Week 4: Community Care in Practice Flashcards
A more straightforward term that simply means “outside the walls” or “outside the hospital.”
Extramural Psychiatry
Is a way of providing mental health care that focuses on treating people within their communities, rather than solely relying on hospitals.
Community Care
What are the concerns of the National Schizophrenia Fellowship (28 Feb 1984) regarding deinstitutionalization?
- Inadequate aftercare for patients
- Insufficient aid for patients and their families
- Underestimation of the severity of mental illness
- Need for ongoing support
- Criticism of highlighting political correctness without addressing real-world challenges of patients and caregivers
Him and his team in The Assessment of Psychiatric Services (TAPS) conducted a thorough investigation into the impact of closing mental hospitals in England.
Julian Leff
What were the highlights of Care in the Community (Julia Leff)?
1) Evolution of policy was influenced by ideology
2) Residential care in the community works well
3) Cost of community care was not cheaper than hospitals
4) Large hospital closure led to challenges in acute hospital service
5) Staff training needs remained a constant issue
6) Media and public attitudes can influence closure of programs
7) Reprovision needs to be “future-proofed”
8) Difficult patients still require specialized care
9) A false antithesis between the hospital and the community
10) Comprehensive community care is essential
4 Essential Elements in Promoting Mental Health Care (Thornicroft, 2011)
1) Address population-based needs in an accessible and acceptable way
2) Build on the goals and strengths of those who experienced mental illness
3) Promote a wide network of support, services, and resources
4) Emphasize services that are evidence-based and recovery-oriented
Evolution of Approach to understanding Need
Normalization: A popular approach in the 1980s and 90s, emphasizing integration into the community.
Recovery (2000s): A more recent approach, emphasizing empowerment, hope, and a fulfilling life.
A concept that aims to promote social inclusion and reduce stigma for individuals with disabilities or mental illness by emphasizing their similarities to people without disabilities.
Normalization
A term used to describe a supportive living arrangement for individuals with disabilities or mental illness, often involving a group of people who live together and share responsibilities.
Pseudo-Family
A type of community-based support service that provides assistance to individuals with disabilities or mental illness in their own homes or in the community, as needed.
Floating Support
2 Contrasting Models of Mental Health Care
1) Implicit Model
2) Psychiatric Model
Key features of the Implicit Model
Focus: Individual needs and strengths
Support: Largely provided by non-professional staff Goals: Social integration and an “ordinary life”
Perspective: Focuses on the individual and their needs within society
Approach: Holistic, optimistic, and empowers users
Key features of the Psychiatric Model
Focus: Specific treatment needs
Support: Professional interventions
Goals: Symptom management and social functioning
Perspective: Epidemiological
Approach: More traditional and symptom-focused.
The study of the distribution, patterns, and determinants of health and disease in a population.
Epidemiology
DOMAINS
Basic Needs: Accommodation, food, self-care, home maintenance.
Activities: Daytime activities, physical health.
Symptoms: Psychotic symptoms, psychological distress.
Safety: Safety to self and others.
Information: Understanding of the condition and treatment.
Substance Abuse: Drugs and alcohol.
Social Life: Company, intimate relationships, sexual expression.
Childcare: Assistance with childcare.
Education: Educational needs.
Technology: Access to telephone and mobile phone.
Transportation: Assistance with transportation.
Financial: Money and benefits.
RATINGS
No problem
Met need
Unmet need
Not known
Camberwell Assessment of Need Short Appraisal Scale (CANSAS)
Provides a comprehensive assessment of an individual’s needs, helping to identify areas where support and intervention are required.
This information can be used to tailor treatment plans and ensure that individuals receive the necessary assistance to improve their quality of life.
Camberwell Assessment of Need Short Appraisal Scale (CANSAS)
A highly effective model for providing intensive community-based mental health care to individuals with severe mental illness.
The requirements identified by Stein and Test highlight the importance of addressing a wide range of needs to ensure successful community living.
Assertive Community Treatment (ACT)
Key requirements of people at risk hospital admission per the Assertive Community Treatment (ACT) model
- Material Resources: food, shelter, clothing
- Coping Skills: budgeting, cooking, using public transport
- Motivation: systems to help cope with stress
- Community Support: education and support
- Assertive Support System: prevent individuals from dropping out of care
- Independence: freedom from dependent relationships
- Effective treatment of symptoms and distress
Provides a comprehensive assessment of an individual’s quality of life, highlighting areas where improvements are needed.
This information can be used to guide service planning and intervention, ensuring that services address the specific needs and priorities of individuals with mental illness.
Manchester Short Assessment of Quality of Life (MANSA)
