Introduction
It is important to note that mental health is an individual’s overall condition concerning their emotional and psychological well-being. The key concept relevant to the given paper is mental illness, which refers to a disorder affecting a person’s behavior, thinking, and mood. One should be aware that stigmatization is an act of regarding or describing someone as less worthy of approval and deserving of disgrace. Essentially, whenever an individual stigmatizes another person based on some characteristic, such as mental illness, they personalize the issue as if it were entirely of the sufferer’s choosing.
The paper will cover the problem of stigmatization when it comes to mental disorders. Firstly, it will introduce and identify the nursing practice problem. Secondly, the PICOT question will be presented to address the issue with greater precision. Thirdly, the literature review will be presented to ensure that the information is evidence-based. Fourthly, a set of comprehensive recommendations with details will be provided. Fifthly, a conclusion will be demonstrated to summarize the key points of the paper.
Nursing Practice Problem
What?
The concern or issue of interest is stigmatization among adults with mental illnesses by nurse practitioners. It is stated that stigmatization and disregard for the effects of mental health problems among adult patients impact the quality of health services they receive as well as outcomes (Corrigan & Nieweglowski, 2019). Stigmatization refers to an attitude of disapproval and discrimination against a specific group of people, who are people with mental illnesses in this case (Crumb et al., 2019). Therefore, it is a destructive and unproductive treatment of vulnerable groups, which has no place in nursing and healthcare in general.
Why?
The key reason why the problem is a significant concern is the fact that it exacerbates health inequity, worsens the quality of care, discriminates against minorities, and can be easily reversed with educational interventions. For instance, a study indicates that depression was historically stigmatized, but currently, it is no longer stigmatized, which made the treatment efforts more effective (Pescosolido et al., 2021). This development is an outstanding sign of improvement, which is a clear indication that the issue has a solution and people can change their views of specific issues. The core element is the fact that uneducated, poorly informed, or misinformed individuals are the ones most susceptible to stigmatizing others. It requires a degree of wisdom and knowledge to understand that many mental health problems have causes and roots in external forces outside the range of control of the victim.
How?
However, other mental health issues remain under its influence, which is hurting people of color and exacerbating health inequities (Misra et al., 2021). The mere fact that there are racial connotations regarding adults with mental illnesses is sufficient to view the problem as a serious one. In addition, stigmatization is relatively easy to overcome through efforts aimed at improving the familiarity of nurses with the conditions (Corrigan & Nieweglowski, 2019). Proper training and education can help nursing professionals to be more aware and competent in dealing with such patients without falling under the influence of stigmatizing thinking and discrimination. The latter, in turn, will significantly improve the effectiveness of treatment procedures, leading to better patient outcomes.
PICOT Question
The problem is the stigmatization of adults with mental health illnesses, who receive poor-quality care as well as experience worse outcomes as a result. The core intervention of interest is familiarity-based training and education of nursing professionals since “stigma diminishes as a group moves from having almost no experience with mental illness to acknowledging its effects (Corrigan & Nieweglowski, 2019, p. 40). The alternative solution is the lack of any intervention to wait until the nurses evolve gradually with the public, such as in the case of depression.
The direct measurement of the outcome will be the improvement of the perception of quality of care by the families, caregivers, and patients themselves. An additional metric would be the competence and knowledge of nursing professionals on the intricacies of a range of mental illnesses. The target date for the effect to manifest is one year or 12 months, which should be sufficient for changes to have a noticeable impact.
PICOT: In adult patients with mental health illnesses, how does familiarity-based training and education, compared with no intervention, lead to better patient satisfaction with the quality of care and nursing knowledge on mental health issues within one year?
Literature Review
The analysis of recent literature on the subject provides evidence to support the validity of familiarity-based training and education. Alegría et al. (2021) found that effective quality care can be achieved by “transforming the behavioral health system to meet people where they are, decriminalizing mental illness and substance use disorders to facilitate recovery” (p. 112852). In addition, the researchers emphasized the importance of “raising awareness of social context and social needs” (Alegría et al., 2021, p. 112852). In other words, providing education and training to caregivers increases the quality of care.
Another study states that “as creators and guardians of this professional culture, medical faculty and other physicians must be the ones who change it” (Brower, 2021, p. 635). Thus, physicians must be involved in the change program alongside nurses as well to ensure the improvement persists. Da Silva et al. (2020) claim that stigma can be reduced by more contact with the mentally challenged and education.
The PICOT question’s outcome on patient satisfaction is tied to less stigmatization as well. It is stated that “patients and HCPs share concerns and ideals for implementation of health promotion in daily clinical practice, including taking into account the individual patient’s situation and resources” (Schnor et al., 2021, p. 878). In other words, a key emphasis should be put on treating a patient with mental illness as an individual with a medical problem rather than attributing their condition to the general personality or worth.
Another study further substantiates the finding by claiming that such efforts can be enhanced through support provided by telehealth methods and telephone assistance (Lawes-Wickwar et al., 2018). Thus, it is evident that stigma is not only ethically unacceptable as a form of human interaction, but it also detrimentally impacts both perceived and actual quality of care.
In the case of why training and education are the most plausible solutions, it should be noted that there is a significant gap in the competence of nurses when it comes to dealing with patients with mental illnesses. A study found that healthcare professionals “endorsed some willingness to help persons with mental illness but reported not having appropriate training and supervision to deliver mental healthcare” (Koschorke et al., 2021, p. e0258729). Thus, the positive effects of familiarity-based training and education not only reduce stigma but also improve the competencies of the nurses willing to help the target patient group. The plausibility of the proposed intervention is further supported by its highly cost-effective nature, creating the most significant treatment gap reductions for the expenses incurred (Koly et al., 2021). In other words, even if it is not the ideal solution, it is practical and accessible for any organization seeking to combat the stigmatization problem among its nurses.
Familiarity is an essential piece of the training protocol since it implies that nurses are exposed to people with mental illnesses, which helps to humanize the patients, encouraging compassion and empathy. It was found that “familiarity with depression is associated with less stigma toward the disorder, but familiarity with the other conditions is not a significant predictor of stigma in the other vignettes” (Jacobi et al., 2022, p. 234). Therefore, “interventions to mitigate stigma in faith communities should consider differences by condition types and the particular characteristics of faith-based settings” (Jacobi et al., 2022, p. 234).
In other words, such training and education efforts need to be comprehensive for all major mental illnesses because focusing on one does not mean lowered stigma for another condition. However, it is essential to include the needs of nurses in training as well. It is stated that “reducing stigma by addressing what matters most to healthcare providers, predominantly through mitigating survival and professional threats” (Kohrt et al., 2020, p. 112852).
Recommendations
Practice Change
The identified evidence-based recommendation for the selected practice change is familiarity-based training and education. The recommended change is to destigmatize and decriminalize mental illness by equipping nurses with key skills, competencies, and knowledge of what mental illnesses are and how they affect patients suffering from them (Alegría et al., 2021). It additionally entails the need to expose nurses to patients with a wide range of mental illnesses to ensure comprehensiveness of familiarity dimensions (Da Silva et al., 2020; Jacobi et al., 2022). A rationale is that a mental disorder must be separated from an individual struggling with it to enhance the quality of care, patient satisfaction, treatment effectiveness, and nurses’ professional growth (Schnor et al., 2021). Interdisciplinary efforts are necessary concerning physicians since they tend to be the prime enablers or preventers of stigma in a healthcare organization (Brower, 2021).
Stakeholders
The key stakeholders are nurses, physicians, and patients with mental illnesses. All three groups are needed to ensure a successful organizational and practice change. Firstly, nurses are the leading group of interest since they will be the ones undergoing familiarity training and education. Therefore, they will need to be cooperative, collaborative, and willing to improve professionally.
Secondly, people with mental illnesses will be impacted because their satisfaction with care, outcomes, and treatments will become better as a result. In addition, they will be needed in familiarity training and education to facilitate the exposure of nurses to the conditions, humanize them, and depersonalize their disorders from their identities. Thirdly, physicians are the key enablers and preventers of stigma, which means they need help from nurses in their de-stigmatization process. It can include providing more details on patients to account for their unique situations and conditions.
Fit, Feasibility, and Appropriateness
The fitness of the familiarity-based training and education is based on evidence provided in the literature review. Familiarity is a crucial part of the training program because it involves nurses interacting directly with individuals with mental illnesses. (Jacobi et al., 2022). The feasibility is based on the fact that it is highly cost-effective, achieving the most significant reduction in treatment gaps relative to the costs involved (Koly et al., 2021). The appropriateness is manifested in even the willing nurses not having appropriate supervision and training, developing a competency gap to be filled by the intervention (Koschorke et al., 2021). Thus, familiarity-based training and education are fit, feasible, and appropriate for the identified practice problem.
Conclusion
In conclusion, adult patients with mental health conditions benefit when nurses receive familiarity-based training and education. If one contrasts this approach with no intervention, one will see how this training can improve patient satisfaction with care and increase nurses’ understanding of mental health issues within a year. Stigma and neglect of mental health concerns can lower the quality of care and harm patient outcomes. By providing nurses with key skills and knowledge, familiarity-based training helps reduce stigma and treat mental illness with understanding rather than judgment. Mental illness, like height, should never define a person’s worth.
References
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