Key Concepts, Theories and Debates in Mental Health Nursing Essay Sample

Mental Health Exam Essay Sample

  1. Describe your understanding of Freudian Slips, relating this to Freud’s Theory of the Unconscious. Please include an example of a Freudian Slip. (10 marks)

Freudian slips involve having a verbal or memory mistake, which is believed to be connected to the unconscious mind. Supposedly, such slips reveal secret feelings and thoughts held by people. Things like dreams, behaviour and speech can sometimes show a person’s unconscious feelings. An example may include a person who calls his or her spouse by an ex’s name, or says the wrong word, or even misinterpret a spoken or written word.  When dreaming, there is a lowering of the ego’s defences, making some of the unconscious come to awareness. Besides, a person can have a good insight into the inner world when trying to understand and unravel dreams.

According to Freud’s theory, speech blunders results from “disturbing influence like an unconscious thought, belief or wish,   which is outside of the intended speech.’ (Freud, 1965). The problem of forgetting names, according to Freud, is a result of repression. Therefore, conscious awareness withholds unacceptable thoughts or beliefs, making the slips reveal what is hidden in the unconscious.

  1. Describe the term stigma in relation to mental health and explain why you think stigma remains such a big issue.                                                   (10 marks)

Mental Health (Discrimination) Act (2013) defines stigma as societal disapproval of individuals living with mental illness or seeking help/support for emotional distress, like depression, anxiety, post-traumatic stress disorder, or bipolar disorder. This may worsen their symptoms, making it hard for them to recover. Also, stigma in a person living with mental illness may cause them to less likely to seek help. Being a significant issue for many service users, professionals, and the general public, stigma remains a big issue. Its impact can be severe and devastating. It can lead to one being discriminated in the society, which can come from staff, close relatives, neighbours, friends or co-workers. In a 2012 study by the Institute of Psychiatry, more than a third of service users felt discriminated by the staff (Henderson, Evans-Lacko & Thornicroft, 2013).  As a result, these individuals lack an understanding of handling the person living with mental illness. Such experiences can fuel intolerance, fear, and anger directed to those with mental issues, causing reluctance in seeking treatment and delayed treatment, increasing mortality and morbidity, social isolation, bullying, and overall poor quality of life.

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  1. List and describe Piaget’s stages of Cognitive Development.        (10 marks)


It covers children growth between 18-24 months, characterised by motor activity without symbols. Things are learned through experience, trial, and error(Lefa, 2014).

The main of this stage is to achieve object permanence(Lefa, 2014).


It covers children growth between 2 to 7 years, characterised by the development of language, memory, and imagination. The intelligence developed at this stage is egocentric as they cannot think outside their viewpoints(Lefa, 2014).

This stage aims to achieve symbiotic thought in attaching an object with a language(Lefa, 2014).

Concrete operational

It covers children growth between 7 to 11 years, characterised by the development of more logical and methodological manipulation of symbols. The children are less egocentric and are more familiar with the outside world events(Lefa, 2014).

The main of this stage is to achieve operational thought by children working things outside their head. It enables children to solve problems by physically encountering the problem scenarios in the real world(Lefa, 2014).

Formal  operational

It covers children growth from 11 years and above. The stage is characterised by the use of symbols to understand abstract concepts. As a result, children can make hypotheses based on previous experience. Additionally, they are able to grasp abstract concepts and understand their relationship.

This stage aims to achieve abstract concepts to help them build upon knowledge and not change how it is understood or acquired(Lefa, 2014).

  1. Carl Rogers discussed three conditions which he believed were essential in Person Centred Approaches. Please identify and briefly describe these three conditions, linking this to how you will work in this way in practice. (10 marks)

The three conditions for the patient-centred approach are empathy, congruence/genuineness(of the therapist)  and unconditional positive regard (Kirschenbaum,2012).

Empathy- Accurate empathetic understanding of the therapist's part would make the service user/client/patient feel understood accurately and compassionately (Kirschenbaum,2012). 

Congruence/Genuineness- The therapist needs to be authentic towards the clients in not exhibiting any false tendency regarding their care(Kirschenbaum,2012).

Unconditional Positive Regard-The therapist should not judge the service user/client/patient as bad or good through thoughts/words/behaviour(Kirschenbaum,2012).

These conditions will inform my practice that service users understand themselves and their input regarding their care. It will also assist me in self-understanding in changing my attitude and self-directed behaviour vital for the effective delivery of patient-centred care. The element of unconditional positive regard enables one as a practitioner to accept their personality in knowing they are loved and valued, and in further knowing that our behaviour that can be perceived as being wrong does not necessarily define an individual.

Further still, the application of Carl Rogers's approach to patient-centred care would ensure that client-centred therapy is adopted to accept patient input on a decision regarding their care. In this way, it allowed patients to have a subjective understanding regarding their situations as opposed to the adoption of unconscious motives.

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  1. List and describe five ways in which our understanding and/ or treatment of mental health has changed though history.                                                                  (10 marks)

The treatment of mental health condition has undergone tremendous changes over time. Initially, the people who had mental health conditions were locked inside the asylum to protect to public. The patients working with the patients believed that the patient needed to be shocked into normality; hence, the treatment was hot or ice-cold baths. Other treatment methods included bloodletting, purging and opium. This was followed by the use gyrating chair, which was used to shake up tissues and blood of the body to restore equilibrium (Foerschiner 2010). This form of treatment only made patients unconscious and did not have any success. The third treatment approach was the use of innovative therapy/ talking cure based on moral treatment. The mental nurses were encouraged to treat a patient with compassion and kindness to uphold the dignity and self-esteem of the patients. Different techniques were used to treat mentally ill patients, including lobotomies, insulin-induced comas, and electroshock therapy. The fourth treatment approach emerged in the 1940s when the chemist focused on finding pills and powder that could calm imbalances in the brain of mentally ill patients and give them real relief (Lysaker et al. 2018). The treatment approach included lithium and antipsychotic medications.  This improved with social support, psychiatric counselling, job training, and housing assistance. The modern treatment approach to mental health included cognitive behaviour, family therapy, and solution-focused therapy. The antipsychotic medication has also improved, including the use of chlorpromazine (Lysaker et al. 2018).

  1. Identify and discuss the CHIME framework in relation to recovery.        (10 marks)

Connectedness, Hope, Identity, Meaning and Empowerment(CHIME)  recovery framework was formulated by Leamy et al. (2011).  The framework was based on finding a systematic review to conceptualise a framework for the personal recovery of people living with mental illness.

The CHIME framework perceives a recovery process to involve five stages, including connectedness, building hope and optimism about the future, acquiring identity, getting meaning out of life and finally getting empowerment(Leamy et al., 2011).

Connectedness Process.

This stage is characterised by peer/social group support, positive relationships, support from others and integrating/ being part of a communal setup. This connectedness develops hope and optimism for recovery in the people living with mental illness.

Hope and  Optimism Process.

The developed hope and optimism about the future ensure the patient belief in the possibility of recovery,  build motivation to change their lifestyle, build hope-inspiring relationships. Adopts the art of positive thinking, appreciating the efforts put in towards overcoming mental illness. Finally, in this process, the service users developed dreams and aspiration for the future when they fully recover.

Identity Process.

This stage is characterised by the dimensions of identity, including rebuilding and redefining the positive sense of identity, which is crucial in overcoming the stigma that is witnessed towards people living with mental illness.

Meaning of Life.

In this stage, people build the meaning of life based on their experience with mental illness.  They create meaning of life based on spirituality, positive quality of life, adopting meaningful life in both social roles and social goals.


This stage is characterised by the development of personal responsibility,  control of life and complete focus on their strength.

  1. Describe your understanding of how people form attitudes.        (10 marks)

Smith & Mackie (2015) describe attitude as a cognitive representation summarising how individuals evaluate a particular person, group, thing or idea. Hence as people are exposed to stimuli and make an evaluation, their attitudes are formed over time. Attitude is also formed through social or observation learning. For example, a person may be attracted to another person who has a particularly strong attitude towards something important to them and thus gradually changes his or her attitude over time to become more in line with this person’s attitude. People also tend to form a negative attitude towards things that do not make them feel good; hence through feelings, attitudes are formed. Pressure or persuasion to conform to a particular way of thinking may cause people to develop attitudes. For instance, if everyone within practice placement has a specific attitude towards a service provider, this might cause you to form a similar attitude.

Pickens (2005) identified direct experiences around an area to affect people’s attitude. For instance, a negative experience in a particular hospital might lead to a negative attitude by other people towards that area. Another way people form attitudes is through rational analysis, whereby individuals, after weighing options, rationally decide on an attitude. For instance, after one considers all the evidence, he or she may form an attitude towards which political party to vote for.

  1. Mental health is usually a result of a combination of biological, social and psychological factors. Please discuss your understanding of the links between biological factors (which can include genes/ physical health etc..) and mental health and discuss three examples. (10 marks)

The assessment of biological, social, and psychosocial factors is based on the concept that health and well-being are influenced by the complex interaction of the biological, psychological, and social aspects. There are diverse ways through which physical health influence the mental health of an individual. The biological elements that precipitate mental illness include pathogens such as toxins and germs, genetics, infections, and substance abuse.

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Genetics: genes are responsible for the development of certain mental health conditions. According to Kano et al. (2020), a more significant proportion of mental health conditions have a high degree of heritability. Hence, individuals are at increased risk of developing mental health condition if another family member is diagnosed with one. According to Kano et al. (2020), the genetic factors contributing to mental health include epigenetic regulation, affecting how one reacts to environmental factors. Next is genetic polymorphisms that entail changes in the DNA, which may combine with environmental factors to develop mental health disorder. Genetic is liked to schizophrenia, depression, bipolar disorder, anxiety, and autism.

Secondly, substance abuse, including alcohol and drug addiction, is linked to mental health conditions. According to Pichini and Busardo (2017), long-terms substance abuse is associated with depression, paranoia, and anxiety. Alcohol and substance abuse can also escalate the underlying risk of mental disorder. Mental health problems are often caused by genetics and the environment, among other factors. Hence, abusing alcohol and substances such as cannabis may push one to the edge, thereby developing depression and schizophrenia.

Thirdly, infections are associated with brain damage and development of mental health conditions or worsening mental health symptoms. For instance, paediatric autoimmune neuropsychiatric disorder (PANDAS) is linked to the Streptococcus bacteria and development of the obsessive-compulsive disorder and other mental disorders in children.

  1. Martin Heidegger claimed: “Words, like the chisel of the carver, can create what never existed before rather than simply describe what already exists.  As a man speaks, not only is the thing which he is declaring coming into existence, but also the man himself.” Describe your understanding of this statement, taking into consideration the impact of labeling.   (10 marks)

The labelling affects how we perceive ourselves and what we at times tell ourselves. For instance, most people hold diverse myths and stereotypes about mental health disorder based on the statement (Kim et al. 2017). These affect how society relates and treat people with mental health conditions. It makes people who have mental health conditions to see him/herself through the mirror of the society, such as people with mental health conditions as violent, they become violent and reaffirm the society labels against mental health (Stolzenburg et al. 2017).

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By reaffirming societal labels, individuals with mental health conditions begin to see themselves as sick and need to be changed instead of being understood by society. The individuals also begin to see themselves as different and undesirable based on societal stigmatisation. The community is quick to assume individuals with mental health conditions based on the labels (Stolzenburg et al. 2017). Moreover, stigmatisation facilitates loneliness and social isolations of individual with mental health conditions. These may contribute to further feelings of depression and experienced of episodes. It can as well contribute to self-harming. These contribute to further deterioration of individuals mental health condition and keep them from seeking social support or mental health care.

  1. A service user is being referred for Cognitive Behaviour Therapy (CBT) to help with her severe anxiety in social situations. How will you explain CBT to that service user? (10 marks)

First, I will establish a clear and understanding language and mode of communication for the service user. I will explain to the service user that cognitive behavioural therapy is a form of non-medical intervention to a mental health condition that focuses on how she thinks or perceives (Hayes and Hofmann 2017).  I will let the service user know that we do not believe some of the things we think are real are only part of our imaginations and our reactions to certain situations are at times not entirely logical (Linardon et al. 2017). Hence we can use CBT to challenge how we see things or react to conditions. I will also inform the service user that CBT helped people recognise distorted thinking and evaluate reality. The approach will also enable him/her to understand her behaviours and motivations better and use problem-solving skills to cope with difficult situations (Hayes and Hofmann 2017). Most importantly, I will stress to the service user that CBT will allow her to improve a sense of self and have confidence in her ability to cope and face her fears and learn better approaches to calm her mind and relax her body.



Foerschiner, A. M. (2010). The History of Mental Illness: “From Skull Drills to Happy Pills”. Student Pulse, 2(99), 1-4

Freud, S. (1965). The psychopathology of everyday life (J. Strachey, Ed. & Trans.).

Hayes, S.C. and Hofmann, S.G., 2017. The third wave of cognitive behavioral therapy and the rise of process‐based care. World Psychiatry16(3), p.245.

Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking, and public health programs. American journal of public health103(5), 777-780.

Kano, S.I., Hodgkinson, C.A., Jones-Brando, L., Eastwood, S., Ishizuka, K., Niwa, M., Choi, E.Y., Chang, D.J., Chen, Y., Velivela, S.D. and Leister, F., 2020. Host-parasite interaction associated with major mental illness. Molecular psychiatry25(1), pp.194-205.

Kim, S.W., Polari, A., Melville, F., Moller, B., Kim, J.M., Amminger, P., Herrman, H., McGorry, P. and Nelson, B., 2017. Are current labeling terms suitable for people who are at risk of psychosis?. Schizophrenia research188, pp.172-177.

Kirschenbaum, H. (2012). What is “person-centered”? A posthumous conversation with Carl Rogers on the development of the person-centered approach. Person-Centered & Experiential Psychotherapies11(1), 14-30.

Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry199(6), 445-452.

Lefa, B. (2014). The Piaget theory of cognitive development: an educational implications. Educational psychology1(9), 1-8.

Linardon, J., Wade, T.D., De la Piedad Garcia, X. and Brennan, L., 2017. The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis. Journal of consulting and clinical psychology85(11), p.1080.

Lysaker, P.H., Pattison, M.L., Leonhardt, B.L., Phelps, S. and Vohs, J.L., 2018. Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry17(1), pp.12-23.

Mackie, D. M., & Smith, E. R. (2015). Intergroup emotions. In APA handbook of personality and social psychology, Volume 2: Group processes. (pp. 263-293). American Psychological Association.

Mental Health (Discrimination) Act (2013). London, The Stationary Office.

Pichini, S. and Busardo, F.P., 2017. Cannabis: Neurological Correlates in Abuse and Medical Use. CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders)16(5), pp.524-526.

Pickens, J. (2005). Attitudes and perceptions. Organizational behavior in health care4(7).

Stolzenburg, S., Freitag, S., Evans-Lacko, S., Muehlan, H., Schmidt, S. and Schomerus, G., 2017. The stigma of mental illness as a barrier to self labeling as having a mental illness. The Journal of nervous and mental disease205(12), pp.903-909.

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