Adolescent Mental Health - Term Paper Example

Adolescent Mental Health Name Institution Course Date of Submission Adolescent Mental Health Introduction Primary health care is a holistic approach comprising custom, culture, social-economic status, environment, land, spirit, mind, and body to the provision of crucial, integrated, quality care being founded on socially acceptable, practical, and scientifically sound methods and technology[Ama09]. It forms an integral part both of Australia’s health system and of the overall economic and social development of the community. The provision and policy of primary health care is shaped based on the ability of the citizens to identify priorities for the promotion of healthy living, the prevention of disability, injury and disease. Additionally, it must fulfill the health care, self-management, rehabilitation, and treatment needs of communities, families, and all people in general; and their desire for humane, safe care across their entire lives[Ama09]. The purpose of this paper is to discuss the primary health care in relation to adolescent mental health. This paper will focus on three contemporary health issues relevant to adolescent mental health. The three health issues will include factors that appear to influence risk, treatment responses and the role of the registered nurse, and recovery or finding a new normal. Discussion A higher percentage of youths and children suffer from mental or emotional disorders that interpose their capability to function in their natural environment[Mar061]. Despite the prevalence of these disorders, a bigger proportion of youths and children do not receive the appropriate services. Currently, mental disorders constitute the largest burden of disease globally (Kutcher, & Davidson, 2007). For instance, in the age bracket of 15-44 year old, the most disabling mental disorders include schizophrenia, alcohol abuse, bipolar disorder, and depression (Bernard & Roberts, 2012). These mental disorders are associated with premature death and considerable illness as well as affecting the economy. Proper diagnosis, early identification and treatment have been indicated to be efficient in addressing adolescent mental illness in both specialty and primary care settings (Platte et al., 2012). Suitable interventions in young people may reduce disability, enhance vocational success and improve quality of life. Early intervention accompanying effective therapies could therefore highly improve people health [Cla06]while enhancing outcomes for adolescent involved. Principles of health care can be used to facilitate a quality health outcome in the three identified health issues relating to adolescent mental health. This section will present the three health issues in a wider context as they relate to adolescent mental health. Factors Influencing Risk Mental health problems are connected with a substantial burden on adolescents concerned, e.g. their relationships with peers and family or regarding school functioning (Wille, Bettge & Ravens-Seiberer, 2008). Moreover, mental health disorders experience poor prognosis, are highly persistent, partly resulting in chronic impairment (Wille, Bettge & Ravens-Seiberer, 2008; Kurtin et al., 2009). Therefore, it of special interest to gain a better understanding of the factors that influence the occurrence of mental health problems because they are associated with a huge burden to the adolescents. About 20% Australian adolescents are affected by mental health problems. Adolescents who are inhabitants of rural areas and in particular rural South Australia are at risk of mental health morbidity because of their location[Nan091]. In fact, adolescents living in rural Australia have been reported to experience higher hospitalization and death rates than those living in metropolitan areas, some of which are connected to mental health problems (Xu et al., 2012). For instance, death rates of adolescents resulting from suicide, injuries and accidents increase in a clearly noticeable manner with increasing geographical remoteness. Torres Strait Islander peoples and Aboriginal are the most affected by this setting (Van Voorhees et al., 2010). Several researches have suggested that culture of rural setting can affect the willingness to access mental health services as well as the experience of mental health problems (Saxena et al., 2011). In rural settings, mental health problems are usually stigmatized and mental health problems are equalized with psychiatric disorders; secondly, people in rural areas do not rust outsiders such as psychiatrist and psychologist who offer help. People are also discouraged from seeking assistance from specialist mental health services since traditional services such as royal flying doctor service and the local hospital are normally highly valued than professional mental health services. Therefore, ‘rurally’ has a direct impact on the Australian adolescents’ mental health[Ama09]. Many adolescents in Australia who live away from home or who are not at school or are working usually have less access to all resources including practical and emotional support, and health care and are particularly vulnerable to mental health problems (Robinson et al., 2011). Other adolescents who are likely to be vulnerable to mental health problems include those with chronic communicable and non-communicable conditions (Robinson et al., 2011). Non-health sector activities are also important in enhancing optimal mental health in adolescents. For instance, monitoring access to the means of self-harm, such as storing agricultural chemicals safely is a crucial prevention strategy which needs national policies concerning regulatory and implementation (Patel et al., 2008). Media sector also plays an important role such as responsible reporting of suicide. National health policies can help in responses to disasters by warranting coordinated inter-sectoral reactions. Non-health sectors should provide the following interventions: making the environment more supportive and safer, helping adolescents to have access to counseling and health services, providing opportunities that can assist adolescents build life skills, and providing education and information concerning mental health (Patel et al., 2008; Adrian, 2009). Generally, risk factors do not come forth in isolation, but tend to interact and cluster together. The exposure to risk factors varies with gender and age, and is dependent on the length of risk impact as well as the simultaneous or sequential occurrence of the factors. A number of cumulative models have indicated higher rates disturbance when multiplex risk occur together. Nevertheless, several risk factors can barely be influenced. Given unalterable inauspicious circumstances, it is advisable to identify factors that may make changes to the effects of presently existing risks so as to center them in preventive interventions (Merry & Spence, 2007; Kutcher, & Davidson, 2007; Reigstad et al., 2006). Staff working in an inpatient unit should be well informed concerning factors associated with self-harm. This will help them not only identify those adolescents at most risk and reduce repeated self-harm, but also to tailor interventions to manage and prevent this conduct. It is also recommendable to understand possible protective factors (Mazza et al., 2010). The knowledge concerning protective and risk factors can be used in developing an effective inpatient treatment program targeting minimization of suicidal behavior and self-harm. Protective and risk factors determinants of mental health are of special interest as prevalence rates of mental health problems in adolescents are high and of considerable significant to public health (Wille, Bettge & Ravens-Seiberer, 2008; Block & Greeno, 2011). Treatment Responses and the Role of the Registered Nurse The Australian vision for primary health care policy empowers individual and the community health consumers to build productive relationships for health care delivery[Ama09]. This successively allows nurses and other health care providers to work and collaborate in partnership with local communities and people who are health consumers. Nurses have an important role in assisting people of all ages and communities become self-reliant and able to handle their own health care needs. They have the responsibility to empower individuals to take an active role in treatment and illness prevention in a mutual respect relationship; to be inclusive of the views of an individual including cultural sensitivities and demands; helping people and the community understands the options available for them; and to communicate clearly[TMc11]. Nurses identify the diversity of people making the Australian society including detainees, refugees, asylum seekers, immigrants; and the role of nurses in such as society is to provide compassionate, just, culturally respectful, culturally competent, and responsive care to each individual receiving or requiring care (Kloet et al., 2011). Hence, comprehensive universal and accessible health care services should be available to everyone in the Australian community, with efficient primary health care building the foundation of the system. One universal funding system is used to fund these services, with funds acquired by national taxation system (Hetrick et al., 2011). Health care is available based on needs, but not the ability to pay, irrespective of geographic location, sexual preference, gender, age, mental illness, intellectual or other disabilities, cultural background, race, or socio-economic status (Hetrick et al., 2011; Haller et al., 2007). Primary health care workers such as medical practitioners, nurses, Aboriginal health workers, as well as traditional practitioners are appropriately educated technically, professionally, and socially to perform as part of a primary health care team and to react to the conveyed health needs of the community (Carlisle et al., 2012). Nurses have a role to play as providers of health promotion, palliation, rehabilitation, treatment, care, assessment, and prevention strategies (Dashiff et al., 2009; Block & Greeno, 2011). Although health professionals can participate as experts and citizens in some phases of providing primary health care, their influences should be as collaborators, guides and partners. Care providers should impose their will and values so that care is not provided in a way that is viewed as dominating. Public awareness of mental health problems in adolescents is very minimal and this necessitates increased general social support and awareness to enhance optimal adolescent’s mental health. Nurses can take a hand by initiating public education programs targeting the parents and general public at large to increase their understanding of the emotional needs of adolescents, to challenge the impression that suicide is the standard way of dealing with humiliations or adversity, understand the urge for empathetic responses to distress, and make them aware of the circumstances in which mental health problems might occur[Nan091]. Mental health education programs linking the whole family will probably enhance the quality of life for adolescents with chronic mental health conditions. Therefore, national health promotion policies should make sure that consideration of adolescent mental health is incorporated into comprehensive clinical care and parenting/public education programs. Secondary school nurses have an important and challenging role in raising awareness and actively being involved with adolescents who consider themselves perdurable. Their critical role is the promotion of health and preventive strategies, while assisting students with disabilities and chronic illnesses to perform to their maximum potential[Ama09]. So as nurses can offer successful delivery of adolescent mental health services in rural areas they should engage with adolescents and try out novel ideas as well as utilizing non-traditional methods of care, change the way in which the current services are being delivered so as to encourage more adolescents to access them, and increase networking and collaboration events among current service providers (Kurtin et al., 2009). Nurses work with mental health service users in arrange of settings including prisons, mental health trusts, primary care trusts among others. As a result of the multidisciplinary nature of the management and treatment of mental disorders, nurses have a greater role to play in providing psychological intervention as well as frontline assessment services (Langeveld, Israel & Thomsen, 2010). They are also the key players in the care of people with mental illness from first contact with primary care services, through involvement with specialist mental health services and during the management of behavior disturbance and acute episodes. Nurses primary role in helping mental health service users monitor their medication include supporting them at home, helping to prevent relapses, and ensuring that they understand their prescribed regime and when and how to take their medicines. Mental health nurses usually have more contact with service users than any other professional group. Therefore, they are well place to identify early symptoms and warning signs of mental disorders and ensure service users may access early intervention and crisis services. Nurses are the key players in ensuring that service users have access to appropriate treatments. As case managers, nurses have a lot to offer. They have the capability of assessing the emotional and physical development of adolescent, can teach parents how to implement various interventions, can monitor prescribed medication, function as crisis managers, and do case findings. For a number of years, the community treatment of adolescent with severe mental disorders has used an evidence-based case management approach referred to as Assertive Community Treatment (ACT) where concerned clients are assigned to multidisciplinary team and intensively followed over time[Mar061]. Systems of care for adolescents suffering from mental illness are still applying this approach. The ACT team often comprises a nurse. The role of nurses in this team varies but may involve providing information to family members, team members and others, initiating preventive interventions, monitoring adolescent’s medication, identifying environmental threats to community and family’s home, conducting a developmental and physical assessment of the adolescent, and problem solving with care givers concerning issues such as sleep disturbance or nutrition. Recovery or Finding a New Normal Primary health care is being founded on a model of cooperative trans-disciplinary care instead of being directed by a single professional group. In a trans-disciplinary care model, handling the continuum through prevention of illness, health promotion, and illness to health comprises a wide range of health professionals and other workers[Ama09]. The quality and safety for the community and individuals of any intervention strategy, prevention or primary health promotion is ever an important consideration. The needs of the local community direct what health care professionals are supposed to lead the health care team and also who is the most suitable to organize overlapping aspects of a community’s care. For instance, in some Aboriginal communities, Aboriginal health workers are usually the most suitable health professionals to lead primary health care initiates[Ama09]. Trans-disciplinary care permits for suitable use and center of the expertise of combined health care professionals[Ama09]. Primary health care models go beyond inter-professional and multidisciplinary collaboration, permitting for greater access, efficiency and effectiveness of the provision of primary health care. Primary health care services are normally the first part of contact for adolescents with the health care system[Nan091]. Therefore, primary health care services play an important role in identifying and reacting to mental health problems and in particular for adolescents out of school system. A number of strategies can be implemented to help achieve this. Some of these strategies may include community health intervention such the use of elders and leaders to decrease family violence and hence reducing g emotional and other depressive symptoms among adolescents, specific training in understanding the common mental health problems that can occur during each adolescence developmental stage, acquiring specific skills required to institute a therapeutic alliance with adolescents and use of supportive counseling strategies incorporating a problem solving approach and empathic listening, and using structured interviewing training so as to determine depressive symptoms associated with suicidal behaviors, substance abuse problems, emotional or conduct, and referring the affected to secondary specialist services (Fisher, & Mello, 2011). There is an effective and balanced use of both private and public resources. Evaluation of new technologies is done in a timely manner, and the cost effective ones are implemented equitably and promptly[Ama09]. To improve indigenous adolescent health, government funding priorities should be focused at primary health care and prevention. Supportive counseling and interpersonal psychotherapy and face-to-face cognitive behavioral interventions in primary health care have presented benefit for adolescents with mental health problems (Fisher & Mello, 2011). Several studies have suggested that screening is a good approach to identify mental and other behavioral health problems in primary care (Fisher & Mello, 2011). Screening is frequently used in primary care for other health problems such as cardiovascular disease or cervical cancer. A screening approach for determining those vulnerable to mental disorders would enable health officers and investigators to understand the characteristics of the population that would likely be determined as candidates for interventions or prevention studies. Mental health care for adolescents should be widely advertised, contain comprehensive services, and easily accessible delivered in familiar settings like primary care. Conclusion There are number of factors that contribute to rapid increase of adolescent mental health problems in some areas. Some of the critical factors which have been identified in this paper include remoteness, culture of rural setting, adolescents who live away from home or who are at school or are working and some non-health sector activities may also contribute. Nurses are the key figures in fighting adolescent mental health problems as they play the role of providing health promotion, palliation, rehabilitation, treatment, care, assessment, and prevention strategies. In most cases, adolescents will come into contact with the health care system through primary health care services. Therefore, primary health care services play an important role in identifying and reacting to mental health problems and in particular for adolescents out of school system. Supportive counseling and interpersonal psychotherapy and face-to-face cognitive behavioral interventions in primary health care have presented benefit for adolescents with mental health problems. Reference List Ama09: , (Adrian, 2009), Mar061: , (Evans, 2006), Cla06: , (Taylor, 2006), Nan091: , (Ahem, 2009), TMc11: , (McDougall, 2011; McDougall, 2009), Read More