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Mental Health Essay: Use of Psychotropic Medication

Question

Task: This assessment enables students to demonstrate understanding of concepts and patient focus factors in mental health. This assessment requires critical discussion on restrictive and coercive practices in mental health. Students will be able to select one question (from a possible two) and will draw from national and international perspectives within contemporary literature. Topics will be available under the Assessment Tile on LEO

Assignment topic choice 1
The use of sedative medications to control behaviours is controversial and has been described as being highly coercive and having significant effects on a person (MuirCochrane & Grace, 2017). In this essay you are required to critically discuss:

  • the controversy of the use of psychotropic medications to control behaviours and manage symptoms for people who experience mental illness.
  • Identify the challenging aspects for registered nurses who administer psychotropic medication to the consumer who poses significant risk of harm to self and/or others, in promoting recovery-oriented practice.

Your essay must utilise a range of national and international contemporary literature, to create an argument that identifies the complexities of this issue.

Answer

1.Introduction
The present mental health essay discusses about the utilization of the coercive and restrictive intervention which is the common phenomenon in the mental health care setting that primarily includes the usage of the power to confine the autonomy and limit the adverse attitude in some way or other (Brady et al., 2017). The coercive practice and its function in infringing the ethical right of the person, several controversies related to such intervention in mental health sector have emerged. Therefore, the utilization of the psychotropic medications change behaviours and control symptoms for mentally ill patient has been a controversial topic to both national and international researchers. The primary purpose of the mental health essay is to critically analyse the controversy associated with the use of psychotropic medication. Therefore, this mental health essay will provide an insight into the controversy of the use of this type of medication on mentally ill patients on both positive and negative sides that they can bring. Then, it will analyse some of the difficulties as well as challenging aspects for health care workers who administer psychotropic medication in promoting the recovery-oriented practice. All of the information and arguments in this mental health essay are based on literature, research, and academic articles from national and international researchers.

  1. Main body
  2. The controversy of the use of psychotropic medications to control behaviours and manage symptoms for people who experience mental illness.

1.1 The supporting ideas for the use of psychotropic medications
There have been many ideas from national and international researchers, authors and doctors about the benefits of using psychotropic medications in controlling the behaviours and managing the symptoms and sign for mental illness. Primarily, in Australia, antipsychotic medication is considered a useful treatment for patients with prodromal symptoms of psychotic such as delusions, hallucinations. This mental illness mentioned in the segments of mental health essay results due to the withdrawing from society, sleep disturbances, depression, family issues, financial troubles, domestic violence which lead to change in behaviours, appearance of unusual thoughts and self-harm (Hercelinskyj & Alexander, 2019). To manage this mental illness, researchers in the USA have also found the effectiveness of psychotropic medications in managing aggressive behaviour of the patients with mental illness through collecting data and conducting its analysis during the treatment process (Miler et al., 2013). In particular, the frequent use of antipsychotic medication is presented by Gerhard and his colleagues (2018) as his study showed that one in seven patients is treated with this medication. They also cited that people who had symptoms of physical condition such as schizophrenia, bipolar disorder as well as drug abuse, use antipsychotics (NIMH, 2016). Besides, other types of psychotropic medications such as amisulpride and clozapine are also considered effective treatments in the context of this mental health essay that strengthen the immune system against severe schizophrenic psychoses (SA Health, 2019 & Health Navigator NZ, 2020).

Moreover, psychotropic medications have also been researched by scientists from many countries about its effectiveness in managing behaviour problems in adults such as intellectual disabilities, mental retardation or learning disability. Hence, treatment should be in accordance with international guide, assessment and formulation of each patient’s condition and circumstances to achieve the best results, there are many patients receiving positive recovery after using these medications (Deb et al., 2009).

Based on the above arguments on the case of mental health essay, the psychotropic medications known as neuroleptics or key tranquillisers (Alzheimer’s Society, 2020) and considered to be useful for patients having mental health, as it improves their health behaviours, control negative moods and emotions, bring about positive actions and feelings as well as social networks engagement. (Sommer et al., 2012). On the other hand, it is noted herein mental health essay that the major purpose of the medications is to manage the harmful symptoms such as agitating, hallucinating, delusions, disorganising of behaviour and thoughts such as schizophrenia and related to psychotic disorders. 

1.2 What are the opposites of the using of psychotropic medications in the case of mental health essay for disorder behaviours and mental ill patients?
There is growing evidence for the potential harmful effect of the psychotropic medication that has given rise to the controversies for its function. The most common type of psychotropic drugs are sedatives that have major impact on the function of the central nervous system and effect the signal transmission of the gamma aminobutyric neurotransmitter (Saxena et al., 2020). Temazepam, Xanax and phenobarbital are the most common administered sedatives medication which holds potential controversy due to the huge dependency on the drug by the patient. It is evident from the study of Arunogiri and Lubman (2016) used to develop this mental health essay that with prolonged consumption of such drugs could lead to physical as well as psychological addiction. Due to the occurrence of abrupt cessation, the withdrawal sign like insomnia, agitation and restlessness are the common manifested signs shown by the patient. Although, the drugs are often utilised for the recreational purpose, however people being into such prescription typically report loss of attention, poor memory, stress and psychomotor problem (Milhorn, 2018).

The Psychoactive drugs is reported to upsurge the risk of the health issue like diabetes mellitus and hyperglycaemia due to its use for longer time, thus require a warning description on the packing of the medicine (Nagata et al., 2018). It is reported in his research that reducing in sensitivity of insulin is associated with the Psychoactive drug like olanzapine and clozapine and gain in body mass and weight is allied with quetiapine and risperidone. It is a known fact that antidepressant drugs are useful for the management of anxiety disorder, stress and even used extensively for pain control. However, a paradoxical finding by Geller (2019) used in the mental health essay elaborated the operating factor that with the administration of such drugs, it intensifies the risk of suicidal ideation among children and adolescent. Recent evidence supports the above finding and state that there is causal correlation amid the adolescent suicidal thought and administration of antidepressant drug, which also cause emergence of aggressive behaviour among them (Brent, 2016). Controversy for its benefit and disadvantage can be cleared as the report presented by Saade et al. (2019) also mention that tricyclic agents like venlafaxine has led to increase the suicide attempt among the depressed young adults.

 In contrast, it is also stated herein mental health essay that psychotropic medications have also received many opposing ideas about its side effects on patients. Antipsychotic medications can bring some side effects such as headache, insomnia, weight gaining, cholesterol & triglyceride elevations (Muench & Hamer, 2010). Some other common side effects can be caused by antipsychotics are constipation, a high risk of diabetes, blurred vision, sexual dysfunction, postural hypotension, dry mouth, and fluid retention; Moreover, it is explained that depot antipsychotic medications including Paliperidone palmitate or Risperidone can cause Hyperprolactinemia or Extrapyramidal symptoms (Therapeutic Guidelines Australia, 2018). Samperi et al. (2019) explained that Hyperprolactinemia is an elevation of prolactin which is released into the bloodstream. Besides that, the mental health essay examines the study of Tenback et al. (2010) which stated that Extrapyramidal symptoms are physical weakness, reduced ability to socialize as well as activities of daily living. This affects the quality of life and cause depression in treatment. More seriously, patients may relapse when they stop pharmacologic treatment such as schizophrenic patients. Furthermore, according to Intellectual Disability (2020), some adverse effects from using psychotropic medications on patients are argued by researchers that they can bring serotonin syndrome including tachycardia, high blood pressure and body temperature, obesity and disorders of the extrapyramidal system.

Mood stabilizer is a different category that falls under psychotropic medications which is used for treating mood disorder, emotional distress, psychoactive disorder, or bipolar disorder. The common available drugs are carbamazepine and lamotrigine, but still linked with some sort of controversies. Galizia, Isaacs and Cock (2017) noted that with the continue intake of lamotrigine, results in nausea, vomiting and dizziness, which can also cause encephalopathy and reduction of the blood platelets. Even, carbamazepine has box warning for the emergence of the hepatotoxicity and foetal abnormalities.

Thus, according to Valdovinos et al. (2016), although psychotropic medications help to reduce unhealthy behaviours frequency, they do not ensure constant effectiveness, after a survey for mental health essay, the author argued that the changing of patients’ behaviours varies among the patient and the whole process of treatment requires changes in using medication flexibly. From the collected evidence, it can be said that use of the Psychoactive drugs tends to create problem for the healthcare professional to provide adequate treatment for psychiatric disorder.

2.The challenging aspects for registered nurses who administer psychotropic medication to the consumer who poses significant risk of harm to self and/or others, in promoting recovery-oriented practice.
The registered nurse has the responsibilities to provide optimum care to the patient and include them in the care process irrespective of the health issue. In care of the psychiatric disorder patients, they are obliged to deliver safe treatment, however due to the inability to recognize their issue they display negative attitude which is a huge challenge for the nurses.

The first challenging aspect mentioned herein mental health essay can be a high pressure to have professional skills and knowledge to apply psychotropic medication in treatment to these patients (World Health Organisation, 2017). This may effect on changing of complex conditions, services and medications such as there have been many symptoms that nurses need to adapt and update their practice and qualities that they bring to that practice. In other words, they need to learn and get more training about medications as well as behaviour therapies that might be consistent with these harmful behaviours from patients, in order to provide them the best treatment and promote recovery-oriented practice effectively (National Health and Medical Research Council, 2012).

Although the psychotropic medications are associated with mental health issues like anxiety, agitation and seizure, nurses often face the situation of lack of support and assistance from the subordinate staffs. Due to the prevalence of unsafe environment, it is a problematic situation for the nurse to manage the adverse effects that could rise due to administration of psychotropic medications. It could cause them to display hostile and violent attitude towards the nursing staffs thus inflicting injuries and harm to the latter (Carr et al., 2017). The challenge faced by the nurse can also be attributed to the issue of chemical coping, where person self-administering the drugs is send for psychiatric disorder and its management. Under such condition there is the chance that patient show aggressive and withdrawal sign and lead to conflicting situation with the nursing staffs (Elbe et al., 2018).

Another challenge for nurses outlined in this mental health essay is the risk management from patients who show some uncontrollable actions towards medical staffs. Due to the high prevalence of mental illness in the healthcare sector, the care and responsibility are laid on the nurse that creates huge burden for them (Bjorkman et al., 2018). The action of the drug on the patient may take time, meanwhile the patient can become agitated and aggressive, which in turn threaten the nurse (Slemon et al., 2017). It can also explain that nurses not only maintain therapeutic relationships with patients and families such as following person-centred care principles in order to support the collaborative process of effective treatment such as being mutual and respectful, but they also face challenges to manage risks from their patients such as violence, assault, the risk of self-harm, suicide in particular (Brunero & Lamont, 2017).

Therefore, according to Kanerva et al. (2016), it is clear in this mental health essay that the concept of safety in the healthcare environment is invoked that promoting recovery-oriented practice such as maintenance, and improvement of patients' health. Within mental health care, nurses firstly who are responsible for providing the right dose, avoiding the error medication, have to be updated and fully equipped with pharmacological knowledge in managing psychotropic drugs; secondly, they must adhere to the professional principles in nursing parallelly with being careful in handing over to update their patient's current situation to supply the best treatment to the patients (Sherwood, 2015).

Conclusion
To sum up, the mental health essay has analysed and evaluated different viewpoints of contemporary literature and researchers about the use of psychotropic medications to patients who have mental illness and unhealthy behaviours. Despite bringing many positive health improvements for patients, this type of medication still needs to be taken into consideration due to the side effects and risk of lethal disease among psychiatric patients. Nurses and doctors who use psychotropic medications need to be cautious with different patient’s health condition, health history, immune system, and circumstances to use the right prescription. Besides, nurses who work with mentally ill patients will have to face many challenges, which call for the risk management and nurse education. Moreover, the treatment therapy training is a good consideration for them to promote recovery-oriented practice effectively, simultaneously, protecting them.

References
Alzheimer’s society. (2020). Antipsychotic drugs. Retrieved from https://www.alzheimers.org.uk/about-dementia/treatments/drugs/antipsychotic-drugs

Arunogiri, S., & Lubman, D. I. (2016). Addressing sedative dependence: Principles for practice. Mental health essay Australian Clinical Psychologist, 2(1), 800.

Bjorkman, A., Andersson, K., Bergström, J., & Salzmann-Erikson, M. (2018). Increased Mental Illness and the Challenges This Brings for District Nurses in Primary Care Settings. Issues in Mental Health Nursing, 39(12), 1023-1030.

Brent, D. A. (2016). Antidepressants and suicidality. Psychiatric Clinics, 39(3), 503-512.

Brunero, S. & Lamont, S. (2017). Chapter 24: Challenging behaviour, risk and responses. In K. Evans, D. Nizette, & A. O'Brien, A (4th ed.), Psychiatric and mental health nursing (pp.552-576). NSW. Australia: Elsevier Australia.

Carr, S., Holley, J., Hafford-Letchfield, T., Faulkner, A., Gould, D., Khisa, C., & Megele, C. (2017). Mental health service user experiences of targeted violence and hostility and help-seeking in the UK: a scoping review. Global Mental Health, 4.

Deb, S., Kwok, H., Bertelli, M., Salvador-Carulla, L., Elspeth, B., Torr, J., Barnhill, J. (2009). International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities. World Psychiatry. 8(3).

Elbe, D., Black, T. R., McGrane, I. R., & Procyshyn, R. M. (Eds.). (2018). Clinical handbook of psychotropic drugs for children and adolescents. Mental health essay Hogrefe Verlag

Galizia, E. C., Isaacs, J. D., & Cock, H. R. (2017). Non-hyperammonaemic valproate encephalopathy after 20 years of treatment. Epilepsy & behavior case reports, 8, 9-11.

Geller, B. (2019). Antipsychotics, Excess Deaths, and Paradoxes of Child Psychiatry. JAMA psychiatry, 76(2), 111-112.

Gerhard, T., Stroup, T., Correll, C., Huang, C., Tan, Z., Crystal, S., & Olfson, M. (2018). Antipsychotic Medication Treatment Patterns in Adult Depression. The Journal of Clinical Psychiatry, 79(2), 55-61.

Hercelinskyj, G & Alexander, L. (2019). Mental Health Nursing - Applying Theory to Practice. Cengage: Singapore Intellectual Disability (2020). The Use of Medication for the Management of Problem (Challenging) Behaviour in Adults who have Intellectual Disabilities. Retrieved from: http://www.intellectualdisability.info/mental-health/articles/the-use-of-medications-for-the-management-of-problem-behaviours-in-adults-who-have-intellectual-disabilities

Kanerva, A., Lammintakanen, J., & Kivinen, T. (2016). Nursing Staff's Perceptions of Patient Safety in Psychiatric Inpatient Care. Perspectives in Psychiatric Care, 52(1), 25-31.

Miler, L., Riddle, M., Pruitt, D., Zachik, L., & DosReis, S. (2013). Antipsychotic Treament Patterns and Aggressive Behaviour Among Adolescents in Residential Facilities. J Behav Health Serv Res. 40(1), 97-110

Milhorn, H. T. (2018). Sedative-hypnotic dependence. Mental health essay In Substance Use Disorders (pp. 59-76). Springer, Cham.

Muench, J., & Hamer, A. (2010). Adverse Effects of Antipsychotic Medications. American Family Physician. 81(5), 617-622.

Nagata, M., Kimura, Y., Ishiwata, Y., Takahashi, H., & Yasuhara, M. (2018). Clozapine-Induced Acute Hyperglycemia Is Accompanied with Elevated Serum Concentrations of Adrenaline and Glucagon in Rats. Biological and Pharmaceutical Bulletin, 41(8), 1286-1290.

National Health and Medical Research Council (Australia). (2012). Clinical Practice Guideline for the Management of Borderline Personality Disorder. Melbourne: National Health and Medical Research Council.

NIMH. (2016). Mental health medications. Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml#part_149855

SA Health. (2019). Clozapine. Retrieved from https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/medicines/clozapine

Saade, Y. M., Nicol, G., Lenze, E. J., Miller, J. P., Yingling, M., Wetherell, J. L., ... & Mulsant, B. H. (2019). Comorbid anxiety in late?life depression: Relationship with remission and suicidal ideation on venlafaxine treatment. Depression and anxiety, 36(12), 1125-1134.

Samperi, I., Lithgow, K., & Karavitaki, N. (2019). Hyperprolactinaemia. Mental health essay Journal of clinical medicine, 8(12), 2203. https://doi.org/10.3390/jcm8122203

Saxena, N., Shaw, A. D., Richmond, L., Babic, A., Singh, K. D., Hall, J. E., ... & Muthukumaraswamy, S. D. (2020). A comparison of GABA-ergic (propofol) and non-GABA-ergic (dexmedetomidine) sedation on visual and motor cortical oscillations, using magnetoencephalography. bioRxiv.

Sherwood, G. (2015). Perspectives: Nurses' expanding role in developing safety culture: Quality and Safety Education for Nurses – competencies in action. Journal of Research in Nursing, 20(8), 734-740.

Slemon, A., Jenkins, E., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing inquiry, 24(4), e12199. https://doi.org/10.1111/nin.12199

Sommer, I., Slotema, C., Daskalakis, Z., Derks, E., Blom, J., & Gaag, M. (2012). The Treatment of Hallucinations in Schizopherenia Spectrum Disorders. Schizophrenia Bullentin. 38 (4), 704-714. doi:10.1093/schbul/sbs034

Tenback, D., Van Harten, P., Slooff, C., & Van Os, J. (2010). Incidence and persistence of tardive dyskinesia and extrapyramidal symptoms in schizophrenia. Journal of Psychopharmacology, 24(7), 1031-1035.

Therapeutic Guidelines Australia (2018). Psychotropic. Retrieved from: https://tgldcdp.tg.org.au/topicTeaser?guidelinePage=Psychotropic&etgAccess=true

Valdovinos, M., Henninger-McMahon, M., Schieber, E., Beard, L., Conley, B., & Haas, A. (2016). Assessing the Impact of Psychotropic Medication Changes on Challenging Behaviour of Individuals with Intellectual Disabilities. Mental health essay Int J Dev Disabil. 62(3); 200-211. 

World Health Organisation (2017). Improving Access to and Appropriate use if Medicines for Mental Disorders. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/254794/9789241511421-eng.pdf;jsessionid=3F1A4204FC21DBC426E35F68254BC05D?sequence=1

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