When I was a nursing student starting my clinical rotation in a psychiatric unit, I was apprehensive; I'd heard horror stories. Although my experiences behind the locked doors dispelled some myths, I did learn a frightening fact: Many of my patients had little hope of getting better. I finished the rotation feeling I hadn't made an impact.
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Years ago, many people with severe mental illness were treated with medications such as haloperidol, which made them feel and look like zombies. Isolated and sedated, they couldn't gain much insight into their illness and relied on the mental health care team to decide their fate. No wonder the inpatient unit seemed like a prison.
Things have changed. As the article on bipolar disorder starting on page 58 points out, new psychotropic medications have fewer unwanted mind- and spirit-numbing effects. People in crisis still need hospitalization, but their stays are typically shorter and their involvement in community-based treatment greater. Recovery-based care focuses on helping people with mental disorders live more normal lives.
The Surgeon General's report on mental health affirms the significance of the "consumer movement" in which people seeking to shed the stigma associated with mental illness call themselves mental health "consumers" or "survivors." Unlike psychiatric patients years ago, these consumers advocate self-determination and speak out on mental health issues. More involved in the community, they support one another in programs sponsored by such organizations as the National Alliance on Mental Illness and the Depression and Bipolar Support Alliance. And more and more mental health agencies are hiring consumers to share their wisdom with others.
Support mental wellness in your practice. Learn about the new medications and techniques to manage mental disorders. Educate and encourage the mental health consumers you meet. If you detect signs of a mental disorder in someone getting care for a medical problem, ask questions and refer him to a mental health practitioner if necessary. In a recent American Psychological Association survey, 47% of respondents said they didn't know when it was appropriate to seek help from a mental health practitioner.
The first week of October is Mental Illness Awareness Week. It's a great time to increase your understanding of mental illness, advocate for those who have it, and enter the consumer age.
Cheryl L. Mee, RN, BC, CMSRN, MSN
Editor-in-Chief, Nursing2006, Cheryl.Mee@wolterskluwer.com