1. Use of Drugs in Mental Health
Assoc. professor E. A. Lothe
Winter School, Maribor University
Maribor, Slovenia, Nov 2015

2. Goals for this lecture: The students should
Acquire some basic insight into Mental Health
Acquire some basic knowledge of Psycho-farmacological groups of medicines
Acquire some basic insight into when, how and why psychofarmacological medication is used –
and how this affects the patient

3. Goals for this lecture, cont.:
The students should
Acquire some knowledge on non-medical treatments and significant factors for resilience and recovery.
Reflect on use of drugs from ethical and legal perspectives

4. Perspectives on mental health
Biological
Psychic (mental)
Psycho-social
Cultural
Mental suffering can be described as Outside-perspective
Vs/ Inside-perspective:
That which is experienced by the patient

5. Perspectives, cont.: Illness/wellness Symptoms/external and internal
Stigma
Exclusion/integration

6. Some common mental illness diagnoses
Psychosis – altered perception of reality
Depression – varying degrees of severity
Suicidal ideation
Anxiety – a number of variables
Bipolar variations – affective disorders
Eating disorders
Susbstance dependency

7. Models for treatment of mental illness
Hospitalization
Outpatient treatment
Voluntary vs/coerced treatment
Medication
Medication-free treatment, examples:
Cognitive therapy
Trauma treatment
Milieu therapy

8. Antidepressants
Block reuptake of of neurotransmitters (serotonon and norepinephrine)
Reduce depression
Control anxiety
Control obsessions
Relieve severe pain
Prevent panic attacks
Undesirable side effects: nausea, headache, sexual dysfunction, sedation, weight gain, etc.

9. Antipsychotic medication
Block dopamin receptors
Some also block a specific serotonin receptor
Relief of psychosis and anxiety
Relief of acute mania
Undesirable side effects: blurred vision, dry mouth, constipation, tachycardia, sedation, weight gain, ejaculatory difficulty, dizziness.
PAUSE ETTER DETTE BILDET

10. Anti-anxiety: Benzodiazepines
Facilitate the transmission of the inhibitory neurotransmitter GABA
Relief of anxiety
Sedation
Undesirable side effects: dependence, confusion, memory impairment, motor incoordination.
Nausea, headache, dizziness, restlessness.

11. Substance abuse and mental health
Co-dependency
Dual diagnoses
Auto-medication
Legal substances
Illegal substances
Dependency-risky prescribed drugs

12. Other issues significant for mental health
Autonomy
Significant relations
Hope
Resilience
Healing and wellbeing
Empowerment
Coping strategies
Recovery

13. Good friends pull together
Research shows that your mental health is boosted when you have friends who can pull with you – not only when you are successful
But also when you fail. A lot of research on how significant relations make you feel useful, loved and needed.

14. Relations and their significance for mental health and recovery
Issues that promote relations competence
Working together:
the individual,
the family,
the social network group and
society

15. Recovery – healing processes
Spontaneous and natural development (without organised treatment)
A consequence of treatment interventions (clinical recovery)
Recovery in spite of countinued suffering from symptoms and functional disability

16. Goals for the nurse Preserve life
Build an alliance – important regarding use of drugs
Strengthen the patient´s self esteem
Encourage the patient in developing the wish to live
Assist in dealing with existential crisis

17. Nursing tools and actions
Multiple different therapies: ex. cognitive, trauma, milieu.
Motivate
Offer togetherness - share time with
Respect
Empathy and attentive listening
Time and full attention

18. The good therapeutic session
Building relations
Communication
Open invitation
Listening attentively
Listen to the silence and to the affective message
Create an alliance for teamwork
Use yourself as a tool

19. Relevant professional ethical and legal issues for reflection
Autonomy vs/paternalism
Principle of beneficence
Confidentiality
Substance legislation

20. Suggested reading:
Davidson, L et al (2008). Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophrenia bulletin, vol:34 (1), pp :5 -8 Link BG; Struening EL; Neese-Todd S; Asmussen S & Phelan JC (2001). Stigma as a barrier to Recovery. The Consequences of Stigma for the Self-Esteem of People with Mental Illnesses. Psychiatric Services, vol.52, (12), Dec. Topor A; Borg M, Di Girolamo S & Davidson L (2011). Not just an individual journey: social aspects of recovery. Int J Soc Psychiatry Jan 20. Townsend, MC (2015). Psychiatric Mental Health Nursing. Concepts of Care in Evidence-Based Practice. Philadelphia, USA, F.A.Davis Co.