Recent past events related to mental illness, including acts of violence and shootings, necessitate a closer look into the public mental health system. Mental health conditions may constitute the most significant cause of disease burden and disability globally ( Shim, & Rust, 2013 ). Comorbidities related to mental health are on the rise, affecting both patients and the population within which they reside. However serious the cases appear, efforts to control this situation seem to be frustrated directly by some factors, like the organization and issuing of mental health therapy, as well as indirectly by societal factors, like the stigma associated with mental illness. This capstone project will look at mental illness and behavioral health, how it is affected by the community and some possible suggestions to improve the quality of care.
Mental illnesses affect different groups of people indiscriminately through all population, income, and education groups. A review conducted by Steel et al. (2014 ) found that an average of one in five adults (17%) experienced a mental disorder within the past year (12 months) and 29% of all adults within their lifetime. The conditions are more prevalent in females (in high income countries) who are prone to mood and anxiety disorders. These conditions most commonly develop in adolescents and young adults and, appearing episodically, the frequency of the episodes increase the chances of lasting disability ( Steel et al. , 2014 ).
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In spite of the longstanding problems associated with mental and their high societal burden, evidence based quality services are often not issued in an effective manner (Malla et al., 2016). Mental health service provision faces system fragmentation and lack of an informed developmental perspective that fails to effectively address integrated care. This could be illustrated by the study showing that people with enduring mental illness have been found to have mortality rates at least twice as high as the general population (Collins et al., 2018). This is caused by physical disease which is neglected as practitioners focus less on these symptoms and focus on their mental health, a situation called diagnostic overshadowing. Policy makers are now turning to models that integrate traditionally separate services into a unified community based setting to meet the therapeutic needs of this group ( Settipani et al., 2019 ).
The treatment of mental illnesses often receives suboptimal attention due to priority issues. Due to the nature of competing demands present in the clinical setting, the primary care provider finds it difficult to prioritize mental health concerns that are more time-consuming ( Nutting et al., 2000 ). This is because management of these conditions tends to be resource intensive with comparatively little return on investment on both the time and the resources.
Mental health is important to nurses, more than other care practitioners, due to the need for shift from institution treatment of mental illness to community based therapy. The nurse is the most crucial coordinator due to the unique holistic perception of patient health as well as their knowledge on community resources (Mental Health and Nursing, 2019). Additionally, nurses are the largest group of professionals that provide mental health care in primary and specialist health services (WHO, 2019). The nurse acts as the mediator between the patient’s interest and health professionals and face the challenge of providing front-line treatment. Since the nurse is actively involved in both parties, they become advocates for supplementary community services to fill the gaps they witness in the system. Additionally, nurses are best positioned to challenge stereotypes and stigma that surround mental health care and campaign for effective systems.
As far as the community is involved, the problem warrants collective responsibility to ensure active prevention measures of mental illness as well as campaigning for better mental health through more efficient systems of care. With respect to mental health therapy, primary and tertiary prevention frameworks could be integrated to the existing primary health care ( Shim, & Rust, 2013 ). This would mimic the treatment of chronic conditions, where primary care is integrated into tertiary therapy (screening and treatment of treatable factors, like depression). This integration of bidirectional treatment would add primary prevention, which would focus on nurturing individual and community resilience, so as to prevent immediate and adverse long-term suffering as well as reduce stigma associated with diagnosis and treatment. Nurses, being the most important stakeholders in mental health, should be involved in developing policies for reducing mental disorder burdens in a population (WHO, 2019). Additionally, there is a need to educate nurses to alter their skills so that they may be better suited for community based treatment rather than the custodial models of mental health (WHO,2019).
References
Collins, C., Larkin, J., Pericin, I., Osborne, B., & Dodd, P. (2018). Why is the physical health of patients with an enduring mental illness neglected? Comparing Irish GPs’ monitoring of physical health parameters among patients with an enduring mental illness and the general population. European Journal of General Practice. 24 (1): 211–222.
Mental Health and Nursing. (2019). Canadian Nurses Association. Retrieved 27 July 2019, from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/bg6_mental_health_e.pdf?la=en
Malla, A., Iyer, S., McGorry, P., Cannon, M., Coughlan, H., Singh, S., ... & Joober, R. (2016). From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people. Social psychiatry and psychiatric epidemiology, 51 (3), 319-326.
Nutting, P. A., Rost, K., Smith, J., Werner, J. J., & Elliot, C. (2000). Competing demands from physical problems. Arch Fam Med , 9 (1059), 1059-64.
Settipani, C. A., Hawke, L. D., Cleverley, K., Chaim, G., Cheung, A., Mehra, K., ... & Henderson, J. (2019). Key attributes of integrated community-based youth service hubs for mental health: a scoping review. International Journal of Mental Health Systems , 13 (1), 52.
Shim, R., & Rust, G. (2013). Primary care, behavioral health, and public health: partners in reducing mental health stigma.
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International journal of epidemiology , 43 (2), 476-493.
WHO | Developing Nursing Resources for Mental Health. (2019). Retrieved 27 July 2019, from https://www.who.int/mental_health/policy/mnh_nursing/en/
