Concurrent Disorders, Research Paper Example

Nursing Treatment for Concurrent Disorders: Substance Abuse and Mental Illness

Abstract

Concurrent illnesses represent a challenge for nurses in today’s healthcare and environments. For patients suffering from addiction and mental illness, it is necessary for nurses to utilize their skills and knowledge in an effective and practical manner to support these concurrent illnesses at an optimal level. Patients with mental illness and addiction require significant clinical and emotional support, which is one of the primary drivers of a successful nursing practice. How nurses work with and treat this patient population plays a significant role in their overall recovery and ongoing progress.

Introduction

Nurses are a primary influence and a source of strength and knowledge for patients suffering from concurrent addiction and mental illness. It is important to determine which areas of nursing knowledge and practice are relevant under these conditions, and to establish a proactive approach to support these patients during the most difficult stages of their treatment. Nurses must establish their primary objectives in treating this patient population, and should recognize how to best support patients who struggle with addiction and mental illness at the same time. In many cases, this patient population is forgotten due to a lack of resources and other limiting factors. Therefore, it is necessary for nurses to recognize the needs of this population and to utilize their skills, knowledge, and experience to achieve effective recovery outcomes for these patients. The following discussion will address literature related to this subject area in greater detail, and will convey the influence of nurses in the treatment of patients who struggle with concurrent illnesses.

Body

Edward and Munro (2009) address the importance of combining nursing and mental health services to enable patients with concurrent mental illness and addiction to receive the treatment that is necessary to support their recovery. In particular, mental health nurses must provide a level of skilled care and attention that is necessary to treat the underlying mental condition as best as possible so that the external addiction may also be treated more efficiently (Edward and Munro, 2009, p. 74). These efforts will provide support to this population, which is historically difficult to treat and for which relapses are very common (Edward and Munro, 2009, p. 75).

Wisdom et.al (2011) address evidence which supports the belief that patients with an initial episode of mental psychosis may also experience substance abuse addiction, which complicates their treatment plan significantly. The primary results of the study indicate that patients who are provided with knowledge and treatment after the first episode of psychosis may respond well, which may lead a reduction in substance abuse for this population (Wisdom et.al, 2011, p. 1007). This study provides important insights regarding the ability of patients to understand their psychosis and subsequent episodes of addiction (Wisdom et.al, 2011, p. 1011).

Mental illness and addiction are common problems within the homeless population, and therefore, strategic efforts regarding treatment must emphasize organized programmatic support for this population group (O’Campo et.al, 2009, p. 966). Since there is a general lack of focus and control regarding the homeless population, it is important for clinicians and mental health services to develop programmatic efforts to perform outreach for this population, and to recognize that this group is highly vulnerable and requires a high level of care and treatment to promote their recovery and housing circumstances (O’Campo et.al, 2009, p. 966).  In addition, treatment alternatives may also provide support for other chronic illnesses for patients in need (O’Campo et.al, 2009, p. 966).

For adults with concurrent addiction and mental illness, other chronic conditions may also be evident, particularly for older adults (Lin et.al, 2011). Therefore, it is important to recognize the comorbidity factors associated with these conditions and the complex nature of symptoms to ensure that nursing care, particularly in nursing home settings, is appropriate and targeted for these conditions (Lin et.al, 2011). Nurses play a critical role in this practice and must demonstrate their knowledge of chronic illness and how it ties into substance abuse and mental illness to provide optimal care and treatment for this patient population (Lin et.al, 2011).

Screening programs for concurrent addiction and mental health conditions requires an effective approach that will identify prospective patients who require further treatment (Saxon Mortlock et.al, 2011, p. 397). Patients with mental disorders often face additional challenges with substance abuse addiction, which exacerbates their illness even further (Saxon Mortlock et.al, 2011, p. 398). It is important to provide patients with the clinical and emotional tools that are necessary to promote a successful treatment plan and long-term recovery strategy for this patient population, which is becoming increasingly common in many communities (Saxon Mortlock et.al, 2011, p. 398).

It is known that “best practice guidelines (BPGs) are an important solution to assist with providing integrated treatment to those with mental illness” (Doran et.al, 2010, p. 175). Under these conditions, it is important for nurses to utilize their knowledge and skills in such a way that they represent the best interests of this population and their specific needs more effectively (Doran et.al, 2010, p. 175). From this perspective, it is important to provide patients with a comprehensive set of tools that will better manage their concurrent conditions at a consistent and practical level (Doran et.al, 2010, p. 175).

Conducting interventions for patients with concurrent conditions requires a careful yet skilled approach to ensure that the highly vulnerable state of this population is not further compromised during the assessment, intervention, and treatment processes (Cleary et.al, 2009, p. 239). When conducted properly, these efforts will provide this patient population with a comprehensive level of attention that will meet their immediate treatment needs as best as possible, using a combination of clinical and psychological assessment factors (Cleary et.al, 2009, p. 239). These efforts are likely to produce successful treatment results when care and attention are paid to how patients respond (Cleary et.al, 2009, p. 239).

In conducting an assessment and in developing a treatment plan, it is important to determine how each phase of the intervention and treatment plan will operate, and how nurses must respond to these patients to ensure that their recovery is not compromised in any way (O’Grady and Skinner, 2012, p. 1047). Nursing practice must incorporate the patient’s perspective and the journey that they will endure throughout all phases of the treatment plan to ensure that these patients are treated properly and with respect at all times (O’Grady and Skinner, 2012, p. 1047).

It is necessary to identify patterns of patient behavior that are common in many communities in order to determine how treatment plans will be established. To be specific, patients who suffer from substance abuse addiction and depression may face a much greater risk of suicide; therefore, nurses working with patients who face this reality must also recognize the value of treating them to reduce their risk of suicide (Archie et.al, 2012, p. 165). These efforts must recognize the vulnerability of patients, as well as their mental concerns so that they are treated in a comprehensive manner to promote improved recovery outcomes (Archie et.al, 2012, p. 165).

Finally, the development of screening tools to improve diagnostic capabilities for mental illness and addiction are critical to the overall success of the desired treatment plan (Rush et.al, 2012, p.1). For example, screening tools provide a more detailed approach to managing mental illness and substance abuse and in developing the appropriate treatment plan (Rush et.al, 2012, p. 1). This is best accomplished through the creation of treatment approaches that are customized upon review of these screening results (Rush et.al, 2012. p.1). These efforts are integral to the success of nursing practice in treating patients with addiction and mental illness, and also support the development of new ideas and concepts that will facilitate the beginning stages of recovery (Rush et.al, 2012, p.8).

Conclusion

Substance abuse and mental illness often coincide with each other in many patient case studies. Due to the already fragile nature of mental illness, it is not surprising to discover that many patients also find themselves with a serious addiction, with no real treatment plan or strategy in place. Therefore, nurses who work with these patients must not only identify the conditions surrounding the diagnosis, but they must also recognize that the treatment plan must be comprehensive for both conditions. Patients who face both mental illness and addiction are in a fragile state; therefore, they must be treated with a strategy that utilizes nursing skills and knowledge as effectively as possible. Nurses are responsible for ensuring that the chosen treatment plan is implemented in the desired manner, and that there is follow through and ongoing assessments to determine how patients respond to the chosen treatment plan. This will enable these patients to have the best possible chance of recovery and symptom management over time.

References

Archie, S., Kazemi, A.Z., & Akhtar-Danesh, N. (2012). Concurrent binge drinking and depression among Canadian youth: prevalence, patterns and suicidality. Alcohol, 46(2), 165-172.

Cleary, M., Hunt, G.E., Matheson, S., & Walter, G. (2009). Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. Journal of Advanced Nursing, 65(2), 238-258.

Doran, D., Paterson, J., Clark, C., Srivastava, R., Goering, P.N., Kushniruk, A.W., Bajnok, I., Nagle, L., Almost, J., & Carryer, J. (2010). A pilot study of an electronic interprofessional evidence-based care planning tool for clients with mental health problems and addictions. Worldviews on Evidence-Based Nursing, 7(3), 174-184.

Edward, K.L., & Munro, I. (2009). Nursing considerations for dual diagnosis in mental health. International Journal of Nursing Practice, 15,74-79.

Lin, W.C., Zhang, J., Leung, G.Y., & Clark, R.E. (2011). Chronic physical conditions in older adults with mental illness and/or substance abuse disorders. Journal of the American Geriatric Society, 59, 1913-1921.

O’Campo, P., Kirst, M., Schaefer-McDaniel, N., Firestone, M., Scott, A., & McShane, K. (2009). Community-based services for homeless adults experiencing concurrent mental health and substance abuse disorders: a realist approach to synthesizing evidence. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 86(6), 965-989.

O’Grady, C.P., & Skinner, W.J.W. (2012). Journey as destination: a recovery model for families affected by concurrent disorders. Qualitative Health Research, 22(8), 1047-1062.

Rush, B., Castel, S., Brands, B., Toneatto, T., & Veldhuizen, S. (2012). Validation and comparison of diagnostic accuracy of four screening tools for mental disorders in people seeking treatment for substance use disorders. Journal of Substance Abuse Treatment, Available Online October 23, 2012, pp. 1-9.

Saxon Mortlock, K., Deane, F.P., & Crowe, T.P. (2011). Screening for mental disorder comorbidity in Australian alcohol and other drug residential treatment settings. Journal of Substance Abuse Treatment, 40, 397-404.

Wisdom, J.P., Manuel, J.I., & Drake, R.E. (2011). Substance use disorder among people with first-episode psychosis: a systematic review of course and treatment. Psychiatric Services, 62(9),1007-1012.