Mental health articles

OF mental health care and mentally ill

Principles of nursing a person experiencing depression

 The main role of the nurse is to build a collaborative relationship with the person experiencing depression. This relationship is the core of working with the depressed person. It is a relationship that must be built on genuine respect and openness in which the nurse is seen as a partner in the depressed person’s recovery. When examining the principles of nursing an individual with depression, it is important to bear in mind the standards of the National Service Framework (NSF) for Mental Health, some of which are particularly relevant to the treatment of depression. Given the high prevalence of depression in primary health care, and the fact that 90 per cent of people with depression are treated in primary health care, Standard 2 is important. Standard 2 states: Any service user who contacts their primary health care team with a common mental health problem should:

have their mental health needs identified and assessed;

be offered effective treatments, including referral to specialist services for further assessment, treatment and care if they require it.

It is therefore important that nurses working in primary health care are familiar with the signs of depression and are able to detect them. It is also important that effective treatments are offered to people who have been detected as having depression. Again this is particularly relevant in primary care since research discussed earlier suggests that people with depression in primary care are often prescribed sub-therapeutic doses of anti-depressants, and there is a shortage of suitably trained professionals to offer cognitive behavioural therapy. It is also important that the provisions of Standard 3 of the NSF for Mental Health are met, that is:

Any individual with a common mental health problem should:

be able to make contact round the clock with the local services necessary to meet their needs and receive adequate care.

be able to use NHS Direct, as it develops, for first-level advice and referral on to specialist helplines or to local services.

Individuals with depression need to be able to seek help and feel able to discuss their feelings with primary health care staff. Many of the feelings and thoughts engendered by depression are intensely personal and difficult to discuss. Nursing staff need to be aware of this and should take time to build a relationship with depressed people and enable them to discuss their problems. Although this sounds simple, the demands of modern primary care mean that primary care practitioners are often busy and under considerable pressure, and it is difficult to spend time discussing an individual’s feelings and problems. However, this is exactly what a person experiencing depression needs. It is important, therefore, that primary care staff recognize this need and ensure that adequate time is allowed for discussion when making appointments for people with depression. The starting point for the nursing care of a person with depression is the preparation of a care plan. It is suggested that five areas are given particular attention, whether in the community or in hospital. These are outlined below and then illustrated through reference to a case study.

 

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