Mental Illnesses: Altered Perception - Case Study Example

Name: Student number: Unit: Course: Supervisor: Submission date: Mental Illnesses: Altered Perception Kokoszta, (2007) supports that, all human beings have a responsive and arousal measure to stimuli arising from the surrounding referred to as level of consciousness (LOC). When the stimuli is high than normal it is referred to as altered perception. Porth, (2007) defines altered perception as disruption in cognitive activities and operations. Cognitive process refers to mental processes involved in knowledge acquisition which are judgment, awareness, comprehension and reality orientation (Porth, 2007) adds. Interruption of these processes results in inaccurate environmental interruption which subsequently leads to inaccurate reality interruption (Kokoszta, 2007) .Altered perception can arise from or lead to depression. Depression is a psychiatric disorder characterised by persistent feeling of suicidal tendencies in some occasions, inability to sleep, lack of energy, poor concentration, dejection and feelings of hopelessness (Maurer et al., 2008). Depression is a public health concern in Australia because it is linked with high prevalence of obesity, eating disorder, alcohol dependence and misuse, substance use like bhang as it is with Tom and drug use (AIHW,2011). Reduced perception performance indicates that there is probably an injury to both the reticular activating and the cerebral hemispheres which may vary in degree. In reference to Tom’s case (altered perception) this study will look at prevalence of mental illness, Signs and symptoms of altered perception, physical health nexus mental health and impacts, the health practitioner and infrastructures system role in mental illness management, prevention, challenges and solution. In addition, the study will put forward a conclusion and recommendations. Mental disorders prevalence: Australian population Depression is the major cause of disability worldwide. Statistics show that still depression is the fourth in reference to disease burden globally (Maurer et al., 2008). In Australia, mental disorder prevalence refers to the number of people compared to the whole population who require mental disorder diagnosis at a particular time in their lifetime. In Australia mental illness is quite a disease burden accounting for 24% non-functional years gone to disability (AIHW, 2011). In addition, 45.5% of the Australian population during their lifetime experience some form of mental disorder. A study conducted on those suffering from mental disorder indicated that mental disorder prevalence among 16y-85 years old experienced mental illness in a period of the last 12 months which was 20.0% of the total population or one in five Australians. Further breakdown of the data showed that substance use disorders was among 5.1% or one of twenty,14.4% had anxiety or one of seven and affective mood disorders was 6.2% one of sixteen. From this statistics in the preceding 12 months substance use disorder was about 800,000 persons, anxiety disorder 2.3 million people and affective disorders was estimated to be about 1million Australian (AIHW, 2006). In Australia, women suffer more on anxiety and mental disorders compared to their male counterparts. However, males are prone to substance use disorders just like Tom; twice compared to women. Mental disorder prevalence declines as the Australian population ages. For instance 1 of 4, 16-24 years suffers mental disorders while for those aged 75-85 years is 1/20 (Australian Indigenous Healthinfonet, 2011) Moreover, mental disorder is highly associated with social situations such as unemployment or job quitting, low education level, un-married relationship. ABS, (2009) adds that, mental illness is prevalent among persons with social issues like young-unemployed persons and struggling individuals. For example, Homelessness did account for 21/2 times higher rate of mental disorder in the past 12months (53.3%) in relation to the whole population, 20.0%. anxiety disorders and mental disorders were also high for those who reported prior homelessness 39.4% and 27.7% respectively compared to 14.4% and 6.2% of the whole population respectively. These factors are portrayed in Tom’s case who is jobless, primary school dropout and struggling with parent and friends death loss. Additional findings (Elliot, & Masters, 2009) show that indigenous Australian had high mental disorder prevalence 24.0% females and 19.5% males versus 19.9% and 17.7% for non-indigenous. Despite the rule to free education Low level of education is a contributing factor to mental disorder among the indigenous community. In a survey 24.9% versus 20.2% low education level and school qualification in indigenous and non-indigenous groups respectively. On the same, 26.8% of the unemployment and 25.8% employed did suffer from mental disorder with indigenous community being highly impacted. According to (ABS, 2006), only 3% indigenous persons own a bachelor of degree. In addition, incarceration rates among the indigenous community are 12 times higher compared to that of the non-indigenous. Signs and symptoms of altered perception Altered perception in some persons crops in slowly by slowly or in other cases it occurs as a sudden reaction without any warning (Nick, & Mach, 2007). The most common observed signs include: Strange word usage or change in the way of speaking, extreme criticism reaction, irrational or odd statement, insomnia or oversleeping, depression, inappropriate cry or laughter, inability to express joy or cry, expressionless, flat gaze, personal hygiene deterioration, suspiciousness or hostility this is demonstrated when Tom turns wild to customers and his boss when was in employment and social withdrawal as Tom has few friends. Symptoms such as; hallucinations (non-existence of something perceived by the person as such is complaint by Tom presence of spying mirrors), disordered thinking, delusions (false personal beliefs), inappropriate or flat affect to emotions at the right time, withdrawal from other persons and demotivation are the common symptoms. Mental illness nexus physical health and impacts In most health system mental health and physical health are treated as separate identities. However, this two health states are actually correlated. Poor mental health is a predisposing factor to chronic physical condition later in life. On the other hand, poor physical health can build up to mental problems. Some of researched synergistic relationship between mental illnesses and physical health are: People with physical chronic conditions are likely to go into depression. On the other hand, mental ill persons are likely to develop a number of physical chronic conditions as compared to those in good mental health (WHO, 2011). Social factor like housing and income, emotional and physiological processes alterations affects both the body and mind. These three biological pathways, health social determinants and illnesses experiences increases the probability of a person either mentally ill or chronic physical ill to build in a co-existing status (Howard, et al, 2007). Impacts: According to (Maurer et al., 2008) mental ill persons develop a spectrum of physical symptoms that arises either from the treatment impacts or the illness. Mental illness alters sleep cycles and hormonal balances a factor which predisposes the patient susceptible to poor physical health development. Mental illness also impacts on the cognitive and social function which in turn lowers energy levels; such changes impacts the way a person can adopt healthy behaviors pessimistically. In addition, mental ill person lacks the driving force to look after their health and, the person is likely to adopt unhealthy substance abuse such cannabis and alcohol in case of Tom or smoking, sleeping habits and eating behaviors which worsens the health outcomes. Diseases such as cancer, respiratory diseases and cardiovascular conditions are highly linked to mental illnesses. An example is given by SAMHSA US report (Robert, 2012): In the past year survey indicated that person with severe depression were also diagnosed with high rates of other chronic condition compared to those in good mental health; stroke 3% compared to 1%, cardiovascular diseases 7% compared to 5%, diabetes 9% compared to 7%, asthma 17% compared to 11% and high blood pressure 24% versus 17%. In addition, hospitalization rates were high among persons with depression being 20% compared to the non-mentally ill of 12%. This can also be supported by the fact that the mentally ill do not get the expected health care demand in reference to their illness (Schmutte & Flanagan, 2008). This supports the reason why Tom is not on any psychotic medication yet is unwell. Access to health care services: challenges and way forward in Australia Mental ill patients have many challenges which avert them from primary health care accessibility. These barriers are quite complex ranging from transport system accessibility especially among the indigenous persons living in the remote areas and poverty. Such factors affect the utilization and provision of PHC in Australian services provision centers (Anderson et al., 2006). In addition, some physician may be reluctant to urgently attend newly-diagnosed-mental-health clients following short appointments (Qun, et al., 2010). According to (Overton, & Medina, 2008) Mental illness is a highly stigmatized condition. Stigma is likely to bar diagnoses and physical chronic condition treatment among the mentally ill persons. Stigma among the mentally ill is a factor of concern as it can prevent persons from seeking medical attention following a previous experience due to fear of being discriminated or can just prevent people from seeking medical health care. In addition, poor diagnoses of physical ailments can arise following stigma. The diagnosis overshadowing is a common occurrence and can mislead the diagnoses and scope of treatment as many physical conditions are left out during early treatment phases (Overton, & Medina, 2008). Another challenge comes in where those who can access PHC have lower chances of getting preventive health checks. In addition, such people have a low opportunity of surgical treatments and specialist care for other physical conditions (Elliot & Masters, 2009 and Qun, 2010). In the health sector, the mentally ill sufferings from other physical conditions are often overlooked. Many a times the patient is provided with short appointments which are not sufficient enough to share complex chronic health in reference to emotional and mental needs (Howard, et al., 2007). To conclude, both chronic physical conditions and mental illnesses share several symptoms like fatigue a factor which can inder the ability to recognize co-existing conditions (Australian Government, 2010). Studies show that mental disorder timely management at PHC level reduces physical chronic disease development while on the other hand; timely physical chronic condition management lowers the risk of mental disorder development (Nick & Mach, 2007). This is because early detection and treatment procedures are feasible (VDHS, 2008). In order to improve and control the rate of mental disorders and physical chronic condition development (Australian Government, 2010), continuous provider training, monitoring and pro-active follow up, relapse prevention planning, psychiatric consults, multidisciplinary teams, evidence-based-treatment protocols, care plans and structured diagnostic assessments need to be actively in place. Educating and supporting those people experiencing mental disorder like Tom and family is vital to encourage them on the need of general self-care (IJMH, 2008). Chronic mental conditions begin early in life altering relationships, employment and education as a result leading to isolation, poverty and disempowerment (Australian Indigenous Healthinfonet 2011). This is portrayed in Tom’s case by quitting employment and his irrational behaviors. On the other hand, Tom’s recovery will be indicated by ability to manage illness through improved mental health, including the mentally ill person in the community life, restoring income status, employment and self determination. Mental health consumer needs Tom needs to be stabilized so as to raise his self esteem, improve self care and sustainable growth despite all life odds (Elliot, & Masters, 2009). This will not be solely achieved. Therefore, Tom’s, general community, family members and the health system has a role to play towards his healing. In addition, (WHO, 2011) supports the need of multisectoral collaboration in promoting health to help in awareness promotion and lower mental illness prevalence. The nurse’s role in recognition and addressing Tom’s case There is need to define characteristics of disorientation in reference to situation, place, person and time (Porth, 2007). For Tom he is highly affected while at work in that, he suffers from altered behavior function such as aggression. He has surrounding stimuli altered perception which are likely to be caused by impaired concentration, comprehension, judgment and memory. Also he suffers from surrounding stimuli altered perception likely to arise from ideas of reference, confabulation, delusions and hallucinations. Being a cannabis and alcohol consumer, this might be also the causative effect to altered behavior disorder as illicit drug consumption can result to organic mental disorder. Organic mental disorder arises from drug ingestion or consuming mood-altering substances. Tom is also likely to be suffering from affective disorder as there is actually evidence of thought processes alteration. In handling Tom, outcome will be portrayed if he can demonstrate reality-based perceptions which will be presented by decreased hallucinations verbalization and delusions. In this case, Tom should actually demonstrate the ability of not hearing unknown sounds or living an assumed life in the environment that he is being watched by the unknown Ongoing assessment (Kokoszta, 2007) is important on Tom’s case to assess his trust building up to people around him, drug withdrawal effects that is alcohol and cannabis stoppage (Morriset al., 2009), safety experiencing in the environment, to assess his remote and recent memory function, investigate how he does problem solving, concentration and instruction follow. During this process his communication patterns will be assessed to look into presence of delusions (baseless beliefs) and hallucinations (unusual external stimuli perceptions) and how he responds to the real environment. Therapeutic intervention The main objective of therapy is to bring healing to Tom and be a real and truthful person to his surroundings. During this process, Tom will be encouraged to speak on the significance of the surrounding rather than bringing in place factors that induce fear. His perceptions, thought and needs will be always validated to induce openness and trust. Clarification of misconceptions will be offered in a respectful manner as such may arise from impaired memory activity (Kokoszta, 2007). Tom will be oriented to situations, persons, place and time as this is likely to have been affected by memory impairment. Anxious situations will be minimized to allow for ease on Tom’s ability to reason, solve problem and communicate amicably. Supervised protection will be provided by engaging his family members to ensure Tom’s safety during therapeutic season until recovery is achieved. Incase Tom is experiencing hallucination the family will let the nurse know about it, the nurse will also use words and gestures not hallucinative related, encourage care giver to always distract tom from hallucinations, find out the reason behind the hallucination so as to avoid provoking places, time and persons as much as possible and find out whether the hallucinations might be backed by ideas to hurt others or himself so as to offer sufficient safety measures (ABS, 2006). According to (VDHS, 2008) as a nurse the great role is to ensure Tom recovers and is back on his feet is connecting him to mental ill and supportive programs within the nation . This will ensure the client is fully provided with services needed cost free a fact which will reduce chances of stress build up and off-scolding treatment during the management period. Some advisable programs include PDRSS provider and Supported Residential Service Initiative (SRSI) which in addition consider working with the mentally ill persons. This will be highly recommendable for Tom as he is not in any employment at the moment following job quintal in the past. Medicine prescription upon Tom’s diagnosis is important since he is not in any medication. Therefore as a nurse, another role is to connect the client to psychiatric to ensure the right treatment is offered. Onwards, there is need to monitor drug effectives and intake and review when necessary to help Tom achieve ultimate healing (Anderson et al., 2006). Future nursing prospects Mental illness is a disease burden in Australia (AIHW, 2011). As a nurse I look forward to be a specialized: mental Health Nurse (MHN) (VDHS, 2008). This is because MHN do play a major role in managing the mentally ill. A patient who gets substantial time to have MHN do create personal attachment a factor which accelerates healing as stigma is reduced. Working in the community health care allows the MHN establish a strong connection with primary care and general practice partnerships and offers service delivery platform in integrated health care which is broad and flexible. In addition, the community health services do have a clear record of the best management programs for ensuring the mentally ill are attended best on their physical demands. In addition, it looks into such programs in reference to marginalization and de-stigmatization environment and cultural and socioeconomic barriers to health treatment and disease management. Currently, MHN faces challenges in that; the population in need of their services is enormous yet the service providers are limited and hence adding to their number is fundamental to the health systems in Australia. Conclusion and recommendation Mental illness is accounted for increase morbidity and mortality rates in Australia. Social factors such drug abuse like cannabis and alcohol, unemployment, young age groups and indigenous population as incase of Tom are the major causes of mental related conditions. Depression is one of signs of altered perception among the mentally ill accounting for most of mental disease burden. Mental illness accounts for lost productivity in the person, the community and nation at large such as job un-sustainability in Tom’s previous experience. During management of persons with altered perception conditions, past person’s history is important for great therapeutic measure. Psychological counseling, physical health assessment, monitoring and evaluating health progress as well as involving care givers and other stakeholders such as supportive programs like SRSI are vital engagement towards Tom’s recovery. Following the weight of mental illness in the Australian economy and the health systems, as a profession looking forward to be among Mental Health Nurse specialist is one of important goals in life. To effectively, manage the mentally ill, programs that look into both physical and mental health needs are vital. Therefore programs which engage the community are advisable. Such include PHC ran by mental health specialist. This is because Community health services present are well coordinated to offer PHC strategically placed to ensure the services are consistently provided, have fewer eligible and geographical issues. Just like (WHO, 2011) the need of multisectoral collaboration in promoting health to help in awareness promotion and lower mental illness prevalence is recommendable in this study. The families should be well educated on the need to report any cases of drug abusers early in time to help safeguard the future consequences. The economic and class differences among the indigenous and non-indigenous communities should be addressed to lower the rate of unemployment due to lack of good education qualification among the indigenous populations. References Anderson, I, Crengle, S, Karnaka, et al.,2006. Indigenous health in Australia, New Zealand and the Pacific. The Lancet 367:1775-1785 Australian Bureau of Statistics 2006, Corrective Services in Australia March 2006 Canberra: Australian Bureau of Statistics Australian Bureau of Statistics 2009. Australian Social Trends: Mental Health retrieved from http:www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4326.0Main%20Features32007?opendocument&tabname=Summary&prodno=4326.0&issue=2007&num=&view 13-10-2013 Australian Institute of Health and Welfare 2006, Australia’s health 2006. 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