Why is Mental Health the Red-Headed Stepchild?
How Does Social Stigma Effect the Mentally Ill?
Social Stigma Effects
• Label avoidance-mental health services are not pursued because they do not want to be called a mental patient or suffer the prejudice and discrimination that the label entails
• Blocked life goals- the mentally ill are frequently unable to obtain good jobs or find suitable housing because of the prejudice of employers and landlords
• Self-stigma- people with mental illness may internalize these ideas and believe that they are less valued because of their psychiatric disorder
Become Active Locally
In the community, start with the local healthcare institution. Research current activities the institution has in place for this population and work with them to develop and increase resources. Reach out to the local mental health facilities for resources and announce the initiative for improvement. When caring for those with mental health diagnoses, discuss the diagnoses directly, ensuring proper education about treatment and medications. Communicate openly with physicians regarding the concern for resources, support, and follow-up care.
What is it about Mental Health?
Many patients admitted to hospitals have a medical history with mental illness present. The Centers for Disease Control and Prevention (CDC) (2011) mention that about 25% of adult Americans have a mental illness and over 50% will have at least one during their lifetime. Some patients admitted due to unsafe symptoms of their illness are sent home without proper preparation and follow up care. According to the Institute of Medicine (IOM) (2007), effective treatments and improvements exist for mental and substance abuse conditions; but, as with health care in general, deficiencies in the way these treatments are delivered prevent many from receiving appropriate care (p. 79). Furthermore, the CDC (2011) states mental illness is associated with increased occurrence of chronic diseases such as cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer. The mentally ill also have a lower use of medical care, reduced adherence to treatment therapies for chronic conditions, and higher risks of adverse health outcomes (CDC, 2011). Mental health is an area of needed attention that needs recognized by all nurses and providers.
Participation with advocacy groups will help raise awareness. The group Mental Health America (2011), established for nearly 100 years, works to inform, advocate and enable access to quality behavioral health services in the United States. The Mental Health Advocacy Coalition provides a unified voice addressing the challenges to public policies and government funding of the mental health system. These groups established comprehensive websites for advocacy, involvement, assistance, and education of mental health issues.
Contacting legislators regarding healthcare reform and funding for mental health can be beneficial. The Mental Health America website posts daily issues addressed in congress about mental health services to keep advocates informed. Choosing a specific bill, act, or issue to lobby will show active support.
A Step by Step Plan to Civic Engagment
Let's pretend that I take on this little project in my area...
Present Problem to Institution
The community hospital must be notified that a problem exists with the care of mental health patients. I would first contact the Directors of Emergency and Critical Care, as they see many acute mentally ill patients such as suicide attempts. Having rapport with these Directors, I believe they will listen and act on concerns brought forward. Presentation of the lack of nurse education, physician education, protocols, referral services, and resource tools will be accomplished.
Policy and Procedure Development
The hospital has an interdisciplinary committee that works to develop and update all protocols. I would request to participate, as volunteers are welcome. With the professionals present, review of resources, research, and best practices would occur, allowing for incorporation of evidence-based research. Patient teaching tools must accompany the development of protocols, providing staff with resources for the patients.
Education of Staff/Physicians
Development of education for the staff and physicians regarding the motivation, treatment, resources, and protocols will be completed. At this time, the community hospital does not employ a psychiatrist or provide referrals to patients discharge home. The education provided must include the need for follow-up care.
Reaching out to Local Resources
Local mental health services should be informed of activities and education being provided. The outpatient centers can supplement patient support and provide feedback to the hospital regarding additional education needs.
Included in the admission of mentally ill patients are the adolescents with suicidal ideation or attempts. Evaluation of resources available to this age group must be accounted for. Junior High and High Schools in the area must be notified of support groups and emergency intervention resources. Education of risk factors, signs and symptoms, support, and intervention should be provided to both teachers and students.
Poll: What Do You Think?
Which Method is the Most Important for Civic Engagement and Mental Health?
Engaging Nurse Leaders and Administrators
Administrators must be able to use the nursing process effectively in practice. Administrators must assess a situation and collect all-inclusive data significant to issue (American Nurses Association, 2009, p. 25). Presenting the problem to the institution would be aided by this skill. The data must then be analyzed and individualize outcomes identified (American Nurses Association, 2009, p. 26). Participation in the design and development of multidisciplinary and interdisciplinary processes must be accomplished by nurse administrators (American Nurses Association, 2009, p. 28). Protocol development for care of the mentally ill would benefit from a multidisciplinary approach as it is often accompanied by other chronic diseases. Lastly, nurse administrators use collaboration and support to aid in implementation of the plan (American Nurses Association, 2009, p. 29). Continued collaboration with staff and other disciplines is necessary to properly care for the complex mental health patient.
Engaging the Advanced Practice Nurse
Practicing nurses are responsible for recognizing the patient population. As medical histories or initial assessments are completed, diagnoses of mental health issues must be acknowledged, documented, and discussed. Practicing nurses must foster open communication between the patient and physician and serve as a patient advocate by ensuring follow-up care and education are complete.
Engaging Nurse Educators
Educators must be instrumental in facilitating learning and having an understanding of the contemporary issues in the field (Halstead, 2007, p. 18). The new education presented to the hospital regarding mental health must be presented in a way that is engaging and motivating. According to Halstead (2007), the nurse educator “shows enthusiasm for teaching, learning, and nursing that inspires and motivates students” (p. 18).
American Nurses Association (2009). Nursing Administration: Scope and standards of practice. Silver Spring, Maryland: Nursesbooks.org
Centers for Disease Control and Prevention. (2011). CDC mental health surveillance. Retrieved from http://www.cdc.gov/mentalhealthsurveillance/
Corrigan, P. W. (2007). How Clinical Diagnosis Might Exacerbate the Stigma of Mental Illness. Social Work, 52(1), 31-39. Retrieved from EBSCOhost.
Halstead, J. A. (2007). Nurse educator competencies: Creating an evidence-based practice for nurse educators. New York, NY: National League for Nursing.
Institute of Medicine. (2007). Informing the future: Critical issues in health .Retrieved from http://www.nap.edu/catalog/12014.html
Mental Health Advocacy Coalition. (n.d.). About us. Retrieved from http://www.mentalhealthadvocacy.org/about.html
Mental Health America. (2011). Mission-vision. Retrieved from http://www.mentalhealthamerica.net/go/mission-vision