Behavioral Health Considerations

Kim Maryniak, PhD, RNC-NIC, NEA-BC

Behavioral Health

The terms behavioral health and mental health are often used interchangeably to identify the aspect of medical practice that relates to an individual’s mental well-being. Regardless of what we call it, there is stigma associated with these conditions. Behavioral health disorders are the leading cause of disability in the United States and Canada (National Institute of Mental Health [NIMH], n.d.). An estimated one in five adults, or approximately 17.9 percent of Americans ages 18 and older, suffers from a diagnosable mental disorder (NIMH, n.d.). The needs of patients with mental illness may challenge nurses unfamiliar with evidence-based treatment options.

Behavioral health patients can be complex. Complexity of care is increased if the mental health patient is also engaging in substance use and/or if physical disorders are present. Mental illness has an increased risk for co-morbidities, including:
   •  Heart disease
   •  Asthma
   •  Gastrointestinal disorders
   •  Skin infections
   •  Diabetes
   •  Cancer
   •  Neurological disorders
   •  Acute respiratory disorders
(Walker & Druss, 2016).

A patient who has a mental illness also has a higher risk of developing another mental illness, and abusing substances (National Alliance on Mental Illness, 2017; Walker & Druss, 2016).

Stigma is common surrounding behavioral health. Stigmatization continues to generate misunderstanding, prejudice, confusion, and fear within the community and in particular, the healthcare setting. Components associated with stigma are labeling, stereotyping, dividing, and discriminating. Stigma is often what keeps nurses and other healthcare personnel from providing the care all patients are entitled to receive. Many individuals report that the behaviors associated with stigma are more hurtful and damaging than the illness itself. Many people are often reluctant to offer empathy and support to an individual with mental illness (Scattergood Foundation, n.d.).

As nurses, it is important to self-reflect, and acknowledge if there are feelings of hesitancy, fear, or bias. Doubt in one’s own skills can also impact the ability to care for patients with behavioral health issues. As a nurse, it is important for you to have knowledge of your patient’s disease processes including mental health disorders. Effective listening and therapeutic communication skills are essential, as well as demonstrating respect, empathy, and building trust with patients (Riley, 2015).

To learn further about behavioral health, check out the RN.com course Identification and Care of Patients with Mental Health Disorders.

National Alliance on Mental Illness (NAMI). (2017). Know the warning signs. Retrieved from https://www.nami.org/Learn-More/Know-the-Warning-Signs

National Institute of Mental Health (NIMH). (n.d.) Any mental illness (AMI) among U.S. adults. Retrieved https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml

Riley, J. (2015). Communication in nursing. St. Louis, MO: Elsevier.

Scattergood Foundation. (n.d.). Stigma and behavioral health. Retrieved from http://scattergoodfoundation.org/sites/default/files/Scattergood%20Foundation%20Stigma%20Guide_0.pdf

Walker, E. R., & Druss, B. G. (2016). A public health perspective on mental and medical comorbidity. Journal of American Medical Association, 316(10), 1104-1105.

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