The text is based on the scientific research carried out by the author during the many years that she has tried to follow the evolution of mental health at an international level, in Portugal and in the Autonomous Region of Madeira. It is based on the knowledge deepened through critical reflection carried out throughout the training and professional processes in which it has participated. The performance as a professor at the University of Madeira-Health Higher School, the real experience as a provider of specialized nursing care in mental and psychiatric health to population groups living in different communities, the various intervention contexts in which mental healthcare is available, the different circumstances of health and illness observed in people who experience transactional and adaptive processes at various stages of the life cycle are real contributions that have been constituted as a source of essential material for a critical and constructive look at one of the great challenges that health and mental health services and their professionals face in today's societies.
TopIntroduction
Current times systematically confront us with a wide range of uncertainties and questions, namely about our sense of life and the health situation.
Health is a fundamental good and it is crucial for our quality of life. The various dimensions of health are recognized as to their importance, assuming primary relevance, in the current context of the evolution of different societies and countries, mental health. In a changing, globalized and too unequal world, the vulnerabilities in this area increase day by day, and are expected to persist and lead to an increasing rise in problems and psychopathological disorders, the consequences of which are expected to be negative and with a complex and demanding approach. Among other factors, because they cause high costs in years of life lost with disability, increased suffering, stigma, and exclusion, if there is no adequate intervention.
This chapter intends to promote the readers' reflection on some factors related to Mental Health, assuming a constructive perspective in relation to it. It is based on the Functional Mental Health Model (Lethinen, V., 2008; Korkeila, 2000), which conceives mental health as a dynamic construct, multifactorial in terms of its determinants and disease precipitants, capable of being more or less positive, that is, balanced and harmonious or disturbed and unbalanced, depending on “the relative weight” of the various risk factors and protective factors, which are present at every moment in the human life cycle.
Scientific evidence has shown that health and mental health literacy levels influence not only the adoption of better health-promoting behaviours, but also contribute to the adoption of more or less healthy lifestyle habits, and are significant in the recognition by citizens of the importance of seeking the help they need more efficiently.
One of the objectives of this chapter is to promote reflection on the communication skills of health professionals and the promotion of mental health literacy among populations, namely, those of nurses and specialist nurses in mental health and psychiatric. Another objective is to relate some characteristics of the communication used with the respective impact in demystifying erroneous beliefs and prejudices that affect the representation of citizens about the person who suffers mental disorders.
It is considered that the interrelational process established between the nurse / specialist nurse and the client is, in its essence, a process in which communication is a primary tool. This is assumed by the specialist nurse as therapeutic relationship and aims to enhance the client's ability to make his decisions, assuming personal control over his life and structuring his health project (Peplau, 1952, 1991a, 1992b; Order of Nurses Portuguese, 2001). It is known that self-care, essential for a healthy life, is among a multidimensional set of factors, influenced by the knowledge that the person owns about the health and mental health situations, reflecting on the perception he formulates about them.
The acceptance of professional help as well as adherence to the guidelines and therapeutic measures necessary to meet their needs, including the establishment of the client's therapeutic relationship with the specialist nurse, are influenced by the characteristics of the communication used. Clarity in communication, assertiveness and positivity (Almeida, 2018; 2019), will be highlighted as essential characteristics to promote literacy in the mental health of populations, which is a structuring pillar throughout the entire cycle of personal development and evolution societal health, including in Portugal (Health Literacy Action Plan 2019-2021, Portuguese General Directorate of Heath). This aim, which is considered urgent and a priority for the improvement of the mental health of individuals and communities, is included in the path of what is recommended at the level of Europe, the World Health Organization (WHO) and United Nations for the next decade (Millenium Sustainable Development Goals). Adherence to it by different health professionals and the motivation and participation of different population groups in overcoming it, is urgent (Almeida 2019).