E E EN N DITIHAN EDITHIANCE ONC OND E D GO ON, BE UNSTOPPABLE The up-to-date content in this book helps you to get the knowledge you need to succeed. Helps you understand the theory and clinical reasoning needed to work in mental health nursing Scenarios from the real world introduce you to intricate mental health nursing challenges Learn about major mental health disorders with coverage of the Mental Health Act and criteria from DSM-5 Gain insight into the effects of global crises, such as the COVID-19 pandemic, on the mental health of consumers and practitioners ISBN 978-0170458610 9 780170 458610 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Mental Health Nursing Applying Theory to Practice Gylo ( Julie ) Hercelinskyj & Louise Alexander Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Mental Health Nursing Applying Theory to Practice Gylo (Julie) Hercelinskyj & Louise Alexander Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Mental health nursing: Applying theory to practice © 2022 Cengage Learning Australia Pty Limited 1st Enhanced Edition Gylo (Julie) Hercelinskyj Copyright Notice Louise Alexander This Work is copyright. No part of this Work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission of the Publisher. Except as permitted under the Senior content manager: Michelle Aarons Copyright Act 1968, for example any fair dealing for the purposes of private study, Content developer: Eleanor Yeoell research, criticism or review, subject to certain limitations. These limitations Senior project editor: Nathan Katz include: Restricting the copying to a maximum of one chapter or 10% of this Cover designer: Danielle Maccarone book, whichever is greater; providing an appropriate notice and warning with the Text designer: Norma Van Rees copies of the Work disseminated; taking all reasonable steps to limit access to Permissions/Photo researcher: Mira Fatin; Corrina Gilbert these copies to people authorised to receive these copies; ensuring you hold the Editor: Anne Mulvaney appropriate Licences issued by the Copyright Agency Limited (“CAL”), supply a Indexer: Julie King remuneration notice to CAL and pay any required fees. For details of CAL licences Art direction: Nikita Bansal and remuneration notices please contact CAL at Level 11, 66 Goulburn Street, Cover: Cover image courtesy of Stocksy.com/Lumina Images Sydney NSW 2000, Tel: (02) 9394 7600, Fax: (02) 9394 7601 Typeset by KnowledgeWorks Global Ltd. Email: [email protected] Website: www.copyright.com.au Any URLs contained in this publication were checked for currency during the production process. Note, however, that the publisher cannot vouch for the For product information and technology assistance, ongoing currency of URLs. in Australia call 1300 790 853; in New Zealand call 0800 449 725 Notice to the Reader Publisher does not warrant or guarantee any of the products described herein or For permission to use material from this text or product, please email perform any independent analysis in connection with any of the product [email protected] information contained herein. Publisher does not assume, and expressly disclaims, any obligation to obtain and include information other than that National Library of Australia Cataloguing-in-Publication Data provided to it by the manufacturer. The reader is expressly warned to consider ISBN: 9780170458610 and adopt all safety precautions that might be indicated by the activities A catalogue record for this book is available from the National Library of described herein and to avoid all potential hazards. Australia. By following the instructions contained herein, the reader willingly assumes all Cengage Learning Australia risks in connection with such instructions. The publisher makes no Level 7, 80 Dorcas Street representations or warranties of any kind, including but not limited to, the South Melbourne, Victoria Australia 3205 warranties of fitness for particular purpose or merchantability, nor are any such representations implied with respect to the material set forth herein, and the Cengage Learning New Zealand publisher takes no responsibility with respect to such material. The publisher Unit 4B Rosedale Office Park shall not be liable for any special, consequential, or exemplary damages resulting, 331 Rosedale Road, Albany, North Shore 0632, NZ in whole or part, from the readers’ use of, or reliance upon, this material. For learning solutions, visit cengage.com.au This 1st Enhanced edition published in 2022. Printed in China by 1010 Printing International Limited. 1 2 3 4 5 6 7 25 24 23 22 21 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 v BRIEF CONTENTS SECTION 1 CHAPTER 15 UNDERPINNINGS OF MENTAL HEALTH NURSING 1 Neurodevelopmental disorders 299 CHAPTER 1 CHAPTER 16 Mental health nursing – then and now 2 Neurocognitive disorders 317 CHAPTER 2 CHAPTER 17 Theoretical frameworks underpinning practice 16 Obsessive compulsive and related disorders 339 CHAPTER 3 CHAPTER 18 Ethics, law and mental health nursing practice 33 Trauma and stress-related disorders 351 CHAPTER 4 CHAPTER 19 Treatment modalities utilised in contemporary mental health Other disorders of clinical interest 367 service delivery 48 CHAPTER 5 SECTION 3 Mental health nursing as a therapeutic process 68 CONTEMPORARY ISSUES IN MENTAL CHAPTER 6 HEALTH NURSING 391 Using evidence to guide mental health nursing practice 91 CHAPTER 20 Suicide and non-suicidal self-injury 392 SECTION 2 CHAPTER 21 THE CLINICAL CONTEXT OF PRACTICE 106 Recovery and resilience in mental health 413 CHAPTER 7 CHAPTER 22 Assessment and diagnosis 107 The family’s role in contemporary mental health service delivery 435 CHAPTER 8 Schizophrenia spectrum and other psychotic disorders 127 CHAPTER 23 The multidisciplinary team 450 CHAPTER 9 Bipolar and related disorders 152 CHAPTER 24 Community mental health context 464 CHAPTER 10 Depressive disorders 171 CHAPTER 25 Cultural context in practice in Australia 482 CHAPTER 11 Anxiety disorders 195 CHAPTER 26 Mental health first aid 497 CHAPTER 12 Personality disorders 211 CHAPTER 13 Eating disorders 235 CHAPTER 14 Substance-related and addictive disorders 258 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 vii CONTENTS Guide to the text x CHAPTER 4 Guide to the online resources xiii Treatment modalities utilised in contemporary Preface xiv mental health service delivery 48 About the authors xv Introduction 49 Acknowledgements xvii Pharmacological interventions 49 Psychosocial interventions 52 Motivational interviewing 52 SECTION 1 Mindfulness-based interventions 57 UNDERPINNINGS OF MENTAL HEALTH NURSING 1 Cognitive behavioural therapy 58 CHAPTER 1 Rational emotive behaviour therapy 60 Mental health nursing – then and now 2 Dialectical behaviour therapy 61 Introduction 3 Structured problem solving 62 Belief in supernatural origins of illness and disease 3 Psychoeducation 63 Asylums of the world 5 Chapter resources 65 History of Australia’s asylums and mental health nursing 6 CHAPTER 5 Treatments throughout history 8 Mental health nursing as a therapeutic process 68 The role and identity of the mental health nurse in Introduction 69 contemporary service delivery 10 Interpersonal communication within the Chapter resources 13 nurse–consumer relationship 69 CHAPTER 2 Core elements of the communication process 70 Theoretical frameworks underpinning practice 16 Effective communication skills 70 Introduction 17 The therapeutic relationship 74 Health, mental health and human behaviour 17 Therapeutic use of self 75 Biomedical theories of personality 17 Developing, maintaining and terminating Psychodynamic theories of personality 18 therapeutic relationships 77 The behavioural/social cognitive orientation 23 The application of therapeutic communication The humanistic orientation 26 qualities and skills in the clinical context 80 The use of psychological and sociological theories of Chapter resources 86 personality in mental health nursing practice 27 CHAPTER 6 Relevance of psychological and/or nursing theories to Using evidence to guide mental health nursing practice 29 nursing practice 91 Chapter resources 30 Introduction 92 CHAPTER 3 What is evidence-based practice? 92 Ethics, law and mental health nursing practice 33 Implementing evidence-based nursing practice 93 Introduction 34 Critical appraisal of research evidence 99 Context of mental health legislation in Australia 34 Translating evidence into clinical practice 100 Legislation facilitating care and treatment of people Mental health outcome measures 101 with a mental health condition 36 Chapter resources 102 Mental health conditions, offending and the law 40 Legal and ethical dimensions of practice for nurses 41 SECTION 2 Compulsory care and treatment from a consumer THE CLINICAL CONTEXT OF PRACTICE 106 perspective 43 Chapter resources 44 CHAPTER 7 Assessment and diagnosis 107 Introduction 108 The context of practice 108 Assessment in mental health 108 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 viii Contents Comprehensive mental health assessment 111 Antisocial personality disorder (APD) 220 Modern diagnostic classification systems in mental Borderline personality disorder 224 health assessment 122 Chapter resources 232 Chapter resources 124 CHAPTER 13 CHAPTER 8 Eating disorders 235 Schizophrenia spectrum and other Introduction 236 psychotic disorders 127 Anorexia nervosa 236 Introduction 128 Bulimia nervosa 246 Aetiology 128 Binge-eating disorder 252 Diagnostic criteria schizophrenia 133 Males and eating disorders 253 Clinical presentation and the mental state examination 136 Chapter resources 254 Treatment 141 CHAPTER 14 Recovery and relapse prevention 146 Substance-related and addictive disorders 258 Other psychotic disorders 147 Introduction 259 Chapter resources 149 The historical context of substance use and misuse 259 CHAPTER 9 Understanding substance misuse, and defining Bipolar and related disorders 152 illicit and psychoactive substances 259 Introduction 153 Addiction and dependence 260 Aetiology 153 Substance use, misuse problems and substance Diagnostic criteria bipolar I and II disorder 155 use disorders 264 Clinical presentation and the mental state examination 158 Diagnostic criteria 274 Treatment 163 Biopsychosocial assessment framework 282 Recovery and relapse prevention 166 Clinical presentation and the mental state examination 285 Chapter resources 169 Chapter resources 294 CHAPTER 10 CHAPTER 15 Depressive disorders 171 Neurodevelopmental disorders 299 Introduction 172 Introduction 300 Aetiology and epidemiology 172 Neurodevelopmental disorders 300 Clinical presentation of depressive disorder in the Attention deficit/hyperactivity disorder 300 context of the mental state examination 176 Intellectual disability (intellectual disability disorder) 303 Treatment 177 Autism spectrum disorder 307 Persistent depressive disorder (dysthymia) 184 Risk assessment for people diagnosed Depression in the perinatal period 185 with a neurodevelopmental disorder 312 Depression and older people 186 The impact of caring for a person with a diagnosis of a Recovery and relapse prevention 189 neurodevelopmental disorder: who cares for the carers? 312 The family’s experience of depression 189 Chapter resources 313 Chapter resources 191 CHAPTER 16 CHAPTER 11 Neurocognitive disorders 317 Anxiety disorders 195 Introduction 318 Introduction 196 Ageing in Australia today: contemporary What is anxiety? 196 trends and issues 318 Aetiology 197 Healthy ageing 319 Diagnostic criteria 198 Elder abuse 319 Treatment of anxiety disorders 203 Mental health issues and older people 320 How do mental health nurses assist a person Delirium 321 experiencing anxiety? 207 Major neurocognitive disorders: dementia 323 Chapter resources 208 The impact of neurocognitive disorders on families 333 Chapter resources 335 CHAPTER 12 Personality disorders 211 CHAPTER 17 Introduction 212 Obsessive compulsive and related disorders 339 Defining personality and understanding general Introduction 340 personality disorder 212 Obsessive-compulsive disorder 340 Introducing cluster A, B and C personality disorders 213 Hoarding disorder 344 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300 Contents ix Trichotillomania 347 CHAPTER 22 Excoriation 348 The family’s role in contemporary mental Chapter resources 349 health service delivery 435 CHAPTER 18 Introduction 436 What is a family? 436 Trauma and stress-related disorders 351 Theories regarding family structure and functioning 436 Introduction 352 The family’s experience of caring for a loved Understanding trauma and stress-related disorders 352 one with a mental health challenge 438 Trauma and stress-related disorders 353 Families and resilience 440 Assessment and treatment of trauma and Mental health nurses work with families 441 stress-related disorders 357 Assessing family structure, function and dynamics 441 Developing an individualised plan of care for a person Strategies for promoting family resilience 443 experiencing a disorder as a result of trauma/stress 359 Consumers’ views of the family in supporting them Supporting family and other caregivers 362 through their journey 444 Supporting clients on the recovery journey 363 Chapter resources 446 Chapter resources 363 CHAPTER 19 CHAPTER 23 The multidisciplinary team 450 Other disorders of clinical interest 367 Introduction 451 Introduction 368 The multidisciplinary team 451 Conduct disorder 368 Characteristics of effective teamwork 453 Oppositional defiant disorder 373 Becoming a member of the multidisciplinary Dissociative identity disorder 375 team: integrating into the team as a student nurse 457 Gender dysphoria 378 Research on consumers’ views on the role of the Conversion disorder 382 mental health nurse as a member of the Factitious disorder 384 multidisciplinary team 459 Chapter resources 387 Chapter resources 461 CHAPTER 24 SECTION 3 Community mental health context 464 CONTEMPORARY ISSUES IN MENTAL Introduction 465 HEALTH NURSING 391 Historical factors of community mental health care 465 CHAPTER 20 Social determinants of mental health 465 Suicide and non-suicidal self-injury 392 Primary mental health care 466 Introduction 393 The roles of the mental health nurse 468 Suicide 393 Specialised community services 471 Theories of suicide 397 Chapter resources 477 Cultural considerations and vulnerable groups 397 CHAPTER 25 The role of the media 399 Cultural context in practice in Australia 482 Assessing risk of suicide 400 Introduction 483 Self-harm/injury (non-suicidal self-injury) 404 Historical and cultural determinants 483 Assessment and collaborative care for consumers Social determinants 486 who experience self-injuring behaviours 406 Indigenous Australians’ social and emotional well-being 488 Chapter resources 409 Culturally safe practice: racial issues 491 CHAPTER 21 Chapter resources 493 Recovery and resilience in mental health 413 CHAPTER 26 Introduction 414 Mental health first aid 497 Recovery and recovery-oriented practice 414 Introduction 498 Trauma-informed practice 416 Introduction to the MHFA acronym 498 Working with people 420 How to apply MHFA to various mental health problems 500 Be an ‘agent of change’ for recovery-oriented and Cultural considerations of MHFA within vulnerable groups 509 trauma-informed practices 427 Mental health first aid for carers 511 The peer workforce and recovery 427 Chapter resources 511 Recovery ethics and reflection 429 Chapter resources 431 Appendix 514 Glossary 517 Index 525 Copyright 2022 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300