Mental Health Nursing in the Community Setting - Term Paper Example

ntаl Неаlth Nursing Соntехt and Тhеоry Name Institution Mental health nursing theory: Behavioural theory Context: Mental health nursing in the community setting Introduction In mental health nursing, there are different theories that are applied in enhancing treatment of mental health problems to patients in different contexts. These theories are used to explain the reason behind the particular mental health problem, thus enhancing the identification of an efficient intervention to be applied towards mental health recovery (Caplan, 2013). Among the mental health nursing theories are, social theories, cognitive theories, behavioural theories, and developmental/ analytical theories. Behavioural theory is the approach of mental health problem with the belief that the portrayed behavior is learned (Jorm, 2012). In the community setting, people with mental health problems are provided mental health care through the application of different mental health nursing theories, such as behavioural theories. This paper seeks to explore the application of behavioural theories in the mental health nursing in the community setting. The paper conducts the review of diverse literature related to this aspect. Although there are many mental health nursing theories applicable in the community setting, behavioural theories is one of the most effective theory in enhancing efficient recovery of the mental health patients in that context. Behavioural theories Behavioural theory is the approach of a mental health problem through the concern that behaviours are learned. According to the argument put forth by Thoits, (2013) unhelpful and dysfunctional behavior like depression is learned. This is because the issue of depression is led by environmental stressors and the development of minimal rate of positive reinforcement. Besides, it is because of being highly associated with the social functions that a person tends to acquire the positive reinforcement leading to depression (Thoits, 2011). There are different types of behavioural theories such as the classical conditioning, operant conditioning. In the operant conditioning, Skinner identifies that the rewards towards the possibility of a certain behavior and the increased punishments assist in the minimization of the occurrence of a certain behavior in a person (Jorm, 2012). Therefore, according to the behavioural therapists, it is essential to change the destructive and unwanted behaviours and this is through the modification techniques applied to some behaviours, such as negative and positive reinforcement. The classical conditioning emphasize that learning of the undesirable behavior occurs through the association of people, for instance, a person learns how to smoke after being connected to other people who practice smoking, therefore a repeated behavior (Francis, O’Connor, & Curran, 2012). Moreover, it is possible to learn the anxiety disorder through the paired association, for example learning how to be afraid of something. Mental health nursing in community setting This is a major context in the provision of mental health care because the majority of the people with mental health problems are located in different community settings (Daumit, Dickerson, Wang, Dalcin, Jerome, Anderson, & Oefinger, 2013). In the community setting, members of a community tend to experience challenges, ethical dilemmas, and barriers to living a healthy life, thus the development of mental health problems. For instance, in the home environment, some individuals live in poverty and hardships, which lead to the development of stress and other psychological problems, therefore having mental disorders. Community mental health care provision through the behavioural theory Community mental health nurses practice their provision of care to their clients through the understanding that they behave the way they do after having learned the behaviour (Creek, & Lougher, 2011). It is apparent that community mental health is a population-based because it majorly results from the needs that are demonstrated by the community members. This entails the needs that are shared, therefore people develop mental illness in the community after learning from other members that their needs are not met as they are necessary. As articulated by Lakey, & Orehek, (2011) the role of the community mental health nurses is to identify the clients’ needs and try to relate their mental illnesses with the particular needs. The mental health nurse in the community setting also guides and enables the clients to be responsible for their mental health recovery (Thoits, 2011). This is enhanced by allowing them to change their behavior. It is important to assist the entire community to express behaviours that are able to enable self-care (Thoits, 2013). The behavioural theory in this setting would be applicable in helping the community members to ensure that their social interaction is positive. The community mental health nurses ensure retention of hope to the clients identified with depression since it is a behavior that is associated with the development of attitude towards being hopeless in life (Elliott, Huizinga, & Menard, 2012). Therefore, if one’s life was characterized by having hope in living a better life, the mental health patients would not be depressed. The same applies to the clients presenting anxiety based on the anticipation of danger. As emphasized by, Caplan, (2013) if one learns that there is some danger attached to something or a place, this leads to the development of anxiety. Thus, there is learned hopelessness and the anticipation of danger. In the community setting, changing of the external contingencies would help in modifying individual behavior (Carlier, Meuldijk, Van Vliet, Van Fenema, Van der Wee, & Zitman, 2012). If it is possible to change the cause of a specific problem, this as well enhances there to be some changes in the personal behavior (Jorm, 2012). This theory entails the inspection of the activities that a person conducts in their daily life. In the application of this theory for community mental health, it is established that if an individual happens to understand a specific circumstance in an undesirable manner for the reason that one is undergoing some destructive situations, the unscrupulous moods make an individual conduct oneself in a different way. It is vital for the community mental health nurse to identify other factors outside of the patient’s thinking that might lead to the development of mental problems such as depression and anxiety. This would aid in the management of the particular mental health problem given that sometimes people develop bad thoughts based on the social interconnections. As identified by Powell, McMillen, Proctor, Carpenter, Griffey, Bunger, and York, (2012), in the community setting, a personality disorder is managed and cured through the emphasis of the behavioral theory, whereby the bad behavior connected with the personality disorder is controlled. That is why psychologists make use of the behavioural techniques in assisting the community members to recognize and learn the most efficient ways of managing the factors making a person develop this mental health problem. In such instances, the psychologist is involved in a conversation with the client to know the particular practices that cause there to be some problematic interpretation of the environment and one’s approaches towards the surrounding. It seems that drinking behaviour can lead to the development of anxiety or depression (Thoits, 2011). Besides, the drinking behaviour is learned from the fact that people who drink were not born knowing how to do so but they develop the thoughts that drinking might give them a better life. This is based on how they perceive the lives of the other drinkers in the community (Lakey, & Orehek, 2011). If the community mental health nurse is able to talk to such an individual and help one to change the thinking regarding the better life enhanced through drinking, this would help in offering support to such a person in changing one’s behaviour. Therefore, undesirable behaviours are learned and can only be changed through learning how to avoid them and through the generation of desirable behaviours (Jorm, 2012). When making use of therapies associated with the behavioural theory in the community mental health nursing, the particular nurses would need to assist in the changing of the learned behavior, therefore being in a good position to promote the patients’ behaviour. Furthermore, Lorenc, Clayton, Neary, Whitehead, Petticrew, Thomson, and Renton, (2012) affirm that in order to have effective mental health treatment in the community context, the mental health nurse is required to assume that people behave in a certain manner because of what they intend to acquire, which is influenced by the social belief (Dingfelder, & Mandell, 2011). The behavioural theory emphasizes that human behavior is directed what people expect regarding the possible outcomes of their behaviour (Powell, et al. 2012). For instance, when offering mental health care to a depressed person in the community, it would be important for the mental health nurse to be considerate of the fact that an individual might be doing something with the increased hope of success (Anestis, & Joiner, 2011). However, in the process, failure to acquire the determined results might lead to the development of hopeless feelings, thus suffering from depression (Carlier, et al., 2012). This means that depression would be a mental disorder that is developed because of attaining the feeling of being hopeless (Creek, & Lougher, 2011). In addition, there is a major influence towards individuals’ behaviour from the normative expectations of the other community members. In the society, people set their expectations towards the life of an individual (Daumit, et al. 2013). Conversely, if in any case the set expectations are not achieved, the community members tend to develop some attitude towards that person that might lead to the development of a mental problem. Therefore, when offering mental health care to such an individual, it is vital to know the particular expectation that people had and the one that failed to be met. This would help in advising the patient to change the behavior by accepting the situation the way it is and trying to avoid thinking about the particular failure (Caplan, 2013). Based on the behavioural theory, the beliefs concerning the availability of factors influencing the conduct of specific behaviour might cause behaviour change (Lorenc, et al., 2012). If a person is seeking for certain help from other community members, it is possible to expect to acquire the specific support without any fail. Nonetheless, in the case of not succeeding in receiving the specific help, this leads to the development of psychological problem for failing to get the expected assistance (Bickman, Kelley, Breda, de Andrade, & Riemer, 2011). In general, it is ostensible that one behaves in a specific manner because of the internal and external occurrences (Lakey, & Orehek, 2011). Therefore, by understanding that personal perceptions and thoughts concerning the world, as well as how one conducts things in the world, this would assist the community mental health nurse to offer effective mental care to the patients in the community setting (Thoits, 2011). Furthermore, it would be essential to enable the client to change their thoughts regarding the circumstances that are likely to change how one tends to behave in the particular situation (Carlier, et al., 2012). For example, in the case of a patient with depression, it is clear that if the client was experiencing some adversity and tried to alleviate that situation without success, this would result in depression (Francis, O’Connor, & Curran, 2012). Hence, the mental health nurse needs to approach the patient through assisting one to learn optimism, whereby a person understands how better one can challenge the undesirable cognitions to be modified from the state of passivity to a controllable state (Anestis, & Joiner, 2011). The behavioural theory emphasizes on the conduct of counseling to the client (Dingfelder, & Mandell, 2011). This means that the community mental health nurse would need to have a conversation with the patient and seek to understand the portrayed behaviour, its causes, and how one can be assisted to change that thinking or behaviour (Powell, et al. 2012). The positive talk will enable the patient to change the negative feelings and assist in the development of positive feelings. It is also essential for the nurse to observe the changes demonstrated by the patient in the form of personal behaviour in order to make the most efficient decision in enabling one have a complete change of the negative behaviour (Kobau, Seligman, Peterson, Diener, Zack, Chapman, & Thompson, 2011). In order for a patient to change their behaviour, this will be determined by the nurse’s ability to aid in the changing of one’s perception and beliefs regarding the world. Therefore, the examination of the behaviour leading to the development of depression and anxiety and the assistance towards the generation of better and effective thoughts and behaviour, this helps in the reduction of negative feelings. Benefits of using behavioural theory in the community mental health nursing Based on research, there are many advantages associated with the application of behavioural theory when the community mental health nurses are offering mental health came to their clients (Bickman, et al., 2011). Some of these benefits are associated with the management of personality disorder, whereby the nurse is supposed to be addressing the patient’s feelings and behavior, as well as discussing the methods through which one can generate the capacity to control the particular contemplations and behavior. According to the argument put forth by Lorenc, et al., (2012), this theory aids in appropriate consideration of the communal interactions and evasion of self-harm. This is because, the community mental health nurse advice and guide the client on the most efficient ways of changing their behavior that might lead to the conduct of bad things and adapt good thinking in relation to life (Bickman, et al., 2011). It is apparent that this theory assists a person to lessen the self-harming behavior and empowers an individual to deal with the emotional imbalances in an effectual way (Daumit, et al. 2013). Moreover, the skills acquired during the application of techniques related to the behavioural theory are likely to be of much benefit to the person with mental health problem even subsequent to one’s recapture from the mental illness since they are supportive even after an individual is done with the recommended therapy periods (Kobau, et al. 2011). As postulated by, through the behavioural theory, it is possible for the other individuals in the household can apply the particular skills. In general, the approach of the community mental health problems using the behavioural theory and its associated therapies enable a client to develop some positive association with family members and other individuals in the entire community (Thoits, 2011). Conclusion Behavioural theory is one of the theories associated with the treatment and management of mental health problems. This theory emphasizes that behaviours are learned. According to this theory, the aspect of learning bad behaviour is what makes people develop undesirable perceptions and thoughts about the world. In the community mental health setting, the behavioural theory is applied in understanding why individuals in the community context develop some mental health problems such as depression and anxiety. In order to offer mental health care, the community mental health nurse is supposed to look for the internal and external factors such as personal and societal expectations leading to the development of a specific mental problem. This would aid in assisting a person to change his or her behaviour and enable one to avoid having bad thoughts and feelings towards a situation in life. The nurse talks to an individual and guides them to take life in a different perspective different from the negative feelings leading to the generation of the particular mental health issue. Therefore, through the application of behavioural theory, it is possible for the professionals to enhance recovery of the mentally ill patients in the community. References Anestis, M. D., & Joiner, T. E. (2011). Examining the role of emotion in suicidality: Negative urgency as an amplifier of the relationship between components of the interpersonal–psychological theory of suicidal behavior and lifetime number of suicide attempts. Journal of affective disorders, 129(1), 261-269. Bickman, L., Kelley, S. D., Breda, C., de Andrade, A. R., & Riemer, M. (2011). Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatric Services, 62(12), 1423-1429. Caplan, G. (2013). An approach to community mental health (Vol. 3). London: Routledge. Carlier, I. V., Meuldijk, D., Van Vliet, I. M., Van Fenema, E., Van der Wee, N. J., & Zitman, F. G. (2012). Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. Journal of Evaluation in Clinical Practice, 18(1), 104-110. Creek, J., & Lougher, L. (2011). Occupational therapy and mental health. Elsevier Health Sciences. Daumit, G. L., Dickerson, F. B., Wang, N. Y., Dalcin, A., Jerome, G. J., Anderson, C. A., ... & Oefinger, M. (2013). A behavioral weight-loss intervention in persons with serious mental illness. New England Journal of Medicine, 368(17), 1594-1602. Dingfelder, H. E., & Mandell, D. S. (2011). Bridging the research-to-practice gap in autism intervention: An application of diffusion of innovation theory. Journal of autism and developmental disorders, 41(5), 597-609. Elliott, D. S., Huizinga, D., & Menard, S. (2012). Multiple problem youth: Delinquency, substance use, and mental health problems. Springer Science & Business Media. Francis, J. J., O’Connor, D., & Curran, J. (2012). Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implementation Science, 7(1), 35. Jorm, A. F. (2012). Mental health literacy: empowering the community to take action for better mental health. American Psychologist, 67(3), 231. Kobau, R., Seligman, M. E., Peterson, C., Diener, E., Zack, M. M., Chapman, D., & Thompson, W. (2011). Mental health promotion in public health: Perspectives and strategies from positive psychology. American journal of public health, 101(8), e1-e9. Lakey, B., & Orehek, E. (2011). Relational regulation theory: a new approach to explain the link between perceived social support and mental health. Psychological review, 118(3), 482. Lorenc, T., Clayton, S., Neary, D., Whitehead, M., Petticrew, M., Thomson, H., ... & Renton, A. (2012). Crime, fear of crime, environment, and mental health and wellbeing: mapping review of theories and causal pathways. Health & place, 18(4), 757-765. Powell, B. J., McMillen, J. C., Proctor, E. K., Carpenter, C. R., Griffey, R. T., Bunger, A. C., ... & York, J. L. (2012). A compilation of strategies for implementing clinical innovations in health and mental health. Medical care research and review, 69(2), 123-157. Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of health and social behavior, 52(2), 145-161. Thoits, P. A. (2011). Resisting the stigma of mental illness. Social Psychology Quarterly, 74(1), 6-28. Thoits, P. A. (2013). Self, identity, stress, and mental health. In Handbook of the sociology of mental health (pp. 357-377). Springer Netherlands. Read More