Mental health care

519 Pages·2018·13.499 MB·English

by  Donna Hodgson, Gideon De Jong, Catherine Hungerford, Richard Bostwick, Richard Clancy, Gillian Murphy, Irene Ngune

Mental
Health
Care
THIRD EDITION
HUNGERFORD
HODGSON
BOSTWICK
CLANCY
MURPHY
DE JONG
NGUNE
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Mental health care
3RD EDITION
Catherine Hungerford
Donna Hodgson
Richard Bostwick
Richard Clancy
Gillian Murphy
Gideon de Jong
Irene Ngune
for more ebook/ testbank/ solution manuals requests: email [email protected]

Third edition published 2018 by
John Wiley & Sons Australia, Ltd
42 McDougall Street, Milton Qld 4064
First edition published 2012
© John Wiley & Sons Australia, Ltd 2018, 2015, 2012
Typeset in 10/12pt Times LT Std
The moral rights of the authors have been asserted.
Authorised adaptation of Mental health care for nurses: Applying mental health skills in
the general hospital, (ISBN 978 1 405 12455 3), published by Blackwell Publishing Ltd,
Oxford, United Kingdom. © 2006 in the United Kingdom by Blackwell Publishing Ltd.
National Library of Australia
Cataloguing-in-Publication data
Creator: Hungerford, Catherine, author.
Title: Mental health care / Catherine Hungerford, Donna Hodgson, Richard
Bostwick, Richard Clancy, Gillian Murphy, Gideon de Jong, Irene
Ngune.
Edition: Third edition.
ISBN: 9780730344612 (ebook)
Subjects: Mental illness — Australia.
Mental health services — Australia.
Community mental health services — Australia.
Psychiatric hospital care — Australia.
Other Creators/
Contributors: Hodgson, Donna, author.
Bostwick, Richard, author.
Clancy, Richard, author.
Murphy, Gillian, author.
de Jong, Gideon, author.
Ngune, Irene, author.
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Cover and internal images: © Shutterstock/mimagephotography
Typeset in India by Aptara
CONTENTS
About the authors viii 2.4 Diagnostic manuals 71
ICD‐11 71
CHAPTER 1 DSM‐5 72
Mental health care in 2.5 Young people and mental health
assessment 73
Australia 1
Young people presenting for
Introduction 2 assessment 73
1.1 Definitions 2 Assessment frameworks for young people 74
Mental health and mental illness 4 2.6 Communicating with young people 77
1.2 Stigma 8 The need to avoid ‘labelling’ young people 78
Community attitudes 9 Summary 80
Attitudes of health professionals 10 Key terms 80
Review questions 81
1.3 A focus on caring 12
Discussion and debate 81
History of caring 12
Project activity 82
Aims of care and caring 13
Websites 82
1.4 Caring in the health context 15
References 82
Current policy directions 17
Acknoweldgements 89
Current service frameworks 19
Current service approaches 20 CHAPTER 3
1.5 The prevalence of mental illness
The legal and ethical context of
in Australia 25
Prevalence of suicide in Australia 26 mental health care 90
Issues for young people 26
Introduction 91
1.6 Common mental health issues 27
3.1 The legal and ethical context 91
Summary 37
Legal requirements 92
Key terms 37
Ethical requirements 93
Review questions 39
Confidentiality and privacy 94
Discussion and debate 39
Professional requirements 96
Project activity 40
Websites 40 3.2 Challenges for health professionals 96
References 41 Legal and ethical frameworks 98
Acknowledgements 46 3.3 Capacity and competence 102
Principles of capacity and competence 102
CHAPTER 2 Incapacity 104
Assessment in the mental Different types of consent 104
Power of attorney 105
health context 47
3.4 Advance care agreements 107
Introduction 48 Legal issues 107
2.1 Mental health assessment of adults 48 Information required to make an informed
2.2 Approaches to assessment 49 decision 108
Reflection 51 3.5 Duty of care 109
Relationship 54 Reasonable and unreasonable 111
Recording 62 Least restrictive environment 111
Reporting 62 3.6 State and territory mental health
2.3 Assessment tools 63 legislation 113
The comprehensive mental health Sectioning and scheduling 114
assessment 64 3.7 Forensic mental health care 116
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Summary 118 Family Group Conferencing 158
Key terms 118 Resource Group Assertive Community
Review questions 119 Treatment 160
Discussion and debate 119 Summary 161
Project activity 119 Key terms 161
Websites 120 Review questions 163
References 120 Discussion and debate 163
Acknowledgements 122 Project activity 164
Websites 164
CHAPTER 4 References 165
Culturally appropriate mental Acknowledgements 172
health care 123
CHAPTER 5
Introduction 124 Common reactions to stressful
4.1 The pervasive nature of culture
situations 173
and subculture 124
Culture and subculture 124 Introduction 174
4.2 Cultural constructions of mental 5.1 Stress reactions 174
illness 126 5.2 Physical, emotional and behavioural
Alternative views to mental health care 127 reactions 176
4.3 Mental health and Indigenous Physiological reactions 176
cultures 127 Emotional and behavioural reactions 177
What is meant by ‘Indigenous’? 128 Reactions of families and carers 183
The Indigenous view of ‘health’ 129 5.3 Factors that influence stress
The mental health and wellbeing of Indigenous reactions 185
Australians 131 Age 186
Issues to consider when supporting the Background 186
mental health and wellbeing of Indigenous Coping style 187
Australians 135 Disasters 189
‘How would you like us to help you?’ 136 Locus of control 192
4.4 Mental health and rural and remote Resilience 193
cultures 139
Setting 194
What is a ‘rural’ or ‘remote’ culture
5.4 Priorities when supporting people through
in Australia? 139
stressful situations 195
Major issues for people living in rural and
Engagement and collaboration 195
remote areas 140
Therapeutic alliance or relationship 196
Addressing the issues in rural and
Referral 197
remote areas 144
5.5 Providing information 198
4.5 Mental health and multiculturalism 147
Understanding information in stressful
The language of multiculturalism 147
situations 199
Individualism and collectivism 150
5.6 Self‐care 201
Gender roles 151
Reflective practice 202
Cultural diversity, stigma and mental
Clinical supervision 203
illness 153
Time out 204
4.6 Towards providing culturally appropriate
Summary 206
mental health care 153
Key terms 206
Cultural proficiency 153
Review questions 207
Culturally appropriate approaches to treating
Discussion and debate 207
mental illness 155
Project activity 208
4.7 Family and social supports 158 Websites 208
From individual rehabilitation to social References 209
network strategies 158 Acknowledgements 211
iv CONTENTS
CHAPTER 6 7.3 Perinatal mental health issues 265
People displaying challenging Policy context 267
Types of perinatal mental health issues 267
behaviours 212
Caring for mothers with perinatal mental
Introduction 213 health issues 268
6.1 The nature of challenging behaviours 213 Supporting the partner 269
6.2 Reasonable and unreasonable 7.4 Caring for children, adolescents and young
behaviour 215 people with depression or psychosis 271
Challenging behaviours in children 215 Nature versus nurture 271
The ‘difficult patient’ 216 Assessment issues to consider for children
Outcomes of labelling 218 and adolescents 272
Defence mechanisms 219 Common childhood diagnoses 273
Control and power 221 Common interventions used with children
and adolescents 274
The influence of health professionals 221
Youth mental health 275
6.3 Causes and triggers of challenging
behaviour 222 Neurobiological influences 275
Communication and challenging behaviours 224 Practice principles 276
General assessment 224 7.5 Anxiety 278
Older people and challenging behaviours 225 Types of anxiety 278
6.4 Challenging behaviours exhibited by Hypochondriasis 283
health professionals 227 Approaches to care for anxiety 284
6.5 Addressing challenging behaviours 228 Summary 286
Organisational responses 228 Key terms 286
Review questions 288
Education and training 230
Discussion and debate 288
6.6 Risk assessment 230
Project activity 289
Working with people with challenging
Websites 289
behaviours 232
References 290
Summary 239
Acknowledgements 292
Key terms 239
Review questions 240
CHAPTER 8
Discussion and debate 240
Project activity 241 Caring for a person who has
Websites 241 self‐harmed 293
References 242
Acknowledgements 245 Introduction 294
8.1 Definitions 294
CHAPTER 7 8.2 Incidence of self‐harming 296
Depression, anxiety and Suicide rates 296
Rates of self‐harm 298
perinatal mental health 246
Indigenous populations 299
Introduction 247 Methods of self‐harm 299
7.1 Depression 247 8.3 ‘Causes’ of self‐harming behaviour 300
Symptoms of depression 248 Other risk factors 302
Causes of depression 249 8.4 Attitudes towards self‐harm 309
Depression and physical illness 250 8.5 National Suicide Prevention Strategy 311
Types of depression 251 Groups ‘at risk’ 312
7.2 Approaches to the care of depression 255 8.6 Assessment of risk 317
Interpersonal skills 256 The ‘why’ of risk assessment 318
Comprehensive approach 257 The ‘who’ of risk assessment 318
Psychoeducation 259 The ‘how’ of risk assessment 320
Treatment options 259 Risk assessment tools 320
CONTENTS v
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8.7 Caring for the person who has CHAPTER 10
self‐harmed 323
Substance use disorders   377
Effective interpersonal communication 323
Managing short‐term high risk 325 Introduction 378
Psychological therapies 326 10.1 Substance use and substance misuse 378
Medication 327 Prevalence of substance use 379
The role of family and carer(s) 327 Adverse effects of substance use 380
Postvention 328 Attitudes to substance use 381
Summary 330 10.2 Attitudes of health professionals 382
Key terms 330 Language use 383
Review questions 331 10.3 Health promotion and disease
Discussion and debate 331 prevention 386
Project activity 332 Harm minimisation 386
Websites 332 10.4 Categories of substances 387
References 334 Stimulants 387
Acknowledgements 338
Depressants 387
Hallucinogens 388
CHAPTER 9
10.5 Substance use disorders 388
Caring for a person with a Substance‐induced disorders 389
serious mental illness 339 Reward pathways 390
10.6 Commonly misused substances 391
Introduction 340
Alcohol 391
9.1 Definitions 340
Amphetamines 397
Schizophrenia 341
Benzodiazepines 398
Bipolar disorder 348
Cannabis 399
9.2 Comorbidities in people with serious
Cocaine 400
mental illness 350
Ecstasy 400
Factors that contribute to poor
Hallucinogens and GHB 400
physical health 350
Opiates and opioids 401
Common physical illnesses 351
Tobacco 404
When is a mental health assessment
10.7 Assessment of substance use 407
required? 356
Standardised substance screening tools 407
Comorbidity and assessment 356
Assessment of alcohol and drug use 409
Comorbid treatment options 357
Referrals 409
9.3 Carers 358
10.8 Caring for family members 410
Roles 359
Support and education 410
Providing information 360
Parents and children 410
Information sharing 361
Homelessness 410
9.4 Treatments for serious mental
10.9 Motivation for behaviour change 411
illness 361
Cycle of Change 411
Pharmacological therapies 362
Stages of treatment 415
Psychological therapies 366
Motivational interviewing 416
9.5 Recovery 370
Brief interventions 421
Summary 371
Key terms 371 10.10 The stress–vulnerability model 422
Review questions 372 What can be helpful? 423
Discussion and debate 373 What things are unhelpful? 423
Project activity 373 Summary 425
Websites 373 Key terms 425
References 374 Review questions 427
Acknowledgements 376 Discussion and debate 427
vi CONTENTS
Project activity 427 CHAPTER 12
Websites 428
Mental health service
References 428
Acknowledgements 431 delivery 464
Introduction 465
CHAPTER 11
12.1 Approaches to mental health service delivery
Caring for an older person with in Australia 465
a mental illness 432 National standards for services 465
State or territory variations 467
Introduction 433
12.2 Primary health care services 467
11.1 Caring for older people 434
Mental health promotion and disease
11.2 The impact of ageism 434 prevention 467
Culture and attitudes 435 Consumer and carer networks 478
Discrimination 436 Not‐for‐profit organisations 479
11.3 Assessing the older person 436 Better Access to Mental Health Care
A biopsychosocial approach 437 Initiative 481
Thinking biopsychosocially 439 Disaster services 481
Cognitive assessment 441 Mental Health Nurse Incentive Program 481
11.4 Dementia 442 Nurse practitioners 482
Dementia and ageing 443 Online services 482
Types of dementia 444 Practice nurses 483
Assessment of dementia 446 12.3 Secondary health care services 483
Ethical and legal considerations 446 Child and adolescent mental health services 484
Dementia and medication 446 Community mental health teams 485
11.5 Depression in older people 447 Consumer and carer consultants 486
What constitutes depression? 447 Inpatient services 487
What does depression look like? 448 Mental health consultation liaison services 488
Assessment of depression 449 Perinatal mental health services 491
Risk factors 452 Older person’s mental health services 492
Suicide 453 12.4 Tertiary health care services 493
11.6 Delirium 454 Forensic mental health services 494
Assessment of delirium 454 Dual disability services 495
Characteristics of a delirium 455 Summary 498
Types of delirium 455 Key terms 498
Responding to a delirium 456 Review questions 499
Summary 458 Discussion and debate 500
Key terms 458 Project activity 500
Review questions 459 Websites 501
Discussion and debate 459 References 501
Project activity 460 Acknowledgements 506
Websites 460
References 461
Acknowledgements 463
CONTENTS vii
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ABOUT THE AUTHORS
Prof. Catherine Hungerford
Professor Catherine Hungerford is Head of School for the School of Nursing, Midwifery and Indige-
nous Health, Charles Sturt University, Australia. This School is located on multiple campuses across rural
New South Wales and supports the education and professional development of some two thousand stu-
dents, undergraduate and postgraduate, in nursing, midwifery and Indigenous mental health. Catherine is
also a Credentialed Mental Health Nurse and endorsed Nurse Practitioner (mental health), with wide experi-
ence in the clinical, management (front-line, project, and area-wide), education (clinical and academic),
research and policy-related areas of health, in a range of metropolitan, regional and rural settings. Catherine
has researched and written widely on mental health Recovery, and a range of other mental health topics,
including leadership, models of health care, health service evaluation, cultural issues, and workforce.
Donna Hodgson
Donna Hodgson is a Registered Nurse who holds a Credential to practice with the Australian College
of Mental Health Nurses. Donna is passionate about professional development activities, and ensuring a
connection exists between evidence-based theory and the practice of mental health nursing. Given this,
Donna has a long history of educating and mentoring undergraduate and postgraduate nurses in the field
of mental health.
Since commencing work in the field of mental health in 1991 with the ACT Health Directorate,
Donna has worked in numerous roles, and holds the honour of being the first nurse in Australia to be
appointed as a Clozapine Co-ordinator under the First National Mental Health Plan. Additionally, Donna
worked for a number of years as the Clinical Nurse Consultant in the acute adult inpatient unit, and as a
Clinical Manager in the community. In recent years, Donna has enjoyed participating with like-minded
colleagues on research and mental health nursing practice projects, and is the co-author of a number of
papers related to mental health nursing, scope of practice, disability and educational frameworks.
Donna has worked as the coordinator of mental health nursing education programs for the past
16 years. Additionally, as an academic she has taught mental health units at the University of Canberra,
and maintains an adjunct position there which involves teaching and assessment of students.
Dr Richard Bostwick
Originally a nurse, Richard Bostwick trained at the University of Sheffield in the United Kingdom who
emigrated to Australia in the 1990s. He is currently working at the University of Notre Dame, Australia,
as a senior lecturer in the School of Nursing and Midwifery, where he teaches across undergraduate and
postgraduate areas as well as supervising HDR students. He has a university career of over 9 years,
previously from the health sector where he spent time in both managerial and clinical roles. These roles
have included: planning and service development in the commissioning of the Fremantle headspace site
(Federal Government initiative for Youth Mental Health); Operations Manager of Royal Perth Hospital
(Department of Psychiatry and Community Mental Health); Manager of South Metropolitan Emergency
Mental Health Services; Clinical Director State-wide Comorbidity Services (AOD and Mental Health);
Clinical Manager Peel and Rockingham, Kwinana Adult Mental Health Services; and Clinical Nurse
Specialist (South Metropolitan Community Mental Health Services). His clinical areas of interest lie
within the treatment of clients with comorbid disorders of substance misuse and mental health, and pri-
mary mental health care. He is passionate about the mental health and wellbeing of the community, with
his PhD focusing on support systems for tertiary students with psychological distress. While engaged in
the university sector, Richard has rolled out a program of mental health first aid training with staff across
all areas of university life, to support the wellbeing of both staff and students and increase their resili-
ence within this community. He has been the recipient of a Vice Chancellor’s Citation for Outstanding
viii ABOUT THE AUTHORS