traits and personal issues in yourself that could affect your ability to interact with clients in the clinical setting Articulate how selfawareness can be an effective tool in the clinical setting ID: 930235
Download Presentation The PPT/PDF document "Objectives. Describe at least two person..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Slide2Objectives.
Describe at least two personality
traits and personal issues in yourself that could affect your ability to interact with clients in the clinical setting?Articulate how self-awareness can be an effective tool in the clinical setting?
9/24/2017
2
Slide3Questions???????????
What was your
initial reaction when you were told that you have posting in psychiatric ward ? How did you feel? How did you resolve your feelings?Are you more
comfortable performing tasks or relating to people? Are you flexible
or do you prefer an orderly routine? Are you an introvert
or extrovert
?
9/24/2017
3
Slide4Question Answer?
Your first assignment in
the psychiatric clinical setting is to provide care for a female client who appears sad and verbalizes hopelessness to the staff. You are uncertain how to approach the client. Which of the following actions would be the
most effective?
9/24/2017
4
Slide5Ask a peer to introduce you to the client.
Wait
for the client to approach you to avoid bothering the client.
Ask a staff member what approach is usually effective with
the client.
Discuss
your feelings with your instructor
before approaching
the client.
9/24/2017
5
Slide6QA?
One of your peers states that your assigned
client looks like a drug addict. Which of the following best describes your peer?Introvert
Judgmental attitudeExtrovert
Prejudice
9/24/2017
6
Slide7Unit I- Topics
Perspectives of mental health nursing, evolution of mental health services, treatments and nursing practices.
Prevalence and incidence of mental health problems and disordersNature and scope of mental health nursing
Role and function of mental health nurse in psychiatric setting and factors affecting the level of nursing practiceConcepts of normal and abnormal behavior
9/24/2017
7
Slide8Introduction
Two major purposes:
To introduce the concepts of mental health and mental illness
To describe the historical development of the role of the psychiatric nurse.
9/24/2017
8
Slide9Perspectives of Mental Health Nursing
The concept of caring for the sick, ‘nurturing’, or ‘nursing’ existed since times immemorial, the mentally ill were tortured, persecuted, ridiculed, neglected and shunned.
9/24/2017
9
Slide10Before 1860, the emphasis in psychiatric institutions was on custodial care.
Untrained people controlled (not cared) the mentally ill.
Psychiatric care as such was non-existent. But psychiatry evolved through ages and attained the stage that is today.
9/24/2017
10
Slide11Concept of mental health
Mental health
is a positive state in which one is responsible, displays self-awareness, is self-directive, is reasonably worry free, and can cope with usual daily tensions.
Such individuals function well in society, are accepted within a group, and are generally satisfied
with their lives.
9/24/2017
11
Slide12MENTAL HEALTH- Definition
Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
WHO,2014.
9/24/2017
12
Slide13Cultural beliefs influence how mental health and mental
illness are
determined. For instance, acceptable behavior in one cultural group may or may not be tolerated in another group.
9/24/2017
13
Slide14Factors Influencing Mental Health
Inherited characteristics
Nurturing during childhoodLife circumstances
9/24/2017
14
Slide15INDICATORS OF MENTAL HEALTH
In the health care and public health arena, more emphasis and
resources have been devoted to screening, diagnosis, and treatment of mental illness than mental health.
Little has been done to protect the mental health of those free of mental illness.
9/24/2017
15
Slide16Three domains- Indicators Of Mental Health
Emotional well-being
such as perceived life satisfaction, happiness, cheerfulness, peacefulness.Psychological well-being such as self-acceptance, personal growth including openness to new experiences, optimism, hopefulness, purpose in life, control of one’s environment, spirituality, self-direction, and positive relationships.
Social well-being social acceptance, beliefs in the potential of people and society as a whole, personal self-worth and usefulness to society, sense of community.
9/24/2017
16
Slide17Characteristics Of Mentally Healthy Person
A mentally healthy person:
has an ability to make adjustments.has a
sense of personal worth, feels worthwhile and important.
solves his problems largely by his own efforts and makes his own decisions.has a sense of personal security
and feels secure in a group, shows understanding of other people’s problems and motives.
has a
sense of responsibility
9/24/2017
17
Slide18CONTD...
can
give and accept love.lives in a world of reality rather than fantasy.shows
emotional maturity in his behaviour, and develops a capacity to tolerate frustration and disappointments in his daily activities.
has a variety of interests and generally lives a well-balanced life of work, rest and recreation.
9/24/2017
18
Slide19MENTAL ILLNESS
Mental illness
is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behaviour (or some combination thereof) associated with distress and/or impaired functioning
.”
9/24/2017
19
Slide20MENTAL HEALTH NURSING
Mental health nursing involves
the diagnosis and treatment of human responses to actual or potential mental health problems.Comprehensive services focus on prevention of mental illness, health maintenance, management of and referral for mental and physical health problems, diagnosis and treatment.
9/24/2017
20
Slide21Historical Development
The origins of most of psychiatry's concepts begin with prehistoric times when primitive people believed
spirits possessed the body and had to be driven out to effect a cure.
Before the 5th century BC, the Greeks, Romans, and Arabs believed that emotional disorders were an organic dysfunction of the brain.
9/24/2017
21
Slide22Pythagras (580-510BC)-
concept that brain is the seat of intellectual activity.
Hippocrates (460-375 BC) described a variety of personalities, or temperaments, and proposed that mental illness was a disturbance of four body fluids, or humours.
9/24/2017
22
Slide23Aristotle (382 -322 BC)
concluded that the mind was associated with the heart.
Galen (130-200 AD), a Greek physician, stated that emotional or mental disorders were associated with the brain.
9/24/2017
23
Slide24Asclepiades
- Father
of PsychiatryTreatment approaches- good
nutrition, good physical hygiene, music, and recreational activities such as riding, walking, and listening to the sounds of a waterfall.
Fresh air, sunshine, and pure water were thought to promote healing for the mentally ill.
9/24/2017
24
Slide25Middle Ages to 1773:
suffered a setback as
mentally ill individuals were excluded from society and confined in asylums or institutions. Various theories- pertaining to demonic possession also were advanced.
Specifically, persons who displayed abnormal behaviour were considered lunatics, witches, or demons possessed by evil spirits.
9/24/2017
25
Slide26Superstition,
magic
, and witchcraft prevailed as patients were locked in asylums, flogged, starved, tortured, or subjected to bloodletting. Beheading, hanging, and burning at the stake were common occurrences. During this same period, physicians described symptoms of depression, paranoia, delusions, hysteria, and nightmares.
9/24/2017
26
Slide27Persons displaying such symptoms were thought to be incompetent and potentially dangerous.
The first mental hospital, Bethlehem Royal Hospital, opened in England in 1403.
Harmless inmates sought charity on the streets.
1773- The first mental hospital in Virginia, US.
9/24/2017
27
Slide281793- Philip Pinel-
first revolution in Psychiatry( removed the chains of mentally ill)
1812- Benjamin Rush(father of American psychiatry) first American textbook of psychiatry.1908- Clifford Beers- The Mind That Found Itself- book changed conditions of mental hospital.
9/24/2017
28
Slide291912- Eugene Bleuler- Swiss Psychiatrist coined the term Schizophrenia.
1938- ECT used
1939- Sigmund Freud- Theory and therapy of psycho analysis.1949- Lithium used for Mania1952- Chlorpromazine- Revolution in Psychopharmacology
9/24/2017
29
Slide30Psychiatric
Nursing History-1773 to 1956:
The 18th century is regarded as an era of reason and observation. According to Peplau (1956), the historical development of psychiatric nursing began in 1773. Peplau-
Mother of Psychiatric Nursing
9/24/2017
30
Slide31Phase 1: The Emergence of
Psychiatric Nursing
(1773 to 1881)Special institutions for individuals with psychiatric disorders were built. Benjamin Rush wrote the
first American textbook on psychiatry. Attendants were hired to socialize with patients. Philippe Pinel classified clients according to their observable
behaviors.
9/24/2017
31
Slide32Schools of nursing were established in Boston and Philadelphia by 1872.
Dorothea
Lynde Dix devoted time to improving conditions for the mentally ill.
9/24/2017
32
Slide33Phase 2: Development of the Work Role of the Psychiatric Nurse (1882 to 1914)
Training schools for nurses in the psychiatric setting were established at McLean Hospital in Belmont, Massachusetts and at Buffalo State Hospital in New York (1882).
Trained nurses were employed in state mental hospitals (1890).
First undergraduate psychiatric nursing program was established.
National Society for Mental Hygiene was founded in 1909.
Large state mental hospitals were built in rural areas.
9/24/2017
33
Slide34Phase
3: Development of Undergraduate Psychiatric Nursing Education (1915 to 1935)
Linda Richards, the first graduate nurse in the United States
, suggested that mentally ill clients receive the same quality care as physically ill clients.
Harriet
Bailey wrote the first psychiatric nursing textbook,
Nursing Mental Diseases.
John Hopkins- First school of nursing had fully developed Psychiatric nursing course
Insulin shock therapy, electroconvulsive therapy, and prefrontal lobotomy were introduced in the psychiatric clinical setting.
9/24/2017
34
Slide35Phase 4: Development of Graduate Psychiatric Nursing Education (1936 to 1945)
Approximately
half of all nursing schools provided psychiatric nursing courses
;
The
National League of Nursing Education developed curriculum guidelines for psychiatric nursing graduate education
.
By 1943, three university-sponsored graduate programs existed.
9/24/2017
35
Slide36Phase 5: Development of Consultation and Research in Psychiatric Nursing Practice (1946 to 1956
)
1952- Hildegard Peplau- Interpersonal relations in nursing
1953- Maxwell Jones- Therapeutic Community
9/24/2017
36
Slide37Mental Health Services in India
BRITISH
ERA:Indian mental health is a child born to British parents and bred in Indian culture.
The Indian Lunacy Act (1912) was based on the British legislation then in force. The
history of Indian psychiatry runs parallel to British Psychiatry and the basic structure remains the same even to this day.
9/24/2017
37
Slide38Before British rule
During the reigns of
King Ashoka, many hospitals were established for mentally ill. A temple of Venkateswara at Tirumukkudal, Chingleput District, Tamil Nadu, contains inscription on the walls belonging to Chola period.
The inscription mentioned a hospital and a school. The hospital was named as Sri Veera Cholaeswara hospital and contained 15 beds.
9/24/2017
38
Slide39The first Indian mental asylum,
i
. e. Mandu Hospital opened by Mahmood Khilji (1436-1469) at Dhar
, M. P.First lunatic Asylum, Bombay Asylum, was built in modern India in approximately 1750 A. D. at the cost of 125/-, no traces of it is present today.
9/24/2017
39
Slide40In 1794, a private lunatic asylum was opened at
Kilpauk
, Madras. The central mental hospital, Yerwada, Pune was opened in 1889. First asylum for insane soldiers was started at Monghyr, Bihar(1795).
9/24/2017
40
Slide41The British established this hospital on 17 May 1918 with the name of 'Ranchi European Lunatic Asylum'. It had then a capacity of 174 patients (92 males and 82 females).
Later
the Hospital for Mental Diseases and The Central Institute Of Psychiatry, Ranchi - for European patients and was staffed by British Army doctors
.
9/24/2017
41
Slide42The history of the institute dates back to 1847, when the Bangalore Lunatic Asylum was founded.
In 1925, the Government of Mysore rechristened the asylum as the Mental Hospital.
The Mysore Government Mental Hospital became the first institute in India for postgraduate training in psychiatry.All India Institute of Mental Health -1954NIMHANS-1974
9/24/2017
42
Slide43The first Indian Psychiatrist to be recognized by the Royal College of Psychiatrists is Prof.
Narendra
Wig. Bhore committee report, 1946
9/24/2017
43
Slide44Independent India
Mental hospital @five places in India
Amristar-1947Hyderabad-1953Srinagar-1958Jamnagar-1960Delhi-1996
9/24/2017
44
Slide451954- Nur Manzil Mental Health Centre started orientation courses in Psyc.Nursing
1956- 1 year diploma in Psy. Nsg @ NIMHANS
1963- Community mental health centres act passed.1982- National Mental Health Programme1986-INC included Psy. Nsg in GNM syllabus.1987- Indian Mental Health Act
9/24/2017
45
Slide46Mental Health Services as on Today in India
Institutionalization Vs Deinstitutionalization
Focus shifted to Community Based CareDistrict Mental Health Programme National Mental Health PolicyRevision Of Mental Health Act
9/24/2017
46
Slide47Current Issues & Trends in Care
Demographic Changes
Type of the family(increased number of nuclear families)Increasing number of the elderly people.Social Changes
The need for maintaining intergroup and intragroup loyalties.Peer pressure
Economic ChangesIndustrializationUrbanisation
Raised standard of living
9/24/2017
47
Slide48Contd
…
Technological ChangesMass mediaElectronic systemsInformation technologyMental Health Care Changes
Increased awareness in the public regarding mental healthNeed to maintain mental stabilityIncreased mental health problems.
9/24/2017
48
Slide49Educational programmes for the psychiatric nurse
Diploma in Psychiatric nursing (started in NIMHANS in
1956)MSc in Psychiatric Nursing (started in RAK, 1976)M.Phil. in Psychiatric nursing (started in MG University, Kottayam in 1990
) PhD in Psychiatric nursing
9/24/2017
49
Slide50Nursing Service
Expanded roles
Advanced practice rolesIndependent practice9/24/2017
50
Slide51Prevalence and incidence of mental health problems and disorders
9/24/2017
51
Slide52Meaning Of Incidence & Prevalence:
Incidence is ‘the number of instances of illness commencing, or of persons becoming ill’ (or dying or being hurt in injuries, or whatever) ‘during a given period in a specified population’.
Incidence can tell us how many new cases of a particular illness have been suffered by a community,9/24/2017
52
Slide53Prevalence is a frequently used epidemiological measure of how commonly a disease or condition occurs in a
population.
Prevalence measures how much of some disease or condition there is in a population at a particular point in time. 9/24/2017
53
Slide54Prevalence Of Mental Illness In Abroad
Mental disorders are common in
India and internationally. One in 10 children have a diagnosable mental disorder in a given year. One in four families has at least one member with a mental disorder.
9/24/2017
54
Slide55Prevalence Of Mental Disorders In India:
The all-India national rate (rural + urban) to be 65.4/1000, rural rate as 64.4 and urban rate as 66.4.
Thus the urban rate is marginally higher than the rural rate.9/24/2017
55
Slide569/24/2017
56
Slide57All mental disorder (national):
For
schizophrenia, the national rate observed was 2.3 per 1000.The category - affective disorders incorporates data regarding all depressive disorders, neurotic and psychotic. The all India value observed was 31.2 per 1000. Mental retardation was observed to have national rate of 4.2 per 1000.
9/24/2017
57
Slide58The
most widely prevalent disorders were observed to be depression and anxiety, in that order (18.5 per 1000 for the later).
Rural-urban difference: The urban morbidity rate was observed to be 2 per 1000 higher than the rural morbidity rate (66.4 and 64.4 respectively). 9/24/2017
58
Slide59Studies reported prevalence rates of psychiatric disorders among children ranging from 13 to 94 per 1000. Since children and adolescent form 40% of the total population of India, approximately four crores of the population requires professional help.
9/24/2017
59
Slide60Uttarkhand
– State mental health system overview
Uttarakhand has neither a mental hospital nor a community mental health facility. There is no specific mental health related information system in the state.The state does not have a separate mental health act however the Mental Health Act 1987 applies to the entire country.
For implementation of the Mental Health Act, the government has constituted (June 2005) a State Mental Health Authority (SMHA) is yet to start regular functioning.
9/24/2017
60
Slide61The state does not have a mental health outpatient facility in the public sector.
The only mental health outpatient facility and day treatment facility is available at the Himalayan Institute Trust Hospital near
Dehradun and AIIMS, Rishikesh.9/24/2017
61
Slide62Population subgroups at high risk of developing mental illness
9/24/2017
62
Slide63Economic cost of treating psychiatric patients in India
Prevalence
of mental illness is approximately 200/1000 population. In simple words, approximately 20 crores of the population requires professional help. Each mentally ill patient requires Rs. 500 per month for mental healthcare. This
includes medication cost, doctor's fees and travelling cost to meet the doctor.
9/24/2017
63
Slide64It is high time to stop the long-term debate about the prevalence rate of mental illness in India and move forward to actual actions that call for investing and improving the mental health services in India.
9/24/2017
64
Slide65ANY QUESTIONS?????
9/24/2017
65
Slide66CONCLUSION
9/24/2017
66
Slide67THANK YOU
9/24/2017
67