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Nursing Times brings you the latest ideas and techniques from all areas of clinical practice

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VOL: 98, ISSUE: 38, PAGE NO: 31

Chris Hart is mental health editor, Nursing Times

The term psychosis is commonly used in mental health, yet it is one of the most misunderstood outside its immediate sphere. The public has a distorted image of it and few nurses working in adult care will have an in-depth understanding of the experience of people with psychotic disorders, even though many of them come into contact with primary or acute services. The devastating and deeply distressing effects psychosis can have on patients, their families and carers often remain shrouded in mystery.

The term psychosis is commonly used in mental health, yet it is one of the most misunderstood outside its immediate sphere. The public has a distorted image of it and few nurses working in adult care will have an in-depth understanding of the experience of people with psychotic disorders, even though many of them come into contact with primary or acute services. The devastating and deeply distressing effects psychosis can have on patients, their families and carers often remain shrouded in mystery.

Nursing Times is running a three-part series focusing on these disorders, which affect more than one in 10 adults. Peter Chadwick (p32) gives a personal account of what it is like to experience psychosis. This is essential reading for all nurses, whatever their specialty. It provides a moving but accessible description of how it feels when one's world unravels and places this within the context of normal, everyday experience.

Next week Jacqueline Freeman approaches the subject from a different perspective. She outlines how nurses can help people who have experienced psychosis to reach some understanding, particularly during the crucial first episode, and looks at various models, including the stress-vulnerability model.

Finally, Tony Gillam completes the series on October 1 by looking at the development and use of psychosocial interventions for people with psychotic disorders and the use of atypical antipsychotic medication as a treatment package.

Despite Mr Gillam's optimistic conclusions, and the satisfaction of seeing someone such as Mr Chadwick having made a powerful recovery, there are concerns about the care and treatment that are available in the short term.

Specialist services such as Ms Freeman's are well resourced and specialist training is available. Yet too many people with psychotic disorders cannot gain access to comprehensive treatment programmes. They often rely on poorly resourced services that have to discharge patients when many nurses know that they would benefit from further care and treatment. The intensive therapeutic interventions that are so beneficial during the crucial days of a psychotic episode are often not available.

The main challenge facing mental health services in the UK is not the provision of increasingly restrictive treatment programmes for the few who may pose a risk to the public, but the mainstream provision of modern programmes of care and treatment for most patients, who suffer unnecessarily prolonged periods of distress and disturbance.

These three articles illuminate psychosis and make an overwhelming case for the nurse's role in helping people to manage and overcome it.

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