Mental Health Care for Nurses Applying Mental Health Skills in the General Hospital

by Harrison, Anthony; Hart, Chris

• ISBN13: 9781405124553
• ISBN10: 1405124555
• Edition: 1st
• Format: Paperback
• Copyright: 2006-04-07
• Publisher: Wiley-Blackwell

Summary

Mental health is a significant factor in providing effective nursing care for patients in hospital and residential settings. Non-mental health nursing staff often lack the confidence, knowledge and skills to effectively meet the mental health needs of patients who are experiencing psychiatric problems and psychological distress. Mental Health Care for Nurses: Applying mental health skills in the general hospital provides a step-by-step guide which will help nurses identify these needs and address them in practice.

Author Biography

Anthony Harrison is Consultant Nurse in Liaison Psychiatry and Visiting Fellow, University of the West of England, Bristol. Chris Hart is Nurse Consultant in Liaison Psychiatry and Principle Lecturer, Kingston. The contributors are all consultant nurses in liaison psychiatry.

Table of Contents

Foreword	ix
Editors	xi
Contributors	xii
Dedication and Acknowledgements	xiii
Introduction	xv
Chris Hart and Anthony Harrison
Terminology	xv
Structure of the book	xvi
References	xviii
Part 1: The Principles of Mental Health Care in the General Hospital	1	(108)
1 The Provision of Holistic Care	3	(29)
Chris Hart and Lyn Williams
Chapter aims	3	(1)
Introduction	3	(1)
The focus of nursing and its relationship to holistic care	4	(2)
The context of care: mental health in the general hospital	6	(3)
Stigma and mental health in the general hospital	9	(1)
The impact on nurses of meeting the mental health needs of the patient	9	(2)
Overview of mental health problems commonly encountered in the general hospital	11	(7)
Mental health assessment	18	(3)
The nurse–patient relationship	21	(1)
Effective use of interpersonal skills and therapeutic communication	22	(4)
Communication and recording of patient-related information	26	(1)
Support mechanisms for nursing staff and other clinicians	26	(1)
Conclusions	27	(1)
References	27	(4)
Websites	31	(1)
2 Psychological Responses to Illness and Injury	32	(17)
Anthony Harrison
Chapter aims	32	(1)
Introduction	32	(1)
Influences upon health and ill health	33	(1)
Personal beliefs, understandings and interpretations of health and illness	34	(3)
Coping and adaptation to illness and injury	37	(1)
Acute stress reactions	40	(1)
Impact of illness on families and carers	41	(2)
Nursing priorities in the provision of psychological care	43	(1)
Dealing with emotions	44	(3)
Conclusions	47	(1)
References	47	(2)
3 The Legal and Ethical Context of Mental Health Care in the General Hospital	49	(15)
Anthony Harrison and Lyn Williams
Chapter aims	49	(1)
Introduction	49	(1)
The ethical and professional context	50	(3)
The legal context: decision-making, capacity and competence	53	(2)
Consent	55	(1)
Duty of care	56	(4)
The Mental Health Act 1983	60	(2)
Conclusions	62	(1)
References	62	(2)
4 Caring for the Person Displaying Challenging Behaviour	64	(18)
Chris Hart
Chapter aims	64	(1)
Introduction	64	(1)
The nature of challenging behaviours	65	(4)
Causes and triggers of disturbed behaviour	69	(2)
What is it that challenges us?	71	(3)
The patient, the institution and the situation	74	(1)
Risk assessment	75	(1)
An organisational response to challenging behaviours	75	(2)
Working with people who challenge us	77	(2)
Conclusions	79	(1)
References	80	(2)
5 Breaking Bad News	82	(13)
Chris Hart
Chapter aims	82	(1)
Introduction	82	(1)
What is bad news?	83	(1)
Issues of grief and loss	84	(2)
How people 'hear' what is said and 'understand' - the difference between being told something and understanding	86	(1)
Preparing to provide information	87	(4)
Impact on practitioners	91	(1)
Conclusions	92	(1)
References	93	(2)
6 The Role of the Mental Health Liaison Team	95	(16)
Anthony Harrison
Chapter aims	95	(1)
Introduction	95	(1)
The development of mental health liaison practice	96	(4)
The role of the mental health liaison team	100	(3)
The process of referral	103	(3)
Conclusions	106	(1)
References	106	(3)
Part 2: Mental Health Care in the General Hospital	109	(114)
7 Depression and Anxiety	111	(19)
Gina Bird
Chapter aims	111	(1)
Introduction	111	(1)
Theoretical perspectives on the causes of depression	112	(1)
Terms used to describe the various types of mood disorder	112	(2)
Recognising depression	114	(1)
Anxiety	115	(1)
Panic attacks	118	(1)
Phobias	119	(1)
Assessment	119	(2)
Treatment strategies for depression	121	(1)
Physical treatments	121	(1)
Psychological treatments	123	(1)
Combination of physical and psychological treatments	123	(1)
Planning care for the person who is depressed or anxious	124	(1)
Use of interpersonal skills	125	(1)
Responding to the person's care needs	125	(2)
Conclusions	127	(1)
References	128	(2)
8 Self-harm and Suicide Prevention	130	(18)
Anthony Harrison
Chapter aims	130	(1)
Introduction	130	(1)
Terminology	131	(1)
Incidence of self-harming and suicidal behaviour	131	(3)
'Causes' of self-harming behaviour	134	(2)
Attitudes	136	(1)
Risk assessment	137	(1)
Short-term risk assessment	139	(1)
Medium-term risk assessment	139	(1)
Long-term risk assessment	142	(1)
Caring for the person who has self-harmed	142	(1)
Initial assessment	142	(1)
Treatment	144	(1)
Managing the potential risk of further self-harm	144	(1)
Observation	144	(1)
Pre-discharge care	144	(1)
Conclusions	145	(1)
References	145	(3)
9 Perinatal and Maternal Mental Health	148	(18)
Alison Blofield
Chapter aims	148	(1)
Introduction	148	(1)
Policy and professional context	149	(1)
Prevalence of perinatal mental health problems	150	(1)
The impact of mental illness	151	(1)
Common perinatal mental health problems	151	(1)
Maternity or baby blues	152	(1)
Postnatal depression	152	(1)
Puerperal psychosis	157	(1)
Breast feeding and the use of psychotropic medication	160	(1)
Principles of effective perinatal mental health care	161	(2)
Conclusions	163	(1)
References	163	(3)
10 Caring for the Person with a Serious Mental Illness	166	(15)
Bob Gardner
Chapter aims	166	(1)
Introduction	166	(1)
Definitions and terminology	167	(1)
Schizophrenia	167	(1)
Bipolar affective disorder	169	(1)
Mortality and morbidity associated with serious mental illness	170	(1)
Factors that contribute to poor physical health	170	(2)
Assessment	172	(1)
Pharmacological treatment of serious mental illness	173	(1)
Antipsychotic medication	173	(1)
Mood stabilisers	175	(1)
Principles of caring for a person with a serious mental illness	176	(2)
Conclusions	178	(1)
References	179	(2)
11 Alcohol and Illicit Drug Use	181	(17)
Bob Gardner
Chapter aims	181	(1)
Introduction	181	(1)
Definitions and terminology	182	(1)
Acute intoxication	182	(1)
Harmful use	183	(1)
Dependency	184	(1)
Withdrawal	185	(2)
Commonly misused illicit drugs	187	(1)
Assessment	188	(2)
Clinical management of alcohol withdrawal	190	(2)
Clinical management of opiate dependence during hospital admission	192	(2)
Mental health promotion	194	(1)
Conclusions	195	(1)
References	196	(2)
12 Caring for Older People with Mental Health Problems	198	(17)
Anthony Harrison
Chapter aims	198	(1)
Introduction	198	(1)
Prevalence of mental health problems	199	(1)
The impact of ageism	199	(1)
Assessment	200	(3)
Dementia	203	(1)
Nursing interventions	205	(4)
Acute confusion (delirium)	209	(3)
Conclusions	212	(1)
References	212	(3)
13 Challenges to the Delivery of Holistic Care	215	(8)
Chris Hart and Anthony Harrison
Chapter aims	215	(1)
Introduction	215	(1)
Impact of changes in the NHS on nursing	216	(1)
Holistic care and the expanding role of the nurse	217	(2)
Difficulties encountered by contemporary nurses in the provision of holistic care	219	(3)
Achieving holistic care for the patient in the modern NHS	222	(1)
References	223	(1)
Website	224	(1)
Index	225