Nurses, Mental Health Nurses and Other Health Professionals
General Description
Individuals with one or more chronic mental illness face enormous challenges receiving the care they need. Not only do they have to cope with their illness, but they and their families must also try to arrange services from complex and often unreceptive systems: the health care system and the social service system. Following the movement of patients from state mental hospitals to community settings 20 years ago, the problems faced by people with chronic mental illness has become more visible to the Australian public.
Need for Program
As mental illness has now been identified as pervasive in our community it is essential that nurses have access to appropriate education that enables them to provide multi-faceted, professional care. Chronic mental illness, often associated with chronic physical illness, is increasingly prevalent in our society. Nurses need to have relevant skills to effectively care for people with chronic mental illness which, may be particularly challenging, due to the ongoing nature of the disease.Nurses are required to obtain a minimum of 20 continuing professional development (CPD) hours, that relate to their context of practice, in order to comply with mandatory regulatory requirements.
Aims and Objectives
This program is designed to provide contemporary information for nurses who work in general hospital, community, general practice, or mental health settings. The major focus concerns the nurse’s role in assessment, and management of these diseases, including the design of care plans to assist those with irreversible mental health problems. Case studies, exercise activities and discussion will be an integral part of this educational event.
At the conclusion of this session it is anticipated that the participant will be able to:
Describe the difference between acute and chronic mental illness.
Describe common behaviours that may be associated with chronic mental illness.
Demonstrate knowledge of how to plan care for a person who has chronic mental illness.
Day 1
Day 2
Educators
8:30am - Registration and Welcome
9.00am - The Blight of Impaired Judgments, Inappropriate Emotions and Bizarre Behaviours
How is a mental/psychiatric disorder diagnosed?
The extent of psychiatric illness in the Australian population.
What is the difference between acute episodes of mental illness and chronic mental illness?
Where are people with chronic mental illness? Summary of the recent history of de-instutionalisation and the consequent, multiple locations of psychiatric clients.
Why are those with chronic mental illnesses over-represented among homeless and prison populations?
A word about madness and stigma.
Overview of the main services/programs available to this population, in the private, public and charitable sectors.
9.45am - The Journey From Acute to Irreversible Mental Illness
Aetiology of the progression of mental instability symptoms to the point where they become chronic.
How are the signs of chronicity identified?
The loneliness of the long-distance client
10.30am - Morning Tea and Coffee
11.00am - Types of Chronic Mental Illnesses
Information about the main types of mental disorders using the framework of the Diagnostic & Statistical Manual of Mental Disorders (DSM IV). Key examples include mood disorders, the psychoses, organic brain disorders, dementia and personality disorders.
12.00am - The Importance of the Multi-Disciplinary Team
The complexity of the presenting symptoms in those with chronic psychiatric disorders combined with their multiple well-being needs are best addressed through the skills of an effective team of health professionals/workers.
Pathways of referral and avoiding duplication of services.
12.30pm - Lunch Break and Networking
1.30pm - The Crippling Burden of Chronic Depression and Chronic Anxiety Disorders
When would severe episodes of depression or anxiety be deemed to have become a chronic condition?
What is meant by the term “agitated depression”?
How to Deal with Panic Attacks:
About 30% of the population will experience a panic attack at some time, and 2% of these people have a diagnosable panic disorder.
Is it possible to identify the triggers?
Helpful approaches include:
Ensuring the person’s safety as a priority
Informed reassurance, tolerance, support and kindness
Authentic listening to the patient’s viewpoints
Conveying respect and empathy for their concerns within a therapeutic framework of reality testing
Use of Medications and Therapies
Commonly used anxiolytics and antidepressants, their impact and the nurse’s role.
A snapshot of some therapeutic activities.
Examples:
Cognitive behaviour therapy (CBT)
Relaxation techniques
Desentisation of phobic behaviours
Behavioural re-training programs for managing obsessive compulsive thoughts
2.45pm - Underestimated Problems in the Elderly
Older people are particularly prone to serious levels of depression and or anxiety.
Why are persistent and serious levels of depression/ anxiety under-reported in the elderly?
What can be done to remedy this so that nursing staff are fully informed about the recognition of these mental concerns and the formal reporting mechanisms.
3.00pm - Afternoon Tea Break
3.30pm - Suicide and Self-Harm Risks
Knowledge of risk factors - critical to an understanding of prevention strategies.
Overcoming the taboo against talking about suicide.
Communicating with an individual who is selfharming, e.g. self-cutting behaviours.
What to do when someone (verbally or non-verbally) signals that they are thinking of taking their life.
Crucial facts about attempted suicide and the nurse’s role.
4.15pm - Close of Day One Program
Start of Day Two
9.00am - The Psychoses, Out of Touch with Reality
What is meant by the term “psychosis”?
Are those who are psychotic invariably dangerous?
How do psychotic disorders differ from so-called ‘neurotic disorders’
9.15am - The Scourge of Chronic Schizophrenia
At what age does a first episode of this condition usually occur?
What are the key signs and symptoms?
Definitions and examples of delusions and hallucinations.
Which type of delusions/ hallucinations are commonly present?
10.10am - Inside the Mind of Someone Affected by Schizophrenia
LISTENING EXERCISE
Learn what it is like, in the absence of anyone speaking, to continually 'hear voices' talking inside your head.
10.30am - Morning Coffee and Tea
11.00am - Bi-Polar Highs and Lows
Previously, bi-polar disorder was known as 'manic-depressive disorder'.
What is the nature of this psychiatric illness and how is it diagnosed?
Main dangers for those with chronic bi-polar disorder.
1.15pm - Lunch Break and Browse the Book Display
2.15pm - Management and Treatment Options
What can be done to help affected individuals and their families survive the disturbing roller coaster of hyper-activity and desolate moods?
Lithium Carbonate - a world-wide, breakthrough discovery from Melbourne. Why is it crucial that those who are prescribed this medication have regular blood tests?
The role of other psycho-pharmacology in controlling crippling episodes of mania / hypomania / depression?
Other psycho-social and medical interventions which aim to increase periods of remission, e.g when is counselling helpful?
Paying attention to the client's physical needs.
3.00pm - Afternoon Tea and Coffee
3.30pm - Dual Diagnosis
This term describes the co-morbid existence of mental illness and substance abuse. Those with chronic mental instability may be addicted to one or more harmful (legal or illegal) substances. Examples are ingesting or injecting prescription medications, alcohol, drugs such as heroin or amphetamines and sniffing solvents.
Why are those with a chronic mental illness prone to developing substance abuse?
Specific roles for nurses in the multi-disciplinary team clinical pathways.
4.15pm - Close of Program and Evaluations
Fiona O'Shea
Fiona is a qualified and experienced general and mental health nurse who teaches a range of related topics to nurses at TAFE and University. As well, Fiona is a Clinical Liaison Nurse Specialist - Mental Health, in the Emergency Department of Noarlunga Hospital. Her clinical background includes substantial experience in rural and community mental health settings.
