Reflective Practice Portfolio: Mental Health example

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Reflective Practice Portfolio: Mental Health


Mental illness has become a serious concern in American society. According to experts at the National Institute of Mental Health (n. d.), nearly one in five adults in the United States experiences mental illness in a given year and the situation will aggravate in the near future. In order to prove the validity of this assertion, Yohanna (2003) admits that in the foreseeable future, 15 individuals out of 100,000 of the general population will need long-term mental health treatment. However, many of them will not receive sufficient mental health care because of the tendency to deinstitutionalize individuals with mental illness. Deinstitutionalization is considered to be a very controversial phenomenon, and some experts even claim that it is the most poorly planned change in US history.

Deinstitutionalization of individuals with mental illness was selected as a topic for this practice portfolio because it falls into the categories of the NCELX-RN examination blueprint. The problem of deinstitutionalization is considered to be the one that affects the patient’s psychosocial integrity. In turn, provision of psychosocial integrity involves nursing care that “promotes and supports the emotional, mental and social well-being of the client experiencing stressful events, as well as clients with acute or chronic mental illness” (National Council of State Boards of Nursing, 2012, p. 5). Provision of the patient’s psychosocial integrity is believed to be one of the top priorities of the practice of nursing, which is proven further in this portfolio.

In order to present an in-depth analysis of deinstitutionalization as an issue that requires immediate fixing, this portfolio approaches a number of relevant questions. Particularly, the portfolio describes the importance of the problems, defines the patient population, and outlines the solution. In addition, the portfolio sets goals to implement the proposed solution. Finally, the portfolio discusses the likely barriers to the implementation of the solution, and provides suggestions to respond to them.


In the 1950s, mental health care was deinstitutionalized. According to Paulson (2012), deinstitutionalization was preconditioned by a range of factors, including major changes in the perception of the concept of mental illness and obsolescence of buildings that could not function as full-fledged asylums. Nasrallah (2008) adds that the discovery of antipsychotics facilitated the process of deinstitutionalization. It was believed that mentally ill individuals, for instance schizophrenics, could use antipsychotics to control the condition and successfully integrate into their communities. Nasrallah (2008) calls these beliefs “naive” because deinstitutionalization had aggravated the problems facing mentally ill individuals, not resolved them.

Davis et al (2012) suggest that deinstitutionalization benefits only a very small group of middle-class individuals with less severe disorders, while the remaining part of the mentally ill population remains one on one with its problems, including medical illnesses. According to Nasrallah (2003), individuals with mental illness are at a greater exposure to infection, obesity, diabetes, and hypertension when compared with the rest of the population. Moreover, mentally ill individuals are often in the risk-groups for poor access to medical care and early mortality. When discussing …

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