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National Survey Of Mental Health

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National Survey Of Mental Health

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National Survey Of Mental Health

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Millions of people in Australia suffer from depression today. Most of the young people are at the highest risk of suffering from depression. According to the Australian statistics, the prevalence of depression rate increased from 6.8% in 2008 to 10.3% in 2012 (“Australian Bureau of Statistics”, 2014). One individual in every seven is suffering from depression at some or the other point in their life. Depression is often considered as the second major reason after heart diseases that have resulted in death and disability of maximum people in the last 20 years (“Australian Bureau of Statistics”, 2007). Most of the reports suggest that men are mainly affected by depression and very little is known about women suffering from depression.
Depression associated with financial and economic status is very high in Australia, as in the case of Edward. Depression related disability cost around $14.9 billion annually to the Australian Government. There are various factors associated with high rate of prevalence of depression and suicide. According to the report of World Health Organization, approximately 2000 Australians commit suicide every year, due to depression (“Australian Institute of Health”, 2012). Men are more likely to die because of depression in comparison to women.
Men often use more violent ways to commit suicides than women. Growing change in living standards and lifestyles are also affecting the mental health of people. In case of Edward his living standards have changed to financial problems. Reports of Australian Suicide Statistics states that around 1.6% deaths between 2007 and 2008 were due to suicides in Australia (“The Australian Bureau of Statistics (ABS)”, 2014). In the year 2014, 77% people were male, who committed suicide and remaining were women. Australian Bureau of Statistics (ABS) is responsible for collecting the evaluating the data related to deaths in Australia. In the year 2011, around 2,273 deaths were reported, where major reason was suicide. Suicide rate in young men aged between 15 and 24 is 27.8% in the year 2011 (“The Australian Bureau of Statistics (ABS)”, 2014). According to the Australian Bureau of Statistics (ABS), Northern Territory of Australia displays the highest death rates (“Australian Institute of Health”, 2012). Thus, it is mainly observed that highest number of people committing suicide due to depression is from the smaller jurisdiction of Australia (“Living is for everyone”, 2014). 
The groups at higher risk of depression and suicides are men, young people, lesbian, gays, Aboriginal and Torres Strait Islanders, people living in remote and rural areas of Australia, people suffering from mental disorders, and people from linguistically and culturally diverse backgrounds (“Facts and stats about mental illness in Australia”, 2014). The mental health issues are greatly responsible for higher rate of depression and suicides. For this reason Australian government provides healthcare help and aid to such people and their families. Family doctors, pediatricians and counselors provide assistance on mental health problems.
But, it has also been reported that only 50% of the people suffering from mental health issues and depression receive medical help and hospitalization. The highest rate of suicide in males was found in the people with 85+ ages. The rate was found to be very high in comparison to the other age specific suicide rates. The next groups of highest age specific suicide rates are found in 40-44 and 50-54 year age groups. The lowest rate of suicide is found in 0-14 year age group and the 15-19 year age group (“The Australian Bureau of Statistics (ABS)”, 2014).
Factors Contributing to Mental Health
There are various genetic, social and environmental factors responsible for affecting the mental health of individuals. The needs for better mental health change with age. People in young age may be at the higher risk of depression due to unhealthy lifestyle, such as smoking, alcohol and substance abuse. However, people in old age may suffer from depression due to abandonment, social un-acceptance, family differences and chronic health issues. In the recent years, the general public awareness about mental health issues has grown. Common symptoms associated with mental health are depression and anxiety, but there could be different symptoms of mental health issues among old age people (Reynolds et al, 2012).
Getting older brings many challenges in physical and mental state of people. People often face difficulty in feeling physically and emotionally fit. The feeling of being lonely and sad results in depression and mental health issues. Some of the major factors associated with mental health and depression in old age are:

Chronic disease or long term illness (Reynolds et al, 2012).
Loss of a loved one and grief (Singh, 2015).
Financial problems
Changes in the living standard and arrangements
Increase in social isolation and abandonment (Singh, 2015).

In many cases the mental health problems are seen as being invisible. Such problems in people are not visible to others. Depression could not be easily detected directly, but they are often visible by the emotional and subjective signs in the individual. According to the given case study Edward is a 62 years old man. He has been living in Australia since last 42 years. He belongs to Malt, but has been living in Australia since a very long time. Edward has faced many stressful and depressing situations in his life. He came to Australia in search of better living and a good job; however he never planned to settle down in Australia permanently. He had his parents in Malt. Edward’s father has passed away 30 years back, but his financial conditions could not allow him to go to Malta for his father’s funeral. He could meet his father for the last time; also he could go on his mother’s funeral as well. All these situations left him heartbroken, but the symptoms of grief and depression were not very visible in his state (Gracias, 2013). His mental health has also deteriorated due to grief caused by the loss of his parents.
Edward had a wife and two sons. He and his wife worked in the farms, until they had bought a 15 acres farm. Now they work as farm workers in their own field. He had two sons, who used to help their parents in farm. His younger son, Thomas (26), died by committing suicide 15 months ago. Since then mental health of Edward is not well, he was hopeful that his sons would take over his farm and will take care of everything. He is also heartbroken by losing his son. Now his elder son also left them and went to Sydney. Edward became hopeless and lonely. He feels that his family is not close anymore and that his life has no reason. The factors affecting mental health of Edward are:

Loss of loved ones (Gracias, 2013)
Financial issues

Financial reasons could also be a factor among the deteriorating mental health of Edward. According to the study of Alston (2012), “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.” Edward and his wife are also facing financial troubles. Due to low rain and low energy, Edward is unable to work properly in field. They are also running out of money in their business. People going through financial issues face severe depression, due to lack of resources and money.
Ethical and Legal Issues in Treatment of People Suffering from Depression
Being patient is a very significant nursing practice. Considering the ethical aspects of nursing is the responsibility of the nurse to ensure quality care. The key principle of the bio-ethics is autonomy, which must always be valued by a nurse. Other values linked with quality nursing care are respect, advocacy and removing barriers to provide quality care. Nurses must relate to ethico-legal practice of nursing. The two major ethico-legal issues that must be considered within the nursing practice are confidentiality and non-maleficience. Non-maleficience stands for doing no harm (Nursing and Midwifery Board of Australia, 2008). Nurses must be able to maintain balance among positive care and maintaining safe professional boundaries. For such practice, it is important that nurse must always be aware of ethical and legal principles and provide care according to that (Codes of ethics for nurses, 2008). While making the ethical decisions towards patient’s care, nurses must take ethical decisions to promote patient safety and confidentiality. According to the case study Edward is 62 years old man was diagnosed to be suffering with depression. According to the ethical principle of autonomy, patient has complete right of making the decisions about treatment and getting involved in care plan. Patient has the right to completely informed consent and right to receive information about diagnosis. According to the case study Edward is displaying suicidal thoughts. The value state 5 of the Code of Ethics for Nursing in Australia, nurses must always values informed decision making. Edward has complete rights to refuse treatment or care plan with the mental health service. The ongoing assessment can be stopped by the nurses, if serious signs of emotional or physical distress are observed in patient’s condition. Nurses may discontinue further assessments on patients when. This is called as non-maleficience, which means to avoid any kind of harm (Nursing and Midwifery Board Australia, 2008).
It is important that nurses must display the understanding towards maintaining the safe boundaries, professional values and morals (Code of Ethics for Nurses, 2008). The legal implication of quality nursing practice is to maintain high professional standards. Nurse must also consult with the patient regarding level of required care. Maintaining the confidentiality and privacy of the patient is the legal aspect of nursing practice. Information related to the patient could never be disclosed without patient’s consent. If the patient is trying to cause any harm to himself, the principle can be dishonored only by the professional medical team to ensure patient’s well-being and safety (Mental Health Act, 2007). Confidentiality also builds trust between patient and nurses, and patient must feel comfort while disclosing any information regarding his condition.  The duty of care also prevents the disclosure of the patient’s information to any one not involved in providing healthcare. Edward can involve his family members, if he wants to (Code of Ethics for Nurses, 2008).
Nursing Concerns Related to the Case of Edward
The major nursing concerns related to providing quality nursing care to Edward are:
Suicidal Tendency: Depression and anxiety are major causes that invoke suicidal tendency in patients. Hopelessness is also a significant factor for increasing suicidal thoughts in the case of Edward. He is not able to cope-up with the emotional and mental distress. He feels that his family is not close enough to him anymore and that he is left alone. Symptoms of distress and hopelessness are considered as determinant of the suicidal thoughts in patient. Hopelessness is directly correlated with suicidal thoughts and self destruction. Hopelessness means loss of meaning in life, where patient do not find any reason to live and have suicidal thoughts. Patient also displays pessimistic personality behavior. Edward is also displaying such trait and it could be a major concern for nurses. If hopelessness could not be changed, then patient may try to commit suicide. Edward may not be able to respond properly to the coping and supportive environment (Tiller, 2013).
Nutrition: Nutrition is another major concern for the nurses in case of Edward. He has not been eating well, since last few months. Nutritional diet is very important for the patients suffering from depression. Reports have shown that nutritional support is very important for the health of the brain (Tiller, 2013). Edward is not eating well and has lost 6 kgs in last 4 months. He feels more depressed and exhausted. He does not have sufficient energy to work in his field. This is a major concern for nurses. If Edward will not have proper diet and if he will lack in nutrition, the condition of his mental health may deteriorate, as his body weight will decrease further. People who take balanced and nutritional diet are healthier and are able to cope with metal distress and depression.
Nursing Care and Interventions to Support Edward’s Health
Interventions for Suicidal Behavior
Intervention 1: I would monitor the behavior and environment of the patient and will document the potential risk of suicide. The patient feeling hopelessness often displays suicidal behavior. I will try to remove everything that he could use to harm himself. I will also try to communicate with Edward to find out situational problems. Situational problems are the problems, due to which a person suffers from depression or mental disorders. This intervention must be immediately done by direct communication with patient and family members (Haddad, Buszewicz, & Murphy, 2011).
Rational 1: Patient suffering from depression often displays feeling of hopelessness. Hopelessness is associated directly with suicidal behavior. Display of such behavior may risk the patient’s safety, thus recognizing them is very important (Tiller, 2013). Situational problems increase the severity of the mental disorder or depression. People suffer from different situational problems and thus, accessing the correct reason of the problem is important for future treatment and counseling. Underlying conditions contributing towards depression are also related to hopelessness (Tiller, 2013).
Intervention 2: I will evaluate the problem solving capability of Edward. Patient suffering from acute depression and mental disorders may not be able to have enhanced problem solving capability and may display self-destructive behavior (Haddad, Buszewicz, & Murphy, 2011).
Rational 2: Problem solving capability of the patient determines the competence level of the patient. Dysfunctional behavior and impaired problem solving skills are correlated with suicidal behavior and hopelessness.
Intervention for Imbalanced Diet
Intervention 1: I will determine the current eating pattern of the patient (Popa, & Ladea, 2012). I will ask Edward about his choices in food, so that his problem of weight loss can be improved (Jacka & Berk, 2013).
Rational 1: This intervention is important to understand the nutrition intake in the patient (Popa, & Ladea, 2012). Patient can be offered the food of his choice, and he might like to eat that food.
Intervention 2: I will assist Edward in taking essential nutrients through balanced diet (Popa, & Ladea, 2012). I will also involve family members in supporting Edward and encouraging balanced food intake for him.
Rational 2: Essential nutrients increase the energy level in the body that affects the mood and generates positivity. Nutrients are also important for proper functioning of brain (Jacka & Berk, 2013). People suffering from depression and mental disorders are often those, who lack family support and ties. Support of family will help them to recover soon (Jacka & Berk, 2013).
Alston, M. (2012). Rural male suicide in Australia. Social Science & Medicin
Australian Bureau of Statistics. (2014). National Survey of Mental Health and Well-being:
Summary of results. Catalogue No. 4326.0. Canberra, ACT: Australian Bureau of Statistics. – Retrieved From: https://www.mindframe-media.info/for-media/reporting-mental-illness/facts-and-stats#AccessingServices
Australian Bureau of Statistics (2014). Causes of Death Australia, 2014 – Catalogue No. 3303.0.
ABS: Canberra. Retrieved From: https://www.abs.gov.au/ausstats/abs@.nsf/mf/3303.0
The Australian Bureau of Statistics (ABS). (2014). Facts and stats about suicide in Australia. Retrieved From: https://www.mindframe-media.info/for-media/reporting-suicide/facts-and-stats
Australian Institute of Health. (2012). Australia’s Health 2012: In Brief. AIHW.
Code of Ethics For Nurses (2008). Retrieved From: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Depression Facts. (2016). White Cloud Foundation. Retrieved From: https://whitecloudfoundation.org/
Facts and stats about mental illness in Australia. (2014). Gender and Mental Illness. Retrieved From: https://www.mindframe-media.info/for-media/reporting-mental-illness/facts-and-stats#AccessingServices
Gracias, M. J. (2013). A Nursing Intervention to Improve Nutrition for Health Promotion for a Vulnerable Urban Adult Group.
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
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.
Jacka, F. N., & Berk, M. (2013). Depression, diet and exercise. The Medical Journal of Australia, 199(6 Suppl), S21-3.
Living is for everyone. (2014). Statistics on suicide in Australia. Retrieved from: https://www.livingisforeveryone.com.au/uploads/LIFE_fact_sheet_3_final.pdf
Mental Health Act (2007). Retrieved From: https://www.health.nsw.gov.au/mentalhealth/publications/Publications/pub-act-2007-guide.pdf
Nursing and Midwifery Board of Australia. (2008). Retrieved From: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Popa, T. A., & Ladea, M. (2012). Nutrition and depression at the forefront of progress. Journal of medicine and life, 5(4), 414.
Reynolds III, C. F., Cuijpers, P., Patel, V., Cohen, A., Dias, A., Chowdhary, N., … & Lotrich, F. (2012). Early intervention to reduce the global health and economic burden of major depression in older adults. Annual review of public health, 33, 123.
Singh, S. D. (2015). Loneliness, depression and sociability in old age. The International Journal of Indian Psychology, Volume 2, Issue 2, No. 2, 73.
Stuart, G. W. (2014). Principles and practice of psychiatric nursing. Elsevier Health Sciences.
Tiller, J. W. (2013). Depression and anxiety. The Medical Journal of Australia, 199(6 Suppl), S28-31.

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