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Reflective Writing In Mental Health

22 Sep 2020 28 Views Sarah

Reflective Writing Assignment

Engaging and Assessment in Mental Health-II


People who are diagnosed with mental health disorders have been stigmatised all around the globe. The aim of this paper is to critically analyse the article “Nursing Students’ Attitudes Towards People Diagnosed with Mental Illness and Mental Health Nursing: An International Project from Europe and Australia”. Furthermore, this paper also talks about the concepts and issues from the most relevant and current research in relation to the topic discussed in the article and the affect it has on the professional nursing practice. The article in question clearly suggests that the stigma of patients suffering from mental health disorders has not decreased to a level one would like to decrease over the years. It has been observed through personal experiences and research studies, that it is not just the general public but the professional healthcare workers like nurses share the same kind of negative attitudes towards people who have mental health disorders. The low intake into mental health nursing as acareer alternative is also a result of the inherent bias towards the people suffering from mental health. It is one those areas in nursing which is least famous (Happell et al., 2020). The goal of this article is to examine the attitudes of the nursing professionals towards mental health and examine the mentalhealth nursing in four European nations including Ireland, Norway, Finland, and the Netherlands) and compare it with Australia with the use of the Mental Health Nurse Education survey and the Opening Minds Scale (Stevens, 2018). It was observed that although the attitudes of nursing students in general was positive towards patients suffering from mental health disorders but it was seen that students from Ireland and Australia have a much more positive attitude compared to students from Norway, Finland and the Netherlands. The quality of health services that are to be provided in the future will depend on the attitude of the nurses that are going to be attracted to it. It is pertinent that nurses having positives attitude knowledge and desire to work with the community suffering mental health issues are selected for it (Happell et al., 2020). The attitude of nursing students towards mental illness and mental health nursing is the basis for mental health nursing and hence this needs to be explored. The negative or positive aspects in the student phase remains set and it affects the way their professional nursing career turns out to be (Al-Ma & Hamdan- Mansour, 2020).


As attitudes among nursing students can be of real importance in how their professional lives turn out to be and hence a study on the approach of nursing students is a great pioneering approach. It has been observed and hence depicted how the changing attitudes of nurses throughout the student life to that of an intern and to that of a professional nurse (Al-Ma & Hamdan- Mansour, 2020). As the article is studied, it helps us understand how mental healthcare is processed and perceived among pursing students and what is the perception of nursing students to be regarded as appropriate, good, important or relevant. To provide patient centred and collaborative care as a nurse to mental health patients, it is important to understand as a nurse, what sort of attitude one has to grow (Alexander et al., 2018). The values and beliefs of nursing students are studied and observed and its impacts on mental healthcare is studied in this article (Harrison, Hauck & Ashby, 2017). The purpose of this article is to make a nursing student feel confident about identifying and managing different attitudes in the field of nursing so much so that a student understands the direct impact of attitude on mental healthcare. The role of persuasion in making nursing students reject behaviour which have less than optimum effect on the outcomes (Stuhlmiller & Tolchard, 2019).

When the attitudes of nurses in mental health is positive, there can be consumer participation into mental health services or the people who want mental health service and support. Without such positive attitude, it becomes a significant obstacle (Alexander et al., 2018). This article helps confirm the role of the positive attitude of the nurses towards mental health patients. Although majority of nurses do not feel any negative sentiments towards mental health patients, but negative perceptions and experiences do make the nursing students associated with mental health disorder patients (Xie et al., 2018). The article, which is based on current research, also compares the attitudes of the present nursing students and with the attitudes of the students of a decade back to arrive at a comparative study (Harrison et al.2017).

The article helps one understand how the education during the student period is responsible for improving socialisation in the culture of the entire nursing profession. The phase of education in nurses is an area of focus because it helps develop thee attributes and qualities which are required to bring about a positive change in the spectrum of professional practice (Alexander et al., 2018). Exposure to the patients with mental health problems happen in the student life for the first time and hence this is the perfect time to explore the attitudes of thee students towards patients of mental health (Günüşen et al., 2017). This period helps to develop the knowledge, skills and attributes of the new graduate nurses, which will help provide high quality care to patients who are mentally ill. The involvement of Experts by Experience in the article is also highly influential. It is helpful in raising the mental health care by developing the attitude towards caring for patients of mental healthcare (Happell et al., 2020).


The article deals with the very important issue of the stigmatisation and the development of the negative attitude of the field of nursing towards mental health patients. It is an issue that requires urgent attention as the negative connotation with the issue needs to be done away with among the mental health professionals, specially the nurses (Pusey-Murray, 2017). The cultural stereotypes developed over the ages and festering among the population, leads to negative prejudices among mental health professionals, psychiatry, psychiatrists and the family members of the mentally ill patients. As the article points out, healthcare professionals are not always immune to the stereotypes of the general public (Xie et al., 2018). The nurses play a prime role in rehabilitating a patient suffering from mental illness and as the patient and their family members are less knowledgeable about the treatment and procedures, they expect the nursing staff to act sans any discrimination or biases (Stuhlmiller & Tolchard, 2019). Nurses thus have to make themselves cognizant of their inherent biases and work towards getting rid of them in a systematic manner (Harrison et al., 2017). Behaviours such as inappropriate distancing and lack of adequate awareness based out of fear which is the major cause of stigma and discrimination. One way is to be acquainted with someone suffering from mental illness as it helps positively influence the attitude (Stevens, 2018).

Nurses have to encourage therapeutic value of the community care along with deinstitutionalised care on an imperative level. This type of care gives the patients who are mentally ill, enough opportunities to understand the behaviour and issues and thus be more involved in their treatment and care (Happell et al., 2020). This also helps them trust the treatment process and the healthcare professionals involved in that, further. Nurses need to learn to be more involved with the patients and such deinstitutionalised therapeutic care (Dickens et al. 2019). Like any other illness, mental illness also requires the same elements of love, support, kindness, dignity and patience and a nurse needs to focus on the implementation of these principles (Pusey-Murray, 2017). These principles seem to be well imbibed for the nursing students in Ireland who are endowed with self-reporting measures and are more capable in general due to their familiarity with mental health patients (İnan et al., 2019). A nurse needs to understand, not just the needs and symptoms of the patient but also but also be knowledgeable about the needs of these patients, be self-sufficient, self-aware and self-efficacious. This helps the nurses reduce social distancing with their patients. It is pertinent that every nation helps develop the skills and understanding of their nursing students to ensure the best mental healthcare scenario in their country (Happell et al., 2020). When the students who are pursuing nursing are involved directly in a specialist field of mental health, their acclimatisation gives them a higher chance to attain more positive attitudes (İnan et al., 2019). This might also be the reason why similar attitudes among nursing students are seen among the nursing students of Finland and Australia (Stuhlmiller & Tolchard, 2019). Being a part of the Australian nursing system has made this particular student really positive towards the aspect of mental healthcare (Stevens, 2018).

This article helps one refocus the career strategies of one’s life with regards to nursing profession. It helps one not just attain experience in mental health nursing but maybe go a step further and make mental health nursing their speciality discipline giving it a more positive outlook (Al-Ma & Hamdan- Mansour, 2020). The comprehensive education approach to popularize mental health as a career choice among nursing professionals has definitely made nursing students more aware and inclined towards choosing mental health as a career (İnan et al., 2019).


Communication with the mentally ill patients and providing care to the mentally ill patients in a manner that is also culturally sensitive (Günüşen et al., 2017). Similarly, providing person-centred care among such patients is also something that is advocated by this article. Teaching strategies need to be revised and modifications into mental health programs need to be done to foster better attitudes among mental health professionals (Pusey-Murray, 2017). The perceived dangerousness of the patients suffering from mental health is a factor that is more present than the other areas and beliefs and attitudes among also influence the patient care (Happell et al., 2020). Although there are concerns regarding the aggressive nature of patients suffering from mental health disorders but over 2/3rd of the studied, students didn’t agree that mentally ill patients rarely pose a risk to surrounding people and more than 50% agreed on them being violent (Al-Ma & Hamdan- Mansour, 2020). Nurses during their student life need to be trained in the skill of managing aggression in their own selves and in the patients and this will help develop a different and ore positive and efficient attitude in dealing with the aggression that patients display (Alexander et al., 2018). This article helps one think in a more positive light, the aggression of mental health patients and hence it motivates to be trained in aggression and conflict management skills and technique, which will help one become a better professional as a whole (Dickens et al. 2019).


The contribution of this article to my professional nursing career is huge and it has become quite evident during the course of this reflective analysis that the single most important aspect that nursing boards and authorities have to focus on for better mental health care is the instilling of positive attitudes among nursing students (Xie et al., 2018). Healthcare services need nurses to be in the leadership role to foster better participation of the consumer in mental health set up (Harrison et al., 2017). At the beginning of the student life is when nursing students should be instilled with the leadership skills, motivational sessions, in-depth learning and evidence-based idea of the mental health set up (Alexander et al., 2018). This will help inculcate nurses with professional attitudes which are optimistic and professional. One of the key reflections of the article is that it made me think that the involvement of mental health experts in to resonate with the “experts by experience”, wherein the experts can share their experiences and help nursing students understand the approach required to deal with such instances in the future with expertise and a positive attitude (İnan et al., 2019).

The approach of “experts by experience” needs to be promulgated along broader national lines and this article focuses on the importance of such collaboration along international lines (Harrison et al., 2017). This will help nurture positive attitude during the education of nursing students towards mental health and mental health illness. It is evident that experts by experience can provide solid baseline data in measuring the attitudes of the nurses and how it has changed (Dickens et al. 2019). Sometimes students have negative attitudes bred due to the negative connotations among the general public about mental health patients and this cant be allowed to persist as it will be disastrous for the mental healthcare scenario and patients (Stuhlmiller & Tolchard, 2019). Senior nurses must lead the example with positive attitudes and positive examples and this will help in the development of a competent workforce which will better the therapeutic environment among mental health patients and professionals (Dickens et al. 2019). This article has helped me understand that nurses play a huge role in the maintenance of positive environment and attitudes in the field of mental healthcare. A nurse leader can ensure that there are enough members who are recovery-oriented and skilled in handling the rigours and demands in taking care of patients suffering from mental health disorders (Xie et al., 2018). A nurse leader can discuss her experiences and involve the students in the discussion about mental health and also try and understand their views and perspective about mental health and the issues they are facing and how they can be sorted out (Pusey-Murray, 2017). These can help student nurses understand the challenges and the ways to be prepared for facing those challenges and thus establish mental healthcare as a much more efficient profession than before (İnan et al., 2019).

In can thus be summarised with the help of supporting evidence that student nurse participants have been influenced in a positive manner by their exposure towards “Experts by Experience”. It has challenged their beliefs, improved their notions and helped them self-reflect and change their attitude for the betterment of the mental healthcare patients and treatment (Williams et al., 2018). Exposing themselves to stereotypes and then reflection by their own selves is found to be the most useful tool in their themes to help them change the mindset of the students. Here the role of the nursing leaders, experts have to work towards making the student nurses observe their stereotypes, work on removing them and remove all such lacunae (Williams et al., 2018).

As wonderfully informative and useful this article is, there is however one criticism that could be stated that it could have looked at mental healthcare from the approach of the consumer also (Stevens, 2018). Data which is only self-reported could be filled with answers that don’t always reflect the most unbiased actual and truthful results as shyness, inability to open up and fear could skew the data (Xie et al., 2018). Nurses can present answers that are considered socially desirable and correct instead of what their actual belief or practice suggests. Consumers can reflect the more analytical and actual attitude of the nurses since consumers have no fear, obligation towards the profession and will not be reluctant to draw the actual picture (İnan et al., 2019). Consumers will hence define the level of service efficiency, their satisfaction, the amount of compassion or the reflection of biases, if any and if all the due procedures and guidelines were followed without fail (Günüşen et al., 2017). Mental health patients and their families can be the best people to highlight the improvement required in the mental healthcare system and appreciate the good work, already done by the nurses, nurse leaders and the entire healthcare system in general (Dickens et al. 2019).


The cultural beliefs existent in the society and the adverse perception of the patients suffering from mental health is something that affects the attitudes and perceptions of the nurses involved in the treatment of the patients suffering from mental disorders. But there aren’t enough studies which talk about the attitudes of the nurses towards patients suffering from mental health problems and how it affects the mental healthcare. When focusing on the article, I have found that mental health as a career speciality among student nurses will be more abundant with proper guidance and exposure to the challenges and how nurse leaders overcome them. On reflection, it can be said that it is certainly possible that the inherent biases that are in the society could also be part of the biases in the nurses, which could prevent them from choosing mental healthcare practice. The article under review and the reflections in the paper can be useful in creating awareness in the education system among nursing students. This will help in the future to improve the field of nursing in mental healthcare and ensure that there are solutions which make the lives of the mental healthcare patients and mental health professionals better.


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Al-Ma, M. A. Q. M., & Hamdan-Mansour, A. M. (2020). The Effect of Contact-Based Interventions on the Attitudes and Behaviors of Nursing Students towards People with Mental Illness: A Literature Review. Open Journal of Nursing10(3), 260-276.

Dickens, G. L., Ion, R., Waters, C., Atlantis, E., & Everett, B. (2019). Mental health nurses’ attitudes, experience, and knowledge regarding routine physical healthcare: systematic, integrative review of studies involving 7,549 nurses working in mental health settings. BMC nursing18(1), 16.

Günüşen, N. P., Duman, Z. Ç., İnan, F. Ş., İnce, S. Ç., Sari, A., & Aksoy, B. (2017). Exploration of the factors affecting the choices of nursing students who choose psychiatric nursing as the first and last choice. Issues in mental health nursing38(10), 837-844.

Happell, B., Foster, K., Lawman, B., Moxham, L., Powell, M., Ryan, T., ... & Muir-Cochrane, E. (2020). Mental health nursing education in undergraduate and postgraduate programs: Time for change.

Harrison, C. A., Hauck, Y., & Ashby, R. (2017). Breaking down the stigma of mental health nursing: A qualitative study reflecting opinions from western australian nurses. Journal of psychiatric and mental health nursing24(7), 513-522.

İnan, F. Ş., Günüşen, N., Duman, Z. Ç., &Ertem, M. Y. (2019). The Impact of Mental Health Nursing Module, Clinical Practice and an Anti-Stigma Program on Nursing Students' Attitudes toward Mental Illness: A Quasi-Experimental Study. Journal of Professional Nursing35(3), 201-208.

Pusey-Murray, A. (2017). Attitudes of nursing students towards individuals with mental illness before doing the mental health nursing course. Open Access Library Journal4(10), 1-13.

Stevens, S. (2018). Nursing & Clinical Practices.

Stuhlmiller, C., & Tolchard, B. (2019). Understanding the impact of mental health placements on student nurses’ attitudes towards mental illness. Nurse education in practice34, 25-30.

Williams, A., Fossey, E., Farhall, J., Foley, F., & Thomas, N. (2018). Recovery after psychosis: qualitative study of service user experiences of lived experience videos on a recovery-oriented website. JMIR mental health5(2), e37.

Xie, H. T., Zhou, Z. Y., Xu, C., Ong, S., & Govindasamy, A. (2018). Nurses’ Attitudes towards Research and Evidence-Based Practice: Perspectives from Psychiatric Setting.