1. MENTAL ILLNESS

2. Approximately one-third of the adult population in the United States at some point in time meets the diagnostic criteria for a mental disorder and at least 12% of children younger than 18 years of age suffer one or more mental disorders. These statistics reveal the relative prevalence of mental illness in our society and indicate that nurses will often care for patients with a psychiatric problem as a primary or secondary diagnosis.

3. Until about 1886, the mentally ill were restrained in iron manacles. With the advent of pharmacotherapy in the 1950s, the life of a person with a mental illness began to change. The discovery of the various neuroleptic and antidepressant drugs was a major contribution to the improved quality of life for the mentally ill. Previously dependent clients were now able to live outside of an institution.

4. For the last 25 years, the care of the mentally ill has been moving into community health centers, and clients are spending less time confined to a mental health facility and more time in the community, at work, at home, and at play.

5. The 1990s have been referred to as the “Decade of the Brain,” with new discoveries linking biochemistry with human behavior and conditions of mental health and illness. The quality of treatments and, therefore, the quality of life for those with mental illness can only improve. It is incumbent upon nurses to examine their own feelings about mental illness so they can enter into a viable teaching–learning relationship. Although teaching clients with mental disorders requires the same basic principles of patient teaching, there are some specific teaching strategies to consider.

6. As with any other nursing intervention, the first step is to begin with a comprehensive assessment. In this case, it is wise to determine whether the consumer has any cognitive impairment or inappropriate behavior as well as to assess the patient’s level of anxiety. High anxiety can make learning nearly impossible. Despite the nurse’s best efforts, clients with a mental disorder may not be able to identify their need to learn and may not be sufficiently ready to learn. However, the nurse may not be able to wait for “readiness” to happen. Therein lies the challenge.

7. In fact, persons with mental disorders are able to learn given the right circumstances and strategies. For instance, it is extremely important that the family or significant other participate in the health education of the client. Therefore, when planning your teaching session, prepare to include the family or significant other. Also keep in mind when planning your teaching strategies that people with mental illness may experience difficulty in processing information and verbally communicating information. In addition, they may experience decreased concentration and are easily distracted, which does limit their ability to stay on task.

8. The following is a summary of three essential strategies that have proved successful when teaching people with mental illness: Teach by using small and brief words, repeating information over and over—use mnemonics, write down important information by placing it on index cards, and use simple drawings or symbols. Be creative. Keep sessions short and frequent. For instance, instead of a one-hour session, break the learning period into four 15- minute sessions. Involve all possible resources, including the client and his or her family. Actively involve them to help determine the client’s learning styles as well as the best way to reinforce content. Consider using computer- assisted instruction, videotapes, and role-modeling with clients.

9. As with any teaching program, it is important to set goals and determine outcomes with the client. Nurse educators may need to explore teaching strategies that have been successful in the field of mental health. A certificate of recognition may be given to each patient when he or she completes a program, which can be a powerful motivator. To have a positive effect on the quality of life of the chronically mentally ill, provide useful information.