Chapter 4: Continuum of Mental Health Care Flashcards
Primary health care approach
An approach that encompasses five types of healthcare promotive, preventative, curative, rehabilitative, and support/palliative. It’s based on principles of accessibility, public participation, health commotion, appropriate technology and inter sectoral cooperation.
Defining the continuum of care
The continuum of care represents the complex integrated system of services provided by health professionals and by those with specialized psychiatric and mental expertise, as well as the supports provided by informal providers and organizations within the community that help people to maintain and restore their mental health and well-being. It begins with health promotion strategies.
The integrated health system of supports and services designated to maximize peoples health and well-being across the lifespan that is provided by health professionals some who offer specialize services such as psychiatric mental health services as well as by non-professional caregivers.
This extends beyond the services for acute events and supports recovery. The core principles for care provision in recovery include hope and optimism, focussed on the individual, occurring in the context of the individuals life, and responsive to diversity among individuals.
Coordination of care
Is the integration of appropriate services so that the individualized person centred care and treatment is provided. Patients input and opinions need to be asked. Patient centred care establishes a partnership among practitioners, patients and their families to ensure that decisions respect patients wants needs and preferences. We are increasing professional coordination of services such as case management, service coordination, care management, care coordination, service navigation and transition care services.
The nurse as manager of patient services:
Nurses can be involved in direct care and coordination of care delivered by others. The nurse must have commanding knowledge of the patient there needs areas of strength in the available community resources. The nurse Patient relationship also influences patient engagement in ongoing mental health care
Mental health promotion and illness prevention
Mental health promotion strategies address the determinants of health that can impact the populations mental health. The strategies address the broader issues. Program examples include early childhood intervention programs, nutritional and psychosocial interventions for vulnerable populations.
Mental illness prevention strategies are designed to keep something from happening. This may be the illness itself the severity or duration of the illness or disability associated with the illness. Three categories of prevention strategies that will reduce the risk include universal prevention which targets the general population, selective prevention which targets groups or individuals at higher risk, and indicated prevention which targets people at high risk for mental illnesses. And example of a service includes respite services for family caregivers of people with mental illness.
Consumer self-help and consumer survival initiatives
Expanding the leadership role of people living with mental health problems and illnesses and their families in setting mental health related policy will improve knowledge and foster collaboration which will have a positive affect on decision making within the system. This is due to the determination and advocacy of self-help groups and organizations of people who have experienced mental illness. These people refer to themselves as consumers or survivors not of their own illness but of their health care experience. Mental health services are mainly operated on a acute care model we’re people do not get the continuous help they need. To extend assistance to people with mental health, is through consumer survival initiative organizations. They are operated by and for people with serious mental illnesses. They Promote member empowerment.
Crisis response systems and psychiatric emergency services
Crisis response systems emphasize flexible portable and person centred support. This short term intervention focusses on de-escalation, stabilizing, symptom reduction, and prevention of relapse. Crisis intervention units can be found in the ER or in a community mental health center. Patients exhibit severe symptoms Such as suicide intentions or self injury behaviors. Chi nursing rules include making an accurate assessment, delivering short term therapeutic interventions and administering medication. Nurses will facilitate referrals for community services, admission to the hospital, or outpatient services.
Crisis Stabilization
The purpose is to control precipitating symptoms through medications, behavioural interventions and coordination with other agencies for appropriate aftercare. The nurses focus is symptom management and linkage to community resources. Nurses provide ongoing assessment, short-term focussed interventions and medication administration while monitoring efficacy and side effects
Psychosocial emergency preparedness and response
Health Canada and the Public Health agency of Canada play critical roles in emergency response to risks to public health. In times of major emergencies families and communities can face severe risk to psychosocial well-being. Canada’s psychosocial preparedness and response initiative offer services to helpCanadians better prepared for disasters and emergencies as well as consultation dream disaster response
Primary care
Refers to the first point of access to the healthcare system. An integrated approach assist people in managing illnesses regardless of its origin, unlike the current system which splits mental and physical illness. Collaborative mental health care models acknowledge that family physicians are the first point of contact for 85% of people with mental illness, And that there’s a shortage of mental health specialists. Secondary care components include opportunities for consultation and support through referrals, as well as supervision and support to facilitate further skill development and education. Collaborative mental health extends to providing support such as housing education and recreational organizations.
Outpatient care
Is a level of care that Oakhurst outside of a hospital or institution. It’s less intensive and is provided to patients who do not require inpatient services. It promotes a continued connection with community and community reintegration, medication management and monitoring and symptom management.
Intensive outpatient programs
The primary focus is on stability Asian and relapse prevention for vulnerable individuals. These people have returned to the previous lifestyle but the quality of life is still impacted by their mental illness. The duration of treatments are based on the patient’s needs but sessions are time-limited normally offered 3 to 4 hours a day 3-4 days a week for 6-12 weeks.
Housing and community support
As symptoms wax and wane family caregivers and workers in non-health communities often experience caregiving fatigue. One of the largest hurtles to overcome for people living with a serious chronic mental illness is finding appropriate housing to meet their social financial and safety needs. Most individuals live in a form of supervised or supported community living which ranges from highly supervised to independent apartments. Those who lack the resources to find housing suffer higher rates of substance abuse, Physical illness, incarceration and victimization. 92% of homeless people in a three cities wide study experienced mental illness.
Supported housing:
Supported housing has site-based health and social services that are aimed at improving the health and residential stability of highly disadvantaged individuals. Community-based residential services provide a place for people to reside during a 24 hour period on an ongoing basis. Intensive residential services are stacked for patient treatment. These services may include medical nursing psychosocial and other support. Nurses provide psychoeducation, basic social skills training aggression management, and activities of daily living training. Education on symptom management, understanding mental illness, and medication management is essential to recovery.
Supportive employment:
Employment is strongly linked to a persons sense of self-worth and personal environment. Supportive employment services assist individuals to find work, assess skills attitudes behaviours and interest relevant to work, offer vocational rehabilitation or training, and provide work opportunities. Programs provide individual placement and support services are highly individualized and competitive. The primary Focus is to maintain attachment between the mentally ill person and the workforce
Acute inpatient care
Acute inpatient hospitalization involves the most intensive treatment and it’s considered the most restrictive setting in the continuum. It’s reserved for acutely ill patients who meet one or more of the three criteria. High risk for harming oneself, high risk for harming others, or inability to care for one’s basic needs. Delivery of care occurs in a psychiatric hospital with or within a General Hospital psychiatric unit. Admission can be voluntary or involuntary. Length of state is kept as short as possible without harmful effects on patient outcomes
