Media representation of people with mental health problems

This article reviews the literature concerning the media portrayal of mental health issues. It also looks at what is being done in this country to try and combat the stigma associated with mental health problems. Findings indicate that despite organisations and campaigns working to reduce stigma, there is still a long way to go.     

Meeting the nutritional needs of people with mental health problems

In these days of holistic care, it is perhaps surprising that the nutritional needs of people with mental health problems may still be overlooked. Alison Sullivan and Rick Tucker describe the role of the nurse in this neglected area of care.     

The role of district nurses in caring for people with mental health problems who live in rural settings

District Nurses in rural areas frequently fulfil, in some permutation, the functions of district nursing, health visiting, school nursing, and community midwifery. This complex role can bring them into contact with a wide range of mental health problems. The extent, nature and type of mental health problems, and their response to these problems, is not well documented in the literature. The findings of this qualitative study indicate that District Nurses do in fact have contact with a wide range of mental health problems. The role of District Nurses in caring for this client group is more substantial than has been previously recognized. It is suggested that this role be formally acknowledged and that systems put in place to optimize the effectiveness of District Nursing interventions.     

Evolving role of mental health nurses in the physical health care of people with serious mental health illness

Life expectancy in members of the general population has steadily improved in most countries since 1960. However, during the same period, the life expectancy of people with serious mental illness (SMI) has actually reduced. The majority of premature deaths result from natural causes, such as coronary heart disease. Obesity, a key risk factor for heart disease in this client group, might be caused both by unhealthy lifestyle behaviours and the side-effects of antipsychotic medication. Mental health nurses (MHN) nurses have an important role to play in improving the physical health of people with SMI. Evidence, however, suggests that they are often ambivalent about this role, and might perceive themselves as being inadequately trained and lacking in confidence. In this paper, we will argue that MHN need to re-evaluate their practice and recognize that the provision of physical health care is as important as other roles they occupy in relation to the care of people with SMI. We will also consider examples of best practice in physical health care, and discuss how these might be adopted by MHN and other professionals, in order to begin to improve services and to reduce health inequalities in this client group.     

Recognising mental health problems in children and young people

Nurses who work with children and young people need to have a basic knowledge of the symptoms of children's mental health illnesses so that they can make appropriate referrals. This articles highlights the risk and protective factors involved and the tools that are used to assess the mental health of children and young people.     

The struggle for social integration in the community--the experiences of people with mental health problems

The goal of social integration is part of the ideological motivation behind the transition from institutionalized to decentralized psychiatry. Modern community mental health care considers social integration as vital for improving mental health. However, reports suggest that efforts to socially integrate people who suffer from mental health problems have not been as successful as anticipated. The aim of this study was to explore how people with mental health problems experience their ability to integrate socially into a community in central Norway. Three multistage focus groups, consisting of 17 people with mental health problems, were set up in two counties of different sizes. In this explorative study, data were analysed using a qualitative content analysis method. The participants experienced shame and fear of exclusion in their struggle to become integrated in the community. They had a sense of loneliness, had to struggle for equality and experienced being neglected. The days passed very slowly and they reported a lack of financial resources. They wanted to work or take part in other daytime activities and sought reciprocal relationships. In conclusion, those working in community mental health care need to ensure that people suffering from mental health problems experience a sense of belonging in the community, thus enabling them to develop a network and achieve social integration.     

Early detection of mental health problems in older people

A survey of the mental health needs of older adults, conducted in 1996 by the Mental Health Services of Salford NHS Trust (Watts et al, 1996), confirmed earlier research findings that mental health problems in older adults are under-recognized and under-treated. This article reports on this survey, the aims of which were to identify within an inner city area in northwest England the extent and method by which primary care staff detect mild to moderate mental health problems in later life, and the best way to support the teams to detect and manage these issues effectively. As a result, this 11-week survey was conducted which sought to interview all attendees aged 65 years and above at a general practice. Given the high levels of psychological distress and low levels of identification, education/training was provided for practice staff, enabling them to develop the use of appropriate screening tools. The article concludes by discussing how the evaluation of the project by the primary healthcare teams involved has demonstrated that primary healthcare nurses can be trained in brief assessment tools and management techniques suitable for primary healthcare settings.     

Survey of the social networks of people with severe mental health problems

Survey of the social networks of people with severe mental health problems.
The social functioning of people with severe mental health problems is an indicator of general physical and emotional well-being. There exists a wealth of literature on the topic from the professional carer's perspective but relatively little from the perspective of the clients themselves. Thirty clients were interviewed in order to explore their understanding of the nature and value of the social networks in which they were currently involved. Despite having participated in a variety of rehabilitation interventions, these clients remained insecure and lacking in confidence. They had few friends beyond members of their immediate family and were generally leading lonely, friendless existences without the capacity to establish new relationships. Although this study suggests that clients often have grandiose plans for the future, mental health nurses may best meet their needs by helping to sustain existing relationships and using them at all levels of therapeutic intervention, rather than attempting to nurture new relationships for which clients are unready and the failure of which may result in a relapse in clients' mental health status.     

A study of stigmatized attitudes towards people with mental health problems among health professionals

The project aimed to assess stigmatized attitudes among health professionals directed towards patients with mental health problems. The Attitude to Mental Illness Questionnaire was used to assess participants' attitudes towards fictitious patients from a secure forensic hospital and patients with schizophrenia and substance use disorders. Participants were health professionals from acute and mental health settings. In total, 108 completed questionnaires were received. Participants had highly stigmatized attitudes towards patients from a forensic hospital and those with active substance use disorders. Attitudes were less stigmatized to people with substance use disorders who were recovering in remission. This suggested that health professionals have stigmatized attitudes towards an illness such as schizophrenia and this is worse towards patients from a secure hospital. The manner in which patients with substance use disorder are presented can have a significant effect on stigmatized attitudes by health professionals.     

The tune of want in the loneliness melody--loneliness experienced by people with serious mental suffering

The prime purpose of this article is to present the results of a study of the significance of loneliness in patients with serious psychiatric disease, who live alone at home. This empirical study lasted about 1 year. Participatory observation, talks with the researcher and conversational qualitative interviews were employed. There were eight informants with serious psychiatric illnesses who lived alone in a large city. Throughout the year, a gradual and deeper understanding of the informants' loneliness was sought through the interpretation process. Want as a common fate become visible as an ideographical invariance through summative discussions about the right to life. The results have implications for caring and nursing practice.     

Dual diagnosis of severe mental health problems and substance abuse/dependence: a major priority for mental health nursing

It is now established that very significant numbers of people with severe mental illness abuse or depend on drugs and/or alcohol. This combination (Dual Diagnosis) leads to increased rates of violence and service use, a reduction in adherence to treatment regimes, an increase in susceptibility to human immunodeficiency virus (HIV) infection and is now found in in-patient populations. Because of their vulnerability to accidents and physical illnesses, dual diagnosis patients are found increasingly in accident and emergency departments, general medical wards and primary care settings. For this reason nurses and other health professionals working in general hospitals should be as aware as their mental health colleagues of the specific needs of this population. There are some excellent models of service organization and training for dealing with dual diagnoses populations in some parts of the USA. However, there is little such development in the UK. There are clear pathways to be followed, but the need for action is urgent.     

Evaluating an assessment scale of irrational beliefs for people with mental health problems

In this paper, Douglas MacInnes examines the validity of a measure of irrational beliefs, the Shortened General Attitude and Belief Scale (SGABS). He examines the overall correlation between the various subscales of the measure, the criterion validity and construct validly of the instrument, as well as internal consistency. Results show that the measure had good validity and was a useful measure of irrational beliefs for clinicians and researchers working in the area of cognitive behaviour therapy.     

Difficulties in the measurement of outcome in people who have serious mental health problems

In the present drive towards evidence-based health care it is essential for nurses to be able to define and measure their contribution in the health services and thereby ensure that resources are deployed to provide maximum improvement in the health of the population. Yet there exist few rigorous studies which examine the impact of the nursing contribution on patient health gain. One explanation for this is the sheer complexity of outcome measurement. This paper considers the multitude of factors which must be taken into account when designing studies to measure the impact of interventions for people with serious mental health problems. The heterogeneous nature of the population, the range of services these people might use, the composite of possible interventions and the paucity of adequate measurement tools are among the issues to be tackled. Although no single methodology can be prescribed, a number of principles are offered to guide study design.