Treatment Settings and Therapeutic Programs-Ch4--T1 Flashcards
Case management
liaison between client & community resources.
Discharge planning – impediments to successful DC planning
(substance abuse, criminal behavior, medication noncompliance) – services may not be available d/t client being ineligible.
Relapse prevention
Crisis resolution/respite care housing
short-term temporary shelter.
Adult foster care
1 to 3 clients in family-like setting, meals, social activities with family.
Board, care homes
provide room, bathroom, laundry facilities, one common meal per day.
Supervised apartments
housed in apartment complexes, share apartments, staff available for crisis intervention, transportation, assistance with daily living tasks, etc.
Group homes
6 to 10 residents, cook meals, household chores under supervision of staff
Evolving Consumer Household:
Group-living situation
Residents make transition from group home to residence where they fulfill own responsibilities and function without onsite supervision.
Transitional Care Model (d)
WHAT ARE THE TWO ESSENTIAL COMPONENTS
intensive services following long hospitalization to facilitate a client’s transition to successful community living.
Two essential components:
Peer support – provided by a consumer now living successfully in community.
Bridging staff – overlap between hospital staff & community care
Psychosocial Rehabilitation
Services to promote recovery process (see Box 4.3, p. 67).
Emphasis on recovery, going beyond symptom control and medication management; includes personal growth.
Reintegration into community.
Empowerment, increased independence.
Improved quality of life.
Characteristics of Later Stages of recovery from mental illness (see Box 4.4).
Accepting illness
Self-love
Gaining control over symptoms
Clubhouse model
Fountain House
intentional community based on belief clients with severe/persistent mental illness can & will achieve normal life goals when given opportunity, time, support, & fellowship.
Four guaranteed rights of members of a CLUBHOUSE MODEL (fountain house)
A place to come to
Meaningful work
Meaningful relationships
A place to return to (lifetime membership)
a CLUBHOUSE MODEL (fountain house):
recognizes the _________relationship is key
focuses on______
physician-client
health, not illness
homeless people in comparison to homeless people with mental illness the following is true:
Spend more time in jail Are homeless longer Spend more time in shelters Have less family contact Face greater barriers to employment
Projects for Assistance in Transition from Homelessness (PATH program)
funds community-based outreach, mental health services
program specifically for the homeless with mental illness
ACCESS Demonstration Project
– sites evidenced improved outcomes using outreach & intensive case management.
(program specifically for the homeless with mental illness)
The rate of mental illness is ______times higher than the general population
5
Factors for placement in criminal justice system
Deinstitutionalization
More rigid criteria for civil commitment
Lack of adequate community support
Economization of treatment for mental illness
Attitudes of police, society
Criminalization of mental illness
practice of arresting & prosecuting mentally ill offenders at a rate 4 times that of general population in effort to contain them in some type of institution where they might receive treatment.
Barriers to successful community reintegration:
Poverty
Homelessness
Substance use
Violence
Victimization, rape, trauma
Self-harm
Active Military & Veterans and mental illness
Increased rate of:
Increased rates of: PTSD Suicide Homicide Injury Physical illness Sleep disorders Substance abuse Marital and family dysfunction
core skills of the members of the interdisciplinary team
Interpersonal skills (tolerance, patience)
Humanity (warmth, acceptance, empathy)
Knowledge base
Communication skills
Personal qualities (consistency, assertiveness, problem solving)
Teamwork skills
Risk assessment, risk management
Examples of care that public health nurses provide to the community for mental health prevention
Primary prevention: stress management education.
Secondary prevention: early identification of mental health problems.
Tertiary prevention: monitoring, coordinating psychiatric rehabilitation services.
Evolution of care away from inpatient settings into community.
Client-centered goals.
Nontraditional settings such as jails or homeless shelters – nurses do not have resources that are available in hospitals (autonomy).
Empowering clients to make their own decisions – may differ from what nurse feels is best course of action.
Frustration of working with clients having persistent and severe mental illness.
