| NRS311: Life-stage Considerations: Child, Adolescent and Family Health. |
| Mental Health and how it Impacts on Nursing in Rural Australia |
| Word count: 2050 |
The mental health of school going children aged between 8 – 12 years has received limited research attention in Australia. There is some acknowledgement by researchers in Australia that, despite the absence of data, it is probable that psychiatric disorder rates are higher in rural areas as compared to metropolitan areas. With respect to young school going children, data have for some years shown that Australia has the highest levels of suicide across the globe, especially among rural young males (Sawyer, et al. 2012). NRS311: Life-stage Considerations: Child, Adolescent and Family Health.
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Department of Social Services (2014) points out that recent statistics show that the death levels as a result of suicide for males aged 8- 12 years tend to rise with rising remoteness to the extent that the degree of suicide for remote regions, (43 per every 100 000 children) is double as high as in metropolitan areas (24 per every 100,000 children). With respect to other mental health issues, rural children are thought to experience more troubles with coping and stress when compared with urban children. Although rural children have shown general higher levels of depression, this has not been studied systematically in Australia according to DoHA (2013).
Mental Health Associated With A Primary School Aged Child between 8-12 Years
Results from a survey carried out in 2013 – 14, revealed that almost 1 in every 7 youth (14 percent) of children and adolescents aged between 8 – 12 years were assessed as to have mental health problems for the period ranging from 2013 to 2014, which is equal to 560,000 children (Australian Institute of Health and Welfare, 2015). Among the most common forms of mental health problem among Australian children was the Attention Deficit Hyperactivity Disorder (ADHD) – representing a little over 7 percent or about 300,000 children- followed closely by anxiety disorders – slightly below 7 percent- major depressive disorder – 3 percent- and conduct disorder – 2 percent as cited by Patel et al. (2010). Almost a third of the 8 – 12 year olds with a mental health disorder had two or more mental problems at some time between 2013 and 2014. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.
The statistics revealed that male children (16 percent) were more likely to experience mental health disorder than females (12 percent) (Chia, et al. 2013). The prevalence of mental illness among slightly higher for females aged between 10 to 12 (13 percent) than young females aged between 8 to 10 (11 percent) as asserted by Atkins, Heller, DeBartolo, Sandel (2014). The prevalence of the mental illness among males, however, did not differ significantly with age. Mental health disorders also comprise low prevalence situations. This group comprises psychotic disorders and a wide range of other conditions including severe personality disorder and eating disorders as McGorry, Purcell, Hickie & Jorm (2007) explained. Notably, mental health problems are characterized by profound distortions of perception, emotional and thinking response (Venning, et al. 2013).
The Extent and Impact of Mental Health on Nursing Practice in Rural Australia
Mental illnesses can vary in severity and be persistent or episodic in nature. According to Gulliver, Griffiths & Christensen (2010), a review that was conducted recently revealed that 2- 3 percent of children in rural Australia experienced a severe mental illness, as judged by degree of disability caused, duration and intensity of symptoms as well as diagnosis. This data is not confined to children with psychotic illnesses, who represent approximately a third of individuals with severe mental problems; it also comprises children with disabling and severe forms of anxiety and depression. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.
Behavioural and mental disorders, such as anxiety and depression are important drivers of morbidity and disability among rural children in Australia. For rural Australia, mental illnesses are estimated to be responsible for about 12. 9 percent of the total disease burden in 2010, ranking third as a broad disease group after cardiovascular and cancer disease (McGorry, Bates & Birchwood, 2013). According to a study conducted in 2013, anxiety and depression disorders among rural children were linked with a rising danger of suicide and ischaemic heart disease.
Due to the absence of health professionals in Australian rural areas with specialized mental health illness, there have been efforts to up-skill practitioners in the primary care segment in order to deliver mental illness care (McGorry, Bates & Birchwood, 2013). Consensus on the fruitfulness of this strategy in terms of improved patient outcomes and consumer satisfaction remains in doubt. A study that was conducted in the rural Australia established that despised the rising need for nurses in rural regions to offer mental illness care, they actually provide, in reality, less mental illness care compared with urban nurses (McGorry, et al. 2007). With respect to child mental illness services, it is not evident how successful the delivery of mental health services in primary health care may be when a family structure approach to the treatment of children living at home is regarded good clinical practice. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
Conclusively, it is unclear presently whether the stigma of mental health is more predominant in rural Australian communities than urban areas, or if the stigma experience is more crucial in rural setups as a result of social proximity. Availability of transport and cost is a substantial issue encountered by parents of children attempting to access specialist mental illness services. young individuals who do not car or do not driving license are required to travel regional facilities to access professional assistance, and in the same line, access to public transport structures in rural setups is non- existent or poor (Atkins, Heller, DeBartolo, & Sandel, 2014). Various efforts at alternative structures of mental illness service delivery to overcome the challenge of distance have been pursued in the Australian context with restrained success. These include visiting/ mobile services, satellite services and tele psychiatry (Rickwood, Van Dyke & Telford, 2015).
The mental illness is influenced by a number of factors including workplace, life experiences or other aspects and the economic and social conditions that influence day- to- day lives. These economic and social conditions are called referred to as the social determinants of health and are some of the crucial aspects that influence on physical and mental health. Studies indicate that the social determinants of health can be more significant than lifestyle choices or health care in influencing health. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.. In Australia, the social determinants of health comprise: aboriginal status, early life, education, health services, food insecurity, race, sexual orientation, social safety net, and income distribution, gender identity, working conditions, job security and unemployment (Rickwood, et al. 2014). Three social determinants of health are fundamentally important for mental health: social inclusion, access to economic resources as well as freedom from violence and discrimination.
Children experiencing mental health are, by the nature of their disease, possibly the most vulnerable and politically powerless group within society. The revelations of mental disorder frequently include withdrawal, distortions in thinking, self- doubt and low self- esteem (Venning, Wilson, Kettler & Eliott, 2013). As a result, this group of individuals finds it difficult to achieve autonomy and experiencing challenges advocating for themselves. Ethical concerns associated with mental illness, and the nursing practice in rural areas is confronted often with the need for making ethical decisions. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
Mental health issues refer to a range of behavioural, emotional and cognitive disorders that affect with the productivity and lives of children. However, there is no single definition of mental health across various professions and jurisdictions. In determining the suitable definition of mental disorder for this assignment, the mental health act of 1990 that defines mental disorder as a condition that is characterized by the presence of conditions such as hallucinations, a severe mood disturbance, repeated or sustained irrational behaviour. It also goes further and states that it is a serious thought disorder that seriously mars, or either permanently or temporarily, the mental functioning of an individual (Cross, et al. 2016). It is worth acknowledging that common mental disorder such as depression and anxiety disorder. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
W.H.O. – Social determinants of health: PHC and the nurses’ role, responsibilities and governing legislation in Australia
Nurses in remote areas general live and work in isolated regions – among indigenous society, on islands, interment centres, refugee camps, or fishing groups. In addition, they work in specialist outreach, emergency retrieval services, as well as in remote regional areas in quality improvement, management, professional support, public health, education, research or strategic development (Chia, et al, 2013). For numerous isolated remote areas in Australia, registered nurses offer the first point of contact for a wide range of PHC care functions that, in urban areas, would normally be offered by general practitioners, allied health professionals and suitably trained specialists. In more remote areas in Australia, nurses frequently act as the only PHC providers and are often required to extend their skills as a result of community demand and the absence of any other aspect of nursing support. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
In this situation, the expert remote regions nurse practices in a holistic, collaborative and comprehensive manner, offering advanced care to families and individuals across the lifespan. As a result, they offer care for children who are chronically and/ or acutely ill and also illness prevention programs (Australian Institute of Health and Welfare, 2015). The expert remote region nurse in conjunction with colleagues on site uses the tools of communication, health education, advocacy, clinical decision making, for groups they are managing. Moreover, they employ/practice public health and advanced nursing practice, hands on care, surveillance and prevention to manage disease and illness, as well as promote improve health results for the groups in which they are practicing, which may be isolated and disadvantaged. Rural nurses offer care across the lifespan (Sawyer, et al 2012).
Consequently, they require knowledge and skills in a wide range of areas such as child and in fact health – including in chronic illness management and communicable diseases. They utilize best management protocols and practice treatment to offer and co- ordinate the various range of care that is necessary in remote areas. All nurses practicing in isolated and rural areas are required in order to develop their competency and knowledge so that they can perform at an advanced degree. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
In Australian traditions, significant emphasis has been placed on primary care instead of primary health care. While these terms have been applied interchangeably, generally, they represent two varied philosophical approaches to rural health care. PHC main focuses on improving the general health of individuals and communities. Importantly, nurses in the rural areas acknowledge that improving health via PHC can only be realized by placing heath care in its cultural, economic, environmental, social and political context (Patel et al. 2010). The wellbeing and health of school-aged children is seen as a crucial aspect in the child’s ability to achieve their maximum potential as humans. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
Conclusion
In conclusion, mental health among rural school aged children in Australia has received limited attention in the world of academia. However, despite this acknowledgement, psychiatric disorder rates are higher in remote areas. Children in rural areas are thought to experience more troubles with coping and stress in as far as mental disorder is concerned. Available statistics indicate that there is a wide discrepancy between females suffering from mental disorders of varied ages. Among the males, this variation was evident. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.. Mental health problems are characterized by profound distortions of perception, emotional and thinking response. Behavioural and mental disorders, such as anxiety and depression are important drivers of morbidity and disability among rural children in Australia.
Due to the absence of health professionals in Australian rural areas with specialized mental health illness, there have been efforts to up-skill practitioners in the primary care segment in order to deliver mental illness care. Studies indicate that the social determinants of health can be more significant than lifestyle choices or health care in influencing health. In Australia, the social determinants of health comprise: aboriginal status, early life, education, health services, food insecurity, race, sexual orientation, social safety net, and income distribution, gender identity, working conditions, job security and unemployment .Nurses in rural areas general live and work in isolated regions – among indigenous society, on islands, interment centres, refugee camps, or fishing groups. In addition, they work in specialist outreach, emergency retrieval services as well as in remote regional areas in quality improvement, management, professional support, public health, education, research or strategic development. In most instances, nurses in rural areas offer the first point of contact for various PHC care functions. NRS311: Life-stage Considerations: Child, Adolescent and Family Health..
References
~ Atkins D, Heller SM, DeBartolo E, & Sandel M. (2014). Medical-Legal Partnership and Healthy Start: integrating civil legal aid services into public health advocacy, Journal of Legal Medicine; 35(1): 195-209.
~ Australian Institute of Health and Welfare (2015). Mental health services—in brief 2015. Cat. no. HSE 169 Canberra: AIHW.
~ Chia, A., Assan, B., Finch, E., Stargatt, R., Burchell, P., Jones, H., & Heywood-Smith, J. (2013). Child & Adolescent Mental Health: Innovations in practice: Effectiveness of specialist adolescent outreach service for at-risk adolescents. Youth Studies Australia, 32(3), 61-62.
~ Cross, S. P., Hermens, D. F., Scott, J., Salvador‐Carulla, L., & Hickie, I. B. (2016). Differential impact of current diagnosis and clinical stage on attendance at a youth mental health service. Early intervention in psychiatry.
~ Department of Social Services (DSS) (2014). Characteristics of Disability Support Pension Recipients, June 2013. Canberra: DSS. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.
~ DoHA (2013). National Mental Health Report 2013: tracking progress of mental health reform in Australia 1993–2011. Canberra: Commonwealth of Australia
~ Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC psychiatry, 10(1), 113.
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~ McGorry, P. D., Tanti, C., Stokes, R., Hickie, I. B., Carnell, K., Littlefield, L. K., & Moran, J. (2007). headspace: Australia’s National Youth Mental Health Foundation-where young minds come first. Medical Journal of Australia, 187(7), S68.
~ McGorry, P., Bates, T., & Birchwood, M. (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), s30-s35.
~ Patel V, Lund C, Hatheril S, Plagerson S, Corrigall J, Funk M, et al (2010). Mental disorders: equity and social determinants. In: Blas E, Kurup AS, editors. Equity, social determinants and public health programmes. Geneva: World Health Organization; p. 115-34.
~ Rickwood, D. J., Telford, N. R., Parker, A. G., Tanti, C. J., & McGorry, P. D. (2014). Headspace—Australia’s innovation in youth mental health: who are the clients and why are they presenting. Med J Aust, 200(2), 108-11.
~ Rickwood, D., Van Dyke, N., & Telford, N. (2015). Innovation in youth mental health services in Australia: common characteristics across the first headspace centres. Early intervention in psychiatry, 9(1), 29-37.
~ Sawyer, S. M., Afifi, R. A., Bearinger, L. H., Blakemore, S. J., Dick, B., Ezeh, A. C., & Patton, G. C. (2012). Adolescence: a foundation for future health. The Lancet, 379(9826), 1630-1640.
~ Venning, A., Wilson, A., Kettler, L., & Eliott, J. (2013). Mental health among youth in South Australia: A survey of flourishing, languishing, struggling, and floundering. Australian Psychologist, 48(4), 299-310. NRS311: Life-stage Considerations: Child, Adolescent and Family Health.