MENTAL HEALTH NURSING

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Presentation Transcript

SEMINAR ON MENTAL HEALTH : 

SEMINAR ON MENTAL HEALTH Ujwala Nikalje 2nd year M.Sc.(Nurs)

Slide 4: 

After Alma - Ata Declaration of "Health for All by 2000 AD" in 1978 mental health care included in primary health care Mental health is an essential dimension, component of health Mental health and physical health are interrelated

DEFINITION OF MENTAL HEALTH : 

DEFINITION OF MENTAL HEALTH a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of the self and that of other people, and that of the environment

WHO DEFINITION OF MENTAL HEALTH : 

WHO DEFINITION OF MENTAL HEALTH a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

COMPONENTS OF MENTAL HEALTH : 

COMPONENTS OF MENTAL HEALTH Self-governance Growth orientation Tolerance of uncertainty Self-esteem Mastery of Environment Reality-orientation Stress Management

Slide 8: 

CHARACTERISTICS OF A MENTALLY HEALTHY PERSON

FREE FROM INTERNAL CONFLICTS : 

FREE FROM INTERNAL CONFLICTS

well-adjusted : 

well-adjusted

ACCEPTS CRITICISM : 

ACCEPTS CRITICISM

STRONG SENSE OF SELF-ESTEEM : 

STRONG SENSE OF SELF-ESTEEM

KNOWS HIMSELF : 

KNOWS HIMSELF

FACES PROBLEMS AND COPES WITH STRESS AND ANXIETY : 

FACES PROBLEMS AND COPES WITH STRESS AND ANXIETY

TAKE HIS OWN DECISIONS : 

TAKE HIS OWN DECISIONS

SETS REASONABLE GOALS FOR HIMSELF : 

SETS REASONABLE GOALS FOR HIMSELF

SELF RESPECT : 

SELF RESPECT

Mental Health Needs : 

Mental Health Needs (1) The need for affection (2) The need for belonging (3) The need for independence (4) The need for achievement (5) The need for recognition or approval (6) The need for a sense of personal worth (7) The need for self-actualization

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT : 

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT BIOLOGICAL Exposure to toxins (e.g. tobacco, alcohol) in pregnancy Head trauma Lack of oxygen to the brain at birth Genetic tendency to psychiatric disorder that is Heredity

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT : 

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT PHYSICAL HEALTH Neurological disease, Endocrine diseases, Various types of acute &chronic infections, Head injuries Malnutrition

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT : 

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT SOCIAL FACTORS Worries, anxieties, emotional stress, tension, frustration Unhappy marriages, broken homes, Family conflict

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT : 

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT Poverty Inconsistent care-giving Poor family discipline Poor family management Death of a family member

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT : 

FACTORS AFFECTING MENTAL HEALTH DEVELOPMENT PSYCHOLOGICAL Sexual, physical & emotional abuse and neglect Difficult temperament Maladaptive personality traits SCHOOL Academic failure and drop out Inappropriate school environment COMMUNITY Community disorganization Discrimination and marginalisation Exposure to violence

PROBLEMS of IMPAIRED MENTAL HEALTH : 

PROBLEMS of IMPAIRED MENTAL HEALTH In adults Confused thinking Long-lasting sadness or irritability Extreme highs and lows in mood Excessive fear, worry, or anxiety Social withdrawal Dramatic changes in eating or sleeping habits Strong feelings of anger

PROBLEMS of IMPAIRED MENTAL HEALTH contd : 

PROBLEMS of IMPAIRED MENTAL HEALTH contd Delusions or hallucinations (seeing or hearing things that are not really there) Increasing inability to cope with daily problems and activities Thoughts of suicide Denial of obvious problems Many unexplained physical problems Abuse of drugs and/or alcohol

Slide 26: 

In older children and pre-teens Abuse of drugs and/or alcohol Inability to cope with daily problems and activities Changes in sleeping and/or eating habits Excessive complaints of physical problems Defying authority, skipping school, stealing, or damaging property Intense fear of gaining weight Long-lasting negative mood, often along with poor appetite and thoughts of death Frequent outbursts of anger

Slide 27: 

In younger children Changes in school performance Poor grades despite strong efforts Excessive worry or anxiety Hyperactivity Persistent nightmares Persistent disobedience and/or aggressive behavior Frequent temper tantrums

Classification of Mental Illnesses : 

Classification of Mental Illnesses Two widely established systems for classifying mental illness – International Classification of Diseases (ICD-10) produced by the World Health Organization (WHO) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) produced by the American Psychiatric Association (APA).

Common Mental Disorders : 

Common Mental Disorders Mood Disorders Unipolar Depression Bipolar I & II Mood Disorder So-called “Personality Disorders” may be milder versions of same (I.e., a person who is diagnosed with “borderline personality may in fact suffer from Bipolar II, depressive type Anxiety Disorders OCD, PTSD, Generalized Anxiety Psychotic Disorders Schizophrenia, Schizoaffective Substance Abuse Disorders Drug effects Addiction Withdrawal

MENTAL HEALTH PROGRAMMES : 

MENTAL HEALTH PROGRAMMES National Mental Health Programme (NMHP) 1982 envisage a community based approach in the rural area supported by the professional psychiatric supervision from the district level and referral services by the mental hospital and mental health units of the general hospital.

National Mental Health Programme (NMHP) : 

National Mental Health Programme (NMHP) Objectives To ensure availability accessibility of minimum mental health care for all To encourage application of mental health knowledge in general health care and in social development. To promote community participation in the mental health services

National Mental Health Programme (NMHP) : 

National Mental Health Programme (NMHP) Strategies National diffusion and democratization of capabilities of mental health facilities. Intensification and strengthening the training in psychiatry and mental health. Peripheral development Development of clinical policies Institution building Focus on research Advocacy

National Mental Health Programme (NMHP) : 

National Mental Health Programme (NMHP) Priority Areas of Concern Substance abuse Disaster and crisis management Women and children and other vulnerable groups Traditional mental illnesses (schizophrenia, depression and anxiety) Epilepsy and other neurological disorders

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Developed(under the National Mental Health Programme 1996–97) by National Institute of Mental Health and Neuro Sciences (NIMHANS) and adopted by States for implementation.

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Objectives a) To provide sustainable basic mental health services to the community and to integrate these services with other health services; b) Early detection and treatment of patients within the community itself; c) To ensure that patients and their relatives do not have to travel long distances to go to hospitals or nursing home in cities;

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Objectives contd.. d) To take the pressure off from mental hospitals; e) To reduce the stigma attached towards mental illness through change of attitude and public education; and f)To treat and rehabilitate mental patients discharged from the mental hospital within the community.

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Key Features 1. The States will find suitable personnel for manning the DMHP teams and train them. 2. The patients will be from the district itself and the adjoining areas. 3. District Mental Health Team will be expected to provide service to the needy mentally ill patients and their families, such as—daily out-patient service, ten bedded in-service facilities, referral service and liaison

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Problems with Implementation 1. There is no provision for guidance and counselling. It is found that at times patients and family members need guidance and counselling to cope with illness. 2. The service available is run by a psychiatrist and a social worker. There is no comprehensive approach and teamwork

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Problems with Implementation 3. Due to crowding, inadequate time to each patient. 4. There is no coordination between the facilities and various agencies, especially the NGOs working in the area. 5.There is no integration of mental health care with primary health care

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Problems with Implementation contd.. 6. No attempt is made to include the community leaders, and grass root level workers 7.There is no provision for early detection and treatment of patients within the community. 8.There is no awareness programme to reduce the stigma attached to mental illness through change of attitude and public education.

DISTRICT MENTAL HEALTH PROGRAMME : 

DISTRICT MENTAL HEALTH PROGRAMME Problems with Implementation contd.. 9.There is no provision to treat and rehabilitate mentally ill patients discharged from the mental hospitals within the community. 10. There is no effort to undertake community surveys 11. At times some medicines are not available and there is no provision for reimbursement.

MENTAL HEALTH PROGRAMMES : 

MENTAL HEALTH PROGRAMMES WHO Mental Health Gap Action Programme (MHGAP)9th Oct,2008 aims at scaling up services for mental, neurological and substance abuse disorders for developing countries focuses on the gap between what is needed to treat a range of priority disorders and what is actually available worldwide

Take her from this…… : 

Take her from this……

To this…… : 

To this……

The Community health nurse has an important role to play in this cause……. : 

The Community health nurse has an important role to play in this cause…….

ROLE OF COMMUNITY HEALTH NURSE : 

ROLE OF COMMUNITY HEALTH NURSE Three primary goals of community health nurse Promotion of mental health Prevention of mental illness Provision of holistic care and support for individuals experiencing mental ill health

ROLE OF COMMUNITY HEALTH NURSE : 

ROLE OF COMMUNITY HEALTH NURSE Three levels of prevention Primary prevention Secondary prevention Tertiary prevention

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Child care and child rearing measures antenatal care to mother and education, Liberalization of laws regarding termination of pregnancy , when it is unwanted, .Dietary correction of infants, who are suffering from metabolic disorders Correction of endocrinal disorders Training programmes for physically, and mentally handicapped children Counselling of the parents of physically and mentally handicapped children Programmes to enrich child-mother relationship

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Programmes Oriented to the child in the school Early signs of learning difficulties or behavioural abnormalities can be detected teachers should be taught to identify the early symptoms of abnormal conduct and behaviour in the children and refer cases

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Family-Centred Activities&Programs Attitudes of mutual trust, love and respect for one ,another need to be fostered Educational services in the field of mental health Parent -teacher associations Home-maker services Child guidance clinics Marital counselling

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Programmes for Families in Crisis Crises like adolescence, Birth of a new baby, Retirement or menopause, Death of a wage earner in the family, Desertion by the spouse Handle at mental hygiene clinics, psychiatric first-aid centres, walk-in-clinics

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Programmes for Culturally Deprived Families Ensure hygienic living conditions, proper food, education, health facilities ,and recreational facilities

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Society-centred Preventive Measures Community development social administration. Collection and evaluation of epidemiological, biostatisical data. Budgeting These measures require coordinated activities among persons belonging to different norms and disciplines

ROLE OF CHN IN PRIMARY PREVENTION : 

ROLE OF CHN IN PRIMARY PREVENTION Different Roles Counsellor Educator Facilitator Role model Advocate

SECONDARY PREVENTION : 

SECONDARY PREVENTION Defined as reduction of the duration of mental disorders Difficulties are identified early and the appropriate intervention is provided

ROLE OF CHN IN SECONDARY PREVENTION : 

ROLE OF CHN IN SECONDARY PREVENTION Early Diagnosis and Case Finding achieved by educating the public and community leaders,mahila Mandals, Balwadis etc. in recognising early symptoms Early Reference 3. Screening programmes Simple questionnaires should be developed and administered 4. Early and Effective Treatment

ROLE OF CHN IN SECONDARY PREVENTION : 

ROLE OF CHN IN SECONDARY PREVENTION Mental Health Educaton Mass camps and through film shows, flash cards, and also through mass media communication 5. Training of Health Personnel Orientation courses 6. Crisis Intervention Problem solving Gather Resources-self, family,society Anticipate crisis 7. Consultation services For those working in the field

TERTIARY PREVENTION : 

TERTIARY PREVENTION Defined as reduction of rate of residual defect that follow mental disorder in the affected population. involves maintaining optimum health in persons with enduring mental health problems

ROLE OF CHN IN TERTIARY PREVENTION : 

ROLE OF CHN IN TERTIARY PREVENTION Accomplished by preventing complications of the mental illness & promoting achievement of each individual’s maximum level of functioning through Regular follow up Diversion therapy Recreation therapy Community Mental Health Facilities Day-Evening Treatment/ Partial Hospitalization Programs Community Residential Facilities Support Groups

Slide 60: 

MENTAL HEALTH -accepts self and others -ability to cope or tolerate stress; can return to normal functioning if temporarily disturbed -ability to form close and lasting relationship -uses sound judgment to make decisions -optimistic -recognizes limitations (abilities and deficiencies) -can function effectively and dependently -able to perceive imagined circumstances from reality Etc….. MENTAL ILLNESS -feelings of inadequacy and poor self-concept -inability to cope maladaptive behavior -inability to establish a meaningful relationship -displays poor judgment Irresponsibility/ inability to accept responsibility for action -pessimistic -does not recognize limitations (abilities and deficiencies) -exhibits dependency needs because of feelings of inadequacy -inability to perceive reality Etc….

Thank You : 

Thank You