Health Problems in Students and Responsibilities In Nursing Education Nursing Students with Mental Health Problems Identification
Nursing students are at significant risk of developing mental health problems due to the high levels of stress they face. Despite this, research on effective interventions for mental health issues in nursing students remains limited. Existing studies are largely descriptive and focus on behaviors associated with anxiety, stress, and anger. Mental health issues in nursing students include anxiety, depression, eating disorders, and obsessive-compulsive behavior (Storrie, Ahern, & Tuckett, 2010).
Some students may have pre-existing mental health conditions when they enroll in nursing programs. Often, individuals with such challenges are drawn to the “helping” professions, including nursing. Students with mental health concerns may need assistance in recognizing and addressing their issues. Both undergraduate and graduate nursing students face fears and worries about their ability to succeed, and test anxiety is a specific form of anxiety commonly experienced by nursing students, particularly with the increasing prevalence of high-stakes testing (Røykenes, Smith, & Larsen, 2014).
Faculty members, due to their close relationships with students, are often the first to notice signs of stress and other mental health issues (Chernomas & Shapiro, 2013). Behavioral indicators may include fatigue, poor concentration, changes in appearance, frequent absences, disorganized thinking, and declining work quality (Phimister, 2009). Early interventions can help mitigate the stress and anxiety nursing students face.
One challenge in identifying sources of stress among nursing students is the inconsistency in research instruments used across studies. Pulido Martos, Augusto Landa, and Lopez-Zafra (2012) concluded that while sources of stress were varied, common factors included academic workload, study challenges, and fear of making mistakes in clinical settings. Similarly, Alzayyat and Al-Gamel (2014) highlighted difficulties in pinpointing stress sources in clinical environments due to varying definitions and measurement tools. Globally, stress related to clinical practice is common and can often lead to depression.
Chernomas and Shapiro (2013) examined the levels of depression, anxiety, and stress in 442 Canadian nursing students. Most students reported normal ranges of depression and anxiety, though 40% experienced sleep disturbances and 41% felt they had little time for leisure activities. Their findings emphasized the role that clinical practice-related fears play in contributing to student stress. The researchers recommended faculty development workshops to help educators learn how to address students’ mental health needs.
In Kurdistan, Moridi, Khaledi, and Valiee (2014) found that clinical practice was a significant source of stress for 230 nursing students. Similarly, Shaban, Khater, and Akhu-Zaheya (2012) discovered that Jordanian students who used avoidance coping behaviors experienced increased stress, while problem-solving coping strategies reduced it.
Depression among nursing students has also been linked to various factors, such as academic performance, career prospects, and interpersonal relationships. Xu et al. (2014) administered a depression scale to 729 Chinese nursing students, showing a positive correlation between lower depression rates and better career outlooks. Family and school-based programs were recommended to help prevent depression. Cha and Sok (2013) found a relationship between anger, depression, and self-esteem in Korean students, suggesting that managing anger could improve self-esteem and reduce depression.
Other international studies have also examined the mental health challenges nursing students face. For instance, Klainin-Yobus et al. (2014) found that high stress levels among Thai nursing students were related to psychological distress, and Papazisis et al. (2014) noted that religious beliefs were associated with lower depression and higher self-esteem in Cypriot students.
While these studies provide insight, the diversity of data collection methods and the fact that many studies occurred outside the U.S. limit their generalizability. Nonetheless, the common themes highlight that clinical practice stress and organizational factors play a role in students’ mental health. Blomberg et al. (2014) found that Swedish students placed in overcrowded hospitals with multiple supervisors experienced higher stress levels, particularly when undergoing a National Clinical Final Examination (NCFE).
Faculty Responsibilities Related to Students with Mental Health Problems
Faculty play a critical role in identifying and addressing mental health problems in nursing students. Mental health issues in students can range from anxiety and stress to more severe conditions, such as depression or other mental illnesses. Faculty are responsible for recognizing early signs of mental health struggles and taking appropriate action. The approach to assisting students with mental health concerns should be similar to the process used for addressing any academic issues.
According to the Americans with Disabilities Act (ADA) and the ADA Amendments Act (ADAAA), students with mental health conditions cannot be discriminated against, and faculty must ensure that all interventions align with institutional policies to protect students’ rights. If a student’s mental health issue interferes with their academic performance, faculty are obligated to address the problem while adhering to institutional guidelines.
Policies for handling mental health issues should involve confronting the student with evidence of problematic behavior and encouraging improvement before any disciplinary action is taken (Cleary, Horsfall, Baines, & Happell, 2012). It is crucial that students understand how their behavior is affecting their academic progress and what specific actions they need to take to improve. Faculty might employ a learning contract outlining the steps a student must take to correct their behavior and the timeline for doing so.
Most campuses have codes of conduct that guide policy development for addressing student behavior, including mental health concerns. Policies should include clear procedures for assessing, documenting, reporting, intervening, and referring students for mental health treatment. Many universities provide counseling services for students at little to no cost, making it easier for students to seek help when needed.
If a student’s behavior does not improve after interventions and their ability to function effectively or ensure patient safety remains compromised, faculty may need to consider administrative withdrawal or dismissal from the program. However, the student still has the right to pursue a grievance or appeal within the institution.
Mental health issues can sometimes manifest as incivility in the classroom, and faculty need to recognize the difference between behavioral disruptions caused by mental health struggles and intentional disrespect. Clark (2009) noted that mental health cannot excuse incivility, which may include sarcastic remarks, tardiness, using cell phones in class, or distracting behavior. Faculty should recognize the risk factors contributing to student stress and anxiety and design strategies to reduce these issues.
Addressing incivility and mental health issues holistically can create a healthier academic environment and foster better learning outcomes. Faculty development programs and interventions aimed at supporting students’ mental health are essential to nursing education’s success.
Conclusion
Faculty have an essential role in recognizing and addressing mental health issues in nursing students. Through early identification, proper intervention, and adherence to institutional policies, faculty can help students manage their mental health, ensuring academic success and protecting patient safety. By fostering supportive environments and developing strategies to reduce stress and anxiety, educators can contribute to students’ overall well-being and success in their nursing careers.
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