The Evidence Based Mental Health Nursing Discussion Paper
Specific area of nursing practice that I have interest in is mental health nursing. In this area of practice one has to go through medical training and more so to specialize in medical treatment of mental disorders (Crowe, Inder & Porter 2015). It requires medical school and specialization in psychiatry, in the area of practice psychotherapy counseling is done to those who are having mental problems.
How does a nurse/physician/health professional balance respect for the patients who are mentally disturbed or are having mental disorder, and the right to involvement in decision making about their health with the demands and wishes of family members or other legal guardians? The Evidence Based Mental Health Nursing Discussion Paper
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Mental disorder is one major are seen to be a major public health problem that is worldwide. There is an increased use of psychotropic drugs and advanced therapies. In the treatment of mental illness pharmacist forms an essential part of the multidisciplinary team for mentally-ill patients (Videbeck & Videbeck 2013). A range of barriers deter nurses and pharmacist from counseling patients with mental illness but there are several interventions or strategies that help in enhancing the management of mental health patients. According to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder, mental illness is a group of disorders which are characterized with deregulations of moods thought and behavior (Halter 2017).
There is supposed to be a balance when dealing with patients who have a mental disorder. In mental health care, there are privacy rights which matter a lot and must be observed (Melnyk, Gallagher?Ford, Long & Fineout?Overholt 2014). That happens because cases of mental health are associated with issues like stigmatization. The Health Insurance Portability and Accountability Act (HIPPAA) give nurses a guide and the consumers too have privacy rights and protection for the health information.
The privacy rule provides a balance between protecting patients who are mentally-ill by protecting their sensitive health information. It also allows for sharing of patients information so as to ensure the patient gets best treatment and that there is patient’s safety and that of others (LoBiondo-Wood & Haber 2014)The Evidence Based Mental Health Nursing Discussion Paper. The guide mostly applies to adult patients, when a nurse is handling a patient with mental disorder he/she has a right to receive copies of the patients’ medical records. The nurse is not allowed to look at the previous psychotherapy notes of the patient. According to HIPAA, psychotherapy notes are recorded by care provider who must be a mental health expert. He/she documents and analyses the content of the conversation during the session.
The notes are kept in a different place, but separate from the billing information of the patients. On the other hand, the privacy regulations also restrict the nurses from revealing the patients’ psychotherapy notes without having an approval from the concerned patients. Such disclosures should not be done to anyone to anyone including the medics, family members or any other interested parties (Chen & Benusa 2017). Such restrictions do not apply on the information on the counseling sessions and how they should be conducted.
Restriction does not also involve the type, numbers of treatment, results of clinical tests, summaries of diagnosis, functional status, treatment plan, symptoms and progress date. According to HIPAA, the disclosure of patient health information to family members is not allowed especially without the consent of the patient. It gives the nurses an opportunity to discuss the patient’s medical records with the family members only if the patient agrees that it should be done (Li, Xu, Luo, Cao, Mathew & Ma 2017). However, despite the fact that the patient gives a consent, the nurse should not just disclose everything to the family members, but only give them the information that they need.
The nurse only gives necessary information that is needed by the family members of the mental ill patient. The information that can help them assists the client on the recovery journey. For instance, a nurse may talk about the medication regime so as to make sure that the client is assisted in taking the drugs. On the other hand the therapist is not authorized to discuss the conversation between him and the patient (Li, Xu, Luo, Cao, Mathew & Ma 2017)The Evidence Based Mental Health Nursing Discussion Paper.
Most people having mental disorder do agree to be treated but others a times needs to be treated compulsorily. A patient who is treated compulsorily is one who has been assessed by a psychiatrist and placed on a treatment. There are some many laws that protect the right of patients being treated with mental illness. The rights includes rights to privacy confidentiality and other human rights, the mental health acts is a recovery oriented because it aims at supporting people to recover. It also gives clear rights to make decision about their own treatment. The act includes people who are on compulsory treatment.
The acts assumes the mental ill patient are able to make informed decision on their treatment unless the nurse decides the patient don’t have capacity of making decision. The mental health act 2014 outlines the rights of people receiving mental health services, such as those being treated, their children and those who care for them. These principles must be considered by those offering mental health services (Li, Xu, Luo, Cao, Mathew & Ma 2017). The person being treated must be told about his/her right under the act when she is being assessed.
There is a mental health tribunal which is an independent tribunal that has the responsibility of making decision on compulsory treatment orders and electroconvulsive treatment. The membership of the tribunal is constituted by the doctors, community members, and the lawyers. If there is a decision made by the tribunal about a patient and the relatives don’t agree they are free to apply again to the tribunal. The care givers of the patient that is mental ill can take other legal actions, such as getting second opinion or even applying to the Victoria civil and administrative tribunal.
The tribunal do assess if the patient meets the requirements to be on compulsory treatment or if the patient should be on community treatment order or otherwise inpatient treatment order. They also decide on the length of one’s treatment order, the tribunal also analyses the patient’s life situation, treatment and mental health records of a patient. However, it should be noted that the patient has a right to take part in the hearig process and actively contribute as much as possible (Fleiszer, Semenic, Ritchie, Richer & Denis 2016). The hearing must not follow rules of evidence and can gather information but must adhere to the legal rule that makes the hearing fair. The tribunal must conduct as quickly and informally. Tribunal hearings always do happen when the patient applies to revoke the treatment order or when the authorized nurse applies for treatment order because the patient needs it. The Evidence Based Mental Health Nursing Discussion Paper
There are so many barriers that hinder the implementation of mental disorder treatment. Stigma and discrimination is one of the barrier to mental disorder treatment, this barrier deter people from seeking treatment. About two third of people diagnosed with mental disorder don’t receive treatment. Stigma makes those who are suffering from mental disorder to have fear feel rejected and most of time distances themselves (DiCenso, Guyatt & Ciliska 2014). The stigma for mental illness makes patients not to seek treatment hence leading to feeling of committing suicide. Stigma is not good for the people with mental illness because it exposes them to a wide range of discriminatory acts in the workplace, learning institutions, medical facilities, and the society in general.
The delivery of mental healthcare services is also subject to challenges like financial barriers which make it difficult for the people to access it. Those who are having health insurance do access health care easily, it seen to have helped in case where a family member is suffering from mental disorder (Fleiszer, Semenic, Ritchie, Richer & Denis 2016). People without the health insurance always experiences greater barriers and have greater unmet needs. Most cases having health insurance doesn’t guarantee one for receiving services because it restricts the mentally-ill more than the other health conditions.
There are also mental health system barriers; the fragmented organization of mental health services has been recognized as barrier to getting treatment. People with mental illness have frequently reported their frustrations and waiting time as they go through disorganized services (DiCenso., Guyatt & Ciliska 2014). The patients who are diagnosed with mental disorder most of the time are under treated, the patients who are receiving anti depressants are a times given inadequate dosage. Those undergoing psychotherapy rarely go for visit as often as one week. There is also patient barrier to treatment where the patients fear being hospitalized. The patient thinks they can handle their own problems.
The patient at times does not adhere to medications prescribed due to the stigma that surrounds mental disorder. The reason why the patients don’t adhere to medication is the impaired cognition from underlying disorders or substance abuse (DiCenso., Guyatt & Ciliska 2014)The Evidence Based Mental Health Nursing Discussion Paper. There is barrier of counseling of the mental ill patient in most of the departments they are referred to. For instance the pharmacist do hesitate to counselor patient who are mental ill because they don’t have much information about them even if the patient is not adhering to his/ her medications.
Family support is a good strategy of overcoming barriers to mental disorder treatment. If the patient is surrounded with caring family members then the treatment can be easy and fast because there will be people to remind on the time of medication. It helps to overcome stigma that people who are mentally ill face (Murray & Huelskoetter 2013). Another way is trying to find a place for the patient who is mental in a metropolitan city if he/she is staying in up country. This is a perfect strategy for overcoming barrier to treatment of mental ill patient. It helps because in a metropolitan city there are so many services ranging from community support services to intensive inpatient treatment (Guise, Chambers & Välimäki 2012).
Finding the right treatment can be a strategy of overcoming barriers to mental health treatment. Mental illness is a real disease which lacks a one precise treatment protocol to be followed by the mentally-ill persons in the society. If one does analysis before embarking on search for treatment may help reduce the barrier of not getting the right mental health care (Happell & Gaskin 2013)The Evidence Based Mental Health Nursing Discussion Paper. Communication is a key strategy of overcoming mental treatment barrier in that in the society there is powerful negative stigma formed against the people with mental illnesses. Stigma is stronger on the cases of schizophrenia in that it is characterized with hallucination, disordered thinking and delusion (Fleiszer, Semenic, Ritchie, Richer & Denis 2016). In this case communicating with the patient can help the patient in seeking mental treatment hence overcoming the barrier.
There are several strategies that can be used in overcoming mental health stigma, it’s very important for everybody to counter stigma by supporting the rights and needs of those who are mental ill (Robson, Haddad, Gray & Gournay 2013). If people take an active role in fighting improper attitudes and behaviors this will help restore well being and empower them hence making them to seek help.
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Conclusion
There mental health disorder is a problem that is faced by so many people all over the world. In the clinical setting it’s an area where nurses are assigned to work in by offering different services to the patients who are having mental disorder. When tackling the problems faced by the patients who are mentally ill there are several barriers that one can encounter that make the treatment to be difficult. The barriers hinder patients with mental disorder from seeking help or even if they get the help they can a times not finish their medication hence reducing the pace of their recovery. There are also several strategies that have been implemented to curb the barriers that hinder treatments of the mental ill patients. The Evidence Based Mental Health Nursing Discussion Paper