INSTITUTIONALIZATION (1)ppt.pptx

mental health nursing ppt

1. CLINICAL TEACHING ON INSTITUTIONALIZATION AND DEINSTITUTIONALIZATION PREPARED BY, Ms.DIVYA THOMAS M.Sc.SECOND YEAR NIN ,NOIDA

2. INTRODUCTION In deinstitutionalization policy ,people who were formerly required long hospital stay become able to leave the institution and return to their community or home The modern deinstitutionalisation movement was made possible by the discovery of  psychiatric drugs and somatic therapies in the mid-20th century, which could manage  psychotic  episodes and reduced the need for patients to be confined and restrained. Another major impetus was a series of socio-political movements that campaigned for patient freedom

3. Asylum before world war 2

4. Example -deinstitutionalization

5. ESSENTIAL COMPONENTS OF SOUND DEINSTITUTIONALIZATION PROCESS: 1.Prevention of inappropriate mental hospital admissions through the provision of community facilities. 2.discharge to the community of long term institutional patients who have received adequate preparation. 3.Establishment and maintenance of community support system of non institutionalized patient.

6. BENEFITS OF DEINSTITUTIONALIZATION Allow for the integration of family and social system in care of patients B etter care would be provided to mentally ill patients in their home communities surrounded by those who are not mentally ill. It was a huge step in returning a sense of worth ,ability and independence to those who had been dependent on others for their care for so long.

7. NEGATIVE EEFFECTS OF DEINSTITUTIONALIZATION: Unfortunately ,adequate support services were not in place in many communities and a decreased quality of life for the mentally ill resulted Revolving door syndrome:patients were often return to hospitals stabilized and discharged again in a cycling pattern Emergency department use by acutely ill individuals has increased dramatically patients with severe and persistent mental illness not receiving adequate care commit homicides Homelessness among patients increased state prisons are occupied by severly mentally ill patients.

8. INSTITUTIONALIZATION In recent years the focus of psychiatric care has moved away from extended care to shorter length of inpatient stays.most inpatient psychiatric settings now have an average stay of 5-10 days when compared to 24-30 days during 1980s .

9. INDICATIONS FOR INSTITUTIONALIZATION INPATIENT HOSPITAL ADMISSION: Prevention of harm to self or others Management of severe symptoms Need for a rapid ,multidisciplinary diagnostic evaluation that requires frequent observation by specially trained personnel

10. enfeeblement’s OBJECTIVES OF INSTITUTIONALIZATION

11. RAPID EVALUATION AND DIAGNOSIS

12. CHANGING BEHAVIOUR THAT IS DANGEROUS TO SELF AND OTHERS

13. PREPARE CARE GIVERS

14. enfeeblement’s ARRANGING EFFECTIVE AFTER CARE

15. MAJOR DEVELOPMENT FOR DEINSTITUTIONALIZATION Community support services programs are developed to meet the needs of the persons with mental illness outside the institution. These programs focus on rehabilitation,vocational needs,education and socialization as well as managemet of symptoms and medications. In India,alternative community based services are not adequately developed and existing mental hospitals are not fully equipped with therapeutic activities

16. CONTI…….. What is now required is the need for a balanced approach , i.e.inpatient treatment needs to be improved and community based health programs strenghthened . There is an urgent need to sensitize governments on the importance of mental health and clearly define goals and objectives of community based health programs.

17. SUMMARY

18. CONCLUSION Mental health services should be integrated into the overall primary health care system. Innovative community based health programs which are culturally and gender appropriate and reach out to every segment of population need to be developed. Well organised community based care is urgently required besides increasing the number of psychiatric beds in general hospitals .

19. BIBLIOGRAPHY: 1.R SREEVANI,A GUIDE TO MENTAL HEALTH AND PSYCHIATRIC NURSING,4 TH EDITION,JAPEE BROTHERS,371-373. 2. https://www.slideshare.net/philiphlevy/deinstitutionalization-35324733