Managing Physical and Mental Health Challenges - Essay Example

MANAGING MENTAL AND PHYSICAL CHALLENGES Mental and physical health are important aspects in day to day social interaction of any human being.(Ryff and Keys,1995) Mental health is the psychological wellness of an individual or simply lack of a mental disorder hence one is able to juggle between the life activities and the efforts to achieve psychological flexibility hence one can express emotions and adapt to a range of demands.(Chapman and Perry ,2005) Stacey, who is seventeen years old, has lacerations to her wrist. This is a sign of self harm which mostly is as a result of mental disturbance and emotional distress(Danny, Katharine, Derek and John2010). She also has type 1 diabetes but she is not taking her medication as instructed which another sigh of self harm . Most teenagers self harm due to stress, depression and peer pressure. These teenagers are often withdrawn. (Roberts, Pryke and Murphy,2013) The society is a major player in individuals’ physical and mental health. There is a significant relationship between these. According to the NHS choices 2008 article on mental health, teenagers, self harm is as a result of anxiety and depression. It affects people of all ages and gender with teenagers taking the lead. It ranges from inflicting pain by burning oneself, cutting oneself, hitting oneself, hair pulling and under dosing or overdosing of drugs which is also addictive. Self harm is a way of dealing with these emotions that cause pressure to the individual involved (Danny, Katharine, Derek and John2010). There are various reasons that could result to anxiety and depression for teenagers. I feel that Stacey could be undergoing bullying in school, pressure for good grades or sexuality problems(Lewinsohn, Hops and Roberts,1993). These results to emotions such as anger, low self esteem and loneliness. Other reasons for self harm include trauma. A person could have through a bad situation in the past and becomes traumatized. This could be rape, a bad accident, witnessing a crime like murder or bullying.(Lewisohn and Rohde,1998) These are situations that need proper and intense counseling and medical attention to overcome. Stacey has type 1 diabetes at only seventeen years old. This could make her peers isolate her due to their ignorance (Lewinsohn, Hops and Roberts, 1993).As a result, the teenager finds it difficult to relate to the peers .The child will then withdraw from any social interactions and this ends up in depression. Teens with cognitive behavior are prone to depression (Sullivan, 2000). According to Dana Sullivan about self injury, people who self mutilate often do this to express their emotions. Fifty percent of them have low self esteem. Stacey’s condition could lower her self esteem as she might see herself different from her peers. This could be made worse by her peers who might call her names and blame her for her condition. The social environment therefore plays a great role in the mental and physical health of individuals (Sullivan, 2000).This is because issues like bullying and rape and the trauma that comes with it are from the society. People that surround a person are the ones that stigmatize by either verbal or non verbal reactions. As a result of societal stigma, depression builds up.(Sullivan,2000) The very first step I would take before recommending any form of treatment for Stacey is to get her consent. I would speak to her alone and get to know her better by creating a rapport. This will help her trust me and allow me to help her. According to the NMC code, a patient has a right to give consent to be treated except for mentally incapable people and children. It should not be forced to anyone. If she consents, I would make it official by making her fill the consent forms and let her sign. Cognitive disabilities basically affect one’s intellectual capacity and affects performance in education(Chapman and Perry,2005). Mental health in simple terms is absence of a mental disorder and physical health is the general wellbeing of the body. Cognitive disability is detected by intellectual capacity, academic ability and adaptive conduct(Ward, Arrighi and Michels,2012). To measure the intellectual capacity, an intelligence test is run. An intelligence test is any of a number of tests designed to measure a person’s mental skills (American heritage dictionary,2000) Academic performance can be measured by communication skills and academic readiness of the person. Adaptive conduct is the age appropriate behavior a normal person should have in order to function in day to day life for example dressing and cleanliness(Tammy and Mark,1995). It can be measured by observing the child, interviewing the guardians or parents, the communication skills, Self care, social skills and interaction at home. I suggest that Stacey should undergo these three tests to verify absence of any cognitive disability since there are some signs in adaptive behavior test. I recommend this test for Stacey to rule out any possibilities of cognitive disability. This is to make sure that the treatment is holistic. Mental health and physical wellbeing can be affected by cognitive disability (Ward, Arrighi and Michels, 2012). When one is confirmed to have cognitive disability, then they end up having a difficult time interacting socially which in turn affects them psychologically. (Chapman and Perry, 2005)Psychological effects end up causing anxiety and depression which in turn makes people to seek different ways to cope. (Lewinsohn and Rhode.1998) Stacey deals with her problems by self mutilation which causes physical problems. If Stacey is confirmed to have cognitive disability, then the choice on the way forward is left to the parents but if she doesn’t have any cognitive disability, then she can make sober decisions on her own .This is according to the Nursing and Midwifery code of conduct. Stacey needs to go through a series of counseling and psychiatric treatment to make her learn how to open up and also to stop her from inflicting injury on herself and causing mental distress on her parents too. She also needs sessions with her parents to discuss issues that may be arising from her home environment. If after this she still continues to self harm, I would refer her to the adult services for diabetes management. According to the Nursing and Midwifery code of conduct, a nurse should always put the patient health first before anything by giving the best care. This will be in her best interest due to her diabetes. I would also refer her to the hospital’s program for people with a similar self harming condition for support. This program consists of a team of therapists and psychiatrists who offer psychological therapy to patients who self harm Carers are mostly informal and not professionals (Given and Sherwood,2008). Carers are people who provide care to their loved ones and they are usually family members of the patient. (Freer,2012) In Stacey’s situation, I would assign the duty of caring to her parents. The parents are emotionally drained by their daughter’s condition. They are anxious and concerned .They need to go through counseling to be able to handle the situation. I refer them to the hospital’s psychologist for counseling, I also suggest weekly sessions with the psychologist for Stacey and her parents. This will help them to deal with the self harming situation while at home, Stacey is equally emotionally, mentally and physically unwell. In this situation, the carers who are Stacey’s parents must take control. The parents must demonstrate a high level of understanding towards their daughter. They need to support her as she goes through this condition. They can do this by talking to her in a gentle way to try to get into her world. She is a teenager and she might need guidance. They need to engage her in distracting activities like family movie nights and picnics. They need to show her that she is not alone in this. I would suggest this to her parents during one of the counseling sessions for them. The parents should accompany her to therapy and also to treat the injuries. They should not show her any negativity due to her condition. This way, the healing process will be faster and effective (Given.2008).Empathy helps a therapist to get to feel the emotion of the patient and those affected in order to give the best treatment. I would have a session with Stacey and I would let her know that I understand what she is going through. I would also let her know that diabetes is a manageable disease and she should not be scared. I would let her know that her parents love her and the hospital doors are open for her whenever she needs someone to talk to. I would then have a session with her parents and let them know that their daughter is not abnormal and that self harm happens to many teenagers. I would let them know that it is not their fault as parents for this condition and they should not feel like they have failed as parents. There are a variety of tradition interventions for self harm. One of them is psychological and psycho social therapies such as manual assisted cognitive behavior therapy and bibliotherapy (use of books that have relevant content to mental disturbances used in the process of healing by patients).As Stacey’s therapist, I would recommend a six booklets to the patient that contain self help information on self harm and then guides the patient through the steps. (Courtois,2004) This could be done at home or at community health centers. This should not only tackle the present problem but a holistic approach by dealing with the social and cognitive factors. Another intervention is partial hospitalization (Anthony and Peter,1999). This is done on extreme cases where suicide has been attempted. A patient is taken to a psychiatric hospital for monitoring and treatment. Group therapy is also very effective(Greem,2011). People with this condition are treated together through therapy. It is very effective because it removes loneliness and feelings of abandonment from patients.(Greem,2011) Another effective intervention is school_ based programs. Therapies are conducted at school for students who are most affected by deliberate self harm abbreviated as DHS. This is very convenient and comfortable for students’(Lewinsohn ,Hops and Roberts,1993). In Stacey and her parents’ case I would recommend psychological and psycho social therapy specifically bibliotherapy. This is because it will cater not only for the problem at hand but a holistic approach of the situation(Courtois,2004). This will also enable the parents to participate by helping her to read through the literature. Psychiatric help will also help to get to the root of the problem (Favazza, 1989). There are various benefits and challenges that affect interdisciplinary and interagency working. One of the benefits includes improvement of services. In adult nursing especially for people with mental health needs, interdisciplinary working enables patients to receive more fulfilling services as different skills are combined(DH,2008a). Another benefit is sharing of knowledge. One health professional might have some skill that another doesn’t therefore passing it on. Another benefit is team work building. The professionals have to work together and they are able to learn how to work as a team to offer the best services to patients. (DH,2008a) Interdisciplinary and interagency working has challenges too. In adult nursing, I think the most significant challenge is communication. There is poor communication between people of different disciplines working together because they have their own unique jargon(GMC,2006). This will result to lack of coordination. Another challenge is unnecessary competition. Some people will want to prove that their profession is more important than their counterparts. This makes it very difficult to work together (GMC,2006). Some professions differ ethically from others. This will pose as a challenge because some things may not be acceptable in one field yet acceptable in another. Character variation is also a major challenge.. A health professional may be money driven therefore they putting money before services. This will bring conflict between him and another professional who believes in services delivery first.(Dinks,2011).I suggest proper documentation, strictness on ethics of health profession and proper leadership to eliminate these challenges in interdisciplinary and interagency working. INTERVENTION ANALYSIS Psychological and psycho social therapy is the most effective intervention of them all. This is because it tackles the problem in a holistic approach (Courtois, 2004). This intervention approaches self harm from psychological and social point of view. Most teenage anxiety and depression is as a result of social factors (Courtois, 2004). This intervention does not focus on the behavior portrayed by the patient only. It ensures that the problem does not recur in the future from any other possible cause (Courtois, 2004).. Psychological therapy includes counseling and psychiatric treatment. It can be done either from home at the comfort of the patient or at community health centers. The psychological therapy includes manual assisted cognitive behavior therapy and bibliotherapy (Courtois, 2004). Bibliotherapy is where the practitioners issues self help booklets as a guide to treat self harm. The clinician then follows up the patients’ progress either in person or through other means like telephone or letter. Another type is dialectical cognitive behavior therapy. This kind of therapy puts emphasis on interaction of a person with others in many environments (Grohol,2010). Partial hospitalization is a weaker intervention strategy. This is because a patient is only treated basing on the behavior at that time. These conditions should not be looked at in a narrow point of view. They should be solved holistically (Goodnick, 1997). Partial hospitalization also caters for only the patient and ignores the importance of involving the parents, friends and other relatives who are equally important in the healing process. This kind of intervention is slow especially when the condition is as a result of social factors. A patient is alienated from the society instead of being taught how to deal with the situation. This makes the patient feel like it’s a very serious condition that needs full monitoring. It is therefore advisable to incorporate the psychological and psychosocial intervention although it is a long process involving manuals to be read by patient.(Grohol,2010) Awareness campaigns about this serious condition should be organized to educate people about this condition. Self harm will in most cases result to suicide. Someone with this condition is likely to commit suicide two to five years after. This is very serious and it should be handled with care to avoid losing children and most young people to it. References D.Sullivan(2000)’Self injury;understanding the condition’journal of psychiatric medicine4(6): 283-291. D.Sullivan(2005)’Interraction between conitive behavior and mental health’ The national strategy Organisation: Department of Health Published:16 August 2005 Levenkron S.(2000)’ Adolescence: Boundaries, connections and dilemmas’ The report of an RCN survey into how nurses support young people in health care settings. Published 2005.New york . Gerald A(2004)’ Suicide,self injury and violence in schools:assessment and interventions’ ome Health Care Management & Practice 24(6): 283-291. 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