Understanding Major Depressive Disorder, Cultural Safety, And Psycho-education For Depression Treatment In An Essay.

Major Depressive Disorder and its Impact

An intense and constant feeling of sadness for a longer period of time is considered to be Major Depressive Disorder (MDD) (Maurer et al., 2018). It involves a recurrent feeling of despair and hopelessness also termed as clinical depression that can impact the various aspects of life such as mood, behavior and physical functioning of the body such as sleep and appetite. Almost 20 to 25% adults have depression and suffered at least one episode in their whole life time (Fava et al., 2020).  Social isolation, loneliness, loss of a dear one, separation or divorce, major changes in life, emotional, physical or sexual abuse can trigger major depressive disorder (Gronewold et al., 2021). A number of population refrain from getting diagnosed or treatment for Major depressive disorder. A psychiatrist, psychologist or a primary health care doctor can assist in evaluating the medical condition and provide assistance in treatment. It is one of the most common and serious disorder; however, it is treatable.

Cultural safety emphasizes on the social factors of health and the influence of power relationships on social processes have provided advantages to one specific group of people to disadvantages to other (Horrill et al., 2018). Safety relating to culture requires to respond and reflect to power dynamics. There is a ethnocentric belief that the particular way of cultural being is superior, natural and correct that that of others. In nursing of mental health, the bias seep into the therapeutic relationship either intentionally or unintentionally that indicates poor communication, erosion of independent actions and decision-making processes considered as disrespectful and regardless of good intention (Miller & Vittrup, 2020). Culture is consistent of six basic elements such as beliefs, values, technology, norms and sanctions, technology, symbols and language. The impact of cultural diversity is all across the world on different factors of mental health, perception of health and illness, attitude of the practitioners, system of mental health, and consumers. The five key elements of diverse cultures have an implication for professionals of mental health are (a) emotional expressions (b) shame (c) power distance (d) collectivism (e) spirituality and religion (Hechanova et al., 2020). Mainstream system of mental health is considering the intersection and differences of cultural diversity. In DSM 5, there is a provision for cultural formulation interview that seeks to explore concept of illness, cultural identity, vulnerability, resilience and psychosocial stressors. Culturally safe practices acknowledge the actions that respect and recognizes the identities of other cultural attitudes and identities. Culturally safe nursing intervention includes screening strategies, assessment processes, time frames and referral options. Symbolism and relevant representation through pictorial version rather than words written revealed steps from pathway to care. The picture presents the complete picture of native perspective of emotional and social well being where the components were interdependent, balanced and related to each other. It recognizes the important connection between land, ancestry, culture, family, community, ancestry and how the factors can affect the individual. Transcultural nursing is referred to as being sensitive to the differences of the individual patients, needs and preferences based on culture (Narayan & Mallinson, 2021). Nurses are required to aware and recognize of Aboriginal and Torres Strait Islander as they are one of the highest consumer and patient of depression in NewZealand. In Maori culture, culturally safe nursing has been integrated to provide treatment for depression as per the needs of the patients according to their cultural demands. Providing care that is free of racism and bias that challenges the belief based upon assumption and to be respectful towards the Aborginal or Torres Strait Islander people. Non-indigenous nurses failed to recognize the indigenous group of people in need of mental health care and mostly discriminated them based on their culture and background. Nurses can teach the Aborginal people about the mental health condition by providing them a brief and understanding by keeping in mind the cultural background they come from. Communication is the key element to develop a safe environment around the patients providing them enough space to open up and communicate with the nurses. The nurses can be empathetic and accepting towards the need of the aboriginal people while providing care regarding a mental health care issue like depression. Australia has a rich culture with linguistically and culturally diverse nation, Aboriginals as their inhabited and they are considered to be the Australia’s first people for millenia. Their history and cultures are uniquely shaped within the nation that needs more care and attention from the nurses during the treatment procedure. Indigenous people also have the right to receive culturally safe responses as incorporated in the United Nations Declaration on the Rights of Indigenous People.

Cultural Safety in Mental Health

Psycho-education is the first important step toward reducing and treating depression. Through psycho-education, it is an important opportunity to educate the patient and their family on important information about the etiology, clinical courses, prognosis, and treatment of the disorder. The aim of psycho-education is to impart an understanding of the mental health condition, and it is an essential aspect of any therapeutic program on mental health disorders like depression, (Jones et al., 2018). Depression and anxiety are frequently seen in clinical practice. Psycho-education on depression can be passed down using leaflets, posters, or internet materials. Cognitive-Behavioral Treatment programs can be one of the treatment procedures that is included or is considered to be an important part of psycho-education. 

Such a program is capable of promoting that client himself is also capable of taking the initiative to manage their illness. Such an intervention has gained importance in the recent past. Implementing psychoeducational programs is the first step that will help in the establishment of cognitive-behavioral psychotherapy and dispel the myth of depression. It is evident through research that CBT in the form of psychoeducation can prove to be evident for reducing and dealing with mood disorders and major depression. Through psychoeducation, patients will learn skills to manage their illness and skills to learn knowledge about their illness, (Miklowitz et al., 2021). While patients have expressed their dissatisfaction with the therapeutic strategy, however, research has suggested its effectiveness. Research has suggested that individuals with severe disorders like depression can benefit from psychoeducational and cognitive treatment programs. If the program is effective enough to sure the purpose of neuropsychological functioning, depression can be effectively treated in patients. Psychoeducation can effectively treat the cognitive deficits and emotional overload that the client suffers from as a result of depression, (Beshai et al., 2019). The patients will be able to learn more about coping skills with their depressive thoughts and low moods. The client will also become insightful about their illness, and they will also learn about the probable treatment outcomes through the involvement of psychoeducation. The coping-oriented group treatment program, which is a part of psychoeducation, helps in providing a rationale for the treatment procedures being adopted for major depressive disorders. Group CBT psychotherapy can be implemented on clients with depressive disorders, and CBT interventions can be implemented on the patients, (Beshai et al., 2019). Psychoeducation through cognitive programs can modify the psychological and social-environmental factors that can precipitate relapse in the clinical condition. It also motivates the patient to stay motivated and extend active collaboration with the goal of improving their course of illness, (Schaub et al., 2016). Through the use of CBT psychoeducation, the clients can be made to realize their faulty negative core beliefs like thoughts, emotions, and resultant behaviors.

CBT-based psychoeducation can also provide effective cognitive distortions that can often occur in patients. Psychoeducation generally begins at the first or second session of CBT, and it might continue throughout the CBT treatment procedure. Psychoeducation can prove to be effective when the therapist has developed their own examples and scripts to teach the clients with depression, (Bernal et al., 2019). CBT is an important part of psychoeducation. Psychoeducation can be provided to the clients with a 15-minute session after the conduction of the initial evaluation of the depressive state of the client, (Schleider, Dobias & Pati, 2019). Through the effective use of psychoeducation, the clients can be taught about their symptoms, diagnosis, and the ways in which CBT can be provided so that the therapeutic process proves to be helpful for the client. Psychoeducation can prove to be providing hope to the client, and it can prove to be the turning point in their treatment process, (Hope, Heimberg & Turk, 2019).

The Role of Psycho-education in Depression Treatment

Conclusion:

Thus, it can be concluded that the CBT can be used effectively while treating depressive symptoms in clients through the utilization of psycho-education. Psychoeducation helps in the process of providing hope to the clients and it can prove to be an effective treatment process for depression.  It can prove to be a turning point in the process of providing effective treatment. Psychoeducation can be effectively provided in a 15-minute session to the concerned clients. It can also be concluded that cultural safety emphasizes on the social factors of health which includes the relationship on social processes. Power dynamics needs to be responded to, in order to ensure culturally safe nursing to the clients who are suffering from depressive symptoms. Diverse culture has an impact on mental health. DSM 5 needs to be referred to in order to formulate culturally diverse interview and treatment structure formulation. Effective strategies are to be included to ensure culturally safe mental health nursing.

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