GNM Nursing psychology - First year Unit 7: Mental Hygiene and Mental Health

GNM Nursing psychology - First year
Unit 7: Mental Hygiene and Mental Health

Contents:

· Concepts of mental hygiene and mental health

· Characteristics of mentally healthy person

· Warning signs of poor mental health

· Promotive and preventive mental health- strategies and services

· Ego defence mechanisms and implications

· Personal and social adjustments

· Guidance and Counseling

· Role of Nurse
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|| MENTAL HEALTH ||

¶ Meaning and Definition of Mental Health:

• Mental health is a state of balance between the individual and the surrounding world.
• A state of harmony between oneself and others.

¶ Components of Mental Health: The components of mental health include:

1. Ability to accept self:

• A mentally healthy individual feels comfortable about himself.
• He feels reasonably secure and adequately accepts his surroundings.
• In other words, he has self-respect.

2. Capacity to feel right towards others:

• An individual who enjoys good mental health is able to be sincerely interested in other’s welfare.
• He has friendships that are satisfying and lasting.
• He is able to feel as a part of a group without being submerged by it.
• He takes responsibility for his neighbors’ and his fellow members.

3. Ability to fulfill life’s tasks:

• A mentally healthy person is able to think for himself, set reasonable goals and take his own decisions.
• He does something about the problems as they arise.
• He shoulders his daily responsibilities and is not bowled over by his own emotions of fear, anger, love and guilt.

¶ Criteria for Mental Health:

• Adequate contact with reality
• Control of thoughts and imagination
• Efficiency in work and play
• Social acceptance
• Positive self-respect
• A healthy emotional living

¶ Indicators of Mental Health:

1. A positive attitude towards self

2. Growth, development and the ability for self-actualization

3. Integration: Integration includes the ability to adaptively respond to the environment and the development of a philosophy of life.

4. Autonomy: Refers to the individual’s ability to perform in an independent self-directed manner.

5. Perception of reality

6. Environmental mastery

¶ Characteristics of a Mentally Healthy Person

• A mentally healthy person has an ability to make adjustments.
• A mentally healthy person has a sense of personal worth, feels worthwhile and important.
• A mentally healthy person solves his problems largely by his own efforts and makes his own decisions.
• He has a sense of personal security and feels secure in a group, shows understanding of other people’s problems and motives.
• A mentally healthy person has a sense of responsibility
• He can give and accept love.
• He lives in a world of reality rather than fantasy.
• He shows emotional maturity in his behaviour, and develops a capacity to tolerate frustration and disappointments in his daily activities.
• A mentally healthy person has a variety of interests and generally lives a well-balanced life of work, rest and recreation.

¶ Factors Responsible for Poor Mental Health

1. Heredity:

• A child with poor heredity has a low IQ.
• He may be having a feeble mind which will not enable him to good mental health.
• He may also inherit some mental diseases which may disturb his mental health.

2. Physical health:

• A normal physical health leads to a normal mental health. We say “sound mind in a sound body”.
• Persons of poor health have a poor approach towards life and hence cannot adjust to new situations due to lack of mental balance.
• They can possibly change with the changing situations.

3. Physical defers:

• Any physical deformity leads to a social stigma.
• This creates a sense of inferiority complex in the mind of the child.
• This leads to frustration and aggression on by the child.
• This also disturbs the mental balance of the child.
• He is not able to adjust himself to various social situations.

4. Role of the family: Family set up, Discipline in family, Family poverty, Family conflicts, Lack of security....

5. Role of the society: Man is a social animal. The child has his birth and growth in the society.

His mind is also influenced by the prevailing social forces conditions that lead to mal adjustment of the child.

Other important social factors which influence the children are social and religious conflicts, high disparity between the rich and the poor and the problem of untouchability.

There brings about mental tension and leads to loss of mental health.

6. Role of the school: The school atmosphere, school curriculum, methods of teaching, the examination system, etc. determine mental health.

¶ Mental Health Promotion and Prevention

• Promotion means improving the positive mental health of the population.

• Prevention means reducing the number of future mental health problems in the population.

✓ Promotion:

Specifically, mental health can be promoted through:

• Early childhood interventions (eg. home visits for pregnant women, pre-school psychosocial activities)
• Providing support for children (eg, skills building programs, child and youth development programs)
• Programs targeted at vulnerable groups, including minorities, indigenous people, migrains, and people affected by conflicts and disasters (eg, psychosocial interventions after disasters)
• Incorporating mental health promotional activities in schools.
• Violence prevention programs.
• Community development programs.

✓ Prevention:

The different types of prevention as defined by the Institute of Medicine:

Universal prevention interventions ➡️ Selective prevention interventions ➡️ Indicated prevention interventions➡️ Treatment
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|| PERSONAL ADJUSTMENT AND SOCIAL ADJUSTMENT ||

¶ Personal Adjustment

Personal adjustment, is a process of harmony between the individual and his environment. The individual purposefully applies efforts and energy not only to accommodate perfectly within the and the environment, but also to fulfil his needs and lead a happy social life.

¶ Characteristics of a Well-adjusted Person

• Basic needs are satisfied

• Leads balanced life

• Respects self and others

• Has realistic goals

• Aware of one's own strengths and weaknesses

• Flexible mind-set

• Ability to deal with adverse circumstances Realistic perception of the world

• Comfortable with the surrounding environment

• Absence of fault-finding attitude

¶ Social Adjustment:

As social beings we live in a society. We form opinions about others and others form opinions about us. Everybody wants acceptance and recognition from and within the society. We try to behave according to the norms of the society, so that we can adjust with others.

Social adjustment can be defined as a psychological process it frequently involves coping with new standards and values in the society.

¶ Areas of Adjustment

Adjustment, although seeming to be a universal characteristic like quality it may have different and dimensions, such as

• Health adjustment Emotional adjustment

• Social adjustment

• Home adjustment

• School or professional adjustment

Adjustment of a person is based on the harmony between his personal characteristics and the environment of which he is a part.
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|| Ego Defence Mechanisms ||

¶ Ego defence mechanisms are methods of attempting to protect self cope with basic drives or emotionally painful thoughts, feelings or events.

► Purposes

The purpose of Defence mechanisms is to reduce or eliminate antey. They may be used to resolve a mental conflict, to reduce anxiety or fear, to protect ones self-esteem or to protect one's sense of security.
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|| Role of a Nurse in Tertiary Prevention ||

• Family members should be involved actively in the treatment program

• Occupational and recreational activities should be organized in the hospital.

• Community based programs can be launched by meeting the family members when the need for discharge from the hospital. These program can be implemented through day hospitals, night hospitals, after care clinics, half way homes, ex-patient hostels, foster care homes etc.

• There should be constant communication between community health nurse and mental health institution regarding the follow up of the discharge patient.

• Nurses need to be familiar with the agencies in the community that provide these services.

• Collaborative relationship between mental health care providers and community agencies are essential.

• An important intervention in the maintenance of patients as their own homes in the community is the training in community living.

• Another aspect of community life that is more difficult to assess accurately and deal with effectively, is the stigma attached to the mental illness.
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|| CHARACTERISTICS OF A MENTALLY HEALTHY PERSON ||

• He has an ability to make adjustment

• He has a sense of personal worth, feels worthwhile and important.

• He solves his problem largely by his own effort and makes his own decision.

• He has a sense of personal security and feels secure in a group, shows understanding of other people problems and motives.

• He has a sense of responsibility.

• He can give and accept love.

• He lives in a world of reality rather than fantasy.

• He shows emotional maturity in his behavior and develops a capacity to tolerate frustration and disappointment in his daily life.

• He has a variety of interests and generally lives a well balanced life of work, rest and recreation.
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|| Warning signs of Poor mental health ||

1. In younger children

✓ changes in school performance

✓ poor grades despite strong efforts

✓ excessive worrying or anxiety

✓ Hyperactivity

✓ Persistent nightmares

✓ Persistent disobedience or aggressive behavior

✓ Frequent temper tantrums

✓ Frequent temper tantrums

2. In older children and Adolescents

✓ Abuse of drugs or alcohol Inability to cope with daily problems and activities

✓ Changes in sleeping or eating habits

✓ Excessive complaints of physical problems

✓ Defying authority, skipping school stealing or damaging property.

✓ Intense fear of gaining weight

✓ Long lasting negative mood along with poor appetite and thoughts of death

✓ Frequent outburst of anger

3. In Adults

✓ Confused thinking

✓ Long lasting sadness or irritability

✓ Extreme high and low moods

✓ Excessive fear worrying or ariety

✓ Social withdrawal

✓ Dramatic changes in eating or sleeping habits

✓ Strong feeling of anger.

✓Delusions or hallucination

✓ Increasing inability to cope with daily problems and activities

✓ Thoughts of suicide

✓ Denial of obvious problem

✓ Many unexplained physical problems

✓ Abuse of drug or alcohol
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|| DEFENCE MECHANISM/MENTAL MECHANISM ||

¶ Definition: when an individual is faced with problem. difficulties or failure, he employs certain way or device to achieve health, happiness and success. These are called defence mechanism.

Defence mechanism enables a person to resolve conflict and reduce the stress and anxiety.

¶ Defence mechanism can be divided into successful and unsuccessful mechanisms as given below:

1. Successful

• Repression
• Rationalization
• Intellectualization
• Compensation
• Substitution
• Sublimation

2. Unsuccessful

• Denial
• Isolation
• Projection
• Regression
• Conversion
• Fixation
• Fantasy
• Introjections
• Identification
• Suppression
• Reaction Formation
• Displacement

¶ Implication of Ego Defence Mechanism:

• The defense mechanism has a profound impact on the development of personality.

• The idea of a defense mechanism is a psychological approach to coping with a particular problem or situation.

• It is a construct of the conscious in dealing with an issue that potentially resides in the sub-consciousness.

• We use defense mechanisms to protect ourselves from feelings of anxiety or guilt, which arise because we feel threatened, or because our id or superego becomes too. demanding.

• We all have thoughts, feelings, and memories that can be difficult to deal with. In some cases, people deal with such feelings by utilizing what are known as defense mechanisms.

• These defense are unconscious psychological responses that protect people from threats and things that they don't want to think about or deal with.
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|| Guidance and counseling ||

¶ MEANING OF GUIDANCE

To guide means to indicate, to point out, and to show the way. It means more than to assist. A man falls on the street; we assist him to get up but we do not guide him unless we help him to go in a certain direction. The synonyms of 'to guide' are to lead, to conduct, to regulate, to direct, to steer, to show, to channel, to point.

¶ PRINCIPLES OF GUIDANCE

01. Principle of all-round development of the individual.

02. The principle of human uniqueness.

03. Principle of holistic development.

04. Forced into guidance.

05. The principle of extension.

06. The principle of adjustment.

07. Principle of individual needs.

08. The principle of responsibility.

09. The principle of expert opinion.

10. The principle of evaluation.

¶ AREA OF GUIDANCE

1. Educational guidance:
2. Vocational guidance
3. Personal guidance
4. Leisure time guidance
5. Social guidance
6. Moral guidance
7. Health guidance
8. Marital guidance
9. Finance guidance

¶ Definition of counseling

:Counselling is an accepting, trusting and safe relationship in which clients learn to discuss openly what worries and upsets them, to define precise behaviours goals to acquire essential social skills and to develop the courage and self confidence to implement the desire new behaviours. (Merle M Ohlsen-1977)

"Counselling is a process through which an individual is able to solve their problem and pursue a path suited to their abilities and aspirations. - JM Brewer

¶ Goals of Counselling:

• Listening carefully to the patient is the main goal.

• To make the patient ventilate his emotions properly and help him to be aware of his own emotions and encourage him to be independent.

• Identify the needs of the patient. E.g., parents need counselling for their children's behaviour problems.

• The main problem should be focused so that the sub- problems should be identified by the patient himself.

• Make the patient accept himself with his problem and help him to adjust with it till it gets over.

• To focus on his strengths by studying the case and produce a positive attitude in him and ultimately help him to reduce his negativity.

¶ Principles of counselling

01. Principle of acceptance

02. Principle of authenticity

03. Principle of communication

04. Principle of empathy

05. Principle of non-judge

06. Principle of confidentiality

07. Principle of individuality

08. Principles of non-emotional involvement

¶ Techniques/Approaches to councelling

• Councellor centred
• Client centred

¶ AREA OF COUNSELLING:

• Emotional Abuse: allows one person to gain power and control over another through words and gestures which gradually undermine the other's self respect.

• Relationship Issues: Some relationships are unable to contain some of life's pressures and stresses; illness. redundancy, retirement or debt all take their toll.

• Trauma: A traumatic event involves an experience or enduring event(s) that overwhelms our ability to cope or understand the ideas and emotions involved with that experience.

• Stress: Too much stress can put your health at risk and leave you unable to function. It is the second major cause of illness at work, after back problems.

• Terminal Illness: Counselling can be a valuable resource for everyone close to the individual, and for the individual themselves.

• Work related issues: Counselling can help unravel patterns of relating to people, and show us how to examine our own issues, helping towards a more fulfilling career.

• Anger Management: Understanding what the trigger points are and re-examining our thoughts around them can be among the first steps to managing anger.

• Anxiety: Anxiety is a problem which feeds on itself and is often covered up and dealt with in isolation.

• Depression: Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless.

• Bereavement Counselling: This focuses on working through the stage of grief. In this counselling talking about the loss is usually helpful and allows a person to adjust to their new life with all its changes, good and bad. However keeping things bottled up, or denying the sadness can prolong the pain.

• Low self-esteem: Counselling can often help those suffering from low self-esteem and help develop a sense of self, to ensure a more fulfilling life.

¶ Differences between counseling and guidance