Kang, 2006). Significant effort has been done to create the sensitive and responsive mental health programs that are needed to have a healthy society. But there is still much to be done and every little effort that can be done today can make a great difference. 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