Mental Illness of Patient and Dealing In Nursing Education
Whats Is Mental illness
In the United States, mental disorders are classified according to the categories outlined in Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Mental disorders affect an estimated 20% of Americans ages 18 and older, that is, nearly one in five adults has a diagnosable mental disorder in any given year, which translates to a total of 45.9 million people.
Serious mental health illnesses such as schizophrenia affect one in 17 Americans (National Alliance on Mental Illness, 2017). Mental disorders are the leading cause of disability in the United States and Canada for people aged 15-44, and only a fraction of those affected receive treatment (NIMH, 2012). These statistics reveal the relative prevalence of mental illness in our society and indicate that nurses will often care for patients with a psychiatric problem as a primary or secondary diagnosis.
Until about 1886, mentally ill persons were restrained in iron manacles. With the advent of pharmacotherapy in the 1950s, the life of a person with a mental illness began to change. The discovery of the various neuroleptic and antidepressant drugs was a major contribution to the improved quality of life for the mentally ill.
Previously dependent clients were now able to live outside of an institution. For the last 35 years, the care of the mentally ill has been moving into community health centers, and clients have spent less time confined to a mental health facility and more time in the community, at work, and at home (Unite for Sight, nd).
The quality of treatments and, therefore, the quality of life for those with mental illness can only improve. It is incumbent upon nurses to examine their own feelings about mental illness so they can engage in a viable teaching-learning relationship.
Although educating people with mental disorders requires many of the same basic principles of patient teaching, some specific teaching strategies should be considered. As with any other nursing intervention, the first step is to begin with a comprehensive assessment. In this case, it is wise to determine whether the patient has any cognitive impairment or inappropriate behavior as well as to assess their level of anxiety.
Assessment also should attempt to determine if the individual has limited literacy. Research has shown that people with mental illness are more likely to have lower literacy skills than the general population, which affects their ability to access health-related information and creates challenges for patient education (Lincoln, Arford, Doran, Guyer, & Hopper , 2015).
The emotional threat that a person with a psychiatric disorder perceives may result in increased anxiety levels and subsequently trigger a chain of physiological reactions that then decrease his or her readiness to learn (Haber, Krainovich -Miller, McMahon, & Price-Hoskins, 1997 ) . High anxiety can make learning nearly impossible ( Kessels , 2003; Stephenson, 2006).
Despite the nurse's best efforts, patients with a mental disorder may not be able to identify their need to learn and may not be sufficiently ready to learn. The nurse, however, may not be able to wait for readiness to happen. Therein lies the challenge.
Although persons with mental disorders can learn given the right circumstances and strategies, it is important to remember that of ten people with mental illness experience difficulty in processing information and verbally communicating information. In addition, they may experience decreased concentration and become easily distracted, which can limit their ability to stay on task.
These symptoms of their disease can be compounded by the medications used to treat mental illness, which can cause drowsiness, difficulty concentrating, blurred vision, or agitation.It is very important that care, including education, of the patient with mental illness build upon the individual's strengths and skills (Jackson, 2009). The nurse must establish a partnership with the patient, and when appropriate.
Teaching Strategies for Mental Illness In Nursing Education
With his or her family or caregiver. Also, because the patient's behavior can be unpredictable, it is very important that the family or significant others participate in patient education sessions (Haber et al., 1997). Three essential strategies have proven especially successful when teaching people with mental illness (Haber et al., 1997):
1. Teach by using small and brief words, repeat information-use mnemonics, write down important information by placing it on index cards, and use simple drawings or symbols.
2. Keep sessions short and frequent. For instance, instead of a half-hour session, break the learning period into two 15-minute sessions or three 10-minute sessions.
3. Involve all possible resources, including the patient and his or her family, by actively engaging them in helping to determine the patient's preferred learning styles as well as the best way to reinforce content.
As with any teaching program, it is important to set goals and determine outcomes with the patient. The specific behavioral objectives depend on individual learning needs, overall, 5 learning outcomes, and abilities. To the extent possible, patients should be empowered to take control over their health and health care.
Despite the great strides made in the treatment of acute mental illness, the mentally ill person still faces the problem of being stigmatized. Assumptions sometimes are made that people who are mentally ill are incapable of and not interested in learning to care for themselves. In fact, their needs for learning are great, but they are often not given the same opportunities to engage in educational programs as those persons with physical disabilities.
Motivating the patient with a chronic mental illness can be challenging. A certificate of recognition may be given to each patient when he or she completes a program, which can be a powerful motivator. To have a positive effect on the quality of life of the chronically mentally ill, educators must provide information to achieve the goals of independence and self-management.
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