UNIVERSITY OF CAPE COAST

COLLEGE OF HEALTH AND ALLIED SCIENCE

SCHOOL OF NURSING AND MIDWIFERY

DEPARTMENT OF MENTAL HEALTH

COURSE TITLE: MENTAL HEALTH NURSING

PRACTICE

LECTURER: MR. FREDERICK NSATIMBA

COURSE CODE: MHN 429

SN/NUS/20/0045
 Question 1

I was placed at the Elmina Polyclinic for mental health nursing practice. It is located in the
Elmina town. I was assigned to the mental health unit.

Monday, 10th June, 2024

It was the reporting day. I got to the unit in the morning with my colleagues. We were met with a
warm reception at the unit. Orientation on the unit was done by a staff. We were introduced to
their general weekly routine activities. Health education was held on Mondays at the polyclinic
but due to the bureaucratic things required on the reporting day, the time for health education
was over-due by the time myself and my colleagues reported to the unit.

After, the orientation on the unit, I had the opportunity to read patient folders and know the
conditions of clients on the unit. I asked questions on some of the conditions and the medications
given to the patients all questions were duly answered.

We were given assignments for presentation in the unit the same day. We were grouped into
three groups and topics were assigned. The assignment was required to be in the power point and
the group would present when due. My group’s topic was on anger and aggression.

Also, we were informed of a school health education within the week at one of the Junior High
Schools in the community. As colleagues, we agreed to educate the students on adolescent and
reproductive health. A letter was written immediately and sent to the school. We had a positive
response from the school on the same day. The headmaster was pleased with the topic and
granted permission to do the health education the Junior High School students only.

Tuesday, 11th June, 2024

On this day, it was home visit / Case Search. We provided health check-ups and patient
education in their homes with the mental health nurses. I and my colleagues visited clients to
observe their environment, check family support and ultimately know how they were responding
to treatment.

The first client had the diagnosis of cannabis use disorder and epilepsy. It was a referral case to
the polyclinic due to proximity so it was new case. He lived in a slum area and the house was
made of blocks. On arrival, we were welcomed by the family warmly and offered seats. On
observation, the family were very supportive. Also, client had relapsed because he had stopped
treatment for about 2 years. He was quite disoriented but could mention his name. He had a room
in the house without a door because the client had removed the door thus, we educated the family
to fix a door for him and get him treated mosquito nets to protect him from malaria.

The family was educated on the need to continue treatment and the treatment options available.
They were informed of clinic hours and the requirements.

Four other patients were also visited as well. They were all schizophrenic and were already on
medications. They were doing well without a sign of relapse. They were all on medications so
they were educated on the need to continue the treatment regimen. They were reminded of the
review dates. Education on how to prevent common illness was done. Their questions and
challenges were addressed to their understanding. They appreciated the visit and were diligent to
adhere to the treatment regimen.

We engaged clients with questions and some shared their experiences with us on how the
condition begun. It was very educative to learn about the onset of the conditions and how they
are managed. After the home visits, a report was written on each client in the report book.

Wednesday, 12th June, 2024

The day after home visits. We asked about observation made from the home visit. It was
observed that most of the gutters in the community were not clean. Also, most of the clients had
schizophrenia so we asked the mental health nurses what could be causing the condition.
Although not proven, there was a conclusion that since there were a lot on intra marriages in the
community, there was a chance the frequency of the condition was as a result of hereditary
factors. The mental health nurses recommended it as a good research topic we could probe in the
future. For the unclean gutters were observed, they recommended that for subsequent days, we
should educate the natives of the town on the need to keep clean gutters in relation to their
health.

The day continued with receiving out patient’s clinic services at the units. Some clients came for
medications and reviews.

Thursday, 13th June, 2024

Presentation of the topics were due. Presentations begun with definition of terms, giving the
signs and symptoms, clinical signs, its management and any other on the topic. Each group
presented on their assigned topics and everyone had the opportunity to questions. Everyone was
engaged in the presentation and took notes. Some shared their experiences on some of the topics
and it was awesome. Each group received feedback from the presentation. Constructive
criticisms were accepted by each person to improve upon on subsequent ones. Although we had
presentations, we paused for client anytime they came to the unit.

Friday, 14th June, 2024

Most of the day was used for school health visit. The school health visit was organized in Dr.
R.P Baffoe Anglican Junior High School on the topic ‘Adolescent and Reproductive Heath’. The
school is a few minutes’ walk from the Elmina Polyclinic. It begun at 9:30am. The team
comprised 2 mental health nurses and 12 students. The objective was to educate the students on
dangers of substance abuse and the importance of menstrual hygiene, promoting healthy choices
and practices. The population consisted Junior High School students. My team was assigned to
the Junior High School 2A students.

We began with a brief and friendly introduction by mentioning our names and ranks. We
introduced to them the purpose of the presentation. We initiated an interactive session by making
students say what they knew about the substance abuse. For each response from a student, their
colleagues clapped for them to ensure a safe and respectful environment. The definition, effects
on mental and physical health was made known to them. Visual aids were used for easy
understanding. Some of the students were called to demonstrate how to use and dispose
menstrual products properly. They were given the opportunity to ask questions. We gave clear,
sensitive and supportive answers to their questions.

We recapped the key points on substance abuse and menstrual hygiene. We encourage them to
say no to substance abuse by avoiding bad friends and not yielding to peer pressure. Also, to be
confident to make healthy choices by maintaining good nutrition, sharing any health issues with
their parents, teachers and reporting to the hospital. We thanked them for their cooperation and
bid them farewell.
 Question 2

The nursing activity I liked the most was the home visit. I liked that the most because, I was able
to meet the client and the family. It was also an opportunity to assess the client, the family and
the environmental factors that could impact the client’s health. Also, clients and the family were
more relaxed to share their problems and experiences. Also, the home visit was an avenue to
know the culture of the family to give a culturally competent and sensitive nursing care. It helped
in identifying problems and the needed plans was done accordingly.
 Question 3

One of the activities I also like was the school health education. The activity was a means to
empower the students with knowledge and confidence to make healthy choices, understand the
risks of substance abuse and maintain proper menstrual hygiene. Also, as we spoke to the
students, I noticed that they were nodding along, taking notes and were engaged in the
discussion. This boosted my confidence. Their thoughtful questions and curiosity made it a
rewarding session. Moreover, the school health education was an opportunity to make a
difference in the student’s lives with such a crucial topic.
 Question 4

1. Clinical placement should be at a psychiatric hospital with patients on the ward. This would
help to observe behaviors associated with some condition and observe the management
effectively. As clients at the static clinics are mostly stable and do not exhibit the behaviors of
their condition unless it is a new or relapsed case at the unit.

2. Provide psychological and educational education to students before clinical placement. This
will be essential because learning in the classroom and experiencing on the clinical placement is
quite different A psychological preparation of the students could prevent any traumatic
experience with a client in their homes during home visits or even at the units as they are
psyched on what could be experienced or witness on the unit.
 Question 5

1. Build capacity to combat stigma and discrimination to promote human rights and recovery.
This is because discrimination with mental health conditions remain pervasive. Creating
significant barriers to their recovery and inclusion in social activities. Community leaders and
organizations should must have initiatives that promote respects for rights of individuals with
mental health conditions.

2. Improving quality of care and human rights conditions in mental health and social services.
The quality of care and the respect for human rights within mental health are necessary for
recovery. This could be enhanced through adopting a person-centered care in mental health to
ensure that care plans are tailored to the unique needs and preferences of each individual. Also,
mental health facilities should be upgraded to ensure safe, welcoming and conducive recovery
with attention on providing privacy.
REFERNCES

Gyamfi, S., Hegadoren, K., & Park, T. (2018). Individual factors that influence experiences and
perceptions of stigma and discrimination towards people with mental health illness in Ghana.
International Journal of Mental Health Nursing, 27(1), 368-377

World Health Organization. (2021). Guidance on community mental health services: promoting
person-centered and rights-based approaches. World Health Organization