Mental health counseling can occur in a variety of settings including private practice, community or agency, wilderness therapy programs, pastoral counseling, hospitals, and corrections. One similarity these settings have is that they were started to facilitate counseling beyond state psychiatric hospitals. These new settings expand the provision of mental health services (Erford, 2018). Another similarity is that they have the same kind of professionals, such as counselors and therapists, to provide care to clients.
Nevertheless, the settings mentioned have distinguishing features, including size of setting and approach to counseling. A private practice is a for-profit business characterized by an autonomous decision-making and work schedule (Erford, 2018). A community or agency is a broad setting comprised of government agencies and community-based clinics (Erford, 2018). Wilderness therapy programs are designed mainly for at-risk youths and usually involve rigorous physical activities as part of the counseling process. Pastoral counseling refers to a setting where a counselor integrates both psychology and spirituality (Erford, 2018). Hospitals are inpatient or outpatient facilities that provide care at any time. Finally, a corrections facility is distinguished by its connection to the court or prison.
One advantage of a private practice is that decision-making is free from the influence of government agencies, charities, and other groups. Another advantage is that a counselor can design their work schedule and select the theoretical approach to follow (Erford, 2018). However, private practices are businesses that may sometimes be forced to decide between treating people and making profits. I would consider working in a private practice because I would have the opportunity to work closely with clients. However, one disadvantage is that private practices are profit-making institutions, and I may not always help a client if their financial situation deteriorates. I would also consider working in a community or agency because it is the broadest setting and would allow me to help many people at once. However, a government agency setting is likely to have countless bureaucracies that would hinder mental health counseling.
Reference
Erford, B. T. (Ed.). (2018). Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations. Pearson Education.
For a long time, professors and instructors have been the primary mentors for professionals in different sectors, including psychiatry. In particular, educators have provided learners with essential skills such as following directives and attending regular meetings, which are essential in clinical supervision and psychology. The integrative developmental model (IDM) formulated by Stoltenberg in 1981 provides a model with four stages useful for professional growth. Supervision refers to a distinct activity involving scientific-oriented education and training, utilization concepts such as observation, knowledge acquisition, evaluation, and one’s self-assessment. This paper annotates three articles on clinical supervision, which is critical in the mental health practice.
McNeill, B. W., & Stoltenberg, C. D. (2016). Research/support for the integrative developmental model and future directions. InClinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 115–120). American Psychological Association. Web.
The IDM supervision model plays a critical role in understanding the best approaches therapists need to deliver quality care. According to McNeill and Stoltenberg (2016), one can understand the framework by considering the empirical evidence supporting it. This indicates the need to understand the most recent literature about IDM and how the concept has evolved and transformed psychological interventions over time. Moreover, McNeill and Stoltenberg (2016) delved deeply into appreciating IDM’s refinement and evolution over time and the limitations it had at the time of the study. This approach was necessary for their research as it led them to formulate recommendations for subsequent studies on the model.
The IDM concept is not new in psychology as it has been used for ages, though it has also transformed from time to time. McNeill and Stoltenberg (2016) found empirical evidence, indicating that the model was reviewed by Worthington in 1987 and later in 1994 by Stoltenberg, McNeill, and Crethar, where both studies concluded that support for general development models was necessary. Other researchers such as Ellis & Ladany (1997) and Ellis, Ladany, Krengel, and Schult (1996) (as cited in McNeill and Stoltenberg, 2016) noted that there were issues with the techniques used to study clinical supervision and that researchers at the time did not adequately explore the IDM model. Other factors, which are vital in clinical supervision include developmental approaches. In particular, McNeill and Stoltenberg (2016) indicate that supervisees at various professional levels of development need unique approaches when overseeing their juniors as this is critical for developing both categories of officers. The authors conclude that there is a need for further research to help respond to the challenges facing clinical supervision.
McNeill, B. W., & Stoltenberg, C. D. (2016). Goals, tasks, and functions. In Clinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 31–52). American Psychological Association. Web.
The IDM approach can only be successful if the supervisors and supervisees using the model understand its various elements and stages. In this section of the book, McNeill and Stoltenberg (2016) explore why psychologists need supervision. In particular, the authors state that the model’s primary goal is to encourage and foster supervisees’ development as they train to become therapists in different levels of service delivery. For instance, psychiatrists often start their jobs at the lowest positions possible and advance with experience and skills. Thus, it essential for the senior psychoanalyst to mentor their juniors to become better equipped for leadership and mental health service delivery.
As the supervisor and supervisee work together, there are often needs and expectations from both sides. For instance, both expect to learn something new and eventually become better at their work. Thus, they all need to set their time and meeting to ensure they benefit the most from their collaboration. During training, junior psychologists must understand how ethical behaviour, such as providing feedback, helps in the overall mentorship outcome. For instance, McNeill and Stoltenberg (2016) indicate the importance of sharing the best evaluation methods with the supervisors, which work best for the students. Moreover, the researchers reveal that a positive relationship between the mentor and mentee is crucial in delivering the needed outcome. Thus, it is critical to consider various elements of supervision such as student assessment practices, supervisor-supervisee relationships, feedback, and consideration of the context of training for each learner.
McNeill, B. W., & Stoltenberg, C. D. (2016). Supervisory methods and techniques. In B. W. McNeill & C. D. Stoltenberg, Clinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 53–78). American Psychological Association. Web.
Effective supervisors possess certain qualities, which distinguish them from unproductive ones. According to McNeill and Stoltenberg (2016), an optimal supervision environment enables learners to develop upwards and become better in their service delivery. However, such a situation requires efforts from both the mentor and the mentee. In particular, McNeill and Stoltenberg (2016) reveal that the process requires taking notes, reviewing recorded sessions, didactic commands, role-playing, and modelling. Each of these tasks requires collaboration, efforts, and skills from both sides of the supervisory process.
Supervisors at different levels require diverse skills to become effective in their space. According to McNeill and Stoltenberg (2016), beginners should reduce their anxiety and use the specified structures to meet their desired outcomes. The supervisor can intervene through facilitation, prescription, conceptualization, and catalytic inputs to help reduce efforts and time needed to deliver the intended goal. Intermediate supervisees should focus on autonomy, especially when they are subjected to stressful events. In this case, a senior mentor should facilitate the learners to achieve their targets through all the means necessary. The advanced mentees need to concentrate on their personal and professional blending into career development. At the same time, the experts should facilitate the advanced students when necessary or provide personalized conceptual therapy. Thus, the main approaches necessary for supervising psychologists include facilitative, prescriptive, conceptual, confrontive, and catalytic interventions.
References
McNeill, B. W., & Stoltenberg, C. D. (2016). Goals, tasks, and functions. In Clinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 31–52). American Psychological Association. Web.
McNeill, B. W., & Stoltenberg, C. D. (2016). Research/support for the integrative developmental model and future directions. In Clinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 115–120). American Psychological Association. Web.
McNeill, B. W., & Stoltenberg, C. D. (2016). Supervisory methods and techniques. In Clinical supervision essentials series. Supervision essentials for the integrative developmental model (p. 53–78). American Psychological Association. Web.
The chosen resource is the first 10 minutes of the segment of “60 Minutes Australia,” a newsmagazine show. It is dedicated to a highly disturbing issue that has recently occurred in the country – the increased rates of suicide among young men. Addressing the real stories of people that have faced this national emergency, reporters Tom Steinfort, Liz Hayes, Liam Bartlett, Tara Brown, and Sarah Abo make efforts to investigate its underlying reasons and raise public awareness.
The video starts with the story of Jake Fitzsimmons on the basis of the interview with his mother and sister. This 25-year-old man from Melbourne, Victoria, was a local footy hero with “a decent job and plenty of great mates” (60 Minutes Australia 2021). However, despite his talent and popularity among peers, Jake was keeping a secret that only his family knew – he was suffering from depression started from his entering into adulthood and enhanced by multiple factors. Although Jake was taken to numerous doctors and counselors, these experts did not help him. As a result, despite his mother’s unconditioned support, Jake took his own life several months ago. His death “set a great way of grief” not only through his family but his football community as well (60 Minutes Australia 2021).
Subsequently, the resource addresses Jake Edwards, another Australian footy hero, who also suffered from depression in his early twenties. Like Fitzsimmons, he wanted to take his own life at the age of 26, however, he managed to survive. In the present day, Jake Edwards is “committed to helping those most affected by suicide” (60 Minutes Australia 2021). In particular, he organizes meetings of young people and tells them his story of beating depression and suicide survival in order to inspire them as the help from the side of the country’s health care system cannot be regarded as efficient.
Alignment with 3 Learning Objectives
LO7.1
According to the resource, thousands of young men start to experience depression entering their adulthood when their masculinity is shaped, and a lack of appropriate emotional and psychological support from society and respectable authorities may lead to their mental health’s decline. In general, three major causes of severe depression that may lead to suicide are illnesses, genetic factors, and environmental stress (National Institute of Mental Health 2017). Another essential issue reflected in the resource is the inability to detect depression in a considerable number of cases, especially when a person creates an impression of a successful one with stability in life and surrounded by friends. According to Jake Fitzsimmons’ mother, she was aware of how desperate her son was only the last twelve months before his death, while no one from his mate knew about his condition at all.
In general, it may be more challenging for health care specialists, friends, and family members to recognize depression symptoms in young men as they may be aggressive or angry instead of sad (Cavanagh et al. 2017). Other common manifestations may include irritability, restlessness, anxiety, lost interest in once-pleasurable activities, a lack of concentration, extreme tiredness, overeating or malnutrition, issues with sexual desire, physical pain, withdrawing from relatives and friends, alcohol and drug abuse, and suicide attempts (Australian Government Department of Health 2021). In addition, affected by social stereotypes, men traditionally prefer to speak less about their physical and mental issues and see treatment in comparison with women.
LO7.2
The resource addresses the traditional treatment of depression, including meetings with doctors and counselors and related therapy. At the same time, it emphasizes severe problems that exist in the Australian health care system in relation to young men’s mental health. In addition, coaches who should be responsible for young men’s male health frequently have a negative impact on the identification of their masculinity. However, the collective help of suicide survivors and other people deeply affected by this devastating issue to young men who suffer from depression is mentioned as an alternative to the health care system’s intervention. In particular, such mental health crisis services, as Mental Health Crisis Assessment and Treatment Team, Kids Helpline, Lifeline, and Beyond Blue, provide all necessary information concerning the detection of depression, ways to prevent suicide, and help for suicide survivors or family members who lost their beloved ones (Australian Government Department of Health 2021).
LO7.4
In general, depression and subsequent suicide attempts may be caused by multiple triggering personal and social factors. According to the resource, a broken relationship, ankle injury, and other setbacks led Jake Fitzsimmons to desperateness, aggression, and alcohol and drug abuse. As a matter of fact, other personal factors determined by the environment may include abusive relationships, loneliness, self-isolation, long-term unemployment, financial burden, and prolonged work stress. At the same time, the resource video emphasizes the impact of social perception of men’s mental health on suicide rates. In other words, men’s mental health issues are highly stigmatized, and asking mental health care specialists for help is regarded as shameful. As a result, according to Jake Fitzsimmons’ mother, a substantial number of young athletes across the country are lost and broken toiling through life. Any issues with their mental health are highly stigmatized, and they refuse to meet specialists who, in turn, do not have clear and efficient guidelines to treat young men’s depression. Although they are trying to help themselves, they cannot cope with depression alone.
Resource Appropriateness to Inform Learning
First of all, the resource chosen helps to learn as it addresses a highly disturbing issue that has already become a national emergency while a tragic scale has not been completely understood and no appropriate actions have been taken yet. In general, the rates of suicide are shocking as it is defined as “a leading cause of premature deaths in Australia” (60 Minutes Australia 2021). At the same time, men who take their own lives drastically outnumber women, and approximately six young men across the country commit suicide every day. In addition, while three-quarters of suicides are men, a considerable amount of them was in their early twenties. In addition, it contributes to raising awareness among people as it focuses on young athletes who are successful in sports and have many friends and supportive families. In other words, considerably high depression and suicide rates among those Australians who are not supposed to be vulnerable according to society’s perception should attract the attention of ordinary people to the country’s health care authorities.
Subsequently, the resource clearly informs about the potential underlying causes of depression in young men and obstacles to this condition’s diagnosis and effective treatment. In general, common barriers for mental help-seeking in young men derived from shame and supported by social standards include traditional masculine ideals, environmental and cultural influences, personal challenges, fear of homophobic or another unacceptable or disrespectful response, self-medicating with alcohol, and acceptance from peers (Lynch et al. 2016). Thus, the resource may be regarded as a reliable basis for further investigation of depression’s factors and causes in Australian men for adequate prevention strategies in the future.
Critique (Strengths/Weaknesses)
First of all, it is essential to define the resource’s information presentation as its main strength. The combination of facts’ presenting, personal stories, and interviews plays a highly essential role in inform learning as it allows to attract attention to a particular issue in the most comprehensive and even emotional way. As a result, residents are supplied with factual information concerning Australia’s suicide rates among young men, their causes, and reasons why they are growing, and the country’s mental health system cannot change this situation. In addition, listening to Jake’s mother, sister, and best friends provides an insight into the emotional state of those who have lost their beloved ones due to depression to raise more awareness of this issue as well.
In addition, as previously mentioned, the resource clearly informs about the potential underlying causes of depression in Australian young men and barriers to this condition’s diagnosis and effective treatment. In other words, it describes an emergency, provides a number of factors that may lead to men’s depression and suicide attempts, presents the main causes why medical help from mental health experts is not efficient and states what people currently do to prevent and mitigate this issue. In general, it is possible to say that this resource may be used to attract the attention of the international health care community to the mental health of young men not only in Australia but across the globe as well and as a basis for further in-depth investigation.
As a weakness, a lack of information from the position of the health care system in relation to the issue may be observed. Thus, there are no representatives who may explain from the medical perspective how the mental health facilities address depression and what obstacles impact suicide rates. Nevertheless, a chosen resource may be regarded as a reliable evidence-based piece of information that may substantially contribute to informed learning.
Reference List
Australian Government Department of Health. 2021. “About Suicide Prevention.” 2021. Web.
Cavanagh, Anna, Coralie J. Wilson, David J. Kavanagh, and Peter Caputi. 2017. “Differences in the Expression of Symptoms in Men Versus Women with Depression: A Systematic Review and Meta-analysis.” Harvard Review of Psychiatry 25 (1): 29-38.
Lynch, Louise, Maggie Long, and Anne Moorhead. 2016. “Young Men, Help-Seeking, and Mental Health Services: Exploring Barriers and Solutions.” American Journal of Men’s Health 12 (1): 138-149.
National Institute of Mental Health. 2017. “Men and Depression.” Web.
The nursing workplace context has always been rather intense due to enormous responsibility and the large number of tasks for nurses to complete. However, the recent surge in health issues observed due to the pandemic has increased the extent of workload, therefore, raising the levels of workplace tension and causing nurses t6o experience distress. Due to the sharp increase in the need to focus, as well as the probability of workplace conflicts and the resulting emotional strain, workplace tensions in the nursing setting, specifically in nurses providing individual care, can be linked to a range of mental health complications and adverse outcomes.
Background
The problem of workplace tension and the resulting challenges faced by nurse is not new. Multiple studies have already linked the problem of increased workload and the resulting workplace burnouts to the concerns associated with the reduced quality of mental health and the exposure to mental health issues such as anxiety, depression, and the associated health concerns (Madadzadeh et al., 2018). However, the exact connection between the problem of tension in the nursing context and the provision of personalized nursing care is yet to be explored. Therefore, the results of this research will be extraordinarily beneficial to nurses and their mental health (Tubbs-Cooley et al., 2019). Namely, strategies for nurses to maintain proper work-life balance will be isolated and introduced as c5ritical components of the workplace strategy.
Rationale
The reasons for selecting the specified issue as the topic of the paper are quite simple. Namely, the rationale for focusing on the effects that tension in the nursing setting has on nurses and healthcare professionals will help gauge the probability of a rise in the prevalence of mental health issues, particularly, those associated with anxiety and the depressive disorder., will be located. The significance of searching for the available healthcare treatment options stems primarily from the lack of exposure to the adverse effects of workplace tensions is justified by the need to support nursing experts as the key source of health management opportunities. Therefore, to ensure that all population members are provided with the necessary assistance and support, one must consider the needs of the nursing staff as well.
Purpose
In turn, the goal of this paper is to study the impact that increased workplace tension has on the mental well-being of nurses. It is believed that the research will return the results pointing to the increase in the extent of mental health issues due to the rise in workplace tension. Apart from considering the problems associated with the rise in the amount of work, concerns linked to ineffective commu8nication and possible conflicts will be considered (Madadzadeh et al., 2018). Therefore, the purpose of the study is to examine the observed phenomenon, locate the impact of increased workplace tension on the nursing staff’s mental well-being, and introduce strategies for alleviating the effects of high workplace tension rates.
Target Population
This research seeks to address the needs of nurses and improve the quality of their work, which suggests that nurses and their parents are the primary target audiences for this research. Additionally, the outcomes of the study will affect healthcare administrators, as well as the community, at large, since the specified study will provide strategies for improving nurses’ performance. It is believed that the outcomes of this study will inform the approaches toward improving the work-life balance in nurses, and the strategies for distributing the workload evenly among the nursing staff.
The memoirist from the book struggles with voices in the head and disordered thoughts that suggest schizophrenia. This mental issue is a severe condition affecting all aspects of an individual’s life. The Worcester Country Health Department has mental health services developed for both adults and youngsters. On the official website, the Mental Health Program is available during working hours for every citizen (Worcesterhealth.org, n.d.). For children and teenagers, there are care services, such as parental education, advocacy, emotional support, family therapy, and many other services. The services are wide-ranged, allowing a comprehensive approach to the care plan of a teenager. To access the resources of the program, people should contact the center. It accepts Medical Assistance and many private insurance types.
The health department also has community-based resources that are free on its website. Everyone can access them and read the materials regarding mental health problems. There are no eligibility criteria for using the materials and services of the department. It provides peer recovery service, ensuring comfortable patient care. The recovery service consists of individuals in long-term recovery who will provide one-to-one support for people willing to recover (Worcesterhealth.org, n.d.).
However, this resource is for people who have non-urgent substance misuse, and all the details can be accessed through the phone number on the official website. Another similar resource is Psychiatric Rehabilitation Program which offers community-based and in-home services. It ensures that individuals can maintain daily tasks and have the necessary skills to live (Worcesterhealth.org, n.d.). Both adults and young men are eligible for the service, and it also can be accessed via insurance. The service has different care plans depending on the age and needs of individuals. Youngsters under 18 years old are allowed to access the services 3 times a month, while adults aged 18 and above have 6 times month access. So Worcester has different mental health programs aiming to help adults as well as teenagers.
The title of the article is “Parental characteristics and offspring mental health and related outcomes: A systematic review of genetically informative literature.” It was published in the Translational Psychiatry journal on April 1, 2021, by Eshim S. Jami. Anke R. Hammerschlag, Meike Bartels, and Christel M. Middeldorp. This journal is an international peer-reviewed site for medical research publications, and it belongs to the Nature Publishing Group.
This article was a systematic review of literature related to the field of offspring mental health outcomes associations with genetic and environmental impact. The authors explored this topic because even if twin studies were done to demonstrate a moderate relationship between psychiatric issues and inheritance, these researches could not articulate mechanisms of disease transmission. Therefore, they decided to synthesize the available knowledge about children’s mental health outcomes and their parents’ characteristics by evaluating the genetics-related studies.
Since this was a systematic literature review, no laboratory or clinical experiments were performed. Instead, the search for scholarly articles was done on the Web of Science database, only including articles from 2014 to 2020 (Jami et al., 2021). The keywords used to find articles were “adoption,” “offspring of twins,” “genetic comparison,” “genetic nurture,” “assisted conception,” “sibling comparison,” and some other terms (Jami et al., 2021). The 89 papers included in this research discussed substance use and personality, externalizing and internalizing behaviors, and educational achievement (Jami et al., 2021). All selected studies had interpretable statistical data and reasonable sample sizes.
This literature review found that there is a correlation between parental behavior and psychiatric issues with the mental health outcomes in their offspring. Specifically, studies showed a statistically significant association between major depressive disorder in biological parents and children (Jami et al., 2021). However, the same connection could not be established in the case of anxiety because only “40% of individual differences in anxiety are explained by genetic factors” (Jami et al., 2021, p. 17). Moreover, the authors found that research demonstrated a strong correlation between maternal smoking and alcohol abuse with the development of anxiety disorder and aggression, respectively, in offspring (Jami et al., 2021). Furthermore, according to the authors of this paper, some studies found that criminal behavior was both environmentally and genetically transmissible.
Another essential finding of this literature review was that a supportive approach to parenting could diminish the rate of the development of various mental health problems. This study revealed that regardless of genetic relations between parents and children, the latter achieved higher academic results if their caregivers were well-educated (Jami et al., 2021). It appears that some traits have a direct genetic causative effect on offspring, while other characteristics can be altered due to environmental influence.
Since the influence of childhood on behaviors, attitudes, success, and failures in adult life is substantial, the implications of this research are immeasurable. Specifically, these findings may be used to prevent and correct mental health issues in children because the presented literature review demonstrated that many seemingly purely genetic problems could be altered due to environmental impact. For instance, positive parenting seems to have a protective effect against some psychiatric issues (Jami et al., 2021). The limitation of this research is that conducting a systematic review is insufficient to give a definitive answer to the question about the relationship between offspring mental health, genetics, and environment. Therefore, I wonder if a meta-analysis could be conducted to perform a statistical assessment of the results in the reviewed articles.
Building provincial mental health capacity in primary care of rural Ontario, Canada.
Description
An initiative of Project Extension for Community Healthcare Outcomes (Project ECHO) uses virtual education to enhance the primary care provider’s mental health capacity. The project has the ultimate objective of solving the perpetual challenge of urban-rural disparities in access to specialist care (Sockalingam et al., 2017). Subsequently, to monitor the effectiveness of the project, evaluators scrutinized a mental health and addiction-oriented ECHO program in Ontario, Canada, at the end of the program.
How was the success of the program or policy measured?
Evaluation is essential to establish the program’s effectiveness in producing desired results. Therefore, the mental health and addiction ECHO program relied on certain indicators of program success, such as primary care providers refined knowledge of mental health or addiction. Additionally, the evaluation conducted measurements on primary care providers’ perceived self-efficacy, active engagement in the virtual education program, satisfaction, and competencies in the management of mental health disorders.
How many people were reached by the program or policy selected?
The program’s effectiveness is a product of information from the program participants. Therefore, the program recruited 131 participants comprising family physicians, nurse practitioners, social workers, nurses, and counselors from 26 spoke sites to engage in virtual medical education. Consequently, the program recorded an average of 4 out of 5 scale program satisfaction rate, indicating that the participants were satisfied with the program. Additionally, the program noted significant improvement in participants’ ability to manage patients, attention to screening patients for mental health disorders, enhanced knowledge of mental health disorders, and inter-professional collaboration following the educational intervention. Moreover, the perceived self-efficacy among the participants was higher in the post-intervention than pre-intervention assessment.
What data was used to conduct the program or policy evaluation?
The program evaluation relied on qualitative information questionnaires administered to the participants at the end of the educational intervention. Additionally, pre-intervention knowledge assessment and weekly satisfaction surveys provided vital data for the program evaluation.
What was specific information on unintended consequences identified?
It is a common phenomenon that programs may yield undesired results. However, the ECHO mental health and addiction program did not yield adverse health or financial consequences.
What stakeholders were identified in the evaluation of the program or policy?
The critical stakeholders of the program evaluation involved the participants, who included nurses, nurse practitioners, family physicians, counselors, and social workers. Moreover, mental health specialists such as psychiatrists and counselors from the University of Toronto conducted the educational intervention consistent with the program plan. Therefore, the reporting of the program evaluation outcomes would be beneficial to the rural Canadian population on account of enhanced primary care providers’ capacity for mental health to deliver comprehensive patient care (Sockalingam et al., 2017).
Did the program or policy meet the original intent and objectives?
The program achieved tremendous success in building the human resource capacity for healthcare. The outcomes indicated that family physicians, nurses, nurse practitioners, social workers, and counselors demonstrated enhanced knowledge and competence in screening and management of mental health and addiction disorders (Sockalingam et al., 2017). Therefore, the program achieved its overall objective of refining populations’ access to mental health services to bridge the gap of inadequate specialist mental healthcare.
Would you recommend implementing this program or policy in your place of work?
I would recommend the implementation of the program in my place of work. (Fukada (2018) indicated the effectiveness of educational interventions for continuous professional development in enhancing nursing competencies. Therefore, I would recommend the program execution in my workplace to refine our knowledge and skills in the management of mental health disorders.
How could a nurse advocate become involved in evaluating a program or policy after one year of implementation?
Nursing advocacy is essential to ensure high-quality and safe patient care. Therefore, as a nurse advocate, I would conduct an assessment of patients’ clinical outcomes as a response to program implementation consistent with the nurse’s role in evidence-based practice (Leming-Lee & Watters, 2019). Moreover, I would assess whether the program has enhanced my skills or knowledge and efficiency in providing high-quality nursing care.
General Notes and Comments
Healthcare programs complement biomedical research in increasing the body of knowledge in clinical practice for evidence-based care. Therefore, the educational intervention in the ECHO project is instrumental in ensuring primary care providers have the requisite capacity to manage various health challenges, including mental health disorders.
The article chosen for the analysis strives to explore the correlation between the social determinants and the development of mental illnesses in people in different stages of their lives. The study is focused on analyzing mental illnesses as the moving power of society’s functioning. In general, the various disorders which negatively affect the lives of millions of people all over the globe are caused by the deeper socially-conditioned constructs which can be modified on the governmental level. The researchers offer to take particular universal actions to solve massive social problems such as poverty. From their perspective, addressing these issues may help reduce the general percentage of mental disorders (Allen et al., 2014). Such activities can improve the quality of people’s lives and minimize the socially-conditioned risks of developing mental illnesses.
Study Design
The study design includes the integration of the multilevel framework with three primary levels of evidence organizing. The framework consists of three levels: the life-course approach, community-level contexts, and country-level contests (Allen et al., 2014. Each of the analyzed spheres is vital for gaining a complete picture of the correlations between the social determinants and mental illnesses. As a part of the framework, the data collection is also divided into segments based on the age principle. Different developmental stages of people’s lives have various correlations with the chance of mental illness occurrences. The differentiative feature of the study design is the provision of the course of action after defining the problem in a particular period. Moreover, the researcher also analyzes the practical cases of different implementation strategies focused on solving a specific social situation. Such a comprehensive study design is chosen due to the complexity of the discovered issue (Allen et al., 2014). The aim of the study is universal, which requires the fundamental analysis of the many of society’s order.
Target Population
The analysis’s general population is divided into several controlled groups: prenatal, early and later childhood, working-age, family building, and older ages. Moreover, the researchers compare the representatives of different social classes (Allen et al., 2014). It is vital to emphasize the differences between the people living under other life conditions to show the correlations between mental illnesses and social determinants. As a result, the target population of the research is not specified. The representatives of varied ages, professions, and social groups were chosen. The information from the World Health Organization (WHO) is actively integrated within the scope of the research. This data is helpful from the perspective of analyzing such a vast population.
Data Collection Procedure
The data was collected through pioneering WHO’s reports on mental health. The researcher discovered the two primary issues within the scope of research. The first one is the social determinants related to mental disorders. The second is the actions on the government and country-level which can be undertaken to prevent the development of negative mental consequences. The WHO reports are valuable information sources regarding mental illness topics. Such data collection is not time-consuming, allowing for analyzing the vast periods and varied populations.
Data Collection Methods
The researchers chose the recent publications on the WHO’s Department of Mental Health and Substance Abuse regarding the selected topic. Different articles and reports were analyzed by the group of researchers, indulging not only the primary authors of the paper but also the staff members of WHO’s Mental Department (Allen et al., 2014). The data was collected before the analysis based on the above target population-defined groups. For the examples, the researcher address differentiated works addressing the actions taken in particular countries to solve definite social issues such as poverty or alcoholism, which can negatively impact people’s mental state. The statistical data also is presented in the form of graphs. However, considering the scope of the study, the statistics seem insufficient.
Data Analysis
The life-course perspective was chosen to analyze the general scope of collected data. The reports were compared, identifying the fundamental principles connecting mental illnesses and social problems. The preferred approach can be called descriptive because the researcher allocated minimum statistical data analyzing primarily the core problem disregarding accurate numbers (Allen et al., 2014). It is also highlighted that the factor analysis was used for the data processing because the information was initially collected only based on the chosen categories. There are no specific tools mentioned within the scope of the research.
Summary of the Findings and Recommendations
In general, the research provides the fundamental analysis of the different aspects of the social function of human beings in relation to the development of mental illnesses. The primary hypothesis was supported based on the study’s results. The essential finding of the research is the correlations between the developmental stages, socially-conditioned cognitive problems, and the practical experiences of policy-making aimed to solve the issues (Allen et al., 2014). The recommendations for future studies are not provided by the authors.
Strengths and Weaknesses of the Article
One of the article’s significant strengths is the vast research scope. Thanks to the implementation of the WHO’s reports, the researchers had the opportunity to cover the broad topic by analyzing it from different angles. The combination of the data regarding mental illnesses, social problems, and the ways of their solutions are vital for the researched issue. Another strength of the article is the practical examples of how the negative impact of the social determinants on mental health can be minimized. The allocation of practical experience to solving theoretical problems is a significant step in understanding the issue more deeply. The paper has theoretical and practical importance because it allocates the results of the WHO’s reports and other experimental research results. Moreover, the collaboration with the WHO makes the work more reliable. The findings are approved by the international organization, which grants the status and high level of validity to the study.
Considering the weaknesses of the article, the lack of statistical data can be mentioned. The researchers provide some data allocations in graphics form. However, this information is not directly addressed in the analyses and findings. As a result, the gap between the theory and practice of the research can be noticed. It would be more rational to not simply state the facts in the data analysis but correlate the factual data with the statistics. Moreover, the statistics can be described as poor considering the vast scope of the research. Such a wide range of problems requires more detailed statistical support. For example, the annual information regarding mental illness among different populations could have been attached. Another weakness that can be highlighted is the language choice and some textual formations. Particular text fragments and ideas are repeated multiple times, which seems unnecessary. More factual information descriptions or statistics could have been implemented instead of repetitions.
Reference
Allen, J., Balfour, R., Bell., & Marmot, M. (2014). Social determinants of mental health. International Review of Psychiatry, 26(4), 391–407.
The health of the nation is one of the major government concerns. The gradual enhancement of citizens’ well-being is the goal of numerous interventions designed by power agencies. Moreover, the healthcare sector focuses on creating the basis for the continuous improvement of people’s quality of life and providing them with the necessary care. Incentives such as Healthy People 2020 focus on outlining the main objectives that should be addressed to help communities to evolve. Mental health is also viewed as one of the important areas that should be addressed. For Florida, the problem remains relevant as the state has problematic access to this type of care and specific conditions that should be discussed.
Current State of Mental Health and Mental Disorders in Florida
In general, Florida and Palm Beach County have specific issues in the given field that should be discussed. Following the official statistics, the state ranks as one of the most problematic ones regarding mental health care. About 20% of people with mental conditions do not have access to the necessary care or the insurance to acquire the needed treatment (National Alliance on Mental Illness, 2021). Moreover, Florida has one of the lowest budgets for supporting the given sphere (National Alliance on Mental Illness, 2021). As a result, the state population suffers from numerous issues that should be addressed and resolved to improve the quality of life in communities and ensure people can enjoy all benefits available to them.
Mental Health Objectives
The topicality of the discussed problem is also evidenced by the fact that incentive Health People 2020 devotes much attention to it. The program’s primary goal is to improve the mental health of populations through prevention and by guaranteeing access to adequate, appropriate, and comprehensive care (Healthy People 2020, n.d.). It means that the state focuses on resolving the problem and offers specific objectives to address the problem. They include reducing the suicide rate, improving access to care, aligning the continuity of treatment and care, increasing the proportion of individuals who require the necessary treatment, and other interventions (Healthy People 2020, n.d.). The listed objectives are also relevant for Florida as their achievement might help to improve the quality of care in the area.
MHMD 6. Increase the Proportion of Children with Mental Health Problems who Receive Treatment
The health of children is one of the major concerns of the healthcare sector as they are the future of the nation. Thus, following the official statistics, only 73% of children with mental health problems receive the necessary care, while the rest of the cohort was excluded (Healthy People 2020, n.d.). In Florida, the situation is more complex because of the problematic access to care, meaning that only about 60% might acquire the necessary care (National Alliance on Mental Illness, 2021). Following the objective, it is vital to ensure that 75.8% of the population group should have access to care (Healthy People 2020, n.d.). For this reason, the given goal is vital for Florida with its problems in the given sphere.
MHMD 9.2. Increase the Proportion of Adults aged 18 Years and Older with Major Depressive Episodes (MDEs) Who Receive Treatment
The importance of the given objective for Florida is also linked to the problem mentioned above. The state suffers from problematic access to mental health care, affecting people with MDEs. Statistics show that about 14.7% of adults in the state suffer from this condition (Healthy People 2020, n.d.). It deteriorates the quality of their lives and preconditions the emergence of new, severer problems. Under these conditions, it becomes critical to follow the objective and attain the 10% improvement in the given sphere. It will help to improve the quality of people’s lives and ensure Florida has better access to care for its citizens, which is vital for their well-being.
The Relationship Between Physical and Mental Health
The necessity to address mental health issues can also be explained by their influence on the health of individuals. In general, the mental and physical conditions of a person are interrelated. It means that the emergence of the problems in one sphere might precondition the corresponding change in another and the overall deterioration of the quality of life. For instance, patients with depression or anxiety more often suffer from chronic diseases, such as gastritis or high blood pressure (“Mental health myths and facts,” n.d.). At the same time, patients with chronic physical conditions are at risk of acquiring mental health issues because of negative emotions and constant stress (National Institute of Mental Health, 2022). In such a way, these two factors are closely interconnected.
Lack of Access to Mental Health Care and Traumas
The lack of access to mental health care might also promote an increased risk of trauma. For instance, the research shows that patients with untreated depression might acquire self-harming patterns. If the problem remains unaddressed, they will evolve and cause more severe harm to a person (National Institute of Mental Health, 2022). Moreover, the high anxiety and stress levels, combined with depression symptoms, might trigger the development of suicidal inclinations and the emergence of critical risks for an individual’s health, well-being, and life (National Institute of Mental Health, 2022). Under these conditions, the existing facts prove that the problematic access to mental health care might result in the gradual deterioration of the client’s condition and create the basis for the emergence of serious physical problems and diseases.
Trauma-Informed Care
Trauma-informed care is another vital incentive to improve the nation’s health. It implies that most individuals have specific traumas impacting their lives (“What is trauma-informed care?” 2021). For this reason, it is critical to provide care regarding this information and ensure the current client’s problems are addressed. The approach emphasizes physical, physiological, and emotional safety for individuals helping them to reacquire a sense of control and move forward (“What is trauma-informed care?” 2021). The given approach is critical for working with individuals who cannot control their lives because of previous psychological damage. It can also be applied to working with children to help them recover and socialize.
The approach has several vital components explaining its importance for communities. First, it focuses on regulating the individuals’ experiences and feelings linked to previous traumas (American Psychological Association, n.d.). In other words, the existing state is viewed as a result of previous impacts. For this reason, it becomes critical to reorganize the current care to boost its effectiveness, and grantee better results are acquired. Moreover, the approach is effective in working with children who experienced different types of abuse (American Psychological Association, n.d.). It also makes it a vital framework that should be used by caregivers today.
Conclusion
Altogether, the mental health of individuals is one of the major concerns of the modern healthcare sector. For this reason, the incentive Healthy People 2020 offers a set of objectives to attain improvement in this sphere. These aims are also relevant for Florida, as the state is characterized by problematic access to this type of care and a significant number of patients with specific mental health conditions. For this reason, it is vital to focus on achieving the outlined objectives to improve communities’ health in Florida.
References
American Psychological Association. (n.d.). Children and trauma. Tips for mental health professionals. Web.
Healthy People 2020. (n.d.). Mental health and mental disorders. Web.
Mental health myths and facts. (n.d.). MentalHealth. Web.
It is generally recognized that the human body’s foundation is the gene: the physical DNA strands responsible for protein biosynthesis and cellular regulatory processes. Although the range of influence of a gene is determined by the size and functionality of the cell in which it is located, the formation of proteins, including those that form homeostasis, plays a key role in controlling the whole organism. It follows that genes determine the functioning of intracellular processes and organ systems, including the brain. At the same time, it is known that disturbances in the natural cognitive states of brain performance lead to the development of disorders and problems related to mental health. Consequently, it is appropriate to assume that, to some extent, the activity or inactivity of genes initiates the formation of mental disorders in the patient. Meanwhile, it is erroneous to assume that isolated gene activity causes such severe cognitive transformations. Indeed, there is a close interaction between the genes and the environment in which the individual is raised, which leads to impaired brain tissue function in clinical cases. Some of the best-known mental problems, the core of which is the gene-environment interaction, are schizophrenia, bipolar personality disorder, and autism.
A preliminary discussion of these pathological conditions is necessary for a deeper understanding of the processes’ mechanisms. Schizophrenia is characterized by significant clinical polymorphism, defined by fundamental disturbances in perception, thinking, reduced affect, and emotional reactions. Despite its multiple manifestations, schizophrenia is one of the most deeply studied pathologies, and specific genetic patterns have been identified for its development. In particular, genome-wide association studies, GWAS, have allowed researchers to identify more than 180 loci directly associated with schizophrenia, but finding the specific mechanism of influence remains a broad question (Huo et al., 2019). For instance, it is recognized that single-nucleotide polymorphisms, SNPs, may be associated with developing a schizophrenic disorder, with about 97 of 132 risk SNPs leading to disruption of transcription factor binding in brain tissue. Admittedly, these findings are in good agreement with another study that even indicated the presence of a specific gene, ZNF804A.rs1344706, in Asian patients with schizophrenia (Falola et al., 2017). At the same time, familial therapeutic GWAS associated with in-depth phenotypic and genotypic analyses within single-family verticals have identified a RELN gene deletion factor leading to neuronal death in the sick child, whereas no such polymorphisms have been seen in the healthy mother (Arioka et al., 2020). Taken together, this leads to an understanding of the hereditary nature of schizophrenic conditions. Nevertheless, the use of twin analysis, which considers the epigenetic level — supragenic, unaffected DNA — of schizophrenic disorder formation, has revealed a socioecological link to cognitive pathology (Imamura et al., 2020). It should be clarified that monozygotic twins have 100% identical genetics and epigenetics, and therefore it is possible to detect the effects of environmental influences rather than internal processes in their example. More specifically, there is a stable correlation between the environment in which a vulnerable individual is raised and schizophrenic manifestations. The main external sources of pressure are the degree of urbanization of the area, poverty, migration, racial discrimination, low standard of living and income, and unemployment (Heslin et al., 2018). In other words, those factors lead to stressful and semi-depressive states even for a healthy patient. Thus, summarizing the collected data, it is appropriate to state that genetic mechanisms of SNPs and gene deletions underlie the formation of schizophrenic cognitive pathologies, but the qualitative manifestation of traits becomes possible under the pressure of environmental factors.
Autism is a serious clinical condition manifested by a comprehensive deficit in social interaction and repetitive primitive behaviors and impaired mental development. By now, there is no doubt that the development of autism in children is closely linked to genes that determine the maturation of synaptic connections in the brain, in particular SHANK3 (Keller et al., 2017). However, it has been shown that targeting only one gene is not sufficient for the development of ASD, but rather that in some cases, pleiotropic and phenotypic penetrance effects have been observed, in which multiple gene effects are observed (Woodbury-Smith & Scherer, 2018). Twin studies have confirmed the complex heritable nature of autism, with the risk of shared pathology increasing when living in identical environments (Taylor et al., 2020; Imamura et al., 2020). However, as with schizophrenia, a gene effect alone may not be a sufficient cause for a child to develop ASD. On the contrary, only when genetic, epigenetic, and environmental factors coincide does the pathology’s formation become most likely. Thus, during the prenatal developmental stages during the first eight weeks after conception, teratogens’ contribution to disease formation is increased (Styles et al., 2020). The main sources of such toxins to inhibit the child’s neural activity are polychlorinated biphenyls, phthalates, and phenols. On the other hand, family social status, episodes of experienced childhood domestic violence, infectious and viral diseases, and even cesarean sections have also been shown to generate stressful situations in which epigenetic pathologies have the potential to manifest (Karimi et al., 2017). An environment-initiated cascade of pathological processes can lead to impaired neuronal migration in early development, maturation of synaptic connections, or an excess of brain tissue neurons. Regardless of the specific exposure, it is clear that the combined effect of genes and environmental factors cannot be ruled out.
Finally, it is appropriate to consider gene-environmental exposures as the cause of the development of yet another cognitive clinical pathology, namely bipolar disorder. At the outset, it should be recalled that this term defines an endogenous disorder manifesting itself in the patient’s manic and depressive states. Dualism defines a regular alternation of these phases, as a result of which an individual may exhibit completely different, in rare cases, opposite patterns of behavior and thinking styles during a period. Although the mechanisms of bipolar disorder are less elucidated than other pathologies discussed in this paper, some genetic patterns have been found. For instance, some authors boldly point to a dominant mode of inheritance and a strong linkage of the allele to the human X chromosome (Jons et al., 2019). From this data, it might seem that women should be more likely to showcase disease because of the chromosomal structure of the 23rd pair, but statistical studies claim the opposite effect (Loomes et al., 2017). In other words, even assuming that the bipolar disorder gene is linked to the sex X chromosome, the process of autism formation must be much more complex and multifaceted. More recent work examining family genomic maps has concluded that at least three loci in different chromosomes are responsible for bipolar disorder. Familial adaptation tests also had weight in determining external factors for the initiation of cognitive pathology because, in a family of healthy patients, a sick child might not show symptoms of the disorder. Consequently, it was reasonable to assume that harsh treatment, and psychological distress, including from severe loss syndrome, or PTSD, may have triggered the first acts of bipolarity and the vulnerable patient (Cerimele et al., 2017). To summarize the above, mutations in genes determine the possibility of bipolar personality disorder, but it is correct to note that this only provides the foundation for manifestations. In other words, only when environmental stressors lead to a series of epigenetic pathologies should a patient be expected to develop bipolar disorder.
References
Arioka, Y., Hirata, A., Kushima, I., Aleksic, B., Mori, D., & Ozaki, N. (2020). Characterization of a schizophrenia patient with a rare RELN deletion by combining genomic and patient-derived cell analyses. Schizophrenia Research, 216, 511-515.
Cerimele, J. M., Bauer, A. M., Fortney, J. C., & Bauer, M. S. (2017). Patients with co- occurring bipolar disorder and posttraumatic stress disorder: a rapid review of the literature. The Journal of Clinical Psychiatry, 78(5), 506-514.
Falola, O., Osamor, V. C., Adebiyi, M., & Adebiyi, E. (2017). Analyzing a single nucleotide polymorphism in schizophrenia: A meta-analysis approach. Neuropsychiatric Disease and Treatment, 13, 2243-2257.
Heslin, M., Khondoker, M., Shetty, H., Pritchard, M., Jones, P. B., Osborn, D.,… & Stewart, R. (2018). Inpatient use and area-level socio-environmental factors in people with psychosis. Social Psychiatry and Psychiatric Epidemiology, 53(10), 1133-1140.
Imamura, A., Morimoto, Y., Ono, S., Kurotaki, N., Kanegae, S., Yamamoto, N.,… & Ozawa, H. (2020). Genetic and environmental factors of schizophrenia and autism spectrum disorder: Insights from twin studies. Journal of Neural Transmission, 127(1), 1501-1515.
Jons, W. A., Colby, C. L., McElroy, S. L., Frye, M. A., Biernacka, J. M., & Winham, S. J. (2019). Statistical methods for testing X chromosome variant associations: application to sex-specific characteristics of bipolar disorder. Biology of Sex Differences, 10(1), 1-11.
Karimi, P., Kamali, E., Mousavi, S. M., & Karahmadi, M. (2017). Environmental factors influencing the risk of autism. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 22(1), 1-27.
Keller, R., Basta, R., Salerno, L., & Elia, M. (2017). Autism, epilepsy, and synaptopathy: A not rare association. Neurological Sciences, 38(8), 1353-1361.
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474.
Styles, M., Alsharshani, D., Samara, M., Alsharshani, M., Khattab, A., Qoronfleh, M. W., & Al-Dewik, N. I. (2020). Risk factors, diagnosis, prognosis and treatment of autism. Frontiers in Bioscience, 25(9), 1682-1717.
Taylor, M. J., Rosenqvist, M. A., Larsson, H., Gillberg, C., D’Onofrio, B. M., Lichtenstein, P., & Lundström, S. (2020). Etiology of autism spectrum disorders and autistic traits over time. JAMA Psychiatry, 77(9), 936-943.
Woodbury‐Smith, M., & Scherer, S. W. (2018). Progress in the genetics of autism spectrum disorder. Developmental Medicine & Child Neurology, 60(5), 445-451.