Special Population Presentation: Community Health Nursing Essay

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Interventions for Mentally-Ill Adolescents

Mental illness is a serious health concern in America today. The National Alliance on Mental Illness (NAMI) estimates that one in every four adults in America, which translates to approximately 61.5 million people, suffer some form of mental illness in every given year (Duckworth, 2013). Worryingly, 13% of children aged between 8 and 15 and 20% of youth aged between 13 and 18 experience some severe mental disorder in any given year (Duckworth, 2013). These statistics are disturbing, particularly because mental illness has been shown to be a significant risk factor for chronic medical conditions, and low life expectancy. It is estimated, for instance, that adults living with serious mental conditions die 25 years earlier than their counterparts in the rest of the population (Duckworth, 2013). Currently, the burden of mental disease takes away approximately $193.2 billion from the economy in lost productivity every year (Duckworth, 2013). This is why there is need for stakeholders to come together to fight mental illness and reduce the annual burden that it imposes on the already-overburdened taxpayer. Community health nurses have a fundamental role to play, which is to increase the community's awareness in the issue of mental illness so that the burden of mental illness becomes one shared by all primary stakeholders. The subsequent sections present a hypothetical two-part awareness program that could be used in identifying the best interventions for mentally-ill adolescents, particularly through increasing the involvement of family members.

The Program

Part One: Criteria for Identifying Suitable Interventions for the Special Population

Special Population

This program specifically targets mentally ill adolescents (aged between 10 and 18). Its main aim is to increase awareness of issues of mental illness among adolescent patients and those people close to them with the aim of reducing the stigma and eliminating the negative stereotypes associated with mental illness. As already mentioned, 53% of adolescents aged between 8 and 18 experience some severe mental disorder in any given year (Duckworth, 2013). Most of these cases, as the National Alliance on Mental Illness shows, result in either suicide or school drop-out -- suicide, for instance, has been named the third leading cause of death among teenagers and adolescents, often times recording higher rates than homicide (Duckworth, 2013). Disturbingly, 90% of teen suicides are mental illness-related (Duckworth, 2013).

Researchers agree that the main reason why the prevalence rates of mental illness for this particular population have remained relatively high is because stakeholders have failed to transfer knowledge on mental health problems from one generation to the next (Lauritzen & Reedtz, 2015). This has created a knowledge dearth that has made it increasingly difficult for families to take an active role and provide effective care for those suffering from mental illness. Having no information to rely upon, families with mentally ill individuals have been forced to base their care on common stereotypes that have been built by society over time, some of which have no empirical basis (Canadian Center for Addiction and Mental Health, 2001). Three common stereotypes, for instance, which lack empirical basis but still inform society's perceptions are that (Canadian Center for Addiction and Mental Health, 2001):

i) Mentally ill persons have nothing tangible to contribute

ii) Mentally ill persons are, to some extent, responsible for their mental conditions

iii) Mentally ill persons are all dangerous and violent

These misconceptions result from the fact that communities have not been adequately educated, and therefore lack the requisite knowledge to deal effectively with the issue of mental illness. Worryingly, such misconceptions add to the stigma that mentally ill persons face and prevent them from receiving the necessary care from those closest to them (Canadian Center for Addiction and Mental Health, 2001).

Strengths, Weaknesses and Resources in the Special Population

It is recommended that therapists identify the strengths, weaknesses and resources inherent in their special population so that they are able to choose the intervention strategies that best meet the characteristics and needs of the selected population.

Strengths: these are the specific qualities of the population that make it better-placed to respond effectively to specific treatment interventions. Our special population (adolescents aged between 10 and 18) belongs to the Millennial generation, whose members have been found to be more inclined to work effectively in teams than the generations before them. Towards this end, therapists could maximize their health outcomes by using group therapy as opposed to individual therapy, and this basically means that a greater proportion of patients are attended to. A second strength inherent in this population is that they are tech-savvy, having been born in a digital era characterized by rapid technological advancement.

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This means that the therapist an make effective use of m-health platforms, where group meetings are held through video conferencing and mobile apps are used to monitor progress and seek clarification.

Resources: having not attained the age of majority, most members of our special population still live with their parents/guardians or are under some form of community care facility. Family and the community are, therefore, among the most crucial resources that these individuals possess (Xie, 2013). Therapists can, therefore, maximize this group's health outcomes by taking in input from family members and the community, and using leverage from the community to develop informal support systems such as self-help groups, where patients can share with, and learn from each other (Xie, 2013).

Weaknesses: the fact that members of the special population are tech-savvy is one of their greatest strengths; however, it also is the source of their most fundamental weakness -- since answers to queries are readily available on 'Google', 'Wikipedia', and other sites on the internet, this group of individuals has grown to appreciate things that provide instant gratification. They expect therapy sessions to yield immediate results and are likely to discontinue participation if they do not see any value within the first few sessions. The therapeutic interventions chosen, therefore, need to be effective, and the therapist must provide platforms for constant monitoring and assurance to help keep participants in line and minimize the risk of relapse.

Community Interventions for Health Promotion among the Special Population

Based on the strengths and resources outlined earlier on, I would conclude that for mentally ill adolescents, maximum outcomes would be realized through a combination of biological and psychosocial interventions.

Biological Interventions

i) Medication

Based on the seriousness and type of mental condition, the therapist could prescribe one of the common medications used to treat mental disorders including anti-anxiety medication, mood stabilizers, antidepressants and antipsychotics (Canadian Center for Addiction and Mental Health, 2001).

ii) Electroconvulsive Therapy (ECT)

This is also referred to as 'shock therapy' and is commonly used on patients with acute depression (Canadian Center for Addiction and Mental Health, 2001). In this case, a muscle relaxer and anesthetic is given to the patient before an electric charge is induced on the brain to create a small seizure (Canadian Center for Addiction and Mental Health, 2001).

Psychosocial Interventions

i) Psychotherapy

This is a form of treatment achieved through talks between a patient and their therapist. It could work perfectly with adolescents because adolescents often feel that their parents are not understanding or liberal enough; and hence, they may be more comfortable laying out their fears with a trusted third-party (Canadian Center for Addiction and Mental Health, 2001). The overriding aim of psychotherapy is to help patients relive stress by expressing their feelings and just having someone listen to them without judgment or criticism. It could take any form, from individual to group psychotherapy -- however, in the case of adolescents; the latter would be preferred because of the degree of significance that they place on peers, social networks, and being able to identify with others.

ii) Self-help groups

Mentally ill adolescents could also use self-help groups as an alternative to psychotherapy. Most of these groups are run by clients in the mental health system, and provide platforms for patients and their families to interact informally with other people who share the same issues and challenges (Canadian Center for Addiction and Mental Health, 2001). Such groups help to eliminate isolation issues and help adolescents to not only identify with other people with similar experiences, but also learn from their peers.

iii) Community Support

Providing mentally-ill adolescents with access to family services, social support systems, effective housing, educational facilities and social services in addition to therapeutic treatment could also go a long way in maintaining their wellness. Moreover, they could be assigned to service clubs (such as Rotary), religious organizations and interest-based groups that allow them to make meaningful impact in the community and rebuild their self-esteem (Canadian Center for Addiction and Mental Health, 2001).

iv) Family involvement and support

Family plays a crucial role in the mental health of members, and is actually a vital resource for this particular population. Getting family members involved in adolescent patients' health through informal settings could go a long way in maximizing their health outcomes, especially if family members are provided with adequate and accurate information on….....

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