Discuss about the Adolescent Depression And Suicidal Tendency.
In Australia, 45 percent of people experience a mental health condition in their lifestyle and in any one year. The Australian Bureau of Statistics states that about 3 million people are living her with depression. On average, 1 in every 6 women and 1 in every 8 men experience some level of depression. These affect well being, personal relationships, career and also productivity of the individuals. Only 35% access treatment and others do not take any form of treatments (Yoo et al. 2016).
Young males are at a higher risk for committing suicides than young females. However age standardize rates of suicide are more stable for females across the country. The nation had seen decrease in suicide rate in young adult men but the rate has increased in middle aged man from 4 to 7 deaths per 100000 middle aged men.
Women and people who are between the age of 40 and 59 are at a higher risk of development of depression in Australian. People who are living below the poverty line are about 2.5 % more likely to be depressed accounting for about 15% in comparison to those who are living above it accounting to about 6.2% (Calear et al., 2016)
The suicidal tendencies are in Australia are found to have increased between the year 2004 to 2014 by 22% with both males and females under the age of 44. However it is the notable cause of death or more males in the last 75 years. The suicidal tendencies are found to be higher in females than males and hospitalizations are 2.5 times higher than men. He rates of suicide among aboriginals and Torres islanders are double to that of non-indigenous people (Monreali et al., 2015). In 2014, suicide accounted for 5.2% of all indigenous health as compared to 1.8% in non indigenous people.
Factors contributing to the deterioration of the mental health of the patient and possessing risks:
The death of a parent is considered to be one of the most painful as well as the traumatic experience for children. When such incidence occurs during the adolescence period of an individual, it results in development of complications of a teenager’s natural process which defines his or her identity in the world (Biddle et al., 2014). The tension that an adolescent experiences between the seeking of independence but at the same time reliance on the family support causes magnification of the process of bereavement. This situation results in mourning of the teenagers who often suffers from low self esteem. In case of Jonathan, it is seen that he misses his late mother when he used to love dearly and was very close to her. Her untimely death was not being able to be handled by him effectively. Therefore he is at a feeling of loss as he cannot decide how to cope up with the death of his mother. He still feels for her feelings and his present condition is believed by him to hurt his mother in heaven. All these state that he is yet not being to get over the loss. At the same time, the distance that he had developed with his father had been an additional strike on his present condition (Solano et al., 2016). He bond that he used to shear with his parents are no longer felt by him and this had created an emotional turmoil on his life. This emotional turmoil had affected his working procedures and therefore he is unable to concentrate on his projects of the TAFE. These missing of assignment are again creating tension in him about his failure in courses which is contributing to the development of depression in the individual. All these mental and emotional turmoil is having a strain on his physical health which is making him lethargic.
Another factor that is adding to his mental stress is the turmoil faced by the Jonathan in his romantic life. Researchers are of the opinion that romantic link ups act as important developmental maker for adolescents; self identity, functioning and also for capacity for intimacy. Different sorts of theories have been provided by authors over the years which have tried to explain the main rationale behind the development of different mental conditions of individuals/ evolutionary theories related to neuro-endocrine functioning and genetics along with different interpersonal theories have helped in providing emphasis on the nature as well as processes of changes in the adolescent social life. This again affects the cognitions, emotions as well as emotions and behaviors (Saewic et al., 2014). The different issues faced by Jonathan in his relationship with Leah are giving him hard times in addition to the grief of him losing his parents and poor performance at TAFE. All the factors although are interlinked and all these result in development of turmoil in the adolescent life. Often teens show different form of expression of the frustration. Many get aggressive, many get withdrawn and many become depressed (Salamone te al., 2015). Jonathan had been found to get depressed on his situations. Moreover Leah’ s conversation with him in finishing their relation and the heated argument they had in the last meeting was a final blow and he could not take any more mental pressure and wanted to free himself by suicide.
Healthcare professionals have to efficiently tackle the emergency situation in a way which will help the professional to maintain all the nursing principles in ethical and legal considerations. The principle of beneficence states that a nurse should promote her actions which would ensure good for the patients. The nurse has the responsibility to ensure that the interventions they are providing should have the best effect on the patient and are also evidence based. An important principle that often lead to dilemma that nurse faces are autonomy and dignity of the patients (Olfson et al., 2014). This principle states that it is the duty of the nurse to maintain the dignity of the patients and thereby design her interventions that would not conflict with the autonomy of the patient. however, in many cases, this two principles lead to dilemma where the nurse’s idea of the best support and intervention might not be accepted by the patients and does not go according to the lieu of their dignity. Often patients’ want may cause harm to his or her own health and therefore the nurses’ sense of beneficence may not permit her to allow such demands of patients (Van Zoonene et al., 2014). Here arises the ethical dilemma of nurses regarding the principle that the patient should be choosing. In case of Jonathan, he is quite determined that he does not want to live as he feels that his life has nothing to offer him anymore. It is Jonathan’s wish and the nursing professionals’ duty is to provide respect to the patient wishes as his dignity should be respected. On the other hand, the nurse should keep in mind that he is a young soul who if treated successfully can overcome his tendency of self harm and overcome depression. So the nurse should try to provide the best intervention for him to overcome depression. Here will be the ethical dilemma (vanZoonene et al., 2014).
Another important principle that the nurse should follow in her practice is the non-maleficence. It stands for Hippocratic duty to do no harm to the patient’s health. In other ways, it can be stated that the duty of the nurses should be such that it cause no pain and suffering to the patient. Any healthcare professional should try to provide interventions which will under no circumstances cause suffering to the patient. Here the nurse therefore should try Jonathan to stop him from doing self harm by introducing different strategies in order to develop his mental health and help him in attaining stability (Lowes et al., 2015). But while doing so, Jonathan presently has to go through a lot of mental turmoil. Jonathan has been suffering from a large number of mental issues due to certain adverse events in his life like his mother’s demise, issues with maintaining academic pressure and also turmoil in his romantic life. All these had caused him such a level of stress that he can take no more stress and want o kill himself. This would relive him fromn pain. In such a case, if the nurse want to provide the principle of beneficence like providing him effective strategies to overcome the issue, she would automatically breach the principle of non maleficence as the patient would have to continue to go through the stressful situations which will give him more pain and suffering which is against the principle of non maleficence. Different sort of legal obligations may arise as situations of patient autonomy may arise (Rohde et al., 2015). The nurse should be very specific to her decision so that she can be accountable for the decisions she would take for the patients and give clear clarification to the higher authority regarding the legal cases. Hence the nurse should effectively handle the ethical and legal principles so that no obligations arise from the case.
Urgent mental health risk factor and two nursing interventions:
The patient has a mental health risk where he would have the highest tendency to end his life. As he is under pressure from different spheres of life, he might develop the tendency quite frequently. He is hopeless about his present situation and sis not seeing a ray of light in any of the situations. All his relationships as well as his career his in complex situation and he is having no clue about how to get them all in the right order (Asarnow et al., 2015).
The first intervention that the nurse should take for the patient is to establish strategies to handle his self ham tendencies. The case already shows that he shows that Jonathan had suicidal plans and also developed suicidal behaviors. The first would be to identify the level of suicide precautions after judging that he requires staying at hospitals or he is able to go home. His family should be properly educated and he should be given a crisis counseling session by the nurses. The client should be encouraged to express his feelings and come out with alternate modes of handling feelings and aggressions. This will help Jonathan to realize his inner capability and use the same capability to overcome his own depression. After the crisis counseling, Jonathan will gradually try to overcome his present situation, and use his inner strength to fight the symptoms of depression and emerge victorious (Zatzick et al., 2014). His father should be educated about how to handle the sensitive cases of his son so that he can involve himself in the son’s life and make his presence felt by discussing his son’s distress and giving him a feeling of companionship. The nurse would modify the environment by removing any object that he might use to harm himself like sharp objects and others.
The second intervention of the nurse would be to develop a collaborative as well as therapeutic relationship with the patient by maintaining a non-judgmental as well as a supportive stance in relation with the patient and also with family. The nurse should try to provide a therapeutic milieu in which Jonathan will feel emotionally safe and also supported. The nurse should use evidences to educate the patient about his suicidal mind, his symptoms of illness and also effectiveness intervention. The nurse should also try to reconcile the differences and the conflicts which come between the nurses’ goal to prevent suicide and the clients’ goal to eliminate pain via suicidal behaviour.
Mental health problem and two interventions to prevent it:
The mental health problem that remains associated with the present situation of the adolescent is that he may enter into intense depression which will hamper his overall quality of life. The main risk factors or rather the symptoms which show that he is highly vulnerable to develop depression need to be discussed. Sadness and hopelessness which have developed due to distance from father and death of his mother and also huge turmoil in his personal relationship respectively are great contributors to depression. Tearfulness often observed among Jonathan who leads him to frequent breakdown is also another symptom for his development of depression. Moreover he had also lost interest over his academic projects although he knows that he might be rusticated form the course (Varcarolis et al., 2016). In spite, he feels tired and does not feel like doing them. All these dilemmas make him entangled into a strenuous situation where he ultimately feels helpless as he cannot see any ray of hope to overcome such situations. Poor performance in academic areas and also changes in overall behaviour of the patients shows him that he is highly vulnerable to suffer from depression phases.
After handling his suicidal tendencies effectively, the nurse should introduce the next intervention to make him relived form the spiritual distress he is facing. He is filled with sadness by thinking that he had not been successful in meeting hi late mother’s expectations. Moreover, he misses his parents terribly making him suffer from terrible pain and distress. He is also not being able to concentrate on his academic courses and therefore he is also achieving negative marks in this domain. Moreover he is also having several issues in his intimate relationships.
All these had led to the development of spiritual distress which and therefore he has no inner peace and feels restlessness. Here the nurse needs to take a comprehensive intervention which will help in reviving his spiritual health. The client should be encouraged to write a journal which would help hum to express his thoughts and reflections (Lowes et al., 2015). This will help him to identify the personal issues as well as his thought and how his spirit has been hampered without his knowledge. Reflections help patients in gaining hold to own emotions. The nurse should also be discussing to the client about what had previously comforted him and provided him meaning in the past and give him ways how to achieve the happiness and be a jolly individual. Helping him to go through the booked on spiritual attainment and discussing in these topics will help him to find inner happiness and it would help him to overcome his spiritual distress.
After attaining his spiritual distress, another intervention also needs to be provided by the nurses to handle his thought processes. He needs proper guidance in this phase so that he does not over think certain situations an stop the development of the feeling of guilty within himself. The nurse should at first establish a baseline data by allowing evaluation of the client’s previous and for this she needs to determine Jonathan previous level of cognitive functioning form his family members (Clarke et al., 2015). The nurse should also allow the patient to have plenty of time to think and frame responses as slowed thinking necessitates the time required to formulate a response. The nurse should also try to make the patient minimize the client’s duty and responsibility which will in turn decrease the feelings of guilt, anxiety and pressure felt by the student. The nurse should also teach him to identify negative thinking and also teach him how to reframe or refute negative thoughts s that will add to hopelessness and sadness.
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