Mental Health Treatment - Assignment Example

 Mental Health Treatment Abstract The paper deals with treatment plan on mental health. The mental illness discussed is depression. In the modern world in general and in Australia in particular, depression is one of the most severe illnesses. The way this illness was treated in the health care institution in Australia, Melbourne is discussed further on. Moreover, general regulations of clinic are correlated with the basic statements of Mental Health Care Act (Australia, Victoria), different strategies and approaches to treatment (such as medication, medical procedures, counseling and family involvement) are considered in the paper. Key words: depression, medication, antidepressants, electroconvulsive therapy, counseling, Mental Health Care Act, family commitment. Introduction A patient Mr. Pall is a year old man had complaints about committing a suicide. He was brought to the hospital by family members. Mr. Pall was very annoyed and he over consumed alcohol. As a result he had the following vital signs on admission: pulse- 60/mt, respiratory rate – 20/mt, Bp- 100/60mmof Hg. Present History The following syndromes are: the presence of suicidal ideas, feelings of hopelessness and worthlessness, helplessness, anxious due to his relapse, self - blaming behaviors, and visual and auditory hallucinations (visual and auditory). Mr. Pall was suffering from chronic depression for the past 2 years. From psyho-emotional conditions, the patient had poor compliance with medications, was unable to maintain him in a particular job, lacked confidence in him and was suspicious. Past History The patient made an attempt to commit a suicide on March, 2010 and head injury 2 years ago. Mental Status Examination The most intimidating syndromes were the following: he was inactive and was staying in the bed. He was too melancholic and his speech was unclear. He had a plan of committing suicide and there was an intimidating fact to have a lethal final. It was evident that the patient was heavily depressed. Moreover, it was necessary to assess perceptual disturbances. On the basis of this assessment, the presence of illusions was revealed. This man used to cry and he could not control his emotions. It was evident, that a man did not have significant impairment of memory. He could not make a proper decision, what to wear and sometimes how to behave. Risk factors The patient was subjected to the following risk factors: risk of self-harm was evident; he had a poor nutrition, he felt a lack of care deficit and he suffered from hallucinations. The most intimidating risk factors were a patient’s risk of aggressive behavior and risk of suicide. Nursing Goals The main goal is to lead a patient to treatment goals; to advance a treatment process by communication with a patient; comply with treatment plan of clinic; implement different treatment strategies and facilitate a treatment process (Hayward, 2006). Treatment Plan In Australia, Melbourne, treatment of mental disorders is usually outlined in terms of the Victorian Brain Disorders Program (BDP). Actually, it should be noted that the norms and basic points of this program are clearly reflected in individual treatment of different patients. The Australian community is protected by this regulation. Individuals aged between 16 and 65 years may receive required mental health treatment connected with neurodegenerative disease and associated psychiatric disturbance (Benek-Higgins, Mcreynolds, Hogan, Savickas, 2008). Medical treatment (tricyclic antidepressants (TCAs) such as Pamelor (nortriptyline), 25 mg T.d.s; Resperidone -3mg/day (an atypical antipsychotic) was chosen. Another component is involved from antianxiety medication. It is Diazepam 5mg prn and suggested treatment, such as Electroconvulsive Therapy (ECT). We can backup medical treatment of the patient in accordance with the following criteria: the effectiveness of TCAs can be proven by the fact that these drugs are effective, but there are a lot of different side-effects. Such drawbacks as low blood pressure are controlled by the doctors nowadays. In accordance with modern researches and studies in mental health, the major attention is paid to implementation of medication and medical procedures (Fact sheet 11 Antidepressant medications - advice for adults). Therefore, a complex approach reflected in the treatment plan was justified. In accordance with thesis published in Understanding Depression and Anxiety (DL Flyer) (2010) there is an important role of psychosocial treatment. This approach reduces depression syndromes and improves a general well-being of the patients. Patients with depression have big chances to commit suicide, but this treatment is directed on suicide risk reduction. In accordance with the studies of the National Institute of Health's (NIH) Consensus Panel on Diagnosis and Treatment of Depression in Late Life (1992) there is a wide scope of treatment strategies directed on depression treatment. These modern approaches are rather safe and effective. This conclusion was made on the basis of meta-analysis studies, evidence-based studies, the practices of the most appropriate models and various comparison studies (Fact Sheet 48 - Electroconvulsive Therapy (ECT). As far as we can see, the development of treatment plan complies with the actual treatment suggestions and is reflected in different documents and clinical guidelines (Fact Sheet 11, Fact Sheet 48). Moreover, a special role was played by the counselors, who suggested counseling services for depression treatment (Happell,2011). There is no doubt that a special attention is needed for helping patients with depression. Thus, the therapist should provide the clients with a great support, to direct mutual efforts of a patient and a doctor on mutual goals’ achievement; to nourish a sense of understanding and respect, 3) establish favorable relationship between a client and a doctor; communicate realistic goals attainment (Petersen, & Zettle, 2009). These features were reflected in treatment plan in the following way: “we” bond was established and supported; respect was shown; the joint efforts of a client and therapist were evident at every treatment stage; a mutual search for understanding was encouraged (Petersen, & Zettle, 2009). Moreover, in the modern times ECT is effective and even the most severe forms of depression can be treated with the help of this therapy. In the process of this treatment electronic current is passed through the brain. There are two opposing opinions, concerning this therapy. On the one hand, in the modern context lifesaving is guaranteed. On the other hand, critics underline that this treatment is unnecessary and invasive. The clinical treatment plan has an option of ECT, but this tendency is supported by a well-weight policy of the program developed by the doctors of the Victorian Brain Disorders Program (Fact Sheet 11, 48). The most severe forms of depression can be treated with the help of this technology and in spite of other treatments ECT is directed on safe treatment and decrease of different depressive syndromes. Therefore, the benefits outweigh the side-effects of the procedure. At the point of ECT implementation, it is relevant to discuss family involvement in the process of treatment. Treatment Plan and Family Members Involvement When patients are unable to make a relevant decision of whether to implement ECT or not their family members are involved and help them. The psychiatrists try to consider about different decisions with family members and get an approval from mental health authority (Fact Sheet 48). This regulation was followed by the authority of the hospital and the patient had to undergo ECT. Moreover, family commitment and directing of the patient on reaching treatment goals is one of the critical points to be solved at governmental and local levels. The members of the community should be interested in the development of appropriate health care programs and patients should be supported both by their family members and therapists. Discharge Care Plan Date & Sign. Plan and Outcome Target Date: Nursing Interventions Date Achieved:   (_) An overall family involvement in discharge planning starts on the day of admission. (_) The following instructions on the day of discharge are: Medications Nutrition Activities Treatments Subsequent appointments Observed symptoms     (_) The importance of family intervention in the treatment process. (_) Anticipated needs/services: Hospital bed (_) Corrections and instructions for discharge plan from a doctor (_) Written and verbal instructions for a patient’s family. (_) Observation of follow-up care of a patient at discharge. (_)Discharge Instruction Sheet and Nursing notes are given to the family     Psychological therapy Another essential measure taken was psychotherapy. This therapy implies patient’s ability to penetrate into the depth of his inner emotional and psychological problems. Moreover, the fact that antidepressants were used in combination with psychotherapy means one of the most important advantages of depression treatment (Ferri, 2008; Schimelpfening, 2011). From the most appropriate form of psychotherapy, which consists of cognitive therapy, behavioral therapy, cognitive-behavioral therapy and dialectical behavioral therapy, behavioral therapy was chosen. This type of therapy is directed on correction of misbehavior of a patient (Rupke, Blecke, Renfrow, 2006). Moreover, another approach, such as interpersonal therapy was actively involved. This type of therapy implies focus on social roles of a patient and his interpersonal interactions within a family. It should be noted, that active involvement of family members and group work with other patients and medical staff was rather beneficial for the patient. The level of his aggression decreased and he was ready to modulate his behavior. Mental Health Act influences the treatment plan The health institution acts in compliance with the Victorian Mental Health Act 1986. There was no pressure and obtrusive treatment, which is guaranteed in terms of the document. With respect to the fact that the document is open for public comment, the patient’s family members were able to review and improve treatment practices implemented by the doctors. The policy of the health organization, where the patient was treated, was correlated with the Brain Disorders Program, which included behavioral modulation programs, community reintegration programs, brain disorders assessment programs etc (Puterbaugh, 2006). Thus, in accordance with the modern researches and studies, the Human Rights of People with Mental Illnesses are strongly protected in Australia. For example, we can illustrate this fact by the Burdekin Report: “While the inquiry received evidence of harassment, intimidation and physical abuse ... the most frequently reiterated concerns related to the way psychiatric patients were devalued, dehumanized and their views ignored” (cited by Happell,2011). Nevertheless, it is evident that patients with depression and other mental illnesses are treated with respect to newly introduced changes and revision of a new Mental Health Act in the State of Victoria (White, Gibbons & Schamberger, 2006). It claims that there is a need to legislate the rights of mentally ill patients and this was reflected in the following way during the process of treatment: firstly, appropriate conditions and standards of care were reflected in the process of treatment. People, suffering from depression have the same rights as other mentally ill people with other kinds of mental diseases. The patients of clinic did not experience a lack of attention from medical staff and felt equal support and care (White, Gibbons & Schamberger, 2006). Conclusion As far as we can see, depression treatment in Australia, Melbourne, is correlated with the basic points of the Melbourne Health Care Act on Mental Illnesses; clinical guidelines are developed in accordance with the modern issues and demands of the Australian patients; family involvement, psycho-social therapy and counseling play the same important role as medication and medical procedures. The considered patient was treated by means of antidepressants, ECT and was constantly counseled and supported by the staff of the clinic. It should be noted that depression treatment is one of the most controversial issues in the modern context of medicine. On the one hand, it is evident that usage of antidepressants and ECT may lead to drastic consequences. On the other hand, it is evident that a complex therapy of depression is one of the most crucial concerns of the scientists and researchers and modern approaches to mental health treatment have been essentially changed and developed with respect to innovative developments of medicine. Consequently, the main concern of mental health treatment in Australia represents a complex and integrative approach to facilitate the consequences of mental health illnesses. Modern Australians deserve availability and affordability of mental health treatment, as well as treatment of any other disease. References 1. 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Psychosocial Treatments for Major Depression and Dysthymia in Older Adults: A Review of the Research Literature. Journal of Counseling and Development, 84(2), 192+. Retrieved November 23, 2011, from Questia database: http://www.questia.com/PM.qst?a=o&d=5014740387 Read More