Why it is associated with mental health
The association of mental health with behavioural health is supported by a large section of researchers, however, the distinction between these two is clear and concise (Mohr et al., 2013). Behavioural health is the ways of promoting wellness by intervening the signs of mental illness such as anxiety and depression and with these helps to prevent substance abuse and addiction. Whereas, mental health is the overall wellbeing of the physical and psychological aspects of health that determines the holistic wellbeing of any individual (Dennison et al., 2013). It has been seen that people affected by mental health concerns are associated with several behavioural changes such as increased aggression, agitation, restlessness, anxiety, and loss of focus or concentration and so on (Chafouleas et al., 2012). These behavioural changes are seen in people affected with mental concerns from moderate to serious mental health conditions and hence, healthcare interventions should be directed towards these behavioural changes so that such mentally ill patients could be protected from their behavioural changes (Dunlop & Tracy, 2013). Therefore, the primary aim of this assignment is to target violence and associated behavioural changes and in the process the rationale for using interventions against that specific behaviour of people affected by mental illness. After that, a critical review related to that specific behaviour will be provided so that the required behaviour change can be supported in people affected by mental illness. Finally, potential barriers to neurophysiological individual, interpersonal and organizational levels and the way these barriers were overcome in the process will be mentioned in the assignment.
As per Ng (2012), within several things that influence people to change their behaviour, mental illness is the primary reason. It has been mentioned by researchers that behaviour of every individual is dependent on their thinking pattern, their habits, their lifestyle and their surrounding environment and hence, mental stability plays an important in role in defining an individual’s behaviour (Dunlop & Tracy, 2013). Further, there are several mental illnesses such as Parkinson’s disease, Alzheimer’s disease, delirium and dementia due to which people are unable to control their thinking and behaviour pattern affecting their interpersonal relationship as well as these diseases control the area of the brain which is responsible for our memory movement and thinking ability (Bamberg, 2013). These diseases cause affected individuals to show less emotion, becomes more passive and lose their hobby in different social activities. Chafouleas et al. (2012) also mentioned that the reason behavioural changes are associated with mental illness due to increased absent-minded behaviour, and inability to manage the thought process in one direction. there is also mental illness due to which people become so aggressive that they started affecting their own body and gets angry in smaller things that facet their own health and affects their relationship in the society with others (Jorm, 2012). This is because researches suggest that mental illness is associated with behavioural health.
In the recent society, violence and mental illness are linked inseparably, which is a treat and a major concern for the people around and the social environment. This violence or aggression is a serious issue as it leads to serious discrimination and sense of isolation in the patients. Alexander et al. (2013) mentions that in the psychiatry department, violence has become one of the major concern as a maximum of the patients presented in such departments are associated with violent behaviour and hence, these aggressive patients are presented in the emergency department of the mental healthcare facility. There is a list of research works with primary and secondary data that helps to identify the link between violent behaviour and mental illness. It has been seen in the research of Volavka (2013) that if the patient of schizophrenia is suffering from substance abuse, then the occurrence of violent behaviour and its aetiology or manifestation will be unidentified due to its greater extent. This is because, in the patients affected with mental illness and addicted to substance abuse, the pharmacological effect of alcohol increases the risk of inherent violence and becomes affected with an impaired impulsive disorder such as negative perception about situations, threat, dysphoria and hostility (Mohr et al., 2013). The worst effect of this increasing violence is that they become non-adherence to the applied intervention of medications due to which the risk of decreased health condition increases in inpatients as well as outpatients.
The rationale for choosing violence as the behavioral aspect
Coid et al. (2013) mentions an important aspect of mental illness and explaining the resulted violence with the help of psychosis as the link between violence and psychosis is not always strong. This is proved using a healthcare facility and its patient’s violent behaviour as only 20% of the cases was due to psychotic impulses within the patients whereas, 80% of the violence occurred in that healthcare facility due to the confusion, psychopathic traits and impulsive behaviour of the patients (Dunlop & Tracy, 2013). Further, it should be noted that these patients were kept without any alcohol or an addictive substance in the presence of strict wardens. Further, the research of Freeman and Garety (2014) indicated towards the life-threatening effect of violence in patients affected with mental ailments as they become prone to suicidal ideations and attempt self-harm related activities. The observational study conducted by Volavka (2013) determined that violence leads the mental illness to a pathway in which the cumulative result of violent behaviour and negative thought process which is affected by negative life consequences, childhood maltreatment and cognitive impairment leads the person to the diverse risk factor of self-harm. Further, besides self-harm, the person becomes a serious threat to the people around them and has the probability to be affected by criminogenic or anti-social thinking. Therefore, from all the above-mentioned risk factors and research evidence, it is determined that violence is the behaviour which causes most of the negative events caused by the patients affected with mental ailments (Coid et al., 2013).
The chosen population for this behavioural change scenario will be mentally ill patients with moderate to high complexity in their wellbeing and the age group which will be chosen for this change purpose will be 25 to 40 years (Yardley et al., 2015). This age group was chosen because it has been seen that aggression and violence in mental illness are witnessed mostly in this age group and beyond this age group the rate of violence decreases whereas, feelings like hopelessness, lack of self-esteemed and confidence emerges as the major challenges for people affected with mental illness. Therefore the age group will be chosen for this behavioural change purpose (Volavka, 2013).
Further the interventions that will be used for behavioural changes are as follows:
- patients will be daily screened for their aggressive and violent behaviour and if they are detected in the risk zone for the violent behaviour, the patient and their families will be asked to join the intervention designing and planning so that things which can trigger the reduction of risk of violence and increase the chances of behavioural modification could be enhanced (Eldredge et al., 2016).
- The staff of that mental healthcare facility will be trained about the aggression management and behavioural change program and they will be taught about patient-centred and value-centred approach using which the staff can reinforce modified and calm behaviour in patients affected with mental illness and excessive aggression (Coid et al., 2013).
- The intervention will be changing the patient environment or removing all the factors that trigger violence and aggression in the patient’s personality. This will help in maintaining a calm and peaceful environment for the patient they will be able to control their aggression in such an environment.
- Patients will be provided with educational and visual training regarding any informative or constructive topic every day so that they divert their thoughts to one constructive direction and could be able to control their aggressive and negative thoughts (Yardley et al., 2015).
- The arrangement of different competitions such as gardening, drawing, art and craft will be arranged for a patient affected with mental disorder and probe to show aggressive behaviour. This will help the patients to divert their aggression into the craft or art they are preparing and their constructive thinking will be revoked.
- The patients will be asked to perform in physical activities under strict guidance and observation and hence, their aggression will be used to make them physically strong (Mohr et al., 2013).
These are the interventions which will be used to change the violent behaviour of the patients affected by mental illness.
The chosen interventions are backed by recent research work of several researchers throughout the world and hence, the effectiveness of the chosen interventions are able to change the behaviour of the patients affected by mental illness. Prochaska (2012) mentioned in the research that to change the behaviour of any person it is important to change their thought process or the way they perceive any situation. This helps the patient to analyze any situation differently and therefore, they are able to change their violent behaviour (Yardley et al., 2015). However, the researcher did mention that there is a possibility that if the patient is provided with factors that trigger his violent behaviour, the chances that the patient will revert to its previous behavioural state is higher (Bearss et al., 2015). Therefore, the interventions are applicable to patients to reduce their violent behaviour however it should be implemented with other interventions so that the patient cannot revert to its previous behavioural state.
Chosen population and behavioral change interventions
While determining the effectiveness of another intervention which was related to educational or training sessions, it was found that Gardner (2017) conducted a research in which it was proven that providing constructive knowledge and sessions to patients help them with their ability to control their behaviour and they start to think differently in any critical situation. Meiklejohn et al. (2012) also mentions that constructive thinking helps them to change their personality by focusing on a positive aspect of any situation. The third and fourth interventions which were about physical activities and crafts also improve the patient condition by allowing them to think differently in any situation and change their direction of thought in a direction where they can find peace and calmness instead of violence (Meichenbaum, 2017). However, in both these research articles, the role of staff and healthcare professionals assessing and managing the patient condition was crucial and without their support, they would not have achieved their target. Therefore, the interventions related to healthcare professionals taking part in the behavioural change program was included in this assignment. As per the research of Riekert, Ockene and Pbert, (2013), if the staff of healthcare activity are unaware of the benefits of behavioural change theory and the strategies using which they can evoke such changes in patients, the patient condition could not be improved. Therefore, the intervention related to staff training was included. Besides these, there should be an assessment process using which the patient assessment should be conducted and hence, the assessment tool was included in the study. Bamberg (2013) also mentioned the need for such an assessment tool and determined that if the patients which are included in the behavioural changes therapy are assessed daily the progress and changes in behavioural change are witnessed properly (Jorm, 2012). Therefore, form these above-mentioned research critics and findings it is evident that the interventions which have been included in the study are supported by latest researches and are able to modify the violent behaviour of patients affected with mental trauma (Yardley et al., 2015). However, there are several barriers in achieving these interventions and associated success which will be discussed in the following section.
Barrier analysis is an important aspect in behavioural change as it helps to identify the determinates of behaviour, communication process and strategies and activities using which applied behavioural change related intervention either become successful or fails to change the behaviour of the patient (Riekert, Ockene & Pbert, 2013). There are several types of barriers such as neurophysiological barriers, individual, interpersonal and organizational barriers that inhibit the behavioural change in people affected by mental illness and increased aggression. The neurophysiological barriers occur due to extreme mental illness in which the neurological aspect of patients thinking is degraded and the patient becomes unable to control its thinking. mental conditions such as schizophrenia, dementia Parkinson’s and Alzheimer’s are the condition in which patients are unable to control their thinking and hence, application of behavioural changes interventions are effective for a specific time after which patients revert to their default thinking pattern (Bamberg, 2013).
The second barrier is of individual barrier in which despite the training and educational sessions provided, the patients cannot change their thinking and construct a single way to divert their thoughts (Mohr et al., 2013). This is because their thoughts become unstable and they lack the concentration which is required for successful behavioural changes. Therefore, the behavioural changes related interventions become temporary and the patient has to face the consequences of such a barrier. The third barrier which is interpersonal barriers is about the communication and behavioural gap present in such behavioural change initiative process (Dennison et al., 2013). Due to impaired cognitive and communication process, the patients are unable to convey their concerns regarding the behavioural change process and its interventions and hence, the probability of the failure of the intervention becomes high (Alexander et al., 2013). Further organizational barriers are one of the crucial aspects due to which proposed change could not occur in the behaviour of the patient. It should be determined that the organization which is evoking such a change in the patients, should be provided with proper techniques and infrastructure using which such changes could be imposed on the patient’s personality (Jorm, 2012). Therefore, if the organization lacks such staff, infrastructure and strategies to manifest change in the patient behaviour,
To overcome the barriers related to organization, the healthcare professionals should be provided with proper training and educational sessions so that they can use the available resources to successfully implement the behavioural change related strategies on patients affected with mental illness (Riekert, Ockene & Pbert, 2013). On the other hand, to overcome barriers related to neurophysiological aspects, the patients should be provided with proper medication and healthcare intervention together with the behavioural change related intervention (Dennison et al., 2013). This will help to increase the efficiency of the intervention and the chances of reverting back to the previous condition will be lowered (Bamberg, 2013). Thirdly, to remove the barriers related to individual and interpersonal aspects, the patient will be provided with communication and stress relief therapy so that they can keep their mental state calm and fresh which going through such behavioural change intervention (Mohr et al., 2013). This will increase the efficiency of the process and the changes in the aggressive behaviour of the patient will become stable and effective.
Conclusion
While summarizing the findings of this assignment, the link between violence and mental illness should be presented as in every patient affected by mental illness, some level of violence and aggression is observed. However, this violence is because of the confusion, impulsive nature and stress that the mentally ill patient goes through. In this assignment few interventions targeting the aggression of the patient is chosen and depending on their application, their possible barriers and strategies’ to overcome those barriers were identified. Further, these interventions were supported by the recent research literature and hence, the effectiveness and efficiency of the interventions were high as the literature provided supporting evidence that favored successful changes of aggressive behaviour in patients affected with mental illness.
References
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