Running head: MENTAL HEALTH

Mental Health
Catherine Fedoruk
1015449
Norquest College
NFDN 2007-001
Assignment 1
TBA
June 10, 2016

Running head: MENTAL HEALTH

According to the Canadian Mental Health Association, 20% of Canadians will personally
experience a mental illness in their life time (CMHA, ????). Mental illness can affect all
Canadians throughout their lifetime indirectly through a family member, friend or colleague.
Attitudes toward mental illness are shaped by personal beliefs, knowledge about mental illness,
and how they experience and express their own emotional problems. According to the Center for
Disease Control (refer). Positive attitudes towards mental health can result in supportive and
inclusive behaviours from the general public, such as a willingness to hire a person with a mental
illness (National Institute of Mental Health, 2012). When such attitudes are negative towards
mental health, it can result in exclusion, avoidance and discrimination. Embarrassment and
stigma associated with mental illness can cause many to hide their symptoms and to prevent
them from seeking treatment (Greene-Shortridge et al., 2007). Stigmas also pose a barrier for
primary prevention efforts designed to treat mental illness before a worsening of symptoms
(Weiss, Ramakrishna, & Somma, 2006).
Bipolar disorder is a debilitating disease if not treated properly, and a lifelong condition
that varies frequently. Bipolar disorder is categorized into different types Bipolar I, Bipolar II,
and Bipolar Not Otherwise Specified all of which involve frequent mood changes with periods
of manic and depressive episodes. Without the manic episodes it would be considered depressive
disorder. Bipolar I has manic episodes lasting at least one week, with depressive episodes lasting
a minimum of two weeks. Bipolar II is a pattern of depressive episodes and hypomanic episodes,
typically lasting less than a week. Bipolar Not Otherwise Specified houses any specific features
similar to bipolar disorder that do not fall within Bipolar I or II. Below are the outlines for
depressive and manic episodes from the DSM-V criteria (Center for Substance Abuse Treatment,

Running head: MENTAL HEALTH

2008). Major depressive must have two or more of the criteria, and manic episodes must have
lasted more than a week with three of more of the following criteria.
DEPRESSIVE:

Depressed mood for most of the day

Diminished interest or pleasure in daily activities
Insomnia or hypersomnia
Agitation
Psychomotor retardation
Fatigue
Feelings of worthlessness or excessive guilt
Indecisiveness, diminished ability to concentrate
Recurrent thoughts of death

MANIC:

Abnormally and persistently elevated, expansive or irritable mood, lasting more than a

week
Decreased need for sleep
Talkative or pressure to keep talking
Unable to concentrate, thoughts racing
Increased goal-directed activities
Psychomotor agitation
Excessive involvement in activities that have a high potential for painful consequences
There are many different theories about the pathophysiology of bipolar disorder; most

agree there is no specific cause as many factors contribute to the disease. Hereditary is a major
contribution to bipolar disorder. Those with a relative are 7 times more likely to develop the
disease (Medscape, 2016). Different neurotransmitters have been linked to bipolar disorder, the
largest being serotonin. Serotonin relays messages from one area of the brain to another. When
this is disrupted it can cause chemical imbalances in the brain. Serotonin can also disrupt the
functioning of muscles, endocrine system and cardiovascular system. This can affect mood,

Running head: MENTAL HEALTH

sexual desire, function, sleep, memory and learning. Psychodynamic and environmental factors
are believed to cause depression; limited self-worth and stress are believed to trigger manic
episodes.
Nursing care with evidenced based practice almost always utilizes a collaboration based
model; nurses, doctors, lab, radiology and primary health care providers work together to
improve patient outcomes. They document patient baselines using tests, objective information
obtained in assessments, and prior history to formulate a treatment plan for their patients. They
document patient findings, improvement and interventions every day and continue to monitor
patients. Mental health nursing encompasses all these things, but relies on the patient and family
for subjective information rather than objective assessment done by the nurse.
The Canadian Federation of Mental Health Nurses published the first nursing standards
of Psychiatric-Mental Health Nursing in 1995; the third edition published in 2006 is a
collaboration of evidence-based practice and surveying working psychiatric nurses. In short, it
outlines best-practices for psychiatric nurses working with bipolar and other mental disorders
and what they should do with their patients to improve outcomes. Ensuring correct and early
diagnosis is key to treating patients. This guideline has implications from the broad standards
like reducing the stigma, future research, and socioeconomics of mental health all the way down
to the psychiatric nursing level.
We will focus on the implications for nursing alone. The CFMHN believe the foundation
for working nurse/patient relationships is based on trust and mutual respect. Nurses need to work
in collaboration not only with health care providers, but also with the patients, family and
community in order to promote recovery and well-being for those with mental health problems
(Deacon, M., 2015). Using a holistic approach is important to understand that the client and

Running head: MENTAL HEALTH

nurses must advocate for safe environments and relationships for their client, assess learning
needs and support the client for recovery. The nurse must be able to support the patients
personal values and beliefs despite not necessarily aligning with their own, and they must be able
to use therapeutic verbal and non-verbal communication skills. The nurse must demonstrate skill
in tailoring nursing care to the pace and needs of the individual and must work with the patient to
promote recovery. The mental health nurse relies on the patients own resources and knowledge
and the clients own perception of their mental health. The nurse encourages patients to seek
support groups to strengthen their own support networks. Through direct observation, patient
self-reporting and family reports, the nurse will monitor client safely and assess early changes in
client status to intervene as needed. The mental health nurse must be able to detect signs that
could put the patient at risk for self-harm or others at risk of violence. The mental health nurse
must be able to effectively use crisis management to ensure patient safety, including suicide
precautions, emergency restraint, elopement in a hospital and community situation.

References
Canadian Nurses Association. (2016). Interprofessional collaboration. Retrieved from
https://www.cna-aiic.ca/en/on-the-issues/better-care/interprofessional-collaboration
Center for Substance Abuse Treatment. (2008). Managing depressive symptoms in substance

Running head: MENTAL HEALTH

abuse clients during early recovery: DSM-IV-TR mood disorders. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK64063/
Deacon, M. (2015). Caring for a person with bipolar disorder. Retrieved from http://www.
nursinginpractice.com/article/caring-person-bipolar-disorder
Jann, M. (2014). Diagnosis and treatment of bipolar disorders in adults: A review of the evidence
on pharmacologic treatments, American Health & Drug Benefits 7 (9), 489-499.
National Institute of Mental Health. (2012). Attitudes toward mental illness: Results from the
behavioral risk factor surveillance system. Retrieved from www.cdc.gov/hrqol/Mental
_Health.../pdf/BRFSS_Full%20Report.pdf

http://www.cmha.ca/media/fast-facts-about-mental-illness/#.V2dbYOQsAsB
http://emedicine.medscape.com/article/286342-overview#a4