Every family at some point in their lives experience death. Reactions to death vary from individual to another with others having overwhelming responses. Grief is a natural expression to the loss of someone. Grief is encompassed by a wide range emotions that are influenced by cultural expectations and norms. As matter of fact, some tribes are expected to highly express themselves to demonstrate loss and not the case with others.
Following the loss, the individual’s first experience is often of denial, disbelief and shock. This can be preceded by sadness, anger, guilt and despair. The ultimate reaction is acceptance of the loss.
Normal grief fades with time, about six months to a year. In some instances, individuals may experience a different form which is termed complicated or pathologic grief. This is characterised by absent grief when individual is not demonstrating loss and delayed grief when symptoms are experienced a long time after the loss. There could also be distortion of normal grief symptoms whereby individual experience suicidal ideations or psychotic symptoms for example seeing images of the deceased in daytime.
Complicated and/or pathological grief is often experienced by individuals whom suffer loss suddenly under horrific circumstances, those dependent upon the deceased and those who believe are responsible for such a loss. It is important to acknowledge that it is not easy to deal with grief but the following can be helpful;
Catharsise feelings and express self Accept
feelings of sadness and the reality of the loss
The need to allow oneself to experience pain of loss
Have adequate sleeping time and plenty of rest
Avoid destructive coping strategies like use of alcohol. Often when they clear off the body, feelings of sadness creeps in Grief therapy may be instituted if the normal grief process does not take course. Medication can also be used to treat symptoms and address sleeping problems when grief has taken a pathological form. As summed up by Shakespeare, “everyone can master a grief but he that has it.”
MENTAL HEALTH FOR PRISON OFFICERS
Recently I officiated at the Moshupa Boys Prison in a workshop organised by students of I.H.S Lobatse and today discussion will reflect on the workshop. The workshop focus was on prison officers’ mental health in the workplace.
According to the 2017 Mental Health at Work Report, “60 % of employees have experienced a mental health issue due to work or where work was a contributing factor at some point in their careers.” Prisons are no different as they are deemed a hostile, demanding and challenging work environment which could be to some extent be a habitat for poor mental health. As reported by Newsweek Online, a survey of Washington State Department of Corrections indicated that 20 % of participants displayed posttraumatic stress disorder (PTSD) symptoms. Another California study in 2018, did also highlight that 10% prison guards did contemplate suicide; a clarion call for dialogue on the matter.
In prisons there are issues of safety rising from violence by inmates which can have a bearing on the prison staff mental health state. Physical security and safety have been seen by the World Health Organisation as protective factors towards mental health.
Prison staff bear witness to traumatising experiences and events as relayed by prisoners or in court appearances. The warders interact a lot with inmates and get to understand their ordeal and get to know what transpired in the purported crime. This at times come to haunt the prison officers in the form of PTSD. PTSD can occur even when one is given a narration of a traumatic event!
Counselling services need be provided and debriefing is also a must as far as the mental health of warders is concerned. Debriefing entails giving an opportunity to individuals to relieve the experiences and emotions in order to allow for catharsis.
Mental health in the prison setup requires a two-pronged approach that seeks to help officers deal with their own issues and on the other hand address the inmates’ issues surrounding their sentencing and thus the need for a fully functional mental health service under prisons. Staff training on mental health issues should be provided to enhance understanding on mental disorders and encourage mental health promotion for both staff and prisoners. The workshop was worthwhile and I recommend that it be expanded to other prison centres!
INTERNATIONAL NURSES DAY: REFLECTING ON THE MENTAL HEALTH CHALLENGES OF NURSES
Today’s reflection will be on the Nurses’’ day that was celebrated worldwide on the 12th of May. The day is celebrated in remembrance of the birth Florence Nightingale who is the pioneer of modern day professional nursing. The theme for this year is “Nurses: A voice to lead-Health for All.”
Nurses are the backbone of the healthcare system as in every health care facility they are there to provide care. They are the single largest group of professionals in the clinical field.
The crux of the discussion is that professional nurses experience burnout and workplace stress because of the nature of the demands of the nursing job. These emanate from working long hours, emotional exhaustion from dealing with vulnerable and ailing clientele, experience of traumatic events, fulfilment of high professional and public expectations and low reward outcomes for their efforts.
The nurses’ already volatile ordeal is further compounded by incidences of nurses being assaulted, emotionally abused, physically abused, sexually assaulted and cyber bullied by the same individuals that they seek to render care for.
The above highlighted challenges can be emotionally draining to the nurses and even facilitate development of mental health problems if they are not attended to promptly. This has been affirmed by various studies.
A review paper done by Vasconcelos and others in 2016 highlighted that the risk of exposure to HIV and poor relationships with administrators as other associated factors that facilitated development of mental disorders.
The review found the following as affecting most of our nurses; post-traumatic stress disorder, acute stress reaction, generalised anxiety disorder, depression and over indulgence in substances.
Nursing managers, the patients as well members of the community need to play a pivotal role in ensuring protective factors towards nurses’ mental health are availed.
The good thing is that this can be ensured by helping nurse build resilience, having debriefing sessions for nurses working in trauma care and having measures like retreats to name but a few. Nurses need to be healthy for them to be custodians for “health for all”.