Treatment Settings and Therapeutic Programs-Ch4--T1

Question 1

Case management

Answer 1

liaison between client & community resources.

Question 2

Discharge planning – impediments to successful DC planning

Answer 2

(substance abuse, criminal behavior, medication noncompliance) – services may not be available d/t client being ineligible.
Relapse prevention

Question 3

Crisis resolution/respite care housing

Answer 3

short-term temporary shelter.

Question 4

Adult foster care

Answer 4

1 to 3 clients in family-like setting, meals, social activities with family.

Question 5

Board, care homes

Answer 5

provide room, bathroom, laundry facilities, one common meal per day.

Question 6

Supervised apartments

Answer 6

housed in apartment complexes, share apartments, staff available for crisis intervention, transportation, assistance with daily living tasks, etc.

Question 7

Group homes

Answer 7

6 to 10 residents, cook meals, household chores under supervision of staff

Question 8

Evolving Consumer Household:

Answer 8

Group-living situation
Residents make transition from group home to residence where they fulfill own responsibilities and function without onsite supervision.

Question 9

Transitional Care Model (d)

WHAT ARE THE TWO ESSENTIAL COMPONENTS

Answer 9

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

Question 10

Psychosocial Rehabilitation

Answer 10

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.

Question 11

Characteristics of Later Stages of recovery from mental illness (see Box 4.4).

Answer 11

Accepting illness
Self-love
Gaining control over symptoms

Question 12

Clubhouse model

Fountain House

Answer 12

intentional community based on belief clients with severe/persistent mental illness can & will achieve normal life goals when given opportunity, time, support, & fellowship.

Question 13

Four guaranteed rights of members of a CLUBHOUSE MODEL (fountain house)

Answer 13

A place to come to

Meaningful work

Meaningful relationships

A place to return to (lifetime membership)

Question 14

a CLUBHOUSE MODEL (fountain house):

recognizes the _________relationship is key

focuses on______

Answer 14

physician-client

health, not illness

Question 15

homeless people in comparison to homeless people with mental illness the following is true:

Answer 15

Spend more time in jail
Are homeless longer
Spend more time in shelters
Have less family contact
Face greater barriers to employment

Question 16

Projects for Assistance in Transition from Homelessness (PATH program)

Answer 16

funds community-based outreach, mental health services

program specifically for the homeless with mental illness

Question 17

ACCESS Demonstration Project

Answer 17

– sites evidenced improved outcomes using outreach & intensive case management.

(program specifically for the homeless with mental illness)

Question 18

The rate of mental illness is ______times higher than the general population

Answer 18

5

Question 19

Factors for placement in criminal justice system

Answer 19

Deinstitutionalization

More rigid criteria for civil commitment

Lack of adequate community support

Economization of treatment for mental illness

Attitudes of police, society

Question 20

Criminalization of mental illness

Answer 20

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.

Question 21

Barriers to successful community reintegration:

Answer 21

Poverty

Homelessness

Substance use

Violence

Victimization, rape, trauma

Self-harm

Question 22

Active Military & Veterans and mental illness

Increased rate of:

Answer 22

Increased rates of:
PTSD
Suicide
Homicide
Injury
Physical illness
Sleep disorders
Substance abuse
Marital and family dysfunction

Question 23

core skills of the members of the interdisciplinary team

Answer 23

Interpersonal skills (tolerance, patience)
Humanity (warmth, acceptance, empathy)
Knowledge base
Communication skills
Personal qualities (consistency, assertiveness, problem solving)
Teamwork skills
Risk assessment, risk management

Question 24

Examples of care that public health nurses provide to the community for mental health prevention

Answer 24

Primary prevention: stress management education.

Secondary prevention: early identification of mental health problems.

Tertiary prevention: monitoring, coordinating psychiatric rehabilitation services.

Question 25

Evolution of care away from inpatient settings into community.

Answer 25

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.