MENTAL HEALTH

Interventions in Serious and Enduring Mental illness

[Name of the write r]

Interventions in Serious and Enduring Mental illness

Introduction

A therapeutic intervention is an intervention or activity aimed at enhancing mental health through one of the following: improving the quality of mental health, reducing the negative effects of mentally ill health or distress, or retaining psychological/psychosocial equilibrium (DerwenNHSTrust,2008:34).

This essay examines the therapeutic intervention of medication and the process of a patient changing to a new medication to hopefully improve the patient's quality of life.

At my most recent placement, I have been working with a community mental health team that specialise in patients with enduring mental health problems. The majority of these patients have either schizophrenia or bi-polar disorder. I have discovered from this placement that the introduction of different therapeutic interventions to patients is a major part of the nurse's role, especially in the community, this includes; suitable medications, social group therapies and other possible interventions that could be tried in conjunction with or instead of medication. Later in this essay I will discuss this in further detail.

I have decided to base my essay on a particular patient; a man aged 45 years old who has Schizophrenia and has been on a depot injection of Depixol (Flupenthixol Decanoate) for nearly 20 years, having been ill since the age of 17. This man has tried other medications throughout these years but Depixol in combination with Chlorpromazine (as per required need (PRN)) seems to be the only medication tried that reduces his auditory hallucinations and idiosyncratic beliefs to a manageable state and controls other symptoms of Schizophrenia, such as; hallucinations, delusions and bizarre behaviours (Strauss, Bowers and Keith, 1983). The central goals of antipsychotic medication in the long-term treatment phase are; continued suppression of the acute symptoms (continuation therapy) or prevention of the occurrence of another episode of acute symptoms (maintenance therapy) (Dixon, LehmanandLevine,1995:56).

This patient currently experiences many extra-pyramidal side effects from being on Depixol. The National Institute for Clinical Excellence (NICE) (2002) recommends that people experiencing side effects with older antipsychotics should be offered an atypical antipsychotic. NICE advise that the oral atypical antipsychotic drugs amisulpride, olanzapine, quetiapine, risperidone and zotepine are considered as first choice treatments for schizophrenia, but Aripiprazole was not considered as part of this guideline as it was not approved until 2004.

This essay will monitor the transition from a fortnightly depot injection of Depixol (80mg) to the use of oral medication Abilify (Aripiprazole) (15mg once daily). It will also explore how this medication has an effect on this patient's Schizophrenia. In addition, I will study the role of the Community Psychiatric Nurse (CPN) and the community mental health team in supporting this patient.

Our community team will observe the transitional change of medication and monitor the effect of the new medication Abilify. This will be achieved by effective communication and various assessments on fortnightly home visits and telephone calls. I will perform a literature search to investigate the positive and possible negative effects of Abilify and compare with other antipsychotic ...