Emotional and mental health needs

As you care for your clients, you will often assist them to meet their emotional and mental health needs as they deal with the stress of illness, hospitalization, changes in their ability to care for themselves, and other personal and family issues.

Understanding how stress and coping affects your client's emotional and mental health will help you give the best care possible for your clients.Now, everyone has felt overwhelmed or stressed at some point in their life.

Stress is a physical or mental factor that causes tension emotionally or physically. This can be due to external factors, like having to adapt to major life changes, or internal factors, like having an illness.

Many people learn to use certain activities to relieve stress and feel better. These are called coping mechanisms, which are specific activities people purposefully decide to engage in to relieve stress.

Some people have healthy coping mechanisms, like jogging, spending time with friends, singing, or meditating, while others may rely on smoking, overeating or undereating, nail biting, or abusing alcohol or illicit drugs.

While these alternative coping mechanisms may relieve stress temporarily, they can increase the risk of both physical and mental health problems.

While coping mechanisms are conscious and deliberate reactions to stress, defense mechanisms are our natural, often unconscious, reactions to stress that try to protect us from emotional trauma.

Compensation is when we try to make up for a loss by filling the void with something else positive. For example, someone struggling with loneliness after a divorce might volunteer at an animal shelter.Conversion is when emotions manifest as, or are changed into, physical symptoms.

For example, someone who is emotionally upset complains of chest pain or difficulty breathing.Denial is refusing to accept or believe something that is true or the feelings associated with it, especially if the truth is frightening or unpleasant.

For example, someone diagnosed with a terminal disease may reject the diagnosis as wrong or impossible.Displacement is the shifting of emotions directed at one person, place, or thing to another less threatening person, place, or thing.

For example, a client might be angry with the medical bill and takes it out on you. Projection is attributing their own unacceptable behaviors, thoughts, or emotions to someone else.

For example, a client might say the nurse is mad at them when they’re the one that is actually mad at the nurse.Rationalization is coming up with an excuse for unacceptable thougths or behaviors.

For example, a nurse might say they were late taking a client’s vitals because they couldn’t find the right equipment.Regression is reverting back to an earlier stage of development.

For example, a 4-year-old child who no longer sucks their thumb might experience a traumatic event and subsequently begin sucking their thumb again.Repression, also known as suppression, is refusing to remember or think about unpleasant, painful, or frightening memories.

For example, an adult who was abused as a child might have no memory of the abuse.Now, clients with mental health disorders often find it difficult to cope with stress, and so, it is especially important to ensure interactions with them are as stress-free and as therapeutic as possible.

Remember that your clients might be experiencing extra stress due to illness, loss of independence, separation from family and friends, or the worry about being a burden to others.

This extra stress can make it difficult to cope effectively, resulting in emotional and mental problems. Your observation and communication skills can be helpful in identifying when a client needs extra support from you or other members of the healthcare team.

Now, sometimes, therapeutic interactions may involve silence as it allows clients time to think, assess the interaction, and determine the pace of the conversation as they vent their feelings.

Be alert to the client’s nonverbal communication, including facial expressions, such as frowning, head and hand movements, gestures, and posture.

You also need to show to the client that you are actively listening by maintaining eye contact, nodding, and restating what they say as they share their thoughts and feelings.

This can help to validate their concerns as well as demonstrate the attentiveness of the healthcare team. Additionally, speaking calmly, clearly, and concisely while maintaining non-threatening body language can help clients to avoid feeling anxious.

Encouraging the client to interact with family, friends, and other clients can help decrease stress and promote a sense of self-worth and belonging.Make sure to also attend to these clients’ special needs regarding activities of daily living, including regular and proper personal hygiene, skin care, food and fluid ingestion, as well as physical activity.

In all cases, remember to explain how you will assist them and why this activity is important. This can be especially helpful for confused clients.

It’s also important to always encourage the client to get involved with their care as much as possible.Now, sometimes clients with mental illness may become angry and exhibit inappropriate or even violent behavior.

In these situations, safety of the client and the healthcare team members is the priority, and you must keep a safe distance and call for help.

Take a deep breath; this will help bring down your own emotions. With angry or violent clients, using a supportive and respectful approach that includes slow, deliberate, and calm speech can help diffuse heightened emotions.

Avoid sudden movements and use non-threatening, relaxed body positioning to help contribute to calming the client and to avoid alarming them.

Remember, clients often experience a loss of control when being admitted to a facility, and this feeling of helplessness can make them feel helpless and angry.

So, avoid being judgmental. Actively listen and respond to the client’s feelings and needs by concisely answering client questions.

Silence can also create a relaxed environment that helps diffuse anger. Additionally, set clear limits on the client’s behavior.

With clients suffering from delusions or hallucinations, it is important that they can see and hear you approach them from the front.

Make sure to avoid touching them without letting them know you are there first. Speaking slowly and calmly with short and simple sentences can also help avoid confusion.

Additionally, it is important to actively listen to clients when they express what they see or hear. Remember not to argue with the client about the delusion and avoid laughing or smirking when the client shares what they see or hear.

Instead, validate their feelings, but focus on reality: real people and events; avoid pretending you see or hear what the person does.

A good idea would be to say something like, "I know the voices are real to you, but I can't hear them.” As a nursing assistant, you may be spending a great deal of time working very closely with clients with emotional or mental health needs, and you will have to develop a sense of what behaviors and moods are normal for them and what is unusual.

Be sure to keep a close eye on your clients as well as an attentive ear so that you can recognize, report, and document any physical changes or deviations from a client’s normal mood or behavior.

These may include an increase or decrease in appetite or amount of sleep; a diminished interest in social interactions or activities that used to be really pleasurable, like no longer enjoying cooking or gardening if that was once a hobby; too much energy or agitation, like pacing around; too little energy or fatigue; decreased concentration or difficulty making decisions; or feelings of hopelessness, pessimism, worthlessness, or even recurrent thoughts of death.Alright, as a quick recap… Many clients may need assistance in order to meet their emotional and mental health needs as they deal with the stress of illness, hospitalization, changes in their ability to care for themselves, and other personal and family issues.

Coping mechanisms and defense mechanisms are both ways in which we deal with stress, but coping mechanisms are conscious and deliberate, while defense mechanisms are natural and, often, unconscious.

Since clients with an emotional or mental health disorder often struggle to deal with stress, it is important to ensure interactions with them are as stress-free as possible.

This often involves a combination of active listening, calm speech, and non-threatening body language. You may also need to assist them with activities of daily living.

For clients with inappropriate or self-destructive behavior, safety comes first. For those with delusions or hallucinations, avoid startling them and being judgmental; instead, kindly focus on reality.

Finally, be sure to develop a keen sense of what is normal for your clients so that you can document and report any changes in your client’s physical condition, mood, or behavior to the nurse.