Delivering Culturally Safe Healthcare - Assignment Example

CULTURAL COMPETENCE IN MENTAL ASSESSMENT Describe how Justin’s wellbeing might be impacted by his recent events Evidence on determinants of mental health shows that: there is a strong link between life events such as financial hardship, chronic disease, unemployment, bereavement and depression.In this case, Justin has experienced various events likely to impact his wellbeing. His family members as well as Justin have been unwell with diabetes which is a chronic disease. Tosevski&Milovancevic (2006, pp. 185-187) explain that there is a strong association between serious illness in a family and mental health. Furthermore, his uncontrolled diabetes has led him to miss out job opportunities which could further impact his wellbeing. Another life event that has impacted Justin’s wellbeing is lack of employment. Justin missed out a coveted apprenticeship and several times was not successful in getting a job due to his uncontrolled diabetes. Even after getting a casual work job, he wasn’t sure of maintaining his job due to his diabetes condition. This is in line with Tosevski & Milovancevic (2006, pp. 188) who found out that unemployment is an event that can have a great impact on mental health. Lastly, Justin losing his uncle is an event that has greatly impacted his wellbeing. Justin lost his uncle who has been extremely close to him throughout his life and they have shared a lot in their lives. This is one event that has had the greatest event on Justin’s wellbeing. Chatterjee, & Arora (2005, p. 4) explain that loss of a loved one is a major cause of severe depressive reactions. How may Justin’s cultural interpretation of mental illness be different from your own? Justin is an aboriginal and therefore he is likely to interpret his mental illness in an indigenous context. Mental health in an indigenous context is perceived as a qualitative index of the integrity and strength of a person’s connection with his/her natural, spiritual as well as social world (Commonwealth of Australia, 2010, p. 17). Therefore, Justin is likely to interpret his mental illness according to his culture and experience. He may be viewing his condition as a form of spiritual weakness and a punishment for having sinned. In addition, he may be thinking that his illness is connected with cultural practices such as witchcraft since aboriginals view mental illness as a witchcraft issue and not a health issue. Additionally, his mental illness is likely to generate fear and significant stigmatization for Justin as well as his family. On the other hand, I am likely to interpret Justin’s mental illness as a health issue that requires treatment while taking into account individual, family as well as community factors. Mental illness is not a spiritual or cultural issue but a clinical health issue that requires the appropriate diagnosis and treatment. Additionally, mental illness should be viewing holistically considering all factors contributing to the illness such as social disadvantage, unemployment, family as well as cultural beliefs (Commonwealth of Australia, 2010, p. 17). Identify how your own attitudes and values relating to mental illness may influence any communication with Justin Nurse’s attitudes and values affect the way they handle their patients and the way they communicate to them (College of Nurses of Ontario 2009, p. 2). Accordingly, my values and attitudes towards mental illness may influence communication with Justin. Viewing mental illness as a health issue and not an abnormal illness will make Justin at ease and hence it will be easier to build rapport with him. According to Queensland Health (2014, p.8)building the appropriate rapport can assist in overcoming individual fears or views that the patient might have and can assist in building trust and respect in the healthcare provider. Therefore, this will facilitate communication because with trust and respect, Justin will be able to communicate effectively about his mental illness. Attitudes and values will also play a role in encouraging and supporting open communication. It will be therefore important to let Justin know that I can talk to him at a personal level and this will be facilitated by the fact that my views and attitude towards mental illness are not biased or discriminatory. This will encourage Justin to participate in communication (College of Nurses of Ontario, 2009, p. 5). How can partnerships with Justin and his immediate and/or extended family be developed and maintained throughout his journey of care Partnerships can be developed by ensuring that Justin’s family members are involved in his care. Personal and family resilience should be built to tackle the risk factors for mental health issue that Justin is experiencing and assist in protecting against the effects of mental health illness of Justin. In addition, the family should be educated regarding Justin’s mental illness for them to be able to accept the condition as a health issue. Supporting the family by referring them to suitable organisations that can support the family in dealing with various issues such as counseling services for Justin and the family, financial support to cater for Justin’s medical expenses as well as referring the family to the appropriate diabetes institutions that can assist them in managing their condition because the family’s illness has contributed to Justin’s mental illness. The relationships can also be built by ensuring that healthcare providers communicate in a culturally sensitive and respectful manner as this will make the family accept the healthcare providers. Moreover, it should be ensured that a culturally sensitive language is used during any interactions with Justin and his family and culturally specific practices are implemented in Justin’s care (Dudgeon et al 2014, p. 27). What needs to happen to ensure culturally safe care for Justin once he is hospitalised? During hospitalization, Justin should not be discriminated but should be treated and handled in the same way as other patients in the hospital. All healthcare providers should treat Justin as equal without patronising him in any way. In addition, all cultural aspects of Justin as an aboriginal should be considered during delivery of care. For example, for aboriginals it is a cultural taboo for a woman to tend needs of a man (Berg 2014, p. 136-137). Therefore, it would appropriate for such aspects to be considered and ensure that whenever Justin has personal needs they are tended by male healthcare providers. Additionally, aboriginals have their cultural foods and thus during his hospital stay it would be appropriate to give him foods that are culturally fit for him. Similarly, his language should be taken into account and since English is not first language for aboriginals, any language barriers should be handled appropriately and if an interpreter is needed, one should be provided to ensure there is effective communication. Justin being an aboriginal, knowing and understanding aboriginal protocols will be the beginning point for ensuring Justin receives culturally safe care during his hospitalization (Berg 2014 p. 136-137). From the information in the Mental Health Assessment and Mental State Examination, what are the identified areas of concern and the priorities of care planning for Justin? Risk for suicide: Justin has had the idea of committing suicide because he feels hopeless in life. He has clear laid plan on how he will end his life and this shows he is at a very high risk of committing suicide. It should be ensured that the risk of Justin committing suicide is eliminated by removing any possible objects that he can use and maintaining close observation. Justin should also be given psychological support and appropriate medication (Goldberg 2013, p. 169-170). Pathological grief: This is demonstrated by Justin’s feelings of suicide, worthlessness and this signals pathological grief and also signals depression. Appropriate medical and psychological treatment should be given (Goldberg 2013, p. 170). Depression: Justin demonstrates symptoms of depression and also needs to be treated. Justin should be administered with antidepressants as well as cognitive therapy (Goldberg 2013 p. 170). Depression secondary to a medical condition: Justin shows symptoms of depressed mood that is as a result of a medical condition namely, diabetes. According to him, he has lost some job offers as a result of his condition and this makes him feel worthless because he cannot help his parents. Therefore, it would be appropriate to aim at ensuring that his diabetes is managed effectively while still taking antidepressants appropriately (Goldberg 2013, p. 170). Identify the communication skills/strategies that are allowing the health professional to talk with Justin in a culturally safe manner Rapport building: The health professional recognizes that building rapport and therapeutic relationship may take time. This is achieved by allowing enough time and making sure that follow-up arrangements are there (Australian Family Physician 2014, p.60). In this case, the health professional provides adequate time during sessions with Justin. Similarly, when Justin does not want to talk, the healthcare professional does not push Justin but left to give him time and comes back later. Asking open-ended questions: The health professional is keen on asking open-ended questions rather than closed questions. This gives Justin a room to explore answers and give comprehensive answers. For instance, the health professional asks Justin to share his feelings about suicide and this enables Justin to give a detailed description about his feelings. The health professional uses language appropriate to Justin and context. The health professional does not use any patronizing language during all conversations and seems to be taking into account Justin’s cultural aspects and the fact that Justin is an aboriginal. Questioning/probing skills: Aboriginal people prefer less direct approach during communications and they find direct questioning somehow antagonizing and offensive as well(Australian Family Physician 2014, p. 60). Accordingly, the health professional established a two way exchange with Justin and always hinted the targeted information indirectly. Review the discharge plan and 3 month review and consider how Justin can be supported to maintain his well-being when he has returned to his family and community The discharge plan should include self-care activities such as: advising Justin to take regular exercises because physical activities improve depression symptoms; getting enough sleep with a worked sleep schedule because sleep is vital for Justin’s emotional health and diet should also be included where the healthcare professional should provide information regarding a meal plan appropriate for Justin (Desplenter, 2011, p. 4-5). In addition, the discharge plan should include medications that Justin should take after being discharged and the information that should be in included consist of: reason for medication, dosage, time to take the medication, and how to obtain medication. After Justin’s discharge, he can be supported by looking for an organization that can assist the family with financial difficulties since the family’s financial status is one of the factors that has contributed to his mental illness. Similarly, being unemployed is one of stress factors for Justin. Justin can be assisted by providing him with various available job opportunities as this can help him get a job and eliminate this stress factor (Desplenter 2011, p. 4). Lastly, Justin can be supported by ensuring that he has sufficient transportation for follow-up appointments. After considering the issues for Justin, reflect on your own experiences of relating to people from different cultures. Consider what you have learnt from Justin's story and how your new knowledge might influence your practice Previously, I have viewed people from different culture as if they are different from me. I have also always preferred interacting with people from my own cultural background. For instance, during my undergraduate studies, I preferred interacting with students with similar culture. However, even though I have always viewed them differently, I never discriminate against anybody who belongs to a different culture from mine. Through Justin’s story, I have learnt that healthcare providers who demonstrate cultural competence always consider culture as a factor during all their interactions with patients. Such healthcare professionals always incorporate self-reflection during all patients’ interactions and apply the core professional skills of cultural respect to do away with cross-cultural communication barriers. I have also learnt that more cultural competence allows patients and clients to be more comfortable during interactions as well as medical interactions/interviews and increases the efficacy of healthcare delivery (Australian Family Physician 2014, p. 58). In addition, communication skills such as listening and questioning skills are important during care delivery. The knowledge will influence my practice in that during practice I will always demonstrate cultural competence by not discriminating or being biased to patients and clients from different cultures. What else do you need to learn/do to be able to deliver culturally safe healthcare in future practice? I need to learn about all attitudes, social, political as well as historical factors that influence health practice. This is because things such as fear of being viewed as culturally stereotype to different patients can hinder a well-intentioned healthcare provider from acknowledging the social-cultural contexts of their patients/clients and how this influences their health and health experiences (Australian Family Physician 2014, p. 58-60). Likewise, I need to learn about the history and background of disadvantaged cultures such as aboriginal health and culture in order to ensure that the learned knowledge is applied appropriately to the context of each and every individual patient in order to provide patient-centered and culturally safe care (Parker 2010 p. 5). This is because delivering culturally safe healthcare requires knowledge on diverse and different culture. Specifically, it is important for me to be extensively knowledgeable about aboriginals because delivering culturally safe care to aboriginal patients requires knowledge regarding their aboriginality as well as knowledge about implemented programs and supports to reduce the health disadvantage of aboriginal individuals (Australian Family Physician 2014, p. 60). Lastly, it would be important to learn about diverse histories, culture, their respective health and health systems to avoid communication drawbacks and to ensure optimum healthcare for diverse patients (Australian Family Physician 2014 p. 60). Reference List Australian Family Physician 2014, What do GPs need to work more effectively with Aboriginal patients? Views of Aboriginal cultural mentors and health workers, vol.43, no. 1, pp. 58-63. Berg, A 2010, Cultural safety in health for Aboriginal people: will it work in Australia?Med J Aust, vol. 193, no. 3, pp. 136-137. Chatterjee, R &Arora, M 2005, Life events and psychiatric disorders, Mental Health Reviews,  Accessed from http://www.psyplexus.com/mhr/life_events_psychiatry.html. College of Nurses of Ontario, 2009, Culturally Sensitive Care, College of Nurses of Ontario, Ontario, pp, 1-15. Commonwealth of Australia, 2010, Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice, Commonwealth of Australia, Australia, pp. 1-334. Desplenter, F Laekeman, G &Simoens 2011, Following up patients with depression after hospital discharge: a mixed methods approach, International Journal of Mental Health Systems, vo. 5, no. 28, pp 1-12. Dudgeon, P Walker, R Scrine, C et al 2014, Effective strategies to strengthen the mental health and wellbeing of Aboriginal and Torres Strait Islander people, no. 12, Closing the Gap Clearinghouse, pp. 1-72. Goldberg, J 2012, Setting Priorities with Patients in Depression Treatment, Medscape Education Psychiatry &Mental Health, Medscape, pp.167-176. Parker, R 2010, Australia’s Aboriginal Population and Mental Health Robert Parker, J NervMent Dis, vol. 198, pp. 3–7. Tosevski, D &Milovancevic, P 2006, Stressful life events and physical health, CurrOpin Psychiatry, vol.19, no. 2, pp. 184-9. Queensland Health, 2014, Aboriginal and Torres Strait Islander patient care guideline, State of Queensland, Queensland, pp. 1-20. Top of Form Read More