Community Mental Health & Reduction Services Flashcards
Alcohol
- In Ontario – alcohol is the most commonly used substance
- alcohol presents the 2nd highest etiological risk factor for disease across Canada
- Alcohol is a carcinogen and is linked to at least 7 types of cancer
- Associated with cardiovascular disease and liver disease
- Linked to increases in many types of violence and accidents
- Can cause harm to developing baby if consumed while pregnant
Alcohol Consumption Per Week
0 drinks/week - not drinking has benefits; better health + sleep
1-2 drinks/week - likely avoid alcohol-related consequences for yourself and others
3-5 drinks/week - risk of developing several different types of cancer (ie. breast and colon)
7 + drinks/week - risk of heart disease and stroke increases
Legislation for Smoking/Vaping
Federal
- Cannabis Act
- Non-Smokers Health Act(for federal workplaces)
- Tobacco and Vaping Products Act(for tobacco retailers)
Provincial
- Smoke-Free Ontario Act, 2017(SFOA, 2017):regulates the sale, supply, use, display, and promotion of tobacco andvapour products(e.g., vapes, e-cigarettes, and e-substances), and the smoking and vaping ofcannabis.
- Tobacco Tax Act(for tobacco retailers)
Municipal
- Various smoking/vaping bylaws
Opiods
Opioids: group of psychoactive substances derived or extracted from the opium poppy.
- Opioids are intentionally used to treat pain, but they also can produce feelings of euphoria.
- highly addictive – leading to physical and psychological dependency.
Includes:
- Heroin
- Codeine
- Morphine
- Methadone
- Oxy/hydrocodone
- Hydromorphone
- Fentanyl
Signs of Overdose?
- slow, weak, or no breathing
- blue lips/nails
- dizziness and confusion
- can be woken up
- choking, gurgling, or snoring sounds
- drowsiness or difficulty staying awake
What is Harm Reduction?
Harm reduction: an approach to healthcare delivery, programs, or policies, implemented to protect the health of, and reduce secondary harm for, individuals who engage in high-risk activities that are associated with poor outcomes
- A harm reduction approach ensures access to evidence-based information for individuals to make informed decisions about their lives and health, and equal access to promotive healthcare services
- Health promotion strategy whereby individuals who engage in high-risk lifestyles and behaviors receive specialized healthcare services to address their concerns, and minimize potential negative health outcomes and harm
Nurses Role in Harm Reduction?
- Requires a nonjudgmental stance that focuses on reducing potential harm from high-risk activities, while treating individuals with respect and dignity
- Nurses doing harm reduction understand that the goal of care is to protect health by reducing harm, but also recognize that complex social issues form the root causes of many high-risk behaviours
Goal of Harm Reduction
- The goal is not the cessation of the high-risk behaviour, but to reduce more immediate, unrelated harms arising from engaging in that behaviour
Harm reduction is not concerned with fixing problems or offering solutions; it is
- meeting people ”where they are at”
- providing non-judgmental, compassionate care with a goal of reducing the secondary harm that people might experience from engaging in high-risk behaviours
- Providing at-risk individuals with products and healthcare services, while they are actively engaging in harmful behaviours, not only promotes health and reduces overall negative health outcomes, but it ensures that the universal right to healthcare is accessible to the most marginalized, vulnerable populations
Harm Reduction Programs
- Harm reduction programs benefit the health of the public and individual, by helping to control the spread of communicable diseases (ie. HIV and Hepatitis C)
Ex’s of harm reduction programs that nurses participate in include:
- Promoting the use of helmets for bicycles
- Distributing condoms to control the spread of STIs
- Seatbelt and distracted driving legislation
- Promoting clean needle exchange programs to reduce incidence of needle sharing and spread of blood-borne illnesses w/in the intravenous drug user community
Types of Prevention in Harm Reduction Efforts
PRIMARY
- preventing initial use or delay of substance use
SECONDARY
- early detection or reduction of substance use once problems have begun
TERTIARY
- reducing substance use problems or harms to prevent further deterioration or death
What are Safe Injection Sites?
Clients are.:
- given clean needles and supplies
- can exchange dirty needles
- are monitored for potential overdose while they inject
- provided with emergency care if an overdose happens
- can have their health concerns addressed and learn about the importance of using clean supplies to protect themselves and others against the spread of blood-borne diseases
- The program has demonstrated value by saving taxpayers $1.9 million a year in HIV and accidental overdose-related healthcare costs
Safe Injection Sites
- Vancouver’s ”Insite Supervised Injection Site” is North America’s 1st safe injection facility, operated by nurses
- Before the opening, users’ self-injected in alleys where they were at high risk of experiencing theft, violence, arrest, or accidental overdose
- After the opening of Insite, the fatal overdose rate decreased by 35% compared to a fatal overdose rate decrease of only 9.3% in the rest of the city
Nursing role in Harm Reduction
Nursing’s role in harm reduction action includes:
- Developing, managing, operating, and promoting harm reduction programs
- Advocacy work to educate government and society about the foundational principles and positive benefits of harm reduction programs
- Reducing barriers to accessing healthcare that exists for homeless people, people who abuse substances, sex trade workers, or others whose lifestyles place them at risk for increased morbidity and mortality
Nursing Support & Interventions
Feedback
- Give feedback on the risks and negative consequences of substance use
- Seek client’s reaction and listen
Responsibility for change and use
- Emphasize that the individual is responsible for making their own decision about their drug use.
Advice to cut down or stop - Give straightforward advice on modifying drug use.
Menu of change options/strategies
- Give menus of options to choose from, fostering the client’s involvement in decision-making.
Empathy
- Empathy is the “glue” of the intervention
- Be empathic, respectful, and non-judgmental.
Self-efficacy
- Express optimism that the individual can modify their substance use if they choose.
Canadian Mental Health Organizations
- In Canada, it is the provincial government’s responsibility to provide community and mental health services
Canadian Mental Health Association (CMHA)
- an umbrella organization founded in 1918
- aim is to prevent mental illness and promote the mental health of people living in their own communities
- Local branches of the CMHA provide resources, mental health programs, and other human services to individuals, families, and groups
- Services such as housing, income, education, leisure opportunities, employment, peer and social support, and self-esteem are based on factors that determine health and wellness
