The Core Concepts of Mental Health and the Need for Its Promotion - Essay Example

?Mental health Promotion The core objective of this assignment is to widen, gauge and evaluate the understanding regarding importance and application of mental health promotion techniques. The author begins with explaining the core concepts of mental health and the need of its promotion leading to a detailed discussion as how it worked and benefited during the care provided to a 35-year old patient (Tomas) facing mental health problems. The author also assesses & diagnoses the client’s mental health condition enabling her to identify the ways & means of mental health promotion, which were exercised in Tomas’s case. The paper also accentuates and reveals the effectiveness of nursing role, rationale behind developing an action plan. Moreover, results achieved by exercising these activities have also been critically evaluated in the light of evidence-based supports. In order to ensure confidentiality the author has supposed the patient name as “Tomas”. The Data Protection Act (1998) states, “Nurses must protect patient’s privacy and Confidentiality.” The NHS Plan (2000) highlights that confidentiality must be ensured during a patient’s assessment. According to NMC (2008), ensuring a person’s confidentiality gives you respect. Mental health is the emotional resilience which enables us to enjoy life and to survive pain, disappointment and sadness. It is a positive sense of well-being and an underlying belief in out own dignity and worth (Health Education Authority, 2000). Mental Health Promotion has a wide range of health and social benefits including increased emotional resilience, improved physical health participation, higher productivity and greater social inclusion (Department of Health, 2001). Cattan and Tilford (2006) looked at mental health promotion as the process of enhancing the capacity of individuals to take control over their lives and improve their mental health. It uses strategies that foster supportive environments and individual resilience, while showing respect for equity, social justice, interconnections and personal dignity. Mental Health promotion is an umbrella term that covers a variety of strategies, all aiming at having a positive effect on mental health. Health is a state of complete mental, physical and social well-being, and not only the absence of disease or infirmity. The Department of health (2001) described mental well being as being influenced by many factors including genetic inheritance, childhood experiences, life events, individual ability to cope and levels of social support, as well as factors like adequate housing, employment, financial security and access to appropriate health care. Mann, et al (2004) considered the focus on self-esteem as the core element of mental health promotion and the fruitful basis for a broad spectrum approach. According to Department of health (2001) mental health promotion works as three levels relevant to the whole population. Individuals are strengthened through the promotion of self-esteem, life and coping skills for example, communicating and relationships. Communities are strengthened, through increasing social inclusion and participation, improving neighborhood environments, developing health and social services which support mental health. Standard one of the National Service Framework for mental health aims to ensure that health and social services promote mental health and reduce the discrimination and social exclusion associated with mental health problems (Barker 2003). According to the National Service Framework (NSF, 1999) standard one mental health promotion states that health and social services, should promote mental health for all, working with individuals and communities, The NSF was put into place to ensure quality and the standard of care throughout the service. NMC (2008) states that nurses have a duty to care and support people in caring for themselves to improve and promote their health. In order to deliver this care an understanding of mental health and mental health promotion is essential for professionals. Tomas is a 35 year old divorcee unemployed man apparently having a long history of mental disorder problems, which started developing when he was only eight. Tomas had total four family members – parents, a handicapped brother and a sister. Tomas’s father did not work regularly and kept on changing jobs. When he was only 7 his mother died. After her death his father left the job and decided not to work anymore. Now the children’s life became miserable, especially Tomas, being the eldest son, had a lot of distress. Consequently he had to quit the school and do a job. Now Tomas worked and fed his father, handicapped brother & sister. He frequently had quarrel with his father and sometimes beat him as he had grown enough while his father lost his sight, became old and weak. Because of poverty and home environment all the relatives had broken relationships with them. Tomas continued working hard and managed to save money for his sister’s marriage. After his sister’s marriage he decided to marry. A year after marriage God blessed him with a cute son. However, due to the prevailing living environment, his wife began demanding for a separate house, which he denied as he did not want to leave alone his unemployed father and disabled brother. Finally, his wife got divorced and took away his son. This tragedy made him so distressed that he left the job and sat at home. Now due to no source of income, their survival became terrible. Meantime, his father and disabled brother died one after the other leaving him alone in this world. Today neither he talks to anyone nor does he have any friend and has no contact with any relative. Tomas was initially assessed to identify needs for nurturing his mental health. Shives and Isaacs (2002) states things to do during the initial assessment phase of the nursing which include collection of an individual’s data, gathering more information from his sister or relatives by interviews, discussions and observations. Barker (2003) states that collecting relevant and right information, that reflect a true picture of the patient circumstances, makes a way forward and facilitates in decision making process. Primary information was collected from Tomas while the secondary (support) information was gathered from his sister, ex-friends, relatives and those who were closed to him. Having conducted the Tomas assessment and collected the desired information/data, an integrated and patient-friendly care plan was formulated by means of educating him in a way that he could pull his life out of darkness and a sense of deprivations. Assessment of Tomas’s mental condition is a continued process and the results achieved are being evaluated from time to time. An assessment tool for Beck’s Depression Inventory was used for Tomas to manage his mental health problems. According to Department of Health 2003-2008 “Make it happen model of mental health which locates problems solely in individual will continue to ignore critical factors that influence mental health and well being.” Tomas’s friends, family members, community networks, and education can serve as shields to alleviate his mental deterioration. His family history, friends & relatives social boycott, leaving him helpless in the need of an hour and above all his divorce and being deprived of his son, aggregated his troubles and caused mental disorder. Health professionals must recognize that there are many personal and social factors, which enable people to overcome or protect developing such difficulties. These factors include autonomy, empowerment, proper upbringing, friendly environment, positive childhood experiences, education, social participation and healthy relations with people, social support, community networks and physical health, etc. etc. Tomas has posed signs of deterioration in his daily living activities, which includes rigidity, unserious attitude & behaviors, social boycott, isolation by cutting-off relationships with friends & family members. During the assessment he disclosed that the Company he used to work in had once sent him Switzerland to visit a factory. However, he underwent such circumstances that he subsequently exhibited signs of poor self-esteem where he undervalued himself. He cornered himself and did not want to participate in any activity arguing that he does not require anybody’s sympathy as every single person is his enemy. Being alone, there is nobody to guide him. Tomas has started smoking and eating things that are injurious to health. He is often found lost in some thoughts having sadness on face. When somebody tries to advise him, he bluntly reacts and humiliates him/her. He bothers least about what co-patients think about him. He wears dirty & tattered clothes; wears unmatched shoes and does not oil his hair. He is at stake of being mentally collapsed. Tomas has been pressing hard to let him go and he does not want to live anymore. He reacts bluntly and threatens staff of dire consequences. At the moment a TV set has been kept in his room enabling him to listen to news and watch advertisements showing various aspects of having a healthy life. A care plan follows to recover his self esteem. According to the Diagnostic and Statistical Manual of Mental Disorders ( DSM iv), negative or unstable self perceptions are a key component in the diagnostic criteria of major depressive disorders, manic and hypo manic episode, dissociative disorders, anorexia nervosa and in personality disorders (Mann, et al 2004). Tomas self esteem needs redevelopment in a way that he does not underestimate himself rather feel positive about himself. Empowerment enhances an individual’s autonomy, strengthens and increases emotional resilience through interventions to promote self-esteem, life-time and coping skills (Making it happen 2004). According to Lowden (2002), autonomy is defined as an individual’s ability to make self-determining choices and involves independence, capacity to reason and decision making ability. Tomas has been educated to become health-conscious and take care at his own for his health by means of eating fruits more than food, drinking milk and doing regular exercises. More importantly Tomas needs to identify the cause & effect of his prevailing health condition and work on it. The author politely introduced herself to Tomas stating her role and indicating the timings she would accompany Tomas. Schultz and Videbeck (2001) argued that staff should introduce themselves to clients so that they know what to expect. This was particularly important to develop a therapeutic relationship with Tomas to ensure an uninterrupted and successful treatment and healing process. The author spent sometime with Tomas, shared his problems and discussed some remedial factors that Tomas shall need to follow. This was done to assure him that nothing has lost and that he could still live a happy & healthy life like others. The only thing that he requires to do is to mould or refine his perception, thoughts and feelings. Barker (2003) argued that self examination may give the patient a better sense of reality. Identifying causes of low-esteem can guide him in adapting strategies to deal with it. Tomas was accepted by all staff with due honor and respect. With the passage of time, he started taking interest and following the guidelines given in the care plan. He expressed his interest to operate a laptop & learn commonly used software, which was welcomed by the author fulfilling his wish. Mann et al (2004) described self-esteem as the value placed on the self concept and also argued that children can experience a full range of life events after parental separation and divorce, transition to school and illness. Tomas confessed that he wittingly neglected himself and revealed the painful story of difficulties that he faced in his childhood. According to McCulloch and Boxer (1997) good mental health involves confidence, peace of mind, good relationships, ability to cope, feeling valued, respect, happy childhood, ability to adapt to change and self-esteem. With the help of staff, Tomas was able to conduct a SWOT analysis of his life ahead. SWOT stands for Strengths, Weaknesses, Opportunities and Threats. This was supported by Barry and Jenkins (2007) who pointed out that service user should be given opportunities to identify their strength’s, needs and capacities. Education was one of the effective mental health promotion interventions as evidenced by Barker (2003) when she stated that clients need to increase knowledge and skill about their health life styles. Information was given to Tomas on positive self-esteem. Mann, et al (2004) pointed out that self-esteem can lead to better health and social behaviour while poor elf-esteem is associated with a broad range of mental disorders and social problems. Tomas was encouraged to keep active, talk and think about future, eat & sleep well and more importantly not to recap his past tragedies as evidenced by the website, mentalhealth.org.uk. Tomas was referred to an occupational therapist where he agreed to go walking and participate in a regular activity that is fun, relaxing or creative. He has also discussed with staff about his participation in welfare activities when doing the job. A plan was put in place for Tomas to nurture his soul by seeking his services (two hours daily) for the patients in the ward. This is supported by Barry and Jenkins (2007) who explained that mental health promotion within mental health services should adopt a holistic approach towards mental health taking into account the individual’s physical, social, emotional, mental and spiritual needs in order to promote improved quality of life. Also Cattan and Tilford (2006) subsequently pointed out that personal and social education is likely to be more effective if it involves the development of better emotional processing and positive self-esteem. Since Tomas has shown interest in sports, he was encouraged to join a sports club. A staff member was deputed to daily take him to the nearby play ground and make him play the games he likes. The main focus was to get him involved in the activities beyond clinical treatment and to consider the needs of the whole person in their social context and for the individual to have a sense of control over their lives and fulfils their role as community members (Zissi and Barry 2006). He was also encouraged to have funs with staff or other patients in the ward. Further, he was asked to forward a few suggestions for improving patient care and when feel boring jot-down an action plan with regard to his future goals that he wishes to achieve. These activities made him feel of having a valuable part of the society and that he is able to determine his future destiny. Positive feedback by staff influenced repetition of desired behaviours and increased feelings of success. It provides encouragement and promotes a sense of direction (Doenges, et al 2000). Tomas was also encouraged self-appreciation after an achievement as acknowledged by Campbell, et al ) (2001) who found individual appraisal of events as being clearly related to their self-esteem. Seeing improvements in Tomas’s condition, he was advised to take care of his medicine himself as supported by Barker (2003) who stated that mental health promotion aims to enable behaviour change where individuals are expected to manage life events, both predictable and unpredictable, by increasing self-esteem and a sense of well-being. Tomas was also get involved in voluntary work such as cleaning his room and give hand to the hospital’s librarian. This is evidenced by Keleher and Armstrong (2005) who looked at volunteering as a mental health promotion intervention to increase self –esteem and social connectedness. Keleher and Armstrong (2005) also state that doing physical activities or exercising has a positive effect on mental health outcomes for adults and children. Tomas was encouraged to take regular exercise, going gym, doing regular walks in the nearby park and visiting shops. The mental health website also noted that exercise is good for everyone’s mental health, and that mental health promotion interventions for positive self-esteem include talking things over, health eating, opportunities for creativity, access to literature and signposting to other agencies. All these tips were practiced on Tomas. Tomas was encouraged to take healthy foods especially fresh fruit juices. When going out shopping he was encouraged to buy clothes & ties to match his personality. Several mental health promoting programs that have addressed self-esteem have proved to be effective in the prevention of eating disorders, problem behaviour and the reduction of substance of eating disorders, problem behaviour and the reduction of substance abuse. Tomas was also motivated to suggest new ideas/improvement for better managing the library activities. Building strength and capacities in individuals and encouraging greater participation and expectation of positive outcomes and recovery are likely to contribute to improved mental health (Barry na Jenkins 2007). Cattan and Tilford (2006) stated that the ultimate goal is to empower individuals and communities to take healthy related decisions by developing positive self-esteem and coping strategies. Steel (2008) states that nurse should use both non-verbal and verbal skills to help the patients manage their experiences. According to Goodstadt, et al (1999) good mental health promotion strategies need to be planned, delivered and evaluated. Tomas had considerably overcome his hesitation and was now able to comfortably talk to staff in the ward, therefore therapeutic relationship was developed. He was gradually moving a way forward by means of acknowledging his negligence in the past but now strictly adhering to the advice of caring himself, socializing with others, things to do in future, etc. Tomas’s past happenings so badly damaged his life and personality that on & off he used to talk about his childhood life. Now Tomas managed to make a few friends and socialize with patients in the ward. Since Tomas couldn’t have continued his education due to the bad economic condition, he showed interest in continuing his education. He is now careful about neatness & cleanness and dressing-up himself. He is now often found playing computer games and experimenting various options/commands on software. He has a lot of future plans and is hesitant to initiate. He now appears to having a far better life and sometimes exhibits an extra-ordinary performance when commended. His outdoor activities helped him see & observe people and apply good things in his life. Although lot more needs to be done in Tomas case to further nurture & excel his self esteem, nonetheless the steps taken, described above, have brought a drastic change to the quality of Tomas’s life. The author’s role was to understand Tomas’s psyche, share & soothe his pains, educate him, and help him recover soon. The author feels a substantial difference between the day Tomas came-in to the hospital and today. He now seems to be able to support himself and start a new life. However, he still requires persistence guidance and counseling in order to become stable and self-dependent. According to the NMC (2008) nurses must recognize and respect the role of clients as partners in their care and the contribution they make to it. In conclusion mental health promotion remains high on the government’s agenda. According to Peate and Chelvanayagam (2006) nurses have to apply the theories and principles associated with key concepts mental health promotion for them to provide high quality of mental health. The (NMC 2008) states that nurses must ensure that they promote interest of patients and clients. This can be done by assisting them to gain information that will promote their health where appropriately involving them in all aspects of care. Read More