Mental Health Modules

• Mental health


  A state of mental well-being that enables people to cope with the stresses of life, realise their abilities, learn well and work well and contribute to their communities
• Social and emotional wellbeing

  A holistic concept that results from a network of relationships between individuals, family, kin and community. It also recognises the importance of connection to land, culture, spirituality and ancestry and how these affect the individual.
• In broad terms, social and emotional wellbeing is the foundation for physical and mental health for aboriginal and torres strait islander peoples
• Mental illness


  Describes conditions diagnosed by a medical professional that significantly affect how a person thinks, feels, and interacts with other people. Mental illnesses such as depression, anxiety, schizophrenia and bipolar disorder are diagnosed according to standardised criteria
• Mental disorder


  It is a syndrome characterised by clinically significant disturbance in an individual cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning. These disturbances are usually associated with distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning
• Mental health condition


  Is a broad term covering mental disorders and psychosocial disabilities. It also covers other mental states associated with significant distress, impairment in functioning, or risk of self-harm
• Psychosocial disability


  A disability arises when someone with a long term mental impairment interacts with various barriers that may hinder their full and effective participation in society on an equal basis with others. Such barriers include discrimination, stigma and exclusion
• Psychological distress


  May include nervousness, agitation, psychological fatigue and depression
• Consumer


  The term 'consumer' is used to describe a person who identifies as having a lived experience of a mental health condition
• Lived experience


  Refers to the firsthand experience of an individual who has either currently or in the past experienced mental illness or mental health challenges. These individuals may be called consumers, survivors, or people/individuals with lived experience of mental illness
• Lived experience workforce


  Lived experience workers have unique knowledge, abilities and attributes. They draw on their own life-changing experience, service use, and journey of recovery and healing to support others. Lived experience workforce, sometimes referred to as peer support workers
• Lived experience


  • Personal lived experience
  • Family/carer role
• Language is powerful. Language is reflective of our attitudes, understanding, values and respect for a person and their experience. Language can label a person and diminish their personhood. Language often feeds directly into the stigma. It affects how people or groups of people are seen and affects other's perceptions of people and mental health as a whole.
• The term "mentally ill" is much more negative than "person experiencing".
• Language impacts families and carers.
• Key points to remember about language

  • Use language that empowers and reflects peoples lived and living experiences
  • Adapt language to suit preferences and audience
  • Use language that is understandable
  • Avoid language that is sensationalised, including in headlines and titles
  • Consider the language you use and ensure it is appropriate for specific contexts
• Three general theories on the causes of mental illness

  • Supernatural
  • Somatogenic
  • Psychogenic
• Bethlem Hospital, London - the oldest psychiatric institution founded in 1247
• The castle hill lunatic asylum - new south wales 1811
• In the 19th century, biomedical explanations emerged where abnormal behaviours are part of a disease
• In the early 20th century, psychoanalysis emerged where the "origin of neurotic behaviours are due to the repressed conflicts during the oedipal phase of development"
• In the mid 20th century, pharmacological treatments such as antipsychotics and antidepressants reduced the reliance on physical restraints, ECT and lobotomy and increased opportunities for engagement
• The anti-psychiatry movements began in the US and Europe in the 1960s, inspired by the writings of Michel Foucault, Erving Goffman, and Thomas Szasz. They argued that psychiatric treatments are more damaging and challenged the practices of mainstream psychiatry, enabling radical reforms in mental health care
• The consumer movements from 1950-1970 were led by individuals with mental illness, promoted self-determination and community integration, and resulted in developing policies for consumer partnerships
• Deinstitutionalisation policy in Australia began in 1965, with consumers discharged to the community in the 1980s in NSW. Simon Champ, Meg Smith and Janet Meagher were "Elders of the consumer movement"
• Globally, there has been a 13% rise in mental health conditions, which cause one in five years lived with disability. Around 20% of the world's children and adolescents have a mental health condition, and suicide is the second leading cause of death among 15-29 year olds. Two of the most common mental health conditions, depression and anxiety, cost the global economy US$1 trillion each year. Despite this, the global median of government health expenditure on mental health is less than 2%
• Prevalence of mental illness in Australia

  • One in five (21%) Australian adults
  • 3% of people have a severe mental illness
  • Almost 1 in 7 (14%) children and adolescents aged 4-17 years
  • Mental and substance use disorders - 12% of the total burden of disease
  • 44% of the population (8.6 million) had a mental disorder at some time of their life
  • 21% of the population: 4.2 million previous 12 months
  • Anxiety disorders - 17% of the population
  • 24% (1875000) of the First Nations population reported a mental health condition
  • 3 in 5 (61%) of LGBTQ+ people reported depression, and almost 1 in 2 (47%) reported anxiety disorder
  • 32% of adults with a disability experienced high or very high psychological distress in the previous week
• Mental health services in Australia

  • Government (public)
  • Non-government
  • Private organisations
• Mental health service delivery in Australia

  • Primary: GPs, other health professionals
  • Community: crisis teams, mobile assessment teams
  • Hospital settings: Eds, general hospitals and inpatient mental health units
• Model of care


  A least restrictive model of care that enhances a person's autonomy, respects their rights, individual worth, dignity and privacy
• Stepped-care approach


  From least restrictive to most intensive, where the person is matched to the intervention level that most suits their current need. The focus is on keeping people out of acute care or getting them back to their community as rapidly as possible
• Biopsychosocial model of mental health

  Mental illness/problems are a result of complex interplay between biological, psychological and social factors. Wellness or illness does not only relate to a person's physical state but is influenced by the person's psychological and social factors
• Adverse childhood experiences (ACE)

  • Sexual abuse, physical abuse, emotional abuse
  • Violence in the home, running away from home
  • Childhood institutionalisation, serious neglect
  • Bullying, poverty, trauma
• Social determinants


  • Poverty, violence, forced migration, stigma
  • Insecure living conditions, homelessness
  • Educational opportunities, employment
  • Financial stressors, parenting/family issues
  • Critical events such as loss and grief
• Vulnerable populations


  • Low socioeconomic status (people living in poverty)
  • People with chronic health conditions
  • Infants/children exposed to maltreatment/neglect
  • Adolescents exposed to substance use early
  • Minority groups and indigenous populations
  • Older people
  • LGBTIQ+
  • People experiencing discrimination/human rights violations
  • People experiencing natural disasters/war/conflict
• Stigma


  Public stigma, self-stigma, discrimination
• Stigma can lead to avoiding help, isolation, social avoidance, diminished self-esteem and worthiness, impact on symptoms, reduced recovery and personal empowerment, and the "why try" effect of self-stigma
• Personality


  The unique set of cognitive, affective, and behavioural characteristics that influence how an individual thinks, feels, and acts
• Understanding the theoretical framework of personality helps nurses to understand the people with whom they work and to understand their own moral development and its influence on their ethical behaviour as professionals
• Major theoretical models used in mental health nursing

  • Sigmund Freud's personality development
  • Abraham Maslow's hierarchy of needs
  • Erik Erikson's psychosocial stages of development
  • Carl Rogers - the humanistic Approach
  • Hildegard Peplau - Nurse Theorist