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Mental Health Nursing : Incidence Of Prevalence Of Depression

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Mental Health Nursing : Incidence Of Prevalence Of Depression

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Mental Health Nursing : Incidence Of Prevalence Of Depression

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Question:
Describe about the Mental Health Nursing for Incidence of Prevalence of Depression.
 
Answer:

Incidence of Prevalence of Depression and Suicide in Australia
The use of term depression is done in many ways. It is used to describe the temporary state of low mood, which is often experienced by people at some point or the other in life. Such problems occur due to some kind of psychiatric disorders. Depression is considered as the state of mind that generally occurs and goes off. Such conditions occur at specific stages of life. Sometimes depression and suicidal thoughts are also result of environmental and genetic factors, as well as the result of traumatic events in life. The clinical diagnosis of depression is detected through specific signs and symptom, which makes it a syndrome. The widely used classification systems in Australia are “Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (APA 1994) and the International Classification of Diseases, tenth edition (ICD-10) (WHO 1992)” (Depression in residential aged care 2008–2012, 2013). Tenth edition (ICD-10), has now been replaced by ICD-9. Most of the clinical practice of depression is done through DSM-IV.  According to Australian Bureau of Statistics (ABS), “in the year 2011, 2,273 deaths by suicide were registered in Australia” (Statistics on suicide in Australia, 2014). According to these reports, more males commit suicides than females. However, according to the aged care study symptoms of depression are higher in females than males (Depression in residential aged care 2008–2012, 2013). The rural societies of Australia also face more burdens of suicidal deaths. The suicidal rate of males is higher than suicidal rate of males in non-rural areas (Kõlves et al, 2012). There is a wide gap in the suicide rate among metropolitan and rural areas. Thus, depression and suicide is a great burden for Australia. Due to different environment, genetic, psychological and social factors, people suffer from depression and often commit suicides.
Factors Affecting Mental Health of Individuals
Mental illness or mental health of individuals is shaped by many economic, social, and physical environmental factors. In the developed countries, the social distribution and high prevalence of mental disorders have been well documented. Depression is a kind of mental disorder, which can be a result of stressful situations. It is a most common mental health disorder in aged people, who are above the age of 65 (Thomas, 2012). According to the case study of Edward, he has faced the separation from his parents, and has gone through a traumatic situation of his son’s death through suicide. DSM-IV classification of depression is done on the types of symptoms and signs and severity (Fu, & Parahoo, 2009).
Significant weight loss, Insomnia or hypersomnia, loss of energy, feeling of being worthless, feeling of guilt and suicidal thoughts are some of the signs of depression. Edward is going through a disturbed mental state and has shown symptoms of reduced diet, Insomnia, weight loss and suicidal thoughts, which clarifies that he is suffering from depression. Elderly individuals may unknowingly display the symptoms of psychiatric problems. According to the study of Fu, & Parahoo (2009), the main factors identified for mental disorders are conflict in extended family, early life experiences, changes in life circumstances, death of family member and long term physical illness.         Not a single factor is responsible for affecting the mental state of an individual, but there are many contributing factors and specific changes in the brain that led to signs and symptoms of depression. According to a research study it is also found that people working on farms in Australia are also affected by mental disorders. The study states that “people living and working on farms are also subject to a number of environmental, climatic, economic and social stressors which may impact on their sense of wellbeing and also on their mental health” (Fragar et al, 2007). There is not accurate information available related to the rate of mental illness and mental health condition of the farm workers. However, study reveals that suicide rates in Australian farm workers (males) is very high. According to the case study of Edward, he had been an assistant at farm and now he and his wife work as farm worker on their own farm land.
Ethical-Legal Issue and Decision Making For Treatment of Depression
Applying the ethical and legal principles in nursing and treatment of patients with psychiatric disorders is very important. Medical management and treatment of depression bring up many ethical issues for the medical professionals and nursing staff. Nurses play a significant role in providing quality care and improving the patient outcomes, which require appropriate consideration of legal and ethical principles of practice. Ethical dilemma could arise at the time of informed consent (Stuart, 2014).
When a patient is diagnoses with mental illness, it is considered that they may have a loss of decision making capacity (DMC) (Hindmarch, Hotopf, & Owen, 2013). However the ethical principle of autonomy states that informed consent of the patient is very important. The patient like Edward, who is suffering from depression, may not be able to provide the consent and may refuse to take medication. In such cases ethical dilemma arises for the nurses, where they have to respect the decisions of the patient and on the other hand it creates conflict between autonomy and Beneficence. In this situation nurses can try to take patient’s consent for medication or treatment without any kind of pressure or control, in order to work ethically and respecting client’s dignity (Amer, 2013).
Legal capacity of decision making of a patient depends on four factors. First patient must be able to express choice, second is patient must be also to understand relevant information related to treatment, third is that respect towards patient’s choice of treatment and fourth is logical weighing the treatment process (Hindmarch, Hotopf, & Owen, 2013). People under mental illness are safeguarded under same civil rights in every federal/state laws. The main legal issue is that mentally ill patients may not be considered as legally competent. It is illegal to consider any patient as legally incompetent till the time it has not been declared by court (Townsend, 2014).
 
Nursing Risks and Rational
Ineffective coping: The first nursing risk could be associated with ineffective coping of the patient. Ineffective coping increases the risk of suicide. Edward may display ineffective coping by displaying inability to understand information, sleep disturbance, destructive behavior towards self and inadequate capability of decision making. Ineffective coping can worsen the mental condition of the patient (Haddad, Buszewicz, & Murphy, 2011).
Rational: Causes of ineffective coping must be observed, such as sign of grief, self destruction, suicidal thoughts, and recent traumatic events in life. It is important to identify the situational factors related to the case of patient, in order to help him cop with situational conditions and to effectively respond towards treatment. Situational factors can increase the risk of sucide thus patient must be encouraged to express fear, emotions and goals (Haddad, Buszewicz, & Murphy, 2011).
Hopelessness: Such feeling can occur when the patient feels that nothing can be done to help him. The appetite of the patient is decreased and he may also lack in taking self care. The factors responsible for such issue are abandonment, deteriorating psychological condition and isolation Nurses are often convinced by the patient’s belief that nothing can be done to help them. This kind of behavior influences the nurses to focus on his or her sadness (Haddad, Buszewicz, & Murphy, 2011).
Rational: Such problem or risk can arise when nurses have lack of knowledge and skills. They must not have high expectations from their capabilities, as this can affect the quality of nursing practice.
Nursing Intervention
Ineffective Coping Intervention
Nurses must observe the cause that leads to ineffective coping skills in patients.
Rational: coping skills helps patients to fight with their depression and develop critical thinking to cop up with situational grief and distress (Haddad, Buszewicz, & Murphy, 2011).
Nurses must also identify the behavioral changes and risk of suicide in patients.
Rational: There are many situational factors that lead to mental disorders and depression in individual. Identifying these situational factors is important to support patient in a relevant manner. Edward is in depression as he has been through traumatic event of his son’s death and his other son also left him. He has lack of support, and feels that he his wife and son have become distant from him. By identifying correct situational factor nurse can help patient in developing effective coping skills (Abuhashem et al, 2015).
Hopelessness
Nursing intervention related to this risk is identifying and documenting the potential signs of suicidal tendency and self directed violence
Rational: Hopelessness is directly linked with suicidal behavior and many other mental dysfunctions. Hopelessness and previous suicide attempts can lead to future completed suicide (Abuhashem et al, 2015).
Nurses should encourage patients to look towards those reasons, which he has to live.
Rational: Increasing the awareness for living helps in decreasing hopelessness (Abuhashem et al, 2015).
 
References
Abuhashem, W. A., Hamed, H., Hassan, M., & Elias, A. (2015). Therapeutic Role of Psychiatric
Mental Health Nursing in Psychological Therapies (Quantitative and Qualitative Study). International Journal, 3(6), 859-879.
Amer, A. B. (2013). Informed consent in adult psychiatry. Oman medical journal, 28(4), 228.
Depression in residential aged care 2008–2012. (2013). Australian Institute of Health and
Welfare Canberra. Retrieved From: https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129544771
Fragar, L., Henderson, A., Morton, C., & Pollock, K. (2007). The mental health of people on
Australian farms-the facts. Retrieved July, 10, 2009.
Fu, C. M., & Parahoo, K. (2009). Causes of depression: Perceptions among people recovering
from depression. Journal of advanced nursing, 65(1), 101-109.
Hindmarch, T., Hotopf, M., & Owen, G. S. (2013). Depression and decision-making capacity for
treatment or research: a systematic review. BMC medical ethics, 14(1), 1.
Haddad, M., Buszewicz, M. & Murphy, B. (2011). Supporting people with depression and
anxiety: a guide for practice nurses. London: Mind. Retrieved from: https://openaccess.city.ac.uk/1689/3/MIND_ProCEED_Training_Pack.pdf
Kõlves, K., Milner, A., McKay, K., & De Leo, D. (2012). Suicide in rural and remote areas of
Australia. Brisbane, Australia: Australian Institute for Suicide Research and Prevention.
Statistics on suicide in Australia. (2014). Retrieved From:
https://www.livingisforeveryone.com.au/uploads/LIFE_fact_sheet_3_final.pdf
Stuart, G. W. (2014). Principles and practice of psychiatric nursing. Elsevier Health Sciences.
Thomas, H. (2012). Assessing and managing depression in older people.Nursing times, 109(43),
16-18.
Townsend, M. C. (2014). Psychiatric mental health nursing: Concepts of care in evidence-based
practice. FA Davis.

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