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The purpose of this paper is to explore mental health and mental illness, considering the relevance of these terms to nursing in general healthcare. To begin, the terms mental health and mental illness will be discussed considering their referencing in the media and the impact on mental health stigma; and the prevalence on mental illness in Australia to highlight the importance of mental health. The definitions of mental health and illness will then be raised, reviewing how these influences overall wellbeing. In addition, common mental illness will be mentioned. Further, considerations of how generalist nurses can support patients’ mental health will be examined with suggestions of practical intervention to support mental health and intervene in mental illness
Unfortunately, the terms ‘mental health’ and ‘mental illness’ are often used interchangeably to describe negative mental health (Smith & Saan, 2013). They are often cited in the media with reference to ‘a person causing harm to another person’, or harm to society in general. The mental ‘psycho’, ‘drug addict’, ‘alco’ person, has been used to reference someone perceived as mentally unwell (SANE, 2019). Such incorrect descriptions within society, generate and effect the stigma of mental health and confuse peoples understanding of mental wellness (Davey, 2013). This can also deter people seeking treatment due to feelings of shame, denial, fear and guilt (Beyond Blue, 2017).
In Australian it is estimated that 45% of the adult population will experience impaired mental health in their lifetime (Australian Bureau of Statistics, 2015). Therefore it is important for Australians to be mental health literate. To understand commonality of mental health, what influences mental health wellbeing, how to prevent mental illness and maintain mental wellness; and when to seek intervention and support when experiencing mental health difficulties. (Queensland Government. 2016).
The World Health Organisation (p.7 , 2013) describes mental health is “a state of wellbeing in which every individual realises 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. Mental health is part of the person’s broader wellbeing. Mental health can be described as a person’s cognitions, emotions and their connectiveness to their broader health which is impacted by both internal and external stimuli to generate positive, neutral and negative wellbeing (Ackerman, C. 2019). For example, a person’s wellbeing is influenced by their environment (such as having a safe place to live or social connectiveness) which impacts on how they feel and subsequently their overall mental health.
All of us have mental health but we must recognise how essential it is to maintain good mental health and wellbeing and the steps needed to safeguard this health. For instance, having family and friends that genuinely care about you, always ensuring that you are eating and sleeping well, exercising regularly and having a job that you like will help maintain good mental health. (Everymind.org. 2017). According to Beyond Blue (2017), if someone is not showing signs of a mental health condition that doesn’t necessarily mean that their mental health is thriving.
Nordqvist, 2017 suggests “mental illness is a deviation in a person’s mental health status, identified through signs and symptoms of a diagnosable mental health disorder”. He goes on to state that it is multi-factual in cause of illness that includes environmental and neurological changes, and can be a consequence of physical or social impairment. (Nordqvist, 2017).
Common mental illnesses in Australia are mood disorders (e.g. depression), anxiety, substance use, and to a lesser extent psychotic disorders (Victorian Government, 2018). For example, Beyond Blue (2017) reports that anxiety affects over 2 million people in Australia. Anxiety is when the feeling of unease and apprehension doesn’t go away after a period of time and there is limited reason for feeling this way; and the coping with daily life requirements becomes problematic.
With progression in mental health literacy in society through organisations like Beyond Blue (2017) and events like ‘RUOK’ (RUOK, 2019), a broader, accepting understanding of mental health and mental illness is being created. It is important for nurses in general healthcare to support this progression and patients’ mental health, with supporting positive mental health (Mentalhealth.gov. 2019) and identifying and intervening in mental illness (Victorian Government, 2018), to support overall patient wellbeing.
According to Beyond Blue (2017), if someone is not showing signs of a mental health condition that doesn’t necessarily mean that their mental health is thriving. Therefore, it is important to routinely explore a person’s mental health and this can be attended through a Mental State Examination (MSE). A Mental State Examination is a brief screen of a person’s mental health to generate an understanding of their mental health needs. It can support specific further investigation to explore particular concern (e.g. mood: Depression, Anxiety, Stress Scale, to enable appropriate care to be provided (DASS, 2018). Common indications of mental health impairment include problems with sleeping or eating, showing signs of withdrawing from friends or family, energy levels that are low, feelings of not caring, excessive drinking or using drugs more than usual. (Mentalhealth.gov. 2019).
As nursing theorist Imogene King describes in her understanding of supporting people with mental health, patients require a sense of self, interpersonal relationships and be connected to their environment (Nursing Theories, 2012). To support patients with positive mental health, nurses can encourage patients to have goals with a strategy to achieve and to have a good understanding of their emotions and how these are influenced by their thoughts and impact on their behaviours (Nursing Theories, 2012).). For example, the nurse can apply motivational interaction to encourage the patient to engage in the care planning (Chen, Daniel-Mullins, Novak, and Thomas. 2015). Brief intervention activities using an approach like FLAGS: Feedback, Listen, Advise, Goals, Strategy, to set and achieve goals (Australian Prescriber (2018) and Cognitive Behaviour Therapy techniques to help the patient understanding how their thoughts-emotions-behaviours are connected (Good Therapy Org. 2018).
The generalist nurse can encourage development of the patient’s interpersonal relationships and their environment (Nursing and Midwifery Studies, 2018) through linkage to community services that support social engagement and to connection to their local supports like family and friends. When the patient is feeling a sense of reduced mental health, suggest they talk to a friend, family member or their GP to gain assistance. Additionally, engaging in daily activities to encourage mental wellbeing or to improve mental health when impaired (Nursing and Midwifery Studies, 2018).
Attendance to good hygiene, diet and exercise, walking at least three times a week for thirty to sixty minutes a day for as little as two weeks to a month can change the brain chemistry levels which in turn help a person alleviate feelings of anxiety and depression. (American Holistic Nurses Association, 2018). Also,taking up activities like yoga or tai chi has the ability to improve one’s emotional balance and wellbeing and therefore help improve positive emotions. (Nursing and Midwifery Studies, 2018) Further, assisting clients with reviewing their broad health needs: their housing, finances, physical health; can directly impact on their mental wellbeing (American Holistic Nurses Association (2018).)
Recovery is a term used to describe how people support their wellbeing. It’s a patient orientated approach rather than a clinician orientated approach. General health nurses can support patients with their recovery by understanding what, when and how they see their recovery. It involves patient healthcare and broader lifestyle choices. When nurses take this generalised understanding of mental health, patience are more likely to have positive mental health because they feel they are being listened to in their needs management’. (Delany, 2018).
In conclusion, this paper has explored mental health and mental illness, considering the relevance to nursing in general healthcare. Mental health and mental illness was discussed in the context of media portrayal and how this influences mental health stigma. The prevalence of mental illness in Australia was raised to highlight the importance of this health issue and the definitions of mental health and illness was presented. Common mental illness was also reviewed. When people experience mental illness it’s important to understand their recovery (Delany, 2018). Recovery is a term used to describe how people support their wellbeing. It’s a patient orientated approach rather than a clinician orientated approach. General health nurses can support patients with their recovery by understanding what, when and how they see their recovery. It involves patient healthcare and a broader lifestyle choice. (National Standards for Mental Health Services. 2010). When nurses take this generalised understanding of mental health, patients are more likely to have positive mental health.
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- Psychology Foundation of Australia (2018). Depression Anxiety Stress Scale (DASS). Retrieved from http://www2.psy.unsw.edu.au/dass/
- Queensland Government. (2016). Signs of mental illness, health and wellbeing.
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- RUOK (2019). You’ve got what it takes. Retrieved from https://www.ruok.org.au/
- SANE (2019). Substance use & mental illness. Retrieved from https://www.sane.org/information-stories/facts-and-guides/drugs-and-mental-illness
- Smith, S. & Saan, D. (2013). Wellness. Vision Journal. 7. (4) pp 5-6.
- Retrieved from; https://www.heretohelp.bc.ca/visions/wellness-vol7/wellness-grappling-with-its-simplicity-and-complexity
- Victorian Government. (2018). Better Health. Early signs and intervention with mental illness. Retrieved from https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/early-signs-and-intervention-with-mental-illness
- World Health Organisation, (2018). Mental health: strengthening our response Retrieved from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-resp
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