Acceptance and Commitment Therapy (ACT) for Mental Health Issues

Mental Health Issues in Australia

Discuss about the Acceptance and Commitment Therapy.

According to Mental Health Services in Australia (MHSA), the most prevalent mental health illness in Australia is depression (Stuart, 2014). It is the major cause of disability in Australia and around 3 million people experience depression. More than 45 percent of Australians experience depression and in a year, around 1 million adults suffer from this mental health condition. Among the adults (aged 16-85) are affected by affective disorders like depression (6%) of the total population. One in five (20%) experience depression in the last 12 months and in the year 2015, an estimated 4 million people suffer from depression. Around one in six women and one in eight women suffer from depression levels as reported by Australian Bureau of Statistics (ABS). Only 35% of the total Australians seek treatment for depression especially men as compared to women. Hospital admissions for depression are rare and less as much as 1% over a year period (Brown et al., 2012). Postnatal depression is also witnessed among mothers as they experience mild to severe depression. 

In Australia in the year 2017, around 3000 suicides were reported that resulted in a great impact on the family members, friends and relatives. Over the past few decades, about 2100 Australians died every year due to suicide and contributed to 1.4% of total deaths in Australia. The suicide rates among the children in Australia below the age of 15 years has increased by 92% and mostly among men, regional and rural dwellers (De Leo, 2015). According to Australian hospital databases, females are more likely to injure themselves as compared to males; however, suicide picks have increased for men. In 2015, around 12.6 per 100,000 (3027 of total cases) Australians attempt suicide and likely to increase in the next ten years (Cheung et al., 2012). This accounts for eight suicide deaths each day in Australia. Suicidal deaths among men are three times higher as compared to females. The highest suicidal rate is among the Aboriginal and Torres Strait Islander peoples as compared to the national rates. About 52% of suicide rates were reported among Indigenous people and 1.8% among the non-indigenous people. There are around 65,300 suicide attempts every year in Australia.

The risk for depression is highest among the Aboriginals and Torres Strait Islanders (TSI) in Australia. They are psychologically depressed and the main cause for the depression is trauma, grief and loss. The impact of colonization, history of invasion, premature mortality, loss of land, culture, and family separations are the major causes of depression among the Aboriginals and TSI people (Heffernan et al., 2012).

Factors Contributing to Mental Health Risks

The suicidal rates are high among the Australian young adults and are a serious issue as they are potentially at risk of committing suicide. It is the leading cause of death among the young adults of the age 15-44 years and in 2015, one-third of the population (33.9%) among 15-24 years and 27.7% among 25-34 years population. Suicidal rates among the 15-24 years are at the highest and it is found that it is higher among men than in women. The young adults in Australia are vulnerable to suicides and occurring in clusters among the youths (Clifford, Doran & Tsey, 2013).

Two factors that contributed to Jonathon’s mental health risks and concerns in the scenario A are the death of his mother due to breast cancer and as his father has a hectic schedule, he was unable to spend quality time with his father as he has a positive relationship with him. After he lost his mother, there were feelings of grief and loss that contributed to his mental health risk and concerns. He misses his mother a lot and experience grief and loss as his closeness with his mom and dependence was indispensable. His mother died of breast cancer and that contributed to his deteriorating mental health condition. He started experiencing grief and sleep problems. He started experiencing depression and sadness because of that thought of never seeing his mother again. Moreover, he showed signs of anxiety that affected his relationship with Leah. They started facing turmoil and on the day f his suicide attempt, she spoke about ending the relationship (Eisma et al., 2013).

On the other hand, after his mother’s death, his father was the only support. He shared a positive relationship with his father and wanted to spend quality time with him. However, his father was busy and was unable to spend time with him and as a result, this started hampering his personal relationship with Leah, as he was emotionally distressed as a result of emotional distance. As a result, his relationship was on the verge of ending. Moreover, he started feeling and weak due to lack of appetite and could not submit his assessments on time leading to suspension from the training program. These factors contributed to his deteriorating health and mental status (Ziaian et al., 2012).

Within the professional healthcare team, mental health issues need to be addressed as it has legal and ethical considerations associated with it. There is a need to protect the patient from self-harm and protect the public from the client. In the case scenario, Jonathon’s mental health condition can make him prone to self-harm and provide emotional support by his family so that they are also protected. In Mental Health Act 2007, two ethical considerations like beneficence and non-maleficence are important to safeguard Jonathon from risk in the case study. In psychiatric nursing, they have the ethical responsibility of duty to do good (beneficence) and non-maleficence that is cause no harm that respect patient autonomy. In the case scenario A, after his suicide attempt, it is evident that the mental healthcare team has the responsibility to provide the best treatment and care (beneficence) and duty to do good safeguarding him from self-harm. As he is prone to self-harm, the mental health professional team has the responsibility to cause no harm to him and provide best quality of care that balances his safety with choices. The professional healthcare team has the responsibility to remove or prevent the harm that is to improve Jonathon’s situation by empowering and providing him emotional support. They have ethical responsibility to protect him from causing harm and have the obligation to help him and his family through this crisis (Johnstone, 2015).

Ethics and Responsibilities of Mental Healthcare Teams

The priority and urgent mental health risk are the immediate effect of suicidal attempt that is affecting his health and quality of life. It may lead to depression and affect his other areas of life like his relationship with his father and Leah. It is so overwhelming that he is unable to cope up and end up harming himself to end the deep emotional pain that he is facing.

On a priority basis, nurses and midwives have the responsibility to safeguard Jonathon. There is risk for self-directed harm that might be physical or emotional harm to him. There might also be impaired social interaction due to dysfunctional interaction with his father and Leah. There is verbalized discomfort and disrupted family interactions that devoted to loneliness and lack of support system. There is also fear of rejection as Leah talked about ending of the relationship. These feelings make him prone to distressed mood and feelings of suicide.

It is important for the nurse to assess the suicidal level and precautions that are needed to protect Jonathon. The rationale behind this intervention is that it would help to assess the risk level and provide safe environment and supervision required for the client. This has an impact that it would prevent him from self-harm and getting suicidal thoughts. It is also important for the nurse to take an active part in the initiation of communication and identify feelings that lead to suicidal attempt and feelings of suicidal attempt. This is important, as it would help him to socialize and provide him ample time to talk to people and enhance social interaction. This has a positive impact, as it would help him to prevent thoughts of suicide and lack of social support that is greatly hampering his quality of life (Fortinash & Worret, 2014).

The mental health problem for Jonathan is depression. It is important for the nurses to identify the psychosocial and physical needs and provide relevant interventions. It is also important that there should be trust and patience along with presence, active listening and beam with the client attitude. Nurses should assess the reactions and feelings of Jonathon and provide supportive interventions so that he is able to recognize and deal with his feelings.

Interpersonal therapy (IPT) would be helpful in focusing on the problems in the personal skills and relationships that have a significant effect on Jonathon who is experiencing depression. It would also help to recognize the patterns in his relationships that is making him vulnerable to depression. This therapy is helpful in identifying the patterns and provides focus on the relationship improvement like grief and loss that is the main cause of depression in Jonathon (Cuijpers et al., 2011).

Acceptance and Commitment therapy (ACT) is a psychological intervention would help him to accept his life situation and embrace the private events that have happened in his life. This helps to increase psychological flexibility in Jonathon and has a potential impact on him to enhance his present contact ability to accept his life situations and persist or change his behaviour-providing acceptance to reality (Pots et al., 2016).

References

Brown, A., Scales, U., Beever, W., Rickards, B., Rowley, K., & O’Dea, K. (2012). Exploring the expression of depression and distress in aboriginal men in central Australia: a qualitative study. BMC psychiatry, 12(1), 97.

Cheung, Y. T. D., Spittal, M. J., Pirkis, J., & Yip, P. S. F. (2012). Spatial analysis of suicide mortality in Australia: investigation of metropolitan-rural-remote differentials of suicide risk across states/territories. Social Science & Medicine, 75(8), 1460-1468.

Clifford, A. C., Doran, C. M., & Tsey, K. (2013). A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand. BMC public health, 13(1), 463.

Cuijpers, P., Geraedts, A. S., van Oppen, P., Andersson, G., Markowitz, J. C., & van Straten, A. (2011). Interpersonal psychotherapy for depression: a meta-analysis. American Journal of Psychiatry, 168(6), 581-592.

De Leo, D. (2015). Australia revises its mortality data on suicide.

Eisma, M. C., Stroebe, M. S., Schut, H. A., Stroebe, W., Boelen, P. A., & van den Bout, J. (2013). Avoidance processes mediate the relationship between rumination and symptoms of complicated grief and depression following loss. Journal of Abnormal Psychology, 122(4), 961.

Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric Mental Health Nursing-E-Book. Elsevier Health Sciences.

Heffernan, E. B., Andersen, K. C., Dev, A., & Kinner, S. (2012). Prevalence of mental illness among Aboriginal and Torres Strait Islander people in Queensland prisons. Medical Journal of Australia, 197(1), 37.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.

Pots, W. T., Fledderus, M., Meulenbeek, P. A., Peter, M., Schreurs, K. M., & Bohlmeijer, E. T. (2016). Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial. The British Journal of Psychiatry, 208(1), 69-77.

Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health Sciences.

Ziaian, T., de Anstiss, H., Antoniou, G., Baghurst, P., & Sawyer, M. (2012). Resilience and its association with depression, emotional and behavioural problems, and mental health service utilisation among refugee adolescents living in South Australia. International Journal of Population Research, 2012.