This article provides a sample Nursing Response.
Unit 4 Discussion
Initial Nursing Response
Social determinants of health refer to conditions in which individuals are born, grow, live and age where the multilevel distribution of resources, money, and power shape these determinants. The conditions include but are not limited to children’s access to quality education, employment for grownups, and wealth distribution that significantly impact an individual’s opportunity within their respective society. Healthcare experts with a specific bias towards mental health providers acknowledge that understanding of these conditions as they impact on health place the responsibility of mental health and mental health equity on a wide range of stakeholders, not just healthcare practitioners but also political leadership, to policymakers and governance experts (Andermann et al., 2016). Therefore, this post purposes of determining three priority SDH to assess the patient represented in the SOAP note on schizophrenia. The patient is a 37 -year -old female who was brought into the state psychiatric hospital by police with a chief complaint ‘you are all morons! I want to go home’.
A review of the patient’s SOAP note led me to consider the patient’s homelessness, traumatic life experience like the death of her son that triggered her depression exacerbated by divorce, and difficulties keeping a job as the three priority SDH. Psychiatric mental health providers opine that social factors impact the risk for mental illnesses and substance abuse disorders besides the health outcomes of individuals with these disorders. Suffice it to say that the patient’s homelessness significantly affected her social isolation (Ayano, 2019). This isolation further denies the patient the required social support to cope and manage her schizophrenic symptoms. At an individual level, the patient has also had traumatic life events like her son’s death, which triggered her depression (Kleber, 2019). Divorce from her marriage only served to make a bad situation worse, while her family history demonstrates that the one person she could have depended on was her mother, diagnosed with schizophrenia at 36. The third and last of the three priority SDH selected for this patient is income inequality resulting from her inability to keep employment in the primary care setting where she has worked as a nurse.
As stipulated in the plan, identifying priority SDH is instrumental in formulating a care plan to resolve the challenges they create for identified patients. Effective addressing these challenges requires individual intervention, some of which is delivered within a clinical setting (Daniel et al., 2018). The provider should also adopt a bigger picture approach and advocate for policy change on homelessness at societal level intervention. Relevant clinical level interventions are also needed.
In conclusion, this post acknowledges the need to address the conceptualization of the SDH of mental health as mental health providers seek to dissect the forces that drive social, environmental, and behavioral risk factors leading to poor health at the mental and physical level.
Ayano, G., Tesfaw, G., & Shumet, S. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis. BMC psychiatry, 19(1), 1-14.
Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a framework for health professionals. Cmaj, 188(17-18), E474-E483.
Daniel, H., Bornstein, S. S., & Kane, G. C. (2018). Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Annals of Internal Medicine, 168(8), 577-578.
Kleber, R. J. (2019). Trauma and public mental health: A focused review. Frontiers in psychiatry, 10, 451.