Introduction
Mental health is of great importance to individuals and contemporary society in general. Psychotic illness involves severe illnesses of an individual’s mental capacity and leads to abnormal perceptions and thinking (McCleery et al., 2019). Such diseases require urgent attention to help address them and ensure that the individual regains their mental health back as soon as possible. Statistics reveal that over eight percent of patients suffer from psychotic disorders, and all mental patients require medical assistance. Mental health first aid refers to the assistance offered to an individual developing a mental problem or in a mental crisis (Jorm et al., 2018). In every illness, there are primary symptoms that their slightest onset and manifestation suggests the presence of a particular disease.
There are two main symptoms of mental illness: hallucinations and delusions (McCleery et al., 2019). The current study focuses more on the former, hallucinations, and their impacts on the individual’s life quality. The brain part responsible for hallucinations remains unclear despite efforts to establish it (Kim et al., 2021). According to Cassidy et al. (2019), hallucinations, a key feature of psychotic disorders, rely on excessive striatal dopamine.
Delusions include false beliefs, a good example being the thoughts that patients’ friends or enemies are plotting to kill them. They result from damage to the cognitive paths and are therefore representative of the dysfunction of cognitive processes (Connors et al., 2020). The leading causes for delusions are alterations in inferential methods through adequate evidence still lacking (Baker et al., 2019). However, more research is being done to identify the causes.
Delusions are similar to hallucinations but have some differentia that nurses need to know. Hallucinations are perceptions without objectively identifiable stimuli; they are generated from scratch in reality (Corlett et al., 2019). There exists no adequate evidence on the interventions of mental health services through some measures lower cases of hospital admissions (Molyneaux et al., 2019). Medical workers defined mentally challenged people as idiots, lunatics, raving mad, intemperate, and hysterical (Hercelinskyj et al., 2019). Hallucinations are a common perceptual disturbance for someone living with a psychotic illness.
Culturally Safe Nursing Intervention for a Consumer with a Psychotic Illness
Culture plays a critical role in the health of community members. Culture is essential at any healthcare level, and its factors influence the interactions between service users and mental health professionals (De et al., 2022). There have been global efforts to treat and avert the adverse effects of mentally ill consumers. The measures are diverse and helpful; they include screening and preventing comorbidities such as diabetes mellitus, cardiovascular diseases, and cancer (Brunero et al., 2020). It is believed that very little is known about the safety of the mentally ill, and that nursing practices target risk management rather than safety promotion (Cutler et al., 2020). Nurses have an active role in care coordination, assessment, planning, implementation, and evaluation of healthcare interventions (Hercelinskyj et al., 2019). Only then will mentally ill people be able to get better and not adapt to circumstances.
Australian Culture
In Australia, doctors and nurses are very attentive to medical documentation, and any work patterns with the mentally ill have already been recorded. There exist significant disparities between the indigenous and non-indigenous Australian populations when considering the wellbeing and health status of the population (McGough et al., 2018). The indigenous people record relatively more mental distress cases than the non-indigenous people, and this has therefore been identified as a problem that requires urgent attention.
There have been suggested strategies applicable in solving health disparities and cultural diversity in health. The methods include; cultural competence, cultural awareness, cultural security, cultural safety, and cultural respect. The concepts seem similar and address the same issue. There are limited working hours in healthcare service delivery for mental services hinder free access and, therefore, should be expanded (Duggan et al., 2020). Careful analysis of each idea enables its understanding of the issues it focuses on in addressing the injustices to healthcare access.
Cultural Safety
The primary task of helping mentally ill people is to protect them from negative social phenomena and moods. The focus is on the professional and the institutions to develop a safe patients’ place-responsive and sensitive to their social, spiritual, economic, linguistic, and political concerns (McGough et al., 2018). In cultural safety, more emphasis is beyond the ethnic background of the patient and calls upon the health experts to have a self-reflection of their cultural identity.
Culturally safe health care services contribute to improved health outcomes. It is the case for Australia’s aboriginal and Torres Strait Islander Peoples (De Zilva et al., 2022). The global health inequities are described and documented based on disease and deficits (Chakanyuka et al., 2021). The above description shows that promoting patient safety is one of the culturally safe nursing interventions for a consumer with a psychotic illness.
People cannot ignore cultural weaves and interactions and how some cultures differ from others. For example, Asian culture is fundamentally different from the culture and society in Australia or the United States. The modern understanding of social and humanitarian terms tells us that culture is a multilayered concept determined by several factors such as class, language, religion, gender, and nationality, among others (Gopalkrishnan, 2018). Any culture has a set of values that the members believe and hold so dearly and consists of social issues and norms.
Understanding Cultural Diversity
It affects mental health, such as the perception of illness and health, health-seeking way of conduct, consumer attitudes, and the mental health systems. Several cultural diversity components have some implications for mental health experts. It is worth noting that despite the prevalence of mental disorders, many undergraduate students still hold stigmatizing, discriminative and inaccurate beliefs towards mental disorders (Hansen et al., 2021). Such issues affect the quality of care offered to the patients seeking them.
Supporting Emotional Expression
Diseases may result from an imbalance in expression in certain cultures. A good example is when discussing a painful or traumatizing event, and there is the possibility of causing painful memories and emotions (Gopalkrishnan, 2018). It means that despite talking therapy being a cultural solution to the mental disturbances in many people, such therapies will be underutilized, thus leaving the problem still a challenge. It remains a fact that talking therapy is another culturally safe nursing intervention for a consumer with a psychotic illness. Therefore, efforts should be made to ensure that strategies are formulated to enhance talking therapy, which will relieve mental distress, thus preventing psychotic illness. Talking therapy is a culturally safe nursing intervention for a consumer with a psychotic illness.
Addressing ‘Shame’
Another element that contains a cultural intervention is a shame which explains why many people, especially Asians are slow to access professional services. In many cases, people feel ashamed of their mentally challenged relatives to abandon and deny them (Gopalkrishnan, 2018). If the problem of shame is addressed and people are made aware that mental issues are common and there is no need to either be ashamed or forsake them, they will half solve this challenge. There is evidence that people from certain minority groups are likely to experience disparities in health care access due to socio-cultural factors (Chauhan et al., 2020). Therefore, shame hinders cultural interventions for mentally ill people, and if this is addressed, interventions will be successful.
Solving Power Distance
In many cases, a gap exists between the therapists and the patients, complicating the development of the patient-therapist relationship hindering service delivery (Gopalkrishnan, 2018). Cultural implications influence the perception of health and illness, dictating the willingness of people to seek medical assistance. The population increase overburdens healthcare facilities with disease incidences and service delivery to the people (Rovito et al., 2022). The perception of disease etiology in culture will influence the response of the culture people. For example, any signs of COVID-19 are likely to compel people to seek medical attention as it is perceived to be deadly compared to malaria, where some cultures treat it traditionally.
Development of Cultural Partnerships
The reason is that various factors hinder medical seeking from several cultures, such as shame and lack of good partnership between the parties involved (Gopalkrishnan, 2018). Therefore, creating a cultural collaboration will ease attempts by people to share their ideas and problems, which reduces addressing the experienced challenges. The need for some constant communication between the communities and the health professionals to address some of these challenges.
Evidence-Based Psychoeducation Strategy
Many people are ignorant about mental illness and how it develops. Psychoeducation is a current affair; it has gained relevance in mentally ill patients (Sarkhel et al., 2020). Most psychotic illnesses are affected by shame, disapproval, and disgrace (Al Saif et al., 2019). There is the need to educate people to reduce cases of bullying by relatives of psychotic ill people or the patients who cannot protect themselves.
Problems Encountered by the Psychotic Patients
There is rejection, discrimination, and rejection from society affairs and socialization. The prejudice these mentally ill people face is equal to a secondary illness. It becomes a problem for them to cope with this secondary illness even before the mental disorder itself—stigma results from the misunderstanding by society on the implications of mental disorders. There is a need for psychoeducation on mental health as an intervention measure (Gupta et al., 2019). Despite past results on these interventions being discouraging, there is a need to continue improving them. There is public stigma where almost everyone in society excludes the patient. There is the double stigma that exists where the patient suffers from two conditions, such as HIV/AIDS and racism, at the same time. Other forms of racism include self-stigma, which results from self-denial, a social distance which means exclusion from the main social issues. Stigma is a great challenge and barrier for the mentally ill people seeking health services (Al Saif et al., 2019). In reality, very few people suffering from mental disorders are identified and treated, significantly affecting the victims’ lives.
Possible Solutions
A solution to this endemic challenge of stigma had to be found, and it theorized to be education, although education on its own is not enough but beneficial. In education, three main problems have been identified for addressing and believed to complicate the issue of not accessing medical attention. The three problems are prejudice, misinformation, and discrimination (Al Saif et al., 2019). Clinical trials and systematic reviews have demonstrated that psychoeducation significantly reduces relapse rates in patients with SMD and caregivers’ burden and stress level (Mottaghipour et al., 2019). Therefore, the strategy is to develop a mental health curriculum that enables mentally ill individuals to share the cognizance of their mental disorders with trainees and health care providers who may have stigmatizing opinions.
The study showed that people involved in the evidence-based practices improved their mental health and lowered stigma in the mental health profession. Efforts on interventions have recorded positive results in reducing mental illness cases (Adkins et al., 2018). Integrating evidence-based practices and cultural competence in mental health remains limited (Knaifel, 2021). In Japan, psychiatrists undertaking evidence-based practices reported low stigmatization levels. Studies show that professionals and patients undertaking evidence-based practices show low stigma levels.
Conclusion
Medical studies state that hallucinations are common among people with psychotic disorders. These hallucinations strongly influence the perception of reality and, as a result, on a person’s life in all aspects: family, work, and relationships. The cultural environment in which a patient lives significantly influences how quickly he seeks help and how boldly he can declare his illness. Asian cultures tend to avoid psychotic problems; the people living in them cannot even admit to friends and relatives that they see hallucinations or suffer from another mental disorder. Australian culture is very different from Asian culture in this question. Most patients can feel at ease and rely on the attentive assistance of doctors and nurses. Taking into account cultural characteristics in providing support to the patient will allow him to recover more quickly and integrate into society, working or studying. It is necessary to make psycho-education accessible in the community, saving people from prejudices.
References
Adkins, T., Luyten, P., & Fonagy, P. (2018). Development and preliminary evaluation of family minds: A mentalization-based psychoeducation program for foster parents.Journal of Child and Family Studies, 27(8), 2519–2532. Web.
Al Saif, F., Al Shakhoori, H., Nooh, S., & Jahrami, H. (2019). Association between attitudes of stigma toward mental illness and attitudes toward adoption of evidence-based practice within health care providers in Bahrain.PLOS ONE, 14(12). Web.
Baker, S. C., Konova, A. B., Daw, N. D., & Horga, G. (2019). A distinct inferential mechanism for delusions in schizophrenia. Brain, 142(6), 1797–1812. Web.
Brunero, S., Everett, B., Ramjan, L. M., Salamonson, Y., Steel, K., Johnson, A. M., Stokes, M., Langdon, R., & Dickens, G. L. (2020). Clarity, confidence and complexity: Learning from mental health nurses’ experiences of events involving physiological deterioration of consumers in acute inpatient mental health settings. Journal of Clinical Nursing, 29(7–8), 1102–1114. Web.
Cassidy, C. M., Balsam, P. D., Weinstein, J. J., Rosengard, R. J., Slifstein, M., Daw, N. D., Abi-Dargham, A., & Horga, G. (2018). A perceptual inference mechanism for hallucinations linked to striatal dopamine.Current Biology, 28(4), 503–514. Web.
Chakanyuka, C., Bacsu, J. D. R., DesRoches, A., Dame, J., Carrier, L., Symenuk, P., O’Connell, M. E., Crowshoe, L., Walker, J., & Bourque Bearskin, L. (2022). Indigenous-specific cultural safety within health and dementia care: A scoping review of reviews.Social Science & Medicine, 293. Web.
Chauhan, A., Walton, M., Manias, E., Walpola, R. L., Seale, H., Latanik, M., Leone, D., Mears, S., & Harrison, R. (2020). The safety of health care for ethnic minority patients: A systematic review. International Journal for Equity in Health, 19(1). Web.
Connors, M. H., & Halligan, P. W. (2020). Delusions and theories of belief.Consciousness and Cognition, 81. Web.
Corlett, P. R., Horga, G., Fletcher, P. C., Alderson-Day, B., Schmack, K., & Powers, A. R. (2019). Hallucinations and strong priors.Trends in Cognitive Sciences, 23(2), 114–127. Web.
Cutler, N. A., Sim, J., Halcomb, E., Moxham, L., & Stephens, M. (2020). Nurses’ influence on consumers’ experience of safety in acute mental health units: A qualitative study. Journal of Clinical Nursing, 29(21–22), 4379–4386. Web.
De, D., Fothergill, A., & Richardson, J. (2021). Implementing cultural safety to enhance the care of mental health service users. Mental Health Practice, 25(2), 34–41. Web.
De Zilva, S., Walker, T., Palermo, C., & Brimblecombe, J. (2021). Culturally safe health care practice for indigenous peoples in Australia: A systematic meta-ethnographic review.Journal of Health Services Research & Policy, 27(1), 74–84. Web.
Duggan M., Harris B., Chislett W. K., & Calder R. (2020). Nowhere else to go: Why Australia’s health system results in people with mental illness getting ‘stuck’ in emergency departments. Mitchell Institute Commissioned Report, Victoria University.
Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in Public Health, 6. Web.
Gupta, N., Tyagi, S., Chavan, B., Kaur, H., & Sharma, V. (2019). Delivery by “Trained hospital-based health workers” of “Family psychoeducation package” to caregivers of patients with schizophrenia through “Task-sharing” strategy. World Social Psychiatry, 1(1). Web.
Hansen, A., McGarry, D., Johnson, A., & Roche, M. A. (2021). The impact of an undergraduate students’ culture on their learning about mental health: A scoping review.Nursing & Health Sciences, 23(2), 352–361. Web.
Hercelinskyj, G. J., & Alexander, L. (2019). Mental health nursing: Applying theory to practice. Cengage AU.
Jorm, A. F., & Ross, A. M. (2018). Guidelines for the public on how to provide mental health first aid: Narrative review. BJPsych Open, 4(6), 427–440. Web.
Kim, N. Y., Hsu, J., Talmasov, D., Joutsa, J., Soussand, L., Wu, O., Rost, N. S., Morenas-Rodríguez, E., Martí-Fàbregas, J., Pascual-Leone, A., Corlett, P. R., & Fox, M. D. (2019). Lesions causing hallucinations localize to one common brain network. Molecular Psychiatry, 26(4), 1299–1309. Web.
Knaifel, E. (2021). Cultural competence in multi-family psychoeducation groups: The experiences of Russian-speaking immigrant mothers of adults with severe mental illness. Transcultural Psychiatry. Web.
McCleery, A., & Nuechterlein, K. H. (2019). Cognitive impairment in psychotic illness: Prevalence, profile of impairment, developmental course, and treatment considerations. Dialogues in Clinical Neuroscience, 21(3), 239–248. Web.
McGough, S., Wynaden, D., & Wright, M. (2017). Experience of providing cultural safety in mental health to aboriginal patients: A grounded theory study. International Journal of Mental Health Nursing, 27(1), 204–213. Web.
Molyneaux, E., Turner, A., Candy, B., Landau, S., Johnson, S., & Lloyd-Evans, B. (2019). Crisis-planning interventions for people with psychotic illness or bipolar disorder: Systematic review and meta-analyses. BJPsych Open, 5(4). Web.
Mottaghipour, Y., & Tabatabaee, M. (2019). Family and patient psychoeducation for severe mental disorder in Iran: A review.Iranian Journal of Psychiatry. Web.
Rovito, K., Kless, A., & Costantini, S. D. (2022). Enhancing workforce diversity by supporting the transition of internationally educated nurses. Nursing Management, 53(2), 20–27. Web.
Sarkhel, S., Singh, O., & Arora, M. (2020). Clinical practice guidelines for psychoeducation in psychiatric disorders general principles of psychoeducation. Indian Journal of Psychiatry, 62(8). Web.