Community mental health nursing

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1. Community Mental Health Nursing
NabinaPaneru

3. Mental Health
AccordingtoWHO“MentalHealthisdefinedasthestateof
wellbeingwhichinwhicheveryindividualrealizeshisorherown
potential,cancopewiththenormalstressesoflife,canwork
productivelyandfruitfully,andisabletomakeacontributiontohis
orhercommunity.”

4. Community Mental Health
Community mental health is the application of specialized
knowledge to population and communities to prevent mental
illness, promote and maintain mental health, and to rehabilitate
population at risk that continue to have residual effects of mental
illness.
-Sreevani

5. Community Mental Health Nursing
Community mental health nursing is the application of knowledge
of psychiatric nursing in promoting and maintaining mental health
of community people, to help in early diagnosis and care and to
rehabilitate the clients after mental illness.
-BimalaKapoor

6. Purposes of Community Mental Health Nursing
•Provide prevention activities to population for the purpose of
promoting mental health.
•Provide prompt interventions
•Help individuals develop a sense of self worth and independence.
•Anticipate emotional problems

7. Contd.
•Identify and change social and psychological factors that
influence human interactions
•Develop innovative approach to primary preventive activities
•Provide mental health education and how to assess the mental
health. e.g.. SIGECAPS

8. Objectives
•Basic mental health care to all the needy.
•Encourage application of mental health knowledge
•Promote community participation.
•Prevention and treatment of mental and neurological disorders
and their associated disabilities.

9. Contd.
•Use of mental health technologies to improve general health
services.
•Application of mental health principles in total national
development to improve quality of life.

10. Trends of Care
Institutionalization
•It is the process of committing a person to a facility where their
freedom to live will be restrained, usually mental hospital.
•Institutional mental health services include specialist institutional
services and mental hospitals
•A key feature of these services is the independent stand –alone
service style, although they may have some links with the rest of
the health care system

11. Institutionalization Contd.
Aims of Institutionalization
•Prevention of harm to self and others
•Management of severe symptoms
•Need for a rapid, multidisciplinary diagnostic evaluation that
requires frequent observation by specially trained personnel.

12. Trends of care contd.
Deinstitutionalization
•The movement toward treating persons with mental illness in less
restrictive environments gained momentum in 1963 with the
enactment of the community Mental Health Center Act.
Deinstitutionalization, a deliberate shift from institutional care
in state hospitals to community facilities began.

13. Deinstitutionalization Contd.
•Deinstitutionalizationis a government policy that moved mental
health patients out of state-run "insane asylums" into federally
funded community mental health centers. It began in the 1960s as
a way to improve the treatment of the mentally ill while also
cutting government budgets.

14. Contd.
Essential components of a deinstitutionalization process
•Prevention of inappropriate mental hospital admissions through
the provision of community facilities
•Discharge to the community of long term institutional patients
who have received adequate preparations
•Establishment and maintenance of community support systems of
non institutionalized patients.

15. Contd.
Positive effects of deinstitutionalization
•Integration of family and social system in acre of patient
•Provision of better care to mentally ill, in their home environment
•Helps in returning sense of worth, ability and independence to
those who had been dependent on others for their care.

16. Contd.
Negative effects of deinstitutionalization
•Failure of implementation effectively
•Emergency department used by acutely disturbed individuals has
increased
•Patient who do not receive adequate care commit homicides

17. Prevention of mental health
Tertiary Prevention: rehabilitation
Secondary Prevention: early
diagnosis and treatment
Primary Prevention: health
maintenance and specific protection
Primordial Prevention

18. Contd.
Primordial Prevention
•The primordial prevention focuses on enhancing healthy
environment so that the disease can be prevented.
•This is a prevention of development of risk factors in a
population group, which they have not yet appeared

19. Primordial Prevention contd.
•Special attention is given in preventing chronic disease
•Main intervention is health education
•In this efforts are dedicated towards discouraging people from
adopting harmful lifestyles/ Habits through individual & Mass
education

20. Prevention Contd.
Primary preventions
•Primary prevention can be defined as the action taken prior to the
onset of disease, which removes the possibility that the disease
will occur
•In this action are taken before the onset of disease

21. Primary Prevention contd.
Measures of primary prevention
•Identification of people at risk
•Identification of stressors actual or potential
•Development of program through education, positive
reinforcement, assertiveness training, and self –help groups.
-Providing classes for adults with elderly parents who provide
care giving services to older adults to help them learn about the
normal aging process

22. Measures Contd.
-Community services availability to cope with the stress of being
responsible for an elderly person.
-School health program/ education
1.Eliminate causative agents –e.gstress, substance abuse,
violence
2.Risk factor

23. Prevention contd.
Secondary preventions
•An action which halts the progress of a disease at its incipient stage and
prevents complications
•The specific interventions are:
I)Early diagnosis (e.g. screening and periodic examinations of the
populations at risk, monitoring clients, crisis interventions through
hotlines, walk –in –clinics, treatment (medical, physical or
psychological interventions) in hospitals and direct services
II)Referral

24. Contd.
Tertiary Prevention
•It is used when the disease process has advanced beyond the
early stages
•All measures available to reduce or limit impairments and
disabilities, and to promote the patients’ adjustment to
irremediable conditions
•Main focus on disability limitation and rehabilitation
•Rehabilitation includes: daycare centers/hospitals, foster homes,
self –help groups and liaison workers

25. Role of Nurse in community in Prevention of Mental Health Problem
•Health monitor
•Care Provider
•Co-ordinator
•Facilitator
•Health Educator
•Counselor
•Motivator
•Change agent
•Problem solver
•Supervisor
•Advocator
•Researcher
•Planner
•Manager
•Evaluator

26. Role of nurses in the community mental health services
•Role of nurses in institutional setting
•Role of a nurse in nursing education
•Role of the nurse in prevention of mental illness
•Role of nurse in the community mental health services