There are several manifestations of mental health stigma, each of which can have severe consequences for people living with mental illness. This reflective report will discuss a time when I witnessed the stigmatization of a loved one due to their mental illness and state of mind. One of my colleagues, whom I will call Jane because we worked together in a retail setting, had a nervous breakdown while at work. With the knowledge I have received in this course, I will reflect on how I and those around me reacted and how I might react differently to battle the stigma I witnessed.
I was working as an intern at a store when the incident occurred. The shop was crammed on a Saturday afternoon with customers. A few months into her employment with me, Jane suddenly began weeping and shivering uncontrollably. Some of the other workers and the customers saw her acting this way and started looking at each other and whispering. Not wasting any time, I went straight to her to check on how she was doing and learn more about what had happened. She tried to explain, but she was stumbling over her words, so I sent her to the break room so that she could collect herself.
Later on, I found out that Jane was in such a bad mood because she had just recently been diagnosed with a mental disorder, depression. She had been battling with symptoms for quite some time, but owing to the stigma associated with mental health, she was afraid to seek help. She felt humiliated and isolated, and she was terrified of the responses her coworkers and friends might give if they learned the truth. She was unable to contain her sobbing and trembling as a direct result of the symptoms of her mental illness, which included her anxiety about being judged and rejected (Mannarini & Rossi, 2019). The diagnosis was unexpected and challenging for her to comprehend and accept, and it harmed her mental and emotional health.
Throughout this episode, the stigma of talking about or seeking help for mental health issues was displayed in various ways. First, there was a severe deficiency in knowledge and understanding of mental health issues among employees and clients (Mannarini & Rossi, 2019). Most of them did not understand what was happening and did not know what to do. It did not help that they were staring at each other and whispering, which added to Jane’s unease. Second, her friends and family did not correctly address Jane’s mental health. Some of the company’s clients and employees did not seem to care about her distress or offer assistance. That only added to her sense of isolation and humiliation. There was reluctance to disclose or discuss the occurrence openly out of fear of discrimination and dire repercussions (Mannarini & Rossi, 2019). This led to a lack of coordination and encouragement from upper management.
Self-stigma, an internalized unfavorable attitude toward people with mental illness, and the associated feeling of shame about one’s mental illness can be shown in this scenario. Internalized discrimination is another name for self-stigma (Subu et al., 2021). The lack of education and understanding, the lack of support and sensitivity, and the fear of discrimination and negative consequences are all examples of the stigma connected with mental health and illness that were displayed in this episode (Subu et al., 2021). Each of these elements negatively impacted the individual who has first-hand experience with mental illness.
The encounter had a significant and long-lasting effect on Jane, the person with personal experience of mental illness. First and foremost, the event made her feel ashamed and embarrassed of herself, which was a negative emotional response (Mannarini & Rossi, 2019). Secondly, she had the impression that her coworkers and clients did not accept her mental health problem, and she had the impression that she was being judged and ostracized because of it. Thus, she had feelings of isolation and lack of support, which contributed to her distress.
The event had a detrimental effect on her sense of self-esteem and self-worth. She believed that her mental health issue was a liability and that she could not perform the duties associated with working in a retail store. As a result, she lacked motivation and self-confidence in her abilities. The incidence had a detrimental effect on her emotional and mental well-being. She had a worsening of her symptoms as a direct result of the incident, which caused her to experience increased stress and worry (Mannarini & Rossi, 2019). She experienced increased feelings of anxiety and depression, and she had trouble sleeping, all of which contributed to a decline in her general well-being.
Lastly, the occurrence made it more difficult for her to maintain employment. Due to her coworkers’ lack of support and understanding, she concluded that she could not continue working in the retail shop. Due to this, she had to take some time off from her job, which negatively influenced her income and her capacity to maintain her financial security. Therefore, the event had a significant and long-lasting adverse effect on Jane’s mental and emotional well-being, as well as her self-esteem, performance at work, and financial security (Mannarini & Rossi, 2019). Her lack of access to help and understanding and her encounters with stigma and prejudice all contributed to her anguish and made it more challenging for her to take care of her mental health condition.
When I was there with Jane and saw what had happened, my initial reactions were shock and bewilderment. It was beyond my comprehension as to why her coworkers and customers were treating her in such a derogatory and condescending manner without minding her feelings. Due to their lack of support and comprehension, I found myself experiencing feelings of rage and irritation toward them. In addition, I experienced feelings of regret and shame because I had not defended Jane and had not fought against the stigma being communicated. I realized that I had been ignorant that the acts I took, or the lack thereof, may affect her overall health and well-being. I had the impression that I could have assisted her more meaningfully and that the lack of response on my part had contributed to the detrimental effects of the occurrence.
In addition, I was overcome with a sense of sorrow and compassion for Jane. I could tell that she was having a hard time and that the event substantially affected her mental and emotional well-being. I felt I ought to have been there for her and offered her the support and understanding she required at that time. In hindsight, I am aware that my response directly resulted from my ignorance of the stigma associated with mental illness and my lack of knowledge regarding it. I lacked the education necessary to detect and combat stigma and the knowledge to assist people with personal experiences with mental illness.
I concluded that my response was influenced by the prejudices and preconceptions I hold about myself. I was completely unaware of my biases and how they might have influenced how I behaved in certain situations. I had no idea that I was contributing to the stigma surrounding Jane in my manner, even if it had been inadvertent to do so. I was unaware of the need to recognize and combat the stigma associated with mental health and sickness and ensure that those with personal experience with mental illness receive the necessary support and understanding. I appreciate the importance of educating oneself on mental health and illness, recognizing and challenging one’s biases and assumptions, and being an ally to others with personal experience dealing with mental illness.
If I were to find myself in a scenario like this again in the future, I would take a more aggressive approach to tackle the stigma associated with mental illness and health in general that is being communicated. The course has educated me on the significance of identifying and rebutting stigmatizing attitudes and actions, not only for the benefit of the individual who is subjected to them (Mannarini & Rossi, 2019). There is a need to foster an environment that is more welcoming and encouraging for all individuals with mental illness (Mannarini & Rossi, 2019). One thing I would change is how I educate myself and others on the subject of mental illness and mental health. If I had a greater understanding of the topic, I would be more equipped to notice and confront attitudes and behaviors that contribute to stigma, and I would be able to do so more effectively. I would be able to provide correct information and assistance to the individual suffering the stigma, as well as to any other individuals who may be witnesses to the incident.
Participating actively in prosocial behavior is yet another strategy that I would recommend taking. Prosocial behaviors are voluntary actions mainly designed to assist or increase the well-being of another individual or group of individuals, they include caring, counseling, reassuring, assisting and safeguarding someone from potential damage (Hecht et al., 2022). Instead of keeping quiet in the past, as I have done, I would speak up and confront the stigmatizing attitudes. I would encourage others to do the same and work together to create an environment that is more welcoming and supportive of people of all backgrounds and identities. I would intentionally confront my preconceived notions, biases, and preconceptions by making a concerted effort to become more self-aware of them. The course has taught me that these biases can unconsciously influence my actions and reactions and that it is essential to be aware of them to be an effective ally to individuals who have lived experiences of mental ill-health (Mannarini & Rossi, 2019). The course has informed me that it is essential to be aware of these biases in order to be an effective ally to individuals who have lived experiences of mental illness.
Mental health is an essential element of human well-being, which predetermines people’s ability to socialize, work, and develop healthily. However, continuous exposure to stressors associated with work in the healthcare setting puts nurses at a high risk of developing mental health issues, such as anxiety, depression, insomnia, post-traumatic stress disorder, and other condition (Huang et al., 2018). With the breakout of the COVID-19 pandemic, the pressure on nurses has rapidly increased, significantly overloading healthcare facilities, intensifying the workload, and contributing to the overall burnout of the nursing staff (Marsden et al., 2022). Research shows that despite the elevated risks of nurses’ mental health deterioration due to the specifics of their work, their conditions are often underdiagnosed and undertreated (Sovold et al., 2021). Therefore, it is essential to research the impacts of the mental health of nurses on their practice to ensure what methods can effectively improve the well-being of healthcare professionals. Since public health outcomes largely depend on the quality of nursing care, it is essential for healthcare professionals to prevent mental health issues and perform their roles uninterruptedly.
In nurses diagnosed with anxiety (Population), what is the effect of cognitive behavioral therapy (Intervention), in comparison to aromatherapy (Comparative/alternative intervention), on anxiety coping skills development (Outcome)?
PICOT Question 1 Article
Bernstein, M. T., Reynolds, K. A., Jakobson, L. S., Stoesz, B. M., Alcolado, G. M., & Furer, P. (2022). Examining anxiety treatment information needs: Web-based survey study. JMIR Formative Research, 6(5), e31338. Web.
PICOT Question #2 (Diagnosis/assessment)
For nurses with their first depressive episode (Population), does molecular biomarkers testing (Identifying tool/procedure) yield more accurate or more appropriate diagnostic/assessment information than the Beck Depression Inventory (Comparative tool/procedure) about major depressive disorder (Outcome)?
PICOT Question #2 Article
Galvao, A. C. D. M., Almeida, R. N., de Sousa Júnior, G. M., Leocadio-Miguel, M. A., Palhano-Fontes, F., de Araujo, D. B., Lobão-Soares, B., Maia-de-Oliveira, J. P., Nunes, E. A., Cecilio Hallak, J. E., Sarris, J., & Galvão-Coelho, N. L. (2021). Potential biomarkers of major depression diagnosis and chronicity. PloS One, 16(9), e0257251. Web.
PICOT Question #3 (Prognosis)
In nurses working with COVID-19 patients (Population), does irregular sleep patterns (Influence/exposure to disease or condition) relative to regular sleep patterns (Comparative disease/condition OR absence of the disease/condition) increase the risk of insomnia (Outcome) during three months?
In nurses delivering care to acute care patients (Population), does cigarette smoking (Influence/exposure/characteristic) compared to abstinence from smoking (Comparative influence/exposure OR lack of influence or exposure) increase the risk of developing symptoms of depression (Outcome)?
What is it like for professional nurses (Population) to socialize after diagnosing with a posttraumatic stress disorder (Condition) during the first three months after diagnosis (T)?
Bernstein, M. T., Reynolds, K. A., Jakobson, L. S., Stoesz, B. M., Alcolado, G. M., & Furer, P. (2022). Examining anxiety treatment information needs: Web-based survey study. JMIR Formative Research, 6(5), e31338.
Galvao, A. C. D. M., Almeida, R. N., de Sousa Júnior, G. M., Leocadio-Miguel, M. A., Palhano-Fontes, F., de Araujo, D. B., Lobão-Soares, B., Maia-de-Oliveira, J. P., Nunes, E. A., Cecilio Hallak, J. E., Sarris, J., & Galvão-Coelho, N. L. (2021). Potential biomarkers of major depression diagnosis and chronicity. PloS One, 16(9), e0257251. Web.
Sovold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health, 9, 679397.
The effects of meditation on health are a rather intriguing, albeit, under-researched aspect. The data presented in the text matters, because the researchers wanted to review other effects this activity has on people’s brains and overall condition. By means of exploring this aspect, they intend to expand on the topic of the alterations in biological processes related to changes in mental and physical health caused by meditation. The researchers believe that the influence meditation has on physical and mental health has very limited data and predominantly concentrate on the alterations that take place at the time of the activity as opposed to a resting control condition in a single experiment. The study is more focused on the long-term changes which can be found in baseline brain function, including brain activity as a result of certain emotional challenges, instead of reviewing the period of meditation itself. Another aspect that motivated researchers to conduct the study is the fact that meditation was documented to have caused a positive affect by reducing anxiety.
The variable that is reviewed at a nominal level is the measure of brain electrical activity that was documented before dividing people into two groups. It is a dependent variable, as it has been assessed before the assignments for the groups, after said assignment, and four months later to define the outcome of the study (Davidson et al., 2003). This variable has been used to compare the outcomes of those who meditated in contrast to those who are on the waiting list. EEG was measured by means of 27 sites placed across the scalp and related to linked ears during 8 1 minute baseline trials. Brain electrical activity encapsulates the responses to negative and positive emotion, as well as the features of the two baseline conditions. This variable describes such attributes as epochs and measures of spectral power density in the alpha-band, related to activation.
The ordinal level variable implemented in this study is represented by times 1, 2 and 3, which take place before, later, and four months after each of the groups were assigned. This variable is included in the study because it is used to measure various aspects, such as trait anxiety. It is a constant variable, as it does not change throughout the entire research. The variable was measured to calculate such moments as Group X Time interaction. This variable describes unit t, which is then used to review the effect of the treatment by being calculated with p. The attributes of the variable are that it has helped review measures of positive and negative effects prior to and after the meditation training provided for some of the participants of the study.
The interval level variable used in the following research is the calculation of antibody titers from the influenza vaccine. It is used to review the effects of the meditation training and to compare the outcomes of the group in the waiting list and the one that partook in the meditation lessons. The variable is a dependent one; as it demonstrates the result of the study and helps researchers better understand the outcomes of their experiment. This variable was measured by means of the units r and p. The value of the variable is that it helps researchers have a clear and concise understanding of the effect meditation has had on the subjects.
As there are no governmental reports, the relevant research’s statistical basis is the article “Mental health impact on healthcare workers due to the COVID-19 pandemic: A US cross-sectional survey study”, whose target audience is physicians. Using validated metrics, researchers quantified psychological health in a heterogeneous ambulatory care healthcare personnel population. These findings highlight the breadth and scope of mental health consequences in ambulatory caregivers, raising critical issues about innovative strategies to alleviate that burden (Biber et al., 2022). The article was written in cooperation with 13 authors under Joshua Biber’s lead, a proven healthcare executive with considerable experience in effective management and globally regarded as a pioneer in public health development.
The article “The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review” gives examples of specific means to overcome the occupation problem. Preventive possible strategies might be less alienating and potentially efficient, and research on the performance of any intervention/strategy is required (Muller et al., 2020). The results of this pertinent article are addressed to the management of healthcare institutions to take measures to prevent psychological consequences and complement the previous sources outcomes.
Olivia Sale is a final-year undergraduate Psychology student volunteering as a Research Assistant on the CARMS project. The rise in mental distress has been linked to several variables, including occupational relocation, isolation from family members, insufficient protection, and a higher likelihood of coronavirus infection (Sale, 2021). This source is relevant because it demonstrates the understanding of the existing problem not by medical practitioners but by students, which diversifies the perspectives considered in the study.
The other pertinent blog was named “Healthcare Workers’ Mental Health in the COVID-19 Warzone.” The ‘warzone’ setting has resulted in new psychic health issues, such as anxiousness and stress, with long-term psychological effects expected to emerge in the future. Healthcare personnel worldwide require extra mental health assistance today and in the future (Thane, 2021). Public Health Insight is a global health information exchange and data transfer company that disseminates information.
The last source of paramount relevance is the video entitled “Frontline stories,” recorded by Tim Wind, a clinical psychologist. Frontline responders in North Macedonia, the Netherlands, Spain, and the United Kingdom explain the enormous psychological, physical, and societal impact on their daily lives (Wind, 2021). In this video, actual cases of psychological effects, described in other sources, can be spectated.
The chosen case study involves the story of Anita, who is a 32-year-old mother experiencing symptoms of depression, self-neglect, anxiety, and doubt. It is associated with her moving to another city, becoming a stay-at-home mother, and getting separated from her friends and family, while receiving very little in terms of emotional support from her children and husband. The proposed model to be used in Anita’s recovery is patient-centered care. The purpose of this paper is to identify factors that impact the individual’s mental health and well-being, possible approaches that could be used to address the issues and provide a strategy involving all resources available to the patient.
Factors that Impact the Individual’s Mental Health and Wellbeing
Humans are social creatures, and prolonged isolation from the usual circles of interaction can negatively influence a person’s mental health in the long term. As it is possible to see, Anita was completely removed from all of her friends, when moving to a new city. Her family remained in another state, and her new position as a stay-at-home mother did not contribute to forming new social circles. Social isolation is a prerequisite to many mental issues, including depression, anxiety, and various kinds of phobias (Hari, 2018). Based on the case study, several factors contribute to Anita’s state:
No friend circles in the city;
No physical contact with one’s parents and relatives;
Little support from husband and children;
No employment, contributing to isolation and anxiety.
These issues have to be addressed to remove the root causes of the woman’s mental health issues. The chosen person-centered approach to recovery means that Anita would have to take an active part in her process, which would be aimed at empowering her to improve her mental well-being.
Possible Evidence-Based Person-Centered Treatment Approaches
There are several possible treatments available for Anita that do not involve intrusive treatments. The first issue that needs to be addressed is the impact of symptoms on her daily functioning. Anxiety and loneliness may be affecting her activity at the physical level by influencing her hormonal levels (Hari, 2018). Anita should undergo an examination to discover if that is the case. It has been discovered that the likelihood of depression is closely related to the levels of serotonin, dopamine, and norepinephrine in one’s body (Erzen & Çikrikci, 2018). If that is indeed the case, then specific medicine should be taken to affect the immediate symptoms of the illness.
The second step should involve repairing the social circles and forming new ones; Opportunities for socialization have to be sought. Anita has access to an assortment of supportive groups full of people with similar issues. Among them, she could find understanding and compassion. Research shows that individuals suffering from loneliness and anxiety could find a reciprocal empathetic bond with people who are similar to them, thus finding common ground, emotional support, and further avenues for conversation, friendship, and self-development (Adhikari, 2022). Finally, Anita should seek to return to work, as a means of restoring her self-worth and independence, while increasing the size of her social circles. According to Cortès-Franch et al. (2018), there is a positive connection between employment, the size of one’s social circle, and emotional stability, when compared to stay-at-home motherhood. Since Anita was a talented manager, she should seek to find self-realization in that field of industry once again.
The Role of the Family and Friends in the Recovery Process
Until Anita manages to rebuild her social circles, it falls upon family members and distant friends and relatives to assist Anita in finding self-actualization, self-love, and companionship. Husband and children should actively engage with her daily, treating one another not as a chore but as valuable family members (Hari, 2018). In particular, they need to realize their partial responsibility for Anita’s current state. Family and friends can engage in long-range communication using social media, to maintain an online presence in her life (Hari, 2018). They should continue to do so even after Anita feels better, to maintain strong empathetic relationships with one another.
Conclusion
Anita’s current signs of anxiety and depression have been caused by social isolation. It was triggered by the complete severance of most of her social circles coupled with minimal effort to build new ones. As a result, she is isolated in her own home. Her symptoms may indicate a hormonal imbalance caused by stress and loneliness. It can be dealt with utilizing medications affecting serotonin, dopamine, and norepinephrine. Once her apathy and low levels of engagement are temporarily restored, she should focus on rebuilding her social circles by finding new friends, reconnecting with old ones, and getting employed. Family should play a crucial role in Anita’s recovery, as it is their duty and responsibility to be there for their mother and wife. The proposed person-centered approach is supported by contemporary evidence and can be extrapolated to other similar cases. Unfortunately, the problem of depressed and lonely stay-at-home mothers is exceedingly common around the world.
References
Adhikari, H. (2022). Anxiety and depression: Comparative study between working and non-working mothers. ACADEMICIA: An International Multidisciplinary Research Journal, 12(2), 273-282.
Cortès-Franch, I., Escribà-Agüir, V., Benach, J., & Artazcoz, L. (2018). Employment stability and mental health in Spain: Towards understanding the influence of gender and partner/marital status. BMC Public Health, 18(1), 1-11.
Erzen, E., & Çikrikci, Ö. (2018). The effect of loneliness on depression: A meta-analysis. International Journal of Social Psychiatry, 64(5), 427-435.
Hari, J. (2018). Lost connections: Uncovering the real causes of depression-and the unexpected solutions. London: Bloomsbury Circus.
Mental health is a crucial problem that has to be addressed by the government to avert local communities from missing out on productive lives, healthy families, and strong interactive relationships. Practically any person from younger children to old adults may be suffering from a variety of mental health disorders due to the prevalence of unsafe behaviors and risky attitudes that might lead them to ultimate self-destruction. As Heun-Johnson et al. (2018) put it, suicide was almost in the top ten leading causes of death across the United States, which is a scary indicator that cannot and should not go unnoticed. Accordingly, mental health illnesses could also be associated with numerous physical states that could be associated with the inability to keep one’s mental health intact. In other words, cancer or diabetes could occur in a person even in the case of severe anxiety or stress, causing the body to respond in unpredictable ways.
Heun-Johnson et al. (2018) also contributed to the existing discussion by stating that the long-lasting effects of mental disorders may be hard to mitigate due to the extensive economic and psychosocial costs of interventions and consequences. Nevertheless, there is still hope that mental health disorders can be managed appropriately, as the growing body of evidence hints at the idea that the burden of mental issues could be reduced significantly. The existing project serves as an assessment of the Downers Grove, Illinois community and a thorough review of how previous experience could be utilized to develop a decent strategy to address the mental health of the target population and improve the quality of mental health care in the region. This project might become a pathway to a stronger Downers Grove community where individuals would not be afraid to share their thoughts on how to approach the issue and collaborate with care providers to reduce the stigma of mental health issues as well.
Target Population
When picking the most appropriate target population for the current project, the author decided to consider numerous variables describing the populace, such as gender, age, ethnicity, sexual orientation, and geolocation. There is also a need to include specific social conditions in order to gain as much insight as possible into the given community. Some of these were interpersonal relations, intrafamilial and community dynamics, school conditions, and social backing. The information provided in the SAMHSA (2017) report disclosed the presence of numerous risks associated with mental health issues in Illinois youth. This is a hint at the fact that there are not enough resources currently available to the Downers Grove community to establish safe places for the target population to interact and contribute to overall change concerning the attitudes toward mental health issues across the State of Illinois.
On the other hand, that same report published by SAMHSA (2017) is the key to understanding that the biggest population currently affected by mental health illnesses is youth. It is a warning sign for the Downers Grove community, as at least one major depressive episode per annum was found in at least 20% of Illinois youth residents. The percentage seems to increase, as in 2014, that same community reached about 14% of youth residents being exposed to major depressive episodes. In addition, the problem is that less than half (approximately 38%) of Illinois youth received appropriate treatment for their mental health issues. This can be important as well because some of the respondents might be too afraid to ask for help due to certain circumstances such as the socioeconomic status, sexual orientation, or gender.
Ultimately, the target population can be described as male, female, or transgender respondents aged from 15 to 24 who are either suffering from major mental health issues or get exposed to certain episodes that damage their mental health time after time. One of the major trends included in SAMHSA (2017) report is the growing prevalence of psychotic disorders in youth. This problem slowly becomes prevalent because it increases the rates of stigmatization among peers and adults and also increases the time of hospital stays. Depending on the primary reason for hospitalization, care providers have to pick the right approach to their patients, which also means that local youth often faces the challenge of not being enrolled in follow-up care. The lack of appropriate prevention measures makes the Downers Grove youth community an especially vulnerable population that has to be protected.
Summary of Articles
The article written by Buchholz et al. (2015) discloses a number of important points that have to be considered when thinking about the best strategy related to youth coping with mental health issues. The researchers investigated the process of youth disclosing mental health issues to their parents or teachers and reviewed the possible social implications of such communication. Buchholz et al. (2015) found that mental health challenges are exceptionally hard to discuss when there is a risk of being misunderstood or ridiculed in front of others, so many young individuals tend to keep their anxiety and worries to themselves in order to protect themselves from unsafe outcomes. Nevertheless, further communication could be helpful when trying to reduce stigma and build effective relationships with the environment. The results of research conducted by Buchholz et al. (2015) could be utilized to manage possible disclosure decisions in the future and help local youth discuss their mental health issues more without obstruction.
Vohra et al. (2019) touched upon the question of how mental illnesses impact mortality and morbidity in youth. In order to introduce a decent prevention measure, they investigated the potential benefits and challenges associated with the mindfulness-based stress reduction (MBSR) strategy when utilized to address the prevalence of mental health issues in youth. Even though Vohra et al. (2019) could not achieve any specific results in terms of finding any relevant evidence regarding the effectiveness of MBSR in youth with mental health issues, their research allowed them to evaluate the efficacy of this strategy and see how psychological interventions could help when treating mental health issues in youth. The results of the study showed that MBSR could be an effective way for youth to cope with the potential stigma and improper emotional responses linked to the advent of mental health issues.
The article written by Mustanski et al. (2016) dwelled on the possibility of reducing the amount of cumulative victimization that LGBT youth representatives could be exposed to while also suffering from mental disorders. In order to complete their research, the investigators picked a sample including transgender, bisexual, lesbian, and gay youth and screened them for depression and anxiety in order to establish the potential level of stigma that these respondents could be facing on a daily basis. The findings published by Mustanski et al. (2016) showed that in addition to depressive episode, LGBT youth in Illinois was at an elevated risk for PTSD symptoms. Overall, the research concluded that there was an extreme amount of victimization affecting the LGBT youth living across the State of Illinois.
References
Buchholz, B., Aylward, S., McKenzie, S., & Corrigan, P. (2015). Should youth disclose their mental health challenges? Perspectives from students, parents, and school professionals. Journal of Public Mental Health, 14(3), 159-168.
Mustanski, B., Andrews, R., & Puckett, J. A. (2016). The effects of cumulative victimization on mental health among lesbian, gay, bisexual, and transgender adolescents and young adults. American Journal of Public Health, 106(3), 527-533.
Vohra, S., Punja, S., Sibinga, E., Baydala, L., Wikman, E., Singhal, A.,… & Van Vliet, K. J. (2019). Mindfulness‐based stress reduction for mental health in youth: A cluster randomized controlled trial. Child and Adolescent Mental Health, 24(1), 29-35.
Mental health is a crucial determining factor of an individual’s overall state of well-being. Among the aged, experiences, philosophical differences, independence and dependency are some of the key concepts that influence their mental health and well-being. Integration of mental health care services in primary health provision with a focus put on achieving optimal medication management in health and medicine is vital in ensuring that the aged enjoy all aspects of wellness (Larsen et al., 2011).
This will in turn ensure that the aged achieve psychological resilience, spiritual, intellectual, emotional and physical wellness. As this research proposal will bring to light, many factors in a community determine the mental health and wellness of the aged. Circumstances and environmental factors such as where they live, their income, education level, relationships with family and friends, and the state of the environment determine to a large extent their mental health and wellness.
It is vital to reiterate that emotional wellness is an important aspect of wellness since it assists an individual to know how to deal with challenging emotional situations, express oneself in a healthy manner, manage individual self-esteem, anger issues and emotional IQ. This may be attained by balancing life’s activities with abilities possessed by an individual. Additionally, the mental well-being of an individual may also be described as a state of enhanced mental health with no diagnosable mental health problem (Zivin, Paczkowski & Galea, 2011).
On the same note, mental wellness among the aged is largely influenced and affected by biological factors as well as the nature of immediate social and environmental determinants. This research proposal will examine the aspects of wellness with regards to the dimensions of mental health and among the aged.
Review of Literature
Aspects of wellness and mental health
Mental health, commonly described as the absence of mental-related complications, is a state of well-being whereby an individual can be able to fruitfully and productively perform duties, cope with issues of stress and make a significant contribution to a community. Many aged people display feelings of anxiety and depressive symptoms related to mental illness. As such, this impacts their enjoyment of quality of life with spiritual, social, physical and emotional wellness. In mental health, the focus is normally put on achieving psychological resilience. This may be attained through balancing life’s activities with the abilities that an individual has.
Research studies indicate that the aspects of wellness and mental health among the aged can be realized when they are put in emotionally enriched environments, have optimistic attitudes such as faith, creativity and humor, get adequate sleep and rest, good nutrition and proper physical activity. It is imperative to note that the mental wellbeing of an individual is a state of enhanced mental health with no diagnosable mental health problem. This, therefore, relates mental wellbeing to the aspects of wellness that include spiritual, intellectual, emotional and physical wellness.
There are many factors in a community that determines the mental health of the aged. Circumstances and environmental factors such as where they live, their income, education level, relationships with family and friends, and the state of the environment determine to a large extent their mental health. This clearly indicates that, a person’s health is determined by the context of his or her life.
Therefore, it would be inappropriate to give credit for good health or to blame an individual for poor health. This means that the determinants of health are unlikely to be in direct control of an individual. Some of the main determinants of mental health discussed here in relation to the aged include social, biological and environmental factors.
Social factors
These may be triggered by both social and economic factors that the aged live in. This can also become determining factor of their health. Social determinants such as low economic status, stress, traumatic events and losses are primary in determining whether communities, individuals or jurisdictions as a whole become ill or remain healthy spiritually, socially, physically and emotionally (Zivin, Paczkowski & Galea, 2011).
In addition, social determinants are important in determining personal, physical and social resources possessed by an individual that would be used to achieve personal goals, cope with the environment and meet personal needs. Therefore, health experts have realized that alongside improving prognosis and prolonging survival from some deadly illnesses among the aged, it is more important to first tackle social and economic conditions that make them sick (Larsen et al., 2011).
Secondly, the health status of the aged community is determined by behavioral choices that they make at the individual level. The determinants leading to a particular behavior are considered in two mechanisms namely materialist mechanisms and cultural or behavioral mechanisms (Zivin, Paczkowski & Galea, 2011).
The behavioral choices among the aged such as the use of alcohol and tobacco, poor health activities, diet and so on are observed to be causes of illnesses that may lead to death. It is important to note that material conditions of life strongly structure the behavioral choices of an individual. These behavioral risks, consistent with mounting evidence, account for incidences of deterioration of mental health. An individual’s material condition can be seen as good working conditions, availability of housing and food, availability of resources to access the amenities life provides among others.
The quality development of family life, community environment and interaction health is influenced by material conditions of life. Also, it may lead to differences in physical, developmental, social and educational problems. As individuals grow old, their mental health deteriorates since most of them tend to lose social support that is necessary for spiritual, social, physical and emotional wellness.
Thirdly, the psychosocial comparison is another social determinant that shapes health. The mental health, spiritual, social, physical and emotional wellness of individuals get affected the instance they begin to lose the support that other age groups are getting. This lack of support and neglect produces a variety of negative and positive effects and exposures in the lives of the aged that may have health outcomes.
For instance, the older individuals who may find themselves in unequal societies where their material needs and health care cannot match with the others may have psychological health effects as the individuals may feel neglected or worthless and adopt health-threatening copying behaviors or additional actions that threaten health in order to alleviate the feeling.
Furthermore, unequal distribution of health resources in a community or in a nation to cater for the aged socially determines their health status. Areas, where hospital care resources have been equally distributed, have many aged individuals with mental wellness and hence narrower exposure to social determinants of health compared to areas where there are fewer health care facilities.
Poor health conditions arise from such unequal jurisdictions (Zivin, Paczkowski & Galea, 2011). Therefore, there is a need for the government to put up in all areas public infrastructure such as health and social services, education, health insurance and support the aged. It is important to note that societal factors like the distribution of resources are determinants of health.
Biological factors
Biological factors influencing well-being and mental health among the aged and other groups include family history, illnesses, medications, and changes in the central nervous system. Biological factors and determinants of health and spiritual, social, physical and emotional wellness can be put into two groups. These are the exogenous and endogenous biological determinants of health (Larsen et al., 2011).
These microorganisms form a relationship with humans. This relationship can either be symbiotic or commensal. Endogenous biological determinants of mental health include immunity and genetic heritage. The latter is determined exposure and response to physical and biological challenges of the environment (Larsen et al., 2011). These exposures may cause conditions like allergies, certain kinds of cancer and errors of metabolism.
In addition, they may influence red blood cell abnormalities to suck as a sickle-cell trait, influence DNA composition and skin pigmentation. Both endogenous and exogenous factors are vital for the mental wellness of an individual.
In addition, immunity plays an important role biological role in determining the mental health and wellness of an individual (Zivin, Paczkowski & Galea, 2011). It is important to note that nutritional status, as well as immunological defenses, determines to a great degree the state of health of a person.
Without proper nutrition, individuals become susceptible to invasion by pathogenic microorganisms. Such individuals are in many cases poorly nourished, deprived of vitamins and starved of proteins. Their bodies lack the ability to develop mechanisms of effective immune defense against pathogens.
Environmental factors
Any external agent such as cultural, social, physical, chemical or biological agents would be considered an environmental health determinant if it causes a change in the health status and spiritual, social, physical or emotional wellness of a person. However, it is important to note that these agents are environmental influences and are involuntary (Larsen et al., 2011).
For example, smoking of tobacco by a second party is considered to be equally the same as polluting the environment since the effects are almost the same. The health outcomes due to the determinants of mental health clearly determine the scope of health promotion, methods and forms to be used. This is done primarily to equip the aged with abilities that will assist them to gain control over determinants of health. Therefore, mental health promotion combines environmental and educational support for conditions and actions of living among the aged, which is conducive to health (Larsen et al., 2011).
The aspects that health promotion touches include personal control of behavior and change in complex lifestyle issues that affect other people’s spiritual, social, physical and emotional wellness like public smoking (Zivin, Paczkowski & Galea, 2011). The government, corporations, groups and individuals are required to take very coercive and aggressive measures to regulate their behavior and actions that may influence the health of other people.
Testable Hypotheses
Based on the literature review, this study proposal hypothesizes that:
Social, biological and environmental determinants of health play a significant role in mental wellness among the aged
The aspects of wellness such as spiritual, occupational, social, environmental, physical, intellectual and emotional wellness are chief components that determine the mental health of older persons.
Lack of aspects of wellness is a cause of mental health.
In many hospitals, the aged diagnosed with serious anxiety and depression bear these symptoms due to a lack of aspects of wellness.
Study Design and Timeline
The study will take a period of 6 months. The table below indicates the processes that the study will follow.
Activity
July
Aug
Sep
Oct
Nov
Dec
Searching of clinical staff, mental health coordinators, and the aged patients with mental health problems via websites, through friends, neighbors and through other credible primary and secondary sources until a long list of names are obtained
Collecting of primary data through the use of questionnaires, individual in-depth interviews, group interviews, laboratory tests, routine physical examinations and gathering information from the medical history of the individual participants
Locating and collating secondary observation, field notes, focus groups transcripts as well as structured and semi-structured interviews
Interviews, fieldwork and further visual analysis (conclusion)
Writing of initial draft
Writing of final copy
The information that will be used for this research will be gathered from primary and secondary sources. Secondary data will be obtained using two broad methods. This will include quantitative and qualitative studies. The former will comprise various databases which will contain information on the aspects of wellbeing in relation to mental health among the aged. Some of the resource materials for quantitative analysis of this research study will include published books, peer-reviewed journals, newspapers, magazines and credible websites.
Primary data will be collected from focus groups which will include clinical staff, mental health coordinators, and the aged patients with mental health problems through the use of questionnaires, individual in-depth interviews, group interviews, laboratory tests, routine physical examinations and gathering information from the medical history of the individual participants. This will be necessary in order to establish the medical background of each of the respondents. The information gathered will form a better part of primary data and will be used for qualitative analysis.
The conditions and demographics of patients and caregivers will be obtained by researchers who will conduct focus group discussions. The questionnaires and interviews will help get responses from questions that will be asked like, “What do you think can be done to improve the mental well-being of a person?”
Additionally, exploratory questions like “What should be done to ensure that the aged enjoy the aspects of wellness in order to overcome mental health problems?” Follow-up questions will be asked after saturation has been reached such as “How can mental health care and treatment be improved in clinics?” data analysis will be done from the transcriptions from the interviews. Content analysis on emerging issues from a set of data collected from mental health coordinators, doctors, nurses, caregivers and patients will be carried out at an individual level and then in groups.
Interview questions
How can the roles of social, biological and environmental determinants of health in mental well-being be improved to ensure that issues of anxiety and depression among other mental health problems among the aged are reduced?
What can be done to provide the aspects of wellness such as spiritual, occupational, social, environmental, physical, intellectual and emotional wellness to the aged to enable them to have better mental health?
What are some of the barriers to mental health and wellness?
Why would doctors and nurses underreport the seriousness of anxiety and depression symptoms in patients?
Sampling Plan
In carrying out this research, a cross-sectional qualitative study design and quantitative method will be used. The quantitative study this research study will focus on up to 450 aged people, 16 health centers and 2 clinics. The mental health patients that will be included in this research will be those suffering from acute, common mental problems such as adjustment disorders and acute anxiety and those with chronic major psychiatric conditions like dementia, bipolar disorder and schizophrenia. The age group selected for interviews will be between the ages of 50-80 years.
The research study has found the age 50-80 convenient since most individuals at these ages are susceptible to being neglected and as such lack the necessary aspects of wellness. The interview will not be gender biased at all. The 450 aged people, 16 health centers and 2 clinics will be searched for via websites, through friends, neighbors and through other credible primary and secondary sources until a long list of names is obtained.
There are some groups that will be excluded from this research. Those will include the aged with a primary diagnosis of mental retardation, those with common problems like sexual difficulties, HIV and spouse abuse issues. Additionally, those with mental health problems but without a concomitant psychiatric diagnosis will be excluded. Such individuals will include those with epilepsy, as this is not a mental health problem.
Data Analysis Strategy
During the study, content analysis will be used to assess gathered information and reports from the data collected. It is imperative to note that for easy evaluation of themes from recorded information collected from primary sources, content analysis will be the preferred method that will be used. The researcher will systematically evaluate collected data, and put into smaller categories a large number of words for quick synthesis.
Even though the research study will seek to gain information from other medical practitioners, the focus of the study will be on the aged. The age to be researched on will be identified first, their health problem and aspect of wellness. Then their levels of performance, activities and sustainability will be determined.
In conducting content analysis, CRA methodology will be applied. This is a system that uses Crawdad, a specifically developed analytical software package, to analyze reports gathered from quantitative data, interpret and determine meanings of words and phrases. It achieves this through the representation of concepts, checking the position of words and building upon inference based on network theory and a combination of linguistics.
The study will use CRA methodology as it is important for analyzing and giving meaning to data that will be gathered from primary sources that have phrases or words through bringing out their inter-relationships, their influence, and main concepts. Individual depth interviews will be conducted when gathering data using the quantitative method. In-depth interviews will be important for this research study since the respondents will provide detailed information and answers to interview questions.
Opportunities/significance of the research study
This research study is will be important in health and medicine for purposes of understanding that health, both mental and physical, is affected by cultural, social, emotional, and mental factors. Gaining recognition of this knowledge will be imperative for making progress in giving individual health an overall approach. It is a fact that most doctors give little notice to the need to integrate the aspects of wellness when dealing with mental issues among the aged. Some exclusively deal with the body while others with the mind.
This study will call for health and medicine practitioners to give mental health issues a holistic look and understand it broadly within the concepts of the aspects of well-being, mental health and illness. This will help correct the problems coming from providers and patients who are dissatisfied and lack compliance, as well as other problems related to misdiagnoses and miscommunication.
Additionally, the study will create an understanding that aspects of well-being and mental health are inseparable. In this sense, medical practitioners will be armed with the knowledge that will ensure that diagnosing and describing symptoms of mental health is done properly and in a way compatible with the biomedical model. Moreover, the concepts surrounding aspects of wellness and mental health explored in this research study will aid health caregivers in distinguishing physical states from mental states.
Furthermore, it will aim at ensuring that people, other than making healthy choices, take mental wellness as their own personal concern. This calls for the intervention of all sectors across the health department, economy and the nation such as education, welfare, justice, housing, community and families among others to provide support towards effective and urgent action to realize the goal of having a mentally healthy nation. This will happen when all the mentioned sectors and people will offer support in all ways. For instance, the support can be social whereby the communities and other sectors will network to enhance mental health promotion.
In order to achieve this, the support needs to be equitable, reciprocal and comprehensive by showing empathy assurances, advice, material support, respect and a sense of belonging. Upon achieving this, both the poor and rich in their respective circumstances will largely benefit from wellness due to good mental health. In making wellness and mental health everyone’s business, the research will call for personal empowerment of each individual in order to enhance the perception of control and power and be able to fully develop health-wise.
Moreover, it will call for the formation of small groups to provide support for lifestyle choices to help promote personal behavior change and improve social support. The research will also call for political action. This is by practicing democracy in participation in matters of health, supporting broad-based social movements, and creating a vision of a better, manageable, preferred future.
Future research studies should advocate for public policies that target healthy living alongside promoting collaborations and proper conflict resolutions in order to achieve consensus. Moreover, the study should seek to develop local actions attached to community levels, lower conflicts to manageable levels and have critical professional and community dialogue.
Besides, in mental wellness, it is pertinent to note that currently, there are quite a number of factors that if not properly handled would continue acting as weak points and a hindrance to achieving the. These issues range from psychological factors to morbidity and mortality. For instance, there are a number of individuals who are living in isolation, they are so poor, and have low self-esteem. Some lack social support, work in a dangerous polluted environments and have low economic power.
Study Limitations
The potential limitation to this study may occur in obtaining primary data from patients with mental problems who may not be successfully interviewed. Another limitation is that most of the findings of this study will be based on interviews as the primary source of information. Indeed, there will be the inevitable challenges of inability by patients to fill questionnaires.
Conclusions
To sum up, the mental wellness of the aged population is significant. This research intends to indicate the importance of accomplishing mental wellness by improving social status, social gradient and ways of acquiring income by any given population.
In addition, the ability to offer food security, access to health services, education on health issues, better and safe working conditions among other things have been identified as some of the important parameters in ensuring healthy mental well-being. Furthermore, it calls for a strategy to be devised in setting viable healthcare infrastructure, interventions, preventions, detecting, screening, treating and managing mental health issues. Therefore, it is imperative to understand that the aforementioned factors are important for the well-being of an individual.
Hence, all societal influences on mental health should be managed well. The deleterious consequence of societal influences on mental health would in fact be mental illness. Therefore, there is a need for individuals to be empowered. This empowerment can be at personal, small group, organizational level or even entire community as part and parcel of building capacity, gaining and utilizing resources in order to enhance control over health determinants.
References
Larsen, T. et al. (2011). Early detection of psychosis: positive effects on the 5-year outcome. Psychological Medicine, 41(7), 1461-1469.
Zivin, K., Paczkowski, M. & Galea, S. (2011). Economic downturns and population mental health: research findings, gaps, challenges and priorities. Psychological Medicine, 41(7), 1343-1348.
The COVID-19 pandemic exacerbated many of the existing health issues in people and healthcare problems in general. The framework for mental health care before was not properly developed in countries around the globe. The healthcare provider and society generally focused most on physical health issues, and the stigma around mental health thrived. Now mental problems are common among people (Falconer & Docherty, 2018). Another challenge in developing an overarching care plan is that, over the years, mental healthcare has shifted from hospitals to community-based solutions. This shift also left some crucial gaps preventing people from obtaining the best healthcare, including poor care coordination, lack of patient awareness, and inadequate resources for care negotiation. Therefore, the proper care coordination plan should provide a framework based on the current assessment of the situation from the side of hospitals, the community, and person-based solutions.
Best Practices for Mental Healthcare
As the shift from hospital care to community-based one has occurred, it is first important to engage the patients in these communities and breach the gap of the lack of information. The first step is assessing the environmental and community factors influencing the patients’ mental health. For example, one of the most contributing factors in mental disorder development is heavy drug use which can be associated with the patient’s surroundings and upbringing. Therefore, a holistic approach focusing on the mind, body, and emotions for mental health is crucial. In other words, the best practices should prioritize the patients’ seamless integration into the community-based healthcare model. Thus, the nurse should establish essential communication with the patient’s families and friends to set common goals. This communication aims to help the patients achieve these goals and stay motivated to avoid negative outcomes.
This focus on the patient’s environment does not exclude the main principle of mental healthcare coordination, its person-centered nature. More than physical issues, mental disorders are distinct from person to person. Moreover, treating the patient without rebuilding the patient’s self-esteem, healthy coping mechanisms, positive thinking, and right attitude toward the stimuli are impossible (Gandré et al., 2020). Therefore, a personalized approach is indispensable to achieving these outcomes. Some examples include literacy sessions, self-care seminars, and lectures on avoiding stressful situations and coping mechanisms for such events. It also combats the issues of the lack of information and misinformation among the patients. The lack of such crucial data can prevent them from achieving the needed results and engaging in the community-based healthcare model in the first place. Thus, this approach allows patients to establish the necessary beliefs and core values to improve their mental health by providing essential resources and encouragement.
Moreover, once the patient is integrated into the system, the risk of the patient dropping out without attaining the desired goals remains. Therefore, the work with the patient’s surroundings, including family, friends, and living environment, should continue. Through this communication with the patient’s relatives and personalized therapy, it is easy to assess the factors contributing to the negative effects on their mental health. Such conditions include cultural and social practices and the absence of an optimal living environment. Thus, healthcare coordination should focus on patients’ gain of understanding and coping with these factors through therapy and even providing alternatives to such arrangements.
Overall, the best practices for mental health care coordination include a mix of primary care in the form of personalized therapy and social care in assessing and influencing patients’ surroundings. In other words, according to Falconer & Docherty (2018), “Primary care centers remain strategic partners in the health care system for collaborative care initiatives, especially in managing care coordination for mental health” (p. 2348). On the other hand, according to Gandré et al. (2020), the healthcare model in the mental health field “ should evolve to include social care” (p. 13). Now the integration between the two is limited. Therefore, imagining the high level of involvement of the nurses in the patients’ lives may seem unfamiliar. However, the research across this field appears to conclude the necessity of such change, concluding the best outcome from such a strategy.
Community Resources
Because of mental healthcare’s community-based nature, community resources are crucial for positive patient treatment results. Moreover, effective community resources can encourage patients to continue treatment and provide the necessary resources. The members of such communities can also substitute or enhance the patients’ environment, supporting each other in their journey and combating isolation and loneliness, which contributes a lot to mental issues. In other words, such communities can provide the necessary positive contrast in the patients’ lives to rebuild their self-esteem and form healthy coping mechanisms. In this case, the patient will learn to understand their living conditions in a healthy environment, deciding to change them or cope with them in healthy ways.
As mentioned above, to engage the patient in the community where treatment happens, the caretakers need to fill the lack of knowledge gap. Aside from the positive influences of the community, the patient may lack the financial resources to receive the treatment required. Thus, caretakers and nurses are responsible for informing the patients of such resources. One of examples of such community resources is governmental and NGO wellness programs. It also can be some small local resources that are hard to know for outsiders in the healthcare community. Furthermore, when engaged in these communities, the patients can learn more about other available resources and share advice and information with the members.
Digital Technology in Mental Healthcare
Digital resources can breach the gap of lacking availability of mental healthcare. Digital resources vary from psychological databases to full-on online consultative services. Falconer & Docherty (2018) concluded, “Our review suggests a knowledge gap regarding newer e-health technologies such as mobile devices and cell phone apps to facilitate coordinated care” (p. 2347). This help mainly consists of obtaining information on mental health issues and the availability of care, as primary care in the form of personalized therapy remains the central treatment. However, Falconer & Docherty (2018) suggest that beyond the patients’ self-care outcomes, the hospitals can adopt technology more to “help patients with medication adherence and chronic disease management” (p. 2348). In other words, the care provider can guide the patients to the resources through technology and integrate it into care coordination further with the specialized health monitoring systems and remainders.
Conclusion
The most comprehensive plan for mental health care consists of primary and social care integration, community effort, and extended use of technology. Research shows that traditional primary care in personalized therapy is important but not enough in recent years. The caretakers also should focus on patients’ surrounding conditions and the environment through social and community work. They can implement technology creatively and extensively to achieve these results.
References
Falconer, E., Kho, D., & Docherty, J. P. (2018). Use of technology for care coordination initiatives for patients with mental health issues: a systematic literature review. Neuropsychiatric Disease and Treatment, 14, 2337. doi: 10.2147/NDT.S172810
Building a career is a process full of challenges, especially when the individual is faced with the task of making a choice. The desire to choose the best option from various possibilities, taking into account personal abilities and interests, can provoke stress and other difficulties. Therefore, it is crucial to carefully evaluate individuals’ experiences and learn more about options to make an informed decision. For the Master of Science in Nursing (MSN) program, I chose the Mental Health Nurse Practitioner (MHNP) specialty. Despite the difficulties of choice, at the moment, I am confident that this opportunity is in line with my goals and interests.
Discussion
One of the choices a nurse makes is a decision on how to progress in a career. MSN is one of the opportunities to advance qualification and educational level to continue the professional journey. Moreover, the program is a step toward the objective of the role of an advanced registered nurse practice (APRN) (Schlette, n.d.). I was confident in the desire to get a higher degree, as my goal is to contribute significantly to health care. However, I had some difficulties in choosing a direction for development. In particular, my professional plan was not clear and determined enough. Moreover, I am interested in several areas of medicine where I would like to prove myself. I also wanted to take into account my experience in a mother-baby and labor unit. The time allocated to assess my goals, interests, and values helped me choose.
Since the goal of obtaining a degree and moving toward the role of APRN prompted me to study in the MSN program, the primary choice was the specialty. My interest in mental health was a key driver in my decision to become an MHNP. I have always been inclined towards this field, and although my experience has been in a different direction, which has also been interesting to me, it has helped me realize the importance of mental health support. Moreover, the demand for highly skilled mental health service providers is growing (Delaney & Vanderhoef, 2019). After choosing a specialty, I set more precise goals aligned with the MHNP role. My educational goal is to obtain the MSN degree to achieve professional goals – providing mental health care, protecting the vulnerable population, influencing mental health policy, and helping patients with mental problems live their fullest lives. Continued education and self-development will help me achieve my goals and benefit patients.
One of the factors contributing to career development is participation in professional organizations. MHNPs may join several associations, such as the American Association of Nurse Practitioners (AANP), American Psychiatric Nurses Association (APNA), International Society of Psychiatric-Mental Health Nurses (ISPN), and other organizations (“Psychiatric-mental health,” n.d.). For example, to become a member of APNA, you need to fill out the corresponding application and make a membership fee (APNA, n.d.). Participation in organizations contributes to networking, helps in ongoing education, provides resources for development, and provides other benefits.
Conclusion
In conclusion, individual choice determines the direction for career development. Due to the many opportunities and interests, people may face difficulties when making decisions. However, gathering information and carefully assessing personal abilities and values can help. I chose the MHNP specialty, which aligned with my early interests and goals, and helped establish new ones. The MSN program will assist me in acquiring the necessary skills and knowledge to advance my career. Another important factor helping to achieve the goals is participation in organizations, which supports nurses in training and professional development.
A defining characteristic of long-term care is that it presupposes a lengthy stay of a person in a healthcare institution or some community-based facility. Both types of long-term care have some benefits and disadvantages, so healthcare providers and patients decide between community or institutional care depending on their possibilities and needs. Institutional care tends to generalize the conditions of patient stay and care whereas community care is more person-oriented and provides a variety of opportunities for patients.
People staying at hospitals must conform to strict rules and regulations and their ability to socialize is limited. Because institutional care is focused on providers’ schedules rather than patient-specific needs, there are frequent cases of patients being alone for a long time.
Patients’ ability to communicate is undervalued, and in the majority of cases, they remain in beds instead of interacting with others. On the other hand, community care provides a wide range of opportunities for patients, enabling them to control their schedule and choose how to spend their time. Another reason that community care is considered better than its institutional counterpart is that the investment into it is proportional to the quality of care provided. The level of institutional care is known not to correlate with the expenditures dedicated to it. The current paper will discuss the implications of community care versus institutional care with a special focus on elderly patients with mental health problems.
A review article by Wysocki et al. (2015) “Long-term services and supports for older adults: A review of home and community-based services versus institutional care is focused on the analysis of institutional care as opposed to home and community-based services (HCBSs). The authors employ two methods in their research: literature identification and evidence rating. The first method involves the process of selecting the studies to be included in the review.
Wysocki et al. (2015) consider randomized control trials and quasi-experimental designs the most suitable for their analysis. All chosen articles incorporate a comparison of care provided for older adults by HCBSs and nursing homes (NHs). Wysocki et al. (2015) review the reports of studies published in English from 1995 to 2012. The authors review the articles in two steps. First, they presuppose an independent review of titles and abstracts by two investigators.
The second phase incorporates a review of the full text of each source and the establishment of whether all inclusion criteria are met. The second method employed by Wysocki et al. (2015) includes the evaluation of the methodological possibility of bias. The authors scrutinize the results qualitatively to discern the level of closeness between the populations receiving care at HCBSs and NHs and evaluate the divergences in outcomes.
As a result of their analysis, Wysocki et al. (2015) conclude that the reviewed studies do not provide sufficient data for the comparison of HCBS and NH care of elderly people. The majority of articles under investigation do not include any information about the cost and quality of care. Thus, Wysocki et al. (2015) suggest that better research should be performed to identify which type of long-term care suggests better patient outcomes.
The article by Wysocki et al. (2015) has strengths as well as weaknesses. The major advantage is that the authors make an effort to analyze a crucial issue of the modern healthcare system. However, the greatest limitation of the study is that there are no sufficient conclusions concerning the advantages and disadvantages of two types of long-term care provided for older adults. Another weak point is that not all of the reviewed papers analyze the effect of long-term care on older adults’ cognitive functions. The validity of the article is measured through the use of many scholarly peer-reviewed research papers.
A possible explanation of the study’s weaknesses is the inclusion of outdated sources instead of current articles that discuss this problem more extensively. The purpose of the article by Beerens et al. (2014) is the analysis of the quality of care and quality of life of older adults with dementia provided by home care and institutional care. Unlike Wysocki et al. (2015), Beerens et al. (2014) manage to establish some differences between the two types of care. The authors conclude that some indicators of quality of care are better in home-based care settings than in institutional care (Beerens et al., 2014).
Older adults with dementia provided with home care are reported to use fewer psychotropic drugs, have fewer inflammations in pressure, and suffer less from physical limitations. At the same time, Beerens et al. (2014) remark that patients receiving home care experience depression and loss of weight more often than those in institutional care. Callahan et al. (2012) investigate the need for transitions in care experienced by elderly patients with dementia. The authors note that the majority of care is obtained by such patients in community settings. According to Callahan et al. (2012), even those patients who spend much time in institutional care eventually return home and receive the rest of their care there.
The implications of the study by Wysocki et al. (2015) to the mental health and addictions field are not as profound as those provided by Beerens et al. (2014) and Callahan et al. (2012). Only some of the articles reviewed by Wysocki et al. (2015) focus on elderly people’s mental health. Meanwhile, two other articles investigate the impact of community-based and home care on older adults with dementia. Beerens et al. (2014) report that receiving community care has a positive impact on elderly patients with dementia. Callahan et al. (2012) note that such people prefer to return home when the disease progresses to the final stage.
References
Beerens, H. C., Sutcliffe, C., Renom-Guiteras, A., Soto, M. E., Suhonen, R., Zabalegui, A, … Hamers, J. P. H. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: The European RightTimePlaceCare study. Journal of the American Medical Directors Association, 15(1), 54-61.
Callahan, C. M., Arling, G., Tu, W., Rosenman, M. B., Counsell, S. R., Stump, T. E., & Hendrie, H. C. (2012). Transitions in care for older adults with and without dementia. Journal of the American Geriatrics Society, 60(5), 813-820.
Wysocki, A., Butler, M., Kane, R. L., Kane, R. A., Shippee, T., & Sainfort, F. (2015). Long-term services and supports for older adults: A review of home and community-based services versus institutional care. Journal of Aging & Social Policy, 27(3), 255-279.