One night after my shift was over, I was returning to my place from the hospital. In the way, I heard someone yelling at people. The voice was seemed to be of an old man. As soon as I reached close to him, I found that he had a half-filled bottle of wine in his hands and he was yelling at people. He also could not maintain his body balance and was staggering on his feet. He looked cold and disheveled as well. He had a medical history of mental illness and had recently been discharged from the hospital from the acute inpatient mental health ward. His name is Bill who is a homeless man and he sleeps out in the cold. As I passed by him, he also yelled at me saying, ‘watch your back or they will get you’.
The moment I heard his voice I realized that he must be a drunken man yelling out on people on the road. After looking at his appearance with a wine bottle in his hands I thought that he was a drunk old and a poor man. The moment he yelled at me, I immediately stepped back to maintain a distance from him ensuring my safety. I also felt pity for him as it was cold outside and he was a homeless and drunk person who could not even stand properly in his feet.
As Bill was yelling on people with a bottle of wine in his hands, so people maintained a distance from him thinking that a drunken man might hurt them. Nobody stepped forward to help him by either admitting him to the hospital or by taking him to the government shelter homes for shelter or treatment. The society looks upon such people with no respect and rarely treats them with dignity. Society rarely relates to the point that a drunken individual might have mental illness issues as well (Muir-Cochrane et al., 2018). The only positive outcome was one of the people on the road took Bill with him to hospital for treatment and health care services.
Being a nurse, it was my duty to approach Bill and get him admitted to the hospital, but I failed as a nurse by not reflecting my responsibilities and duties. An individual with behavior like Bill might also have mental illness issues but a potential bias developed regarding him stating that such behavior is similar to that of alcohol addicts. According to Hansson et al. (2013), health professionals are stereotyped for addicts and exhibit a negative attitude. The society too considers such individuals as drinkers or alcohol addicts but never thought the other way around that they might have developed mental illness. The patient after recoverying from mental illness can develop the same issues again with time and age. Poor knowledge and biased thinking among society and health care professionals can lead to increased risk of developing mental illness issues in individuals who have recently recovered (Worley, 2020).
The assumption made was that addicts like bill which could have been due to alcohol or drugs. However, these were illogical and potential biases because I learned that he had recently recovered from acute inpatient mental illness but his alcohol addiction was affecting his brain activities and making him more prone to develop his mental illness issues again. The personal/professional lessons learned from this event was that a nurse must reflect positive attitude for mentally ill and addict patients and give them complete and quality care. It was found that an individual with addiction or mental illness is often restricted from many basic facilities like clean water, health care services, shelter, and sanitization facilities (Worley, 2020). This is because the addicts and mentally ill patients are not considered as a part of society.
I need to develop a positive attitude for the mentally ill and addict patient. A nurse should always aim at providing comprehensive, patient-centered, and quality care to the patients not only inside the hospital but such attitude and values should also be exhibited outside the hospital as well. If I came across such a situation in the future then immediate actions will be taken concerning the patient. The patient should be admitted to the hospital or taken to the health centers to provide treatment. Alcohol addiction is associated with the development of mental illness as such addictions disturb the neurotransmitters in the brain resulting in mental illness symptoms or mood disorders (de Jacq et al., 2016). If a mentally ill patient is not treated in time then with age and time his/her condition gets worse with other related health issues like aggression, depression, or stress. According to Nash et al. (2017), discrimination and negative attitude are still prevalent in society for mentally ill patients, thereby making it difficult for them to get health services, rehabilitation, or treatment.
The isolation of addicts by society and poor quality care makes them feel lonely; this may also stigmatize their mental illness, thus affecting their health to a great extent. So society’s and health professionals’ perspectives and attitudes need to be changed. The cases of stereotyped thinking leading to ineffective care to such individuals should be changed and if any of such cases are found then they should be strictly punished as it is a right of every patient to get proper and complete access to the health care services. Such individuals without homes should also be made aware about the services like homelessness and social housing that support homeless people by providing them with shelter or emergency shelter where they can sleep to send their cold nights. Moreover, the families or the workers in the health care sector also should encourage others, not to show violence and discrimination for mentally ill or addicts as this might prevent them from living a happy and normal life, andwill make their health condition worse with time.
In the future,if the same situation arises, then the patient/individual will be immediately taken for admission to a mental hospital or other general health care centers for treatment. Mental health awareness programs should be organized for both the health care professionals as well for the society to make them aware that mental illness and addicts are correlated in a few cases. Such programs will also reduce the prejudice among the health professionals that a patient show symptoms of an addict but there can be chances of development of some mental illness issues with him/her. According to Okkels et al. (2018), the members of health care services providers show a negative attitude that prevents a patient with mental illness to get treatment for mental health. Alcohol addiction is also found to be a more common problem among people with serious mental illnesses. However, it can never be said that alcohol causes mental illness but high intake of alcohol increases the risk of reoccurring of mental health problems if the patient had a similar history or risk of development of serious health complications like high depression, mood swing or others that can lead to mental illness.
Therefore, a patient like Bill should be double diagnosed as he had a medical history of mental illness and he also seemed to be an alcohol addict. Such patients should be diagnosed with mental illness problems and for alcohol or drug addictions as well. This provides them patient-centered and effective care. According to Knaak et al. (2017), many associated health problems are often seen in patients with mental illness and addiction-like depression, insomnia, bipolar disorder, obsessive-compulsive disorder (OCD), and others. So the health professionals should also detect the symptoms of these mentioned health issues as well. Such patients should be sent for outpatient rehab, inpatient rehab, or detoxification. Moreover, the patient should be made aware of his health issues and treatments. He/she should be involved in shared decision making as this will increase the quality of care provided to the patient.
The society should be encouraged to show empathy and care for such individuals, get them admitted to the hospital, or inform the health care centers about such patients so that they can take them for treatment. 24/7 centers provide health care services to patients with mental illness and addiction, where patients like Bill can be admitted. According to Okkels et al. (2018), unplanned urbanization has led to restricting the patents or individuals with mental illness or addiction to get access to mental health care. Society’s behavior poses many challenges for such individuals like no access to homes, social services, or basic supplies, there has to be changed by making them aware by organizing programs and conduction counseling. Moreover, such individuals should be provided with homes like under the homelessness and shelter mission by the Australian Red Cross. This mission aims at providing help and support to the homeless people in Australia by providing them with homes ensuring their safety and developing pathways to eliminate the causes of homelessness.
deJacq, K., Norful, A. A., & Larson, E. (2016). The variability of nursing attitudes toward mental illness: An integrative review. Archives of Psychiatric Nursing, 30(6), 788-796.
Hansson, L., Jormfeldt, H., Svedberg, P., &Svensson, B. (2013). Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness? International Journal of Social Psychiatry, 59(1), 48–54. https://doi.org/10.1177/0020764011423176
Knaak, S., Mantler, E., &Szeto, A. (2017, March). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2), 111-116.
Molina-Mula, J., González-Trujillo, A., &Simonet-Bennassar, M. (2018). Emergency and mental health nurses’ perceptions and attitudes towards alcoholics. International Journal of Environmental Research and Public Health, 15(8), 1733.https://doi.org/10.3390/ijerph15081733
Muir-Cochrane, E., Barkway, P., &Nizette, D. (2018). Pocketbook of Mental Health.Elsevier.
Nash, A. J., Marcus, M. T., Cron, S., Scamp, N., Truitt, M., & McKenna, Z. (2017).Preparing nursing students to work with patients with alcohol or drug-related problems. Journal of Addictions Nursing, 28(3), 124-130.
Okkels, N., Kristiansen, C. B., Munk-Jørgensen, P., & Sartorius, N. (2018). Urban mental health: Challenges and perspectives. Current Opinion in Psychiatry, 31(3), 258-264.https://doi.org/10.1097/YCO.0000000000000413
Worley, J. (2020). Self-injury as an addictive disorder. Journal of Psychosocial Nursing and Mental Health Services, 58(6), 13-16. https://doi.org/10.1007/s11469-016-9682-2
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