Session 17 Concepts of Community Mental Health Care.pptx

Students

1. Concepts of community Mental Health Care

2. Learning tasks By the end of this session learner is expected to be able: Define community psychiatry, rehabilitation and domiciliary care Explain concepts of community mental health Explain roles of a nurse in community mental health Explain roles of the family members in caring for a mentally ill patient

3. Definition (1) Community is defined as a group, population, or cluster of people with at least one common characteristic, such as geographic location, occupation, ethnicity, or health concern Community Mental Health (Psychiatry) is the mental health care that is provided at the community level It involves shifting mental health care from health facilities to the community

4. Definition (2) It enables patient to be seen and treated rapidly in the community or as a day patient, thereby helping to pre- empty their need for admission as in patient These services are offered by multidisciplinary teams, including psychiatrists and community psychiatric nurses and provide a cost effective form of treatment rather than hospital – based treatment

5. Definition (3) The target within the community is: Primary prevention (reducing the incidence of mental disorders within the population) Secondary prevention (reducing the prevalence of mental illness by shortening the course of the illness) Tertiary prevention (reducing the defects that are associated with severe or chronic mental illness.)

6. Definition (4) Rehabilitation is the type of therapy that focuses on return injured workers to an appropriate level of work activity It aim is to enhance and restore functional ability to those with physical impairments or disabilities Domiciliary care is care provided to people who still live in their own homes but who require additional support with household tasks, personal care or any other activity that allows them to maintain their independence and quality of life

7. Concepts of community mental health The main concepts of community mental health care is designed to supplement and decrease the need for more costly inpatients mental health care delivered in hospitals To achieve this following three levels of prevention which have been put in place includes: Primary prevention, Secondary prevention and Tertiary prevention

8. Primary Prevention (1) Primary prevention in the community includes: Identifying stressful life events that precipitate crises and targeting the relevant populations at risk This can be through; Maturational crisis and Situational crisis

9. Primary Prevention (2) Maturational crisis are crucial experience that are associated with various stage of growth and development i.e Adolescence Marriage Parenthood Midlife period and Retirement

10. Primary Prevention (3) S ituational crisis are acute responses that occur as a result of an external circumstantial stressor including; Poverty High rate of life change events Environmental condition Trauma Intervening with these high – risk populations to prevent or minimize harmful consequences

11. Primary Prevention (4) Intervention includes: Mental Health educational programs that inform about; Nutritional needs specific for this age group, Sexuality, Pregnancy, Contraception, and Sexually transmitted diseases, Use of alcohol and other drugs support groups for teenagers who are in need of assistance to cope with stressful situations

12. Primary Prevention (5) In marital relationship encouraging honest communication, determining what each person expects from the relationship and ascertaining whether or not each individual can accept compromise In parenthood educate on parent-infant bonding, changing husband-wife relationships, clothing equipment and feeding Provide information and Support related to care of aging parents

13. Secondary Prevention (1) Secondary prevention in the community relates to using early detection and prompts intervention with individuals experiencing mental illness symptoms Interventions include Early identification of the problem and possible solutions; support and guidance as changes are undertaken

14. Secondary Prevention (2) Referral to sex therapist, financial advisor, couples’ support group Recognize the physical and behavioral signs that indicate possible abuse of a child and care of child may be cared in the emergency department or as an inpatient Teaching effective methods of disciplining children, aside from physical punishment and positive reinforcement for acceptable behavior

15. Tertiary Prevention (1) T ertiary prevention is concerned with preventing or reducing the duration of the long term disability that is often a residual effect of the major psychiatric disorders such as; schizophrenia , organic brain syndrome Treatment in tertiary prevention depends upon the particular psychiatric disorder

16. Tertiary Prevention (2) Treatment may include: Use of somatic therapy Group therapy Individual therapy Psychotherapy Rehabilitative therapies

17. Roles of nurses in community mental health (1) Eliminate factors that contribute to mental illness Provide care that is familiar to the patient or residents Utilize supportive services of the community and family. Shorten time of rehabilitation through early detection and treatment of those at risk. Coordinate mental health services and other services

18. Roles of nurses in community mental health (2) Reduce the illnesses and suffering Reduce or eliminate residual disability following the illness Influence community on accountability and mastering of their heath. Undertake physical check up on regular basis Prevent long hospitalization Encourage people to live normal life- work, rest, play and good interaction etc. Link clients to the needed support and care

19. Roles of the family members in caring for a mentally ill patient (1) Detect client vulnerability for future episodes will help in early management of the illness Help client accept the necessary ongoing medication administration and other therapy Family dynamics and attitudes plays crucial roles in the outcome of the client recovery Reduce relapses by increasing medication adherences Monitoring their relative’s progress, and watching out for signs of relapse

20. Roles of the family members in caring for a mentally ill patient (2) Play a vital role in monitoring the use of medication by learning about side effects and how to deal with them. Help to foster a lifestyle conducive to recovery and maintenance of good mental health by; Providing social support Encouraging engagement in exercise, social activities, work, school

21. Roles of the family members in caring for a mentally ill patient (3) Engage person in a treatment plan learning how to communicate with a person in ways that will encourage them to seek help Learn about mental illness and services available behaviours/symptoms that create refuse to seek help self-management skills ,medications are used and their side-effects services needed

22. Key Points Community Psychiatry care is shifting from that of in-patient hospitalization to a focus of outpatient care within the community. Rehabilitation is the type of therapy that focuses on return injured workers to an appropriate level of work activity. Domiciliary care is care provided to people who still live in their own homes but who require additional support with household tasks, personal care Prevention of mental illness early detection and treatment

23. Session Evaluation What is community psychiatry? What are the roles of family in care of mental ill patient? What are the roles of nurse in community mental health ?

24. REFERENCES Keltner N.K, & Steele D, (2015) Psychiatric Nursing 7 th ed . St Louis, Missouri: Mosby Blashki . G, Judd. F, Piterman . L, (2007) General Practice Psychiatry , Australia: McGraw-Hill companies Halter MJ. (2014). Varcarolis ’ Foundation of Psychiatric Mental Health Nursing 7th ed. St. Louis: Elsevier Sounders Townsend M C. (2011), Essentials of Psychiatric Mental Health and Nursing: Concepts of Care in