Substance Abuse and Addiction a Mental Illness

“A state of complete physical, mental and social well-being and not merely the absence of disease” is the World Health Organization’s (WHO, 2012) well known definition of health. It is understood that health is referring to one’s physical state however it is also unnoticed that mental state is also a determinant of health. The general public has little or no knowledge about mental illness, as it is often a sensitive subject. Furthermore, mental illness is completely invisible unlike most general health conditions. This leads the majority of society to be unaware of its presence. This lack of awareness has a direct effect on society’s general knowledge of the subject. As a result, stigma coexists with all forms of mental illness, affecting all individuals involved with the area of health. Nurses have a responsibility to be advocates for patient health as a part of their practice.

The Canadian Nurses Association (CNA) outlines a list of competencies which nurses must maintain and meet within their practice. The CNA framework (2010) specifically mentions supporting healthy public policy and social justice in nursing practice. This includes working to regulate and support those affected by mental illness stigma. As practicing student nurses, we understand that it is our role in the health care system and within our communities to raise awareness about mental illness stigma and promote prevention

As a result, we have chosen to research and present our information and knowledge on substance abuse and addiction as a part of mental illness to a grade nine class. On October 13, 2012, we presented a topic on substance abuse and addiction to a group of grade nine students at Erindale Secondary School (International) in Mississauga. We felt this group was appropriate due to the fact that they are at a stage in life where they may be coming across or be thinking about experimenting with drugs and alcohol. High school is a time when most students are a susceptible target for substance abuse. School starts getting harder towards the end of high school; grades need to be higher for college or university application; expectations from the family increases; and there may be peer pressure to smoke, do drugs, or drink alcohol.

All of these things may pose as factors that increase the likelihood to use substances. This recreational experimentation can eventually lead to substance abuse. At the same time, a lot of stigma is attached to high school students as well. Those that are not under as much stress or have better coping strategies and better support systems may look at substance abuse as something others do to be cool. The most effective method we found would be to use a PowerPoint presentation along with a video presentation. By using the PowerPoint presentation, it would draw the attention of the students and allow them to easily visualize what is being explained.

It also gave the students a chance to read along with the presentation, again making it easier to follow. The images added along with the video add visual appeal and draw the students in and keep them interested. At the beginning of the project, we decided to look at different ways in which we could present to a group of students to help them gain more knowledge about mental health. We looked at several different subtopics we could cover about substance abuse and addiction as a mental illness. Ultimately we decided to focus on substance abuse and addictions and how it affects people, in specific, young people. We wanted to raise awareness about this issue. Some of the members of the groups have loved ones who have dealt with the issue of substance abuse and addiction.

This helped steer the group to pursue the topic. Due to the stigmatization of substance abuse and addiction, many people feel that it can be shameful to admit and seek help if they are experiencing such a mental illness, this in turn makes it difficult for addicted individuals to reach out to the community for assistance. We decided that we wanted to help decrease the stigmatization that comes with substance abuse and addiction. People who are dealing with substance abuse and addictions should not be afraid to seek help if they need it. They should not feel that they will be shunned by society if people find out about what they are going through.

Also as human beings, we all hold biases against a variety of things. As a group, we wanted to help bring forth any biases we may hold on the topic and hopefully be able to confront these biases by the time we are finished with the assignment. We also wanted to explain to these students that substance abuse and addictions are like any other disorder and are classified as a mental illness. In today’s society stress can occur from many different things, such as work, school, and bad relationships. Some people are able to cope better while others cannot. In some cases people start using substances like drugs or alcohol to help with stress. Such substances are at times taken when no stress is present. People may take only small amounts of drugs or alcohol for a period of time, but eventually the body develops tolerance.

In order to achieve the same state, the individual begins to increase the dosage of the substance or the frequency. A change in the brain occurs that makes the body more tolerant of the substance or substances being used, leading to an increased use of the substance to achieve the same state. This change in ones brains anatomy is the main reason why one may classify substance abuse and addiction as a mental illness. As students, we are able to determine firsthand the various factors that may cause stress in the lives of young people. Factors such as tuition fees, grades, and expectations from others are a few amongst the many stressors. Smoking is something our group has observed as a coping strategy amongst many students.

Based on our observations, students have increased the amount of smoking on a day to day basis as they have aged. Once our presentation topic was selected, we sought out resources that would help us understand the topic ourselves as well as provide credited support for our presentation. We looked at different organizations such as the World Health Organization (WHO), Canadian Mental Health Association (CMHA), Health Canada, Canadian Alliance on Mental Illness and Mental Health (CAMIMH), and the Centre for Addiction and Mental Health (CAMH). We felt these organizations would help provide us with a global point of view as well as a Canadian perspective. We found that substance abuse and addiction amongst the Canadian population costs the Canadian economy a great deal of money in terms of health care.

Substance abuse also hinders general productivity. This cost is estimated at almost $40 billion dollars annually. This figure is greater than the impact of all other mental illnesses combined (Austin & Boyd, 2010). Addiction in Canada accounts for 21% of total mortality in Canada, 23% of total potential years of life lost, and approximately 8% of total hospitalizations. Overall, addiction is the leading cause of morbidity and mortality in Canada (Austin & Boyd, 2010). Hence, if we are able to educate and help to spread awareness about substance abuse and addiction, we may play a role in decreasing the negative effects this issue has on our economy.

If we look at our target audience, we find that young people in the age bracket of 15-24 are more likely to report that they have a mental illness and likely be abusing substances compared to any other age group (CAMH, 2006). Due to this high prevalence rate in this age group, we decided that focusing on the grade nine students would help to educate them at an early age when they may more likely be experimenting with drugs or alcohol. By creating awareness and educating students, we would be able to help educate and perhaps prevent the use of harmful substances.

Additionally, we decided to focus on the stigma around mental health considering it is the main reason why those with mental illnesses do not seek assistance with society. In Canada, around 46% of Canadians believe that people use mental illness as an excuse for bad behaviour and about 27% fear being around those who have a serious mental illness (CAMH, 2012). By presenting facts about this specific mental illness we are decreasing the misconceptions and biases these students may previously have had.

Research showed that the general public has a difficult time defining the terms mental illness and addiction (Plichta & Garzon, 2009). This is was the starting point of our presentation. We needed to determine what sorts of definitions and words the grade nine students associate with mental illness. Asking them to define these terms in their own words was essential for the group to know the depth of their understanding about the topic at hand. The group then decided to make the students further explores the ideas and to determine if any of them associate addiction with mental illness. Prior to researching the topic the group brainstormed what they felt was important to know about this mental illness and based their research off these questions.

These questions covered a wide range of information and we decided to divide it into four sections. The first was defining mental illness and addiction. The second is to explain to the students why addiction and substance abuse is a mental illness. Considering the importance of this topic we decided to use not just auditory learning but also visual by showing a Youtube video that displayed the “normal” brain and one that is affected by substance abuse. Thirdly we explored the most commonly abused substances. The purpose of this section is to inform students of a variety of substances that can potentially be addictive.

The last section’s purpose is to relate to the students. Considering celebrities are constantly being reported on, showing the students that no matter their income and status within society they too are vulnerable to this mental illness. The group has taken into account the age group of the audience and ensured various learning styles were accounted for. The content was age appropriate and easily relatable. The celebrities used within this presentation are commonly seen in the media and are popular. This helps catch the attention of the students as they can relate to these icons.

It shows that anyone can be affected by this mental illness. It also removes the stigma that only the homeless are substance abusers (Centre for Addiction and Mental Health, 2012). Each group member discussed one topic based on their strengths and in-depth understanding of their topic. Each member of the group worked together to help each other understand their individual parts. We learn best from one another and work stronger when together. This is the very reason the group decided to split the report evenly and in the end come together and edit the content. During the presentation various methods of learning were utilized such as auditory, musical, visual, interpersonal and intrapersonal.

Using these methods, the learning plan was based on Howard Garner and his learning theory known as multiple intelligences. Howard Garner says “students possess different kinds of minds and therefore learn, remember, perform, and understand in different ways”. Keeping this in mind, we prepared an appealing power point which included words as well as pictures for visual cues. During the presentation we also included various examples to help the students understand. This follows Garner’s idea of linguistics. He states when auditory and visual learning are brought together to teach a topic it is a more effective method as it allows the learner to “see the word.”

For this same reason we used a video to aid in the understanding of what happens in the brain of those individuals who suffer from a mental illness. We also made use of Garner’s (2010) interpersonal way of understanding by engaging the class. Garner believes that students learn through interaction. Taking this into consideration, we opened our presentation with a discussion regarding mental illness and addiction and whether or not people consider it to be a mental illness (Garner, 2010). Also our presentation was followed by a question and answer session where students were free to express themselves and pose any questions they may need answered.

Intrapersonal is defined as one’s own curiosity. The topic of addiction and substance abuse is a hot topic amongst teens. Most teens are being introduced to a variety of drugs at this stage of life. In fact 2011 statistics show that 41.1% of young people have used drugs (Oxford Brookes University, 2010). Since it is such a new, yet common topic amongst teens, their curiosity is high. It is important to educate them on this topic. Educating teens regarding drug and substance use is not too difficult as they are already interested in the topic and will be keen to learn. According to Garner (2010), when a student is interested in a topic they are more likely to participate and actively listen.

We also handed out information and resources to students if they have any further questions or need more information regarding this topic. Feedback forms were presented to the students as a method of evaluating our presentation. This feedback allowed us to determine the relevance and clarity of our presentation. The forms also included a section for any other comments or questions that the students may have. Due the anonymous nature of these forms, the students were able to be more open about their questions and concerns.

We wanted students to not only understand substance abuse solely from our presentation, but for them to understand it through their own opinions and life circumstances as well. This is known as interpersonal learning. This type of learning requires that individuals look within themselves to understand the meaning, relevance, and purpose of life, evaluate goals, and values in life (Garner, 2010).

For all of the points that we presented, we asked students to reflect on the topics and apply the knowledge, based on their understating of it, to situations that present themselves in their day to day lives. Discussions of the relevancy of the knowledge and information were done with the students. Many students shared specific situations which showed their comprehension of the topic, and how substance abuse affected people. This presentation had a positive impact on students. Not only did the presentation share information about substance abuse, but it also involved a great deal of participation from the students as they reflected on the issues and took part in discussion activities.

The use of interpersonal learning in our presentation was quite important as it was our main method of getting the students involved. The students were able to identify their own stigmas and opinions and then discuss it all as a class. Reflection was something we used a lot in our presentation. Horn & Shirley (2008) say that reflection helps make connections between knowledge and real life situations. After the students shared their opinions on mental illness and substance abuse, we discussed with how everyone was able to share their views and talk about associated stigmas.

The opinions of some students changed and their negative bias was also decreased. There was a better understanding of mental illness and substance abuse. Jensen & Joy (2005) say that Meziro’s reflection model helps reach higher levels of thinking. Also, according to a study, after using Mezior’s model more nurses had higher reflective thought in situations which helped them work better from many points. The reflection exercise is a method that can be applied to a wide range of situations that may arise in the future. They can then further discuss topics without having stigmatizing views on things.

As nurses, we understand the importance of reflection in practice. Reflection is useful to evaluate our strengths, weakness and overall learning from the experience. This being our first experience in the mental health field, we were looking to explore all aspects that were included as a part of mental health. Substance abuse and addiction are often not considered mental illnesses by the general public. Thus, we were looking to inquire how these illnesses were mentally related and share our knowledge to a vulnerable age group as a part of our role in prevention. Evaluating our own strengths over the course of designing this project, we interpreted useful strategies which helped us succeed.

We found that we were efficient in finding useful and scholarly resources as the base of our research and information. This information was used to create our presentation and was a sufficient learning tool to help educate others regarding substance abuse and addiction. In order to evaluate our successes we created an audience feedback form. We had the audience complete this form anonymously after the presentation. The results from the feedback form were positive. 75% of the class felt that the presentation was informative, and 60% felt that the topic was useful.

This allows us to interpret that our presentation was overall successful and valuable to our chosen audience. In consideration of Howard Gardner’s multiple intelligences (Smith, 2008), we feel that we met the needs of certain learning styles within the criteria means of presentation. Specifically, spatial/visual learning with our powerpoint presentation and video, and interpersonal learning through verbal dialogue and presentation and allowing for audience interaction through a question and answer session.

We felt that this question and answer session was a useful method of evaluation as we were able to visibly observe the comprehension and interest of our audience during the time of the presentation. The several questions asked by the students indicated the increase of general interest regarding the issue or substance abuse and addiction as mental illnesses. There are always areas for improvement in any learning experience; as a result we feel that there is room for us to improve upon our public speaking skills as it is something we will work to exercise throughout our careers as students and nurses.

In essence, it was agreed upon by all group members that this was an overall positive learning experience. The research component was beneficial to our skills as students and useful to our future practice as nurses, as we feel that successful researching skills will be necessary for our entire practice as nurses. Furthermore, this was an efficient way to build a foundation for an understanding of mental health, specifically regarding the topic of substance abuse and addiction. We feel that a strong knowledge base in all aspects of nursing is crucial despite which career path is chosen. It was rewarding and significant for us to receive positive feedback from our audience as it gave us insight to our success and strategies which were useful in developing this presentation.

These skills, such as researching, topic and audience targeting and presenting are important to obtain as students. These skills can be applied in various situations in our future careers as nurses. We feel that being advocates of health is important to our values as nurses but also plays a larger role in our responsibilities. Furthermore, discussing the topic of mental illness stigma and working toward preventing it in our community was a successful way to meet the standards of our profession and practice.

As a result, we feel that through this successful learning experience we have earned enough knowledge that we can apply to maintaining our role as professional health care advocates. We have developed a strong understanding of substance abuse and addiction in mental illness and look forward to continuing to share our knowledge with our peers in our practice.

Overall this presentation was a positive learning experience for our group. We were able to obtain useful information for our mental health and nursing practice. Furthermore, we were able to fulfill our responsibilities as nurses to be health advocates and promote prevention within our community. We gained insight to the area of substance abuse and addiction and are able to take this new information and share it with our nursing peers and within our health care communities.

We feel that we have successfully met our responsibility of creating awareness and providing our community with information based on an area of mental illness. It is important that we maintain these skills and use them throughout our nursing careers. We hope that our audience will pass on their knowledge to their peers and our presentation will be impactful. We must continue to work towards being patient advocates for health and equality both in the health care settings and within our communities and society. All in all, we feel that this aspect of mental health nursing has been an overall rewarding experiencing.

References
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Emotional competence and its influences on teaching and learning. Educational Psychology, 22(1), 297-321. Doi: 10.1007/s10648-010-9129-4 Jensen, Sharon K,M.N., R.N., & Joy, C. (2005). Exploring a model to evaluate levels of reflection in baccalaureate nursing students’ journals. Journal of Nursing Education, 44(3), 139-142. Retrieved from http://search.proquest.com.uproxy.library.dc-uoit.ca Plichta, S., & Garzon, L. (2009). Statistics for Nursing and Allied Health. Philadelphia, PA: Lippincott Williams & Wilkins. Rassool, G. (2008). Addiction: future directions and responding to the challenges. Complacency or commitment?. Journal of Addictions Nursing, 19(4), 179-181. Retrieved from EBSCOhost. Smith, M. (2008). Howard Gardner multiple intelligences and education. Retrieved from http://www.infed.org/thinkers/gardner.htm

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