Definition and Background History of Mental Illness
For one to understand what mental disorder is, one has to know the precise meaning of mental is (Berzins et al. 2018). Mental health is described as the state of individual wellbeing. Moreover, mental health is described as the state of psychological as well as emotional wellbeing in which a person can fully utilize his or her emotional and cognitive abilities, fulfill his or her daily demands, and effectively operate in society.
On the other hand, mental illness is emotional, psychological, and behavioral disorders which affect the mind of an individual. It is key to note that mental illness is very hard to avoid. There are various types of mental illness happening to individuals in society. Currently, there have been concepts which have significantly impacted on the people with mental disorders as well as their support. The aim of this paper, thus, is to critically analyze the key concepts which have impacted on individuals with mental disorders and their support.
To effectively understand the various key concepts that impact on the people with mental issues and their support, I will analyze political, historical changes and present occurrences affect the understanding of mental illness and the support services. I will start by giving a precise definition of mental illness, background history of mental illness, the different types of mental illness. Moreover, I will compare the biomedical model to the psychological and biopsychological model. I will also highlight the sociological and psychological impacts of mental illness on people and the available and accessing treatments options available to individuals with mental disorders. I will use the tidal recovery model and Orem’s theory to help in analyzing the aim of the topic. Lastly, I will pinpoint the role of nurses in mental illness cases.
There are numerous types of mental illness in the United Kingdom, and depending on the various description of mental illness, 11% or 27% of individuals in the country are considered to have suffered from mental illness at some stage of their lines in the country. Mental illness does occur in the lives of human beings just like any other disease (Brooks et al. 2018). According to the World Health Organization, Mental health is described as the state in the wellbeing of an individual in which he or she realizes his or her capabilities, the individual can withstand and cope with the normal life stresses and can fruitfully as well as productively contribute to the community. Mental health issues or mental ill health is usually broad from individual grief, experience, and worries which happen daily to the complete loss an individual touch, suicidal depression. There are numerous issues which impact individuals’ mental health such as his or her social status, physical health, his or her genetic and environmental factors. These issues make individuals vulnerable to developing mental ill health in some states of their lives. However, it is prudent to note that most of the people who suffer from mental illness do recover or can learn to effectively manage their mental ill health and live a fulfilled as well as meaningful lives. Mental illness is a term which is used to describe and refer to the whole spectrum of diagnosed health conditions like schizophrenia, bipolar, depression, psychosis or anxiety. most of the mental illness symptoms are divided into two major groups such as psychotic or neurotic symptoms. Nevertheless, there are no strict differences between the severe as well as common symptoms of mental ill health. Some of the mental illness does occur both as psychotic and neurotic symptoms.
Historical Background of Mental Illness
Psychiatry history in the post-war in the United Kingdom can be narrated through two intertwined stories, that is, the process of decarceration as well as the development of psychopharmacology (Stapley, Target & Midgley, 2017). The stories share with increased histories of 19th century psychiatry an issue with the concepts of asylum population level, treatments, confinements, and rights. Even though the mentioned tropes have revealed the various facets of the psychiatry history, there is a sharp difference between the management of mental ill health and disorders that define the services in the United Kingdom mental health and the single-issue mythologies at the beginning of the 21st century. The rapidity, as well as the reforms which have taken place in the mental health sector, has left numerous enhancements in service design, medico-legal practice, legislation, social policy, service delivery as well as healthcare practice devoid of systematic historical evaluation (Givan, 2016).
The new focus on service delivery like recovery, wellbeing, person-centered care, inadequate historical setting, service user’s involvement and the rise in psychological have characterized the changes in mental health. The history of mental health which was structured around the right to liberty as well as the right to mental health has become complicated and complex due to the rise in various organizing groups like the equality, inclusion, costs, needs, and risks that are used in defining the competing mental health service visions. There have been various changes in mental health in the United Kingdom.
The mental services can be traced back to around 1247. It was at this time that a monastic priory was established in London. The priory offered shelter to the mentally ill patients as well as the infirm from about 1331. In 1676, London commissioned and started establishing new buildings and built Bethlem hospital which was the first healthcare center for the insane individuals in the country. However, various concerns were raised regarding the treatment of the mentally ill patients which led to the creation of various political and charitable social policies. In 1807, county asylums were set up to look into the state of mental illness. The Wynn Act of 1808 was formulated to create various asylums to cater to the needs of the lunatics. The asylums were majorly built on the outskirts of cities to offer a rural retreat for the mentally ill individuals. In 1890, the Lunacy Act was enacted which created the parameters for offering legal system, and admission in which an individual had to be confirmed and certified to be insane before being admitted to the asylums (Dobbing, 2016). Thus, the asylums were considered as places of last resort rather than for mental recovery.
To offer solutions to the issues of asylums, the country enacted in 1930 mental treatment act which allowed voluntary admissions. Thus, encouraging patients to come up with departments for outpatients for the evaluation of individuals who were to be admitted voluntarily as asylum patients. The mental treatment Act of 1930 led to the establishment of about 25 mental health outpatient department in the country. The figure further increased to about 165 in 1935. The mental health Act of 1959, as well as the hospital Plan of 1962, portended the neglect of asylum as well as the assimilation of the mental health care into the greater hospital system — most of the services that developed afterward started against the reorganization of the local government and NHS (Millard & Ougrin, 2017). The Lunacy Act of 1980 stated that the asylum was to be the last resort for the mentally ill patients but not act as a means to their recovery. Before the Lunacy Act of 1980, mentally ill patients lived in asylums where their rights were highly restricted and received inhuman treatments. Some of the patients were housed in various prisons in the country. The Lunacy Act of 1980 allowed the treatments of mentally ill patients without having the certification requirements which were needed before the patient could be treated. Before the Lunacy Act of 1980, there was some legislation like the Mental Act of 1959 which stipulated the implementation of the Royal Commission report on the law concerning mental deficiency and mental disorder. The Enoch Powel of 1961 which initiated the abolition of the asylum system. In 1968, the social work profession was established by the local authority committee and the allied individual social services.
Alongside the various reforms in the mental health sector in the country, there were paradigm shifts in the provision of services which were based in the communities for the mentally ill patients like the daily services, supported shelter as well as the society based social and healthcare workers (Wilding, Martin, & Moon, 2018). In the 1990s, the country’s attention shifted to the increased fear from the charitable concerns of the various groups. The formulation and execution of the Care Programme Approach that has offered a basic framework in the mental health service operations tried to enhance the continuity of healthcare for individuals with mental illness. The National Service Framework for mental ill health has pinpointed a host of new societal mental health programs which are designed to interlink with the existing society’s health groups.
When an individual visits a mental healthcare center to receive an examination for his or her symptom, the professional identifies a particular condition or set of conditions affecting the person. Nevertheless, what most people do not know or go unnoticed is that regardless of the clinician examining the client, the examination will be influenced and be determined by treatment model which the clinician sticks to (Deacon, 2013). Every professional healthcare learns about illness as well as health in a particular manner, yet there is every possibility that this concept does not correlate with the how a clinician will view the patient. Having these healthcare variables in mind is very vital when a successful and effective is needed as the end goal.
The biomedical model was initiated in around 20th century and states that all illness can be explained through certain sort of abnormal cells (Bendelow, 2010). The model describes health as a comprehensive absence of defect, pain or illness. The model was established under the assumption that mental disorders have physical causes (Sercu & Bracke, 2017). There are various identified biomedical explanations for the mental illness causes like the genetical problems; neurological problems or misuse of substances. Mental illness also has signs and symptoms just like other diseases. For instance, an individual with depression can be affected by the change in moods as well as the change in the way he or she eats, sleep alteration, etc. since this model assumes that causes of mental illness are biomedical, treatment and recovery process must also be medical like the use of antidepressants, psychosurgery.
It should be noted that treatment of mental illness through the use of drugs have been viewed as the universal health intervention for numerous problems. The model has enhanced the establishment of psychiatry. Nevertheless, the model has been criticized on numerous occasions. Some of the critics argue that it leads to the medicalization of some common anomalies of mental health.
The biopsychosocial model is prudently named since it has three vital components, that is, social, psychological and biological concepts (Samoborec et al. 2018). Health concept is thus, seen as a balance between social, psychological and biological factors. The Biopsychosocial model was proposed as an alternative to the biomedical model. To effectively understand and comprehend an individual’s mental health, clinicians must recognize all the components affecting the person both positively and negatively to have a complete and better picture of the whole wellbeing and health (Alladin, 2009). The model has been hailed as effective when looking at the causes of mental disorders. The model links the outside environment of an individual with his or her psyche and biology (Simpson-Adkins & Daiches, 2018). Thus, the model involves an individual’s behaviors, sentiments, and consciousness. One of the vital reasons why the model is important is because it explains how individuals who are healthy can have mental disorders and why certain individuals are more prone to mental disorders as compared to others. People who are considered mentally sound do exercise (McKay et al. 2012), have strong social bonds, and energy which helps them not to suffer from mental disorder. The model offers evidence that even though an individual can be mentally sound at a given stage of their life, they may still have a mental disorder if their social, biological and psychological balance is altered or disturbed (Kinderman et al. 2013). According to this model, linkages between an individual genetic makeup, sociocultural environment, and mental health contribute to his or her experience of illness or health.
Because of the shifting issue in healthcare to mental affliction from infectious illness, the Biopsychosocial model has slowly become the common standard of analyzing illnesses. The new model seeks to give more explanations instead of narrowing explanations down. The biopsychosocial model also promotes the concept of the connection between the mind and body which pinpoints the relationship between the mental as well as the physical process in situations of illness, overall health, and recovery processes. Empirical evidence has highlighted the failures of the biomedical model. The conventional view is well-organized in scientific evidence which has pushed and motivated the development of empirically supported modalities as well as methods like drug trials (McCarthy & McDonald, 2009). Nevertheless, the strictness has led to the lack of invention in the field of medicine.
Moreover, it has established a glaring division between the healthcare practitioners and scientists. In spite of these limitations, numerous clinicians still apply the model because of its focused reasoning and longstanding history. Biopsychosocial model has also faced opposition with the critics claiming that it is complicated as well as broad. Empirical research has indicated that most studies do not adhere to the strict health definition and numerous elements are subjective and not measurable. Some critics also believe that the model was only necessary for the the medical invention, yet the new model emphasizes on the treatment of an individual and shifts away from the electric concepts (Gathright et al. 2016). The all-inclusive characteristic of Biopsychosocial model is a direct and sustainable solution to the biomedical model (Black & Hoeft, 2015).
In numerous countries individuals do not have adequate access to fundamental mental health care as well as recovery and treatment they need. Most of the available mental health care services are found in psychiatric centers which have been marred with gross, and serious violation of human rights. Mentally ill patients are excluded from the society as well as denied basic rights like clothing, food and, shelter. World Health Organization guided by the Convention of the rights of the persons with disabilities came up with various policies to protect people with disabilities including mentally ill patients. The policy requires that awareness should be done as well as advocating for behavioral change toward mentally ill patients.
Treating individuals with mental illness like schizophrenia has been widely met with disdain because of the inception. Emil Kraepelin was the first healthcare expert to examine schizophrenia as well as described it as dementia praecox. In his view, the illness had to disorder degenerating from the brain with no exact direction for treatment and recovery. He believed that if any healthcare professional had found a recovery path, then there was a case of misdiagnosis. The assumption of Kraepelin was challenged by Dr. Bleuler who discovered that the disorder was thinking disorganization instead of dementia. The discovery of Dr. Bleuler offered hope to the recovery process of the disorder. Around 1939, the available treatment options for mentally ill patients included insulin shock surgeries, lobotomies as well as electroconvulsive therapy (ECT).
Cognitive behavioral therapy model which was constructed by Beck and Rector had the intention of meeting the particular needs of people having a mental illness like schizophrenia. The model assists the mentally ill individual to become aware of the stressors of his or her illness and how he or she should respond and perceive such stressors (Jones et al., 2012). The model helps the patients in understanding their symptoms as well as recognizing that they are not suffering alone. For example, one can have delusional beliefs by lack of consensual validation resulting in paranoia. Hallucinations is equated to inadequate sleep. CBT has offered a glimmer of hope to mentally ill patients in their recovery paths by aiding them in evaluating their beliefs concerning their symptoms. Low self-efficacy may interfere with one’s ability to examine his or her symptoms like hallucinations and voices (Botting, Durkin, Toseeb, Pickles & Conti, 2016). For instance, hallucination is an individual’s misinterpretation of his or her thoughts. Sadly, mentally ill patients are normally separated from the rest of the community as being crazy and, in the process, enduring stigmatization as well as discrimination (Reiter, Dobmeyer & Hunter, 2018). Most of them eventually view themselves as outcasts in the community and see themselves as not able to recover from their illness. To effectively treat mental illness, professional psychiatrists must address the challenge of low self-efficacy and self-esteem which have been described as vital factors in the treatment process (McCabe et al. 2018).
Human beings have in one point of their lives been at a situation in which they cannot cope with the stressors of life, and thus, confining themselves in a cage from which it is hard to challenge or come out of the trap. People lack interests in such situations in taking care of themselves making them partially or wholly dependent on other people’s care (Seed & Torkelson, 2012). The nurse, thus, plays a great role in taking care of the patient. A similar situation happened in the hospital setting through the application of Orem theory which led to improved changes to the patient. Orem theory is a combination of various concepts like self-care deficit, nursing system concept and self-care concept; the three concepts focus on the recovery of the patient. The self-care concept emphasizes the individuals self-reasoning as well as the ability to effectively take care of themselves (Lucock et al., 2011). The self-care concept further focusses on the limitation of an individual as well as the assistance of healthcare providers in the treatment and recovery process. The self-care deficit concept emphasizes the assistance of the nurses’ care in the recovery processes of patients. The nursing system concept emphasizes the team spirit of nurses, that is, the mental health nurses like you and me, and other healthcare professionals. All the healthcare providers must unite in aiding the mentally ill patients.
The tidal recovery model is a midrange model of nursing which was developed by Poppy Buchanan-Barker and Phil Barker in the United Kingdom (Barker, 2003; Young, 2010). Tidal model is a recovery model that can be used as the foundation for holistic mental health care. It offers a framework for the exploration of an individual’s needs for recovery as well as the offering of care based on individual care. The model holds the assumption that there should respect for one’s wishes instead of being paternalistic. We as nurses should listen to the story of every patient and take them as serious as we can. Nurses must appreciate the person-centered approach in dealing with people with mental illness to listen to their voices.
Conclusion
It is very important to listen to the needs of people with mental illness and the understand their recovery process. In this paper, I have learned that certain key concepts influence and impact on people with mental illness. The political, historical and the present changes in mental health have shaped my understanding of why various people have a mental illness. In the treatment and recovery process, I have learned that there are certain important theories and models like CBT which have to apply to aid in the full recovery of mentally ill patients.
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