Community Mental Health
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This document discusses the role of community mental health nurses. It provides context on the history of deinstitutionalization and principles of community mental health care. The roles of community mental health nurses include assessment, planning, linking clients to services, monitoring, advocacy, and evaluation. Nurses aim to establish therapeutic relationships with clients and work as part of a multidisciplinary team. The presentation also covers models of community mental health care, such as recovery, strengths, and psychosocial rehabilitation approaches.
Community Mental Health
- 1. Nursing the person with a mental health problem in the community Paul McNamara RGN (RAH), RPN (SAMHS), BN (Flin.), MMHN (USQ), Cert IMH (WCHN), CMHN, FACMHN @meta4RN #NS3360
- 2. Acknowledgements Tanya Park @Tanya_M_Park Elizabeth Emmanual via @SCUonline + Nurses 1988-2015
- 3. Learning Outcomes Role of the community mental health nurse Therapeutic relationships Community mental health services Mental health legislation in the community Self care
- 4. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care
- 5. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care
- 8. Principles: 1. Consumer and carer participation 2. Resilience and recovery 3. Social inclusion 4. Collaboration and partnerships 5. Promotion, prevention and early intervention 6. Evidence - based
- 9. Community Mental Health GP, NGOs etc Carers Person Inpatient Mental Health
- 13. Inpatient Community ~50 ~2450 Cairns & Hinterland Mental Health Consumers
- 14. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care
- 15. “someone who has the lived experience of mental distress and who has received care from mental health professionals” Elder, Evans & Nizette (2013) page 524 A patient client consumer is…
- 16. “…a balance between the personal self, offering human closeness and professional distance” “…an enabling relationship that supports the needs of the client” “…based on rapport - establishing a connection with the person and developing trust” Usher & Foster (2013) page 454 A therapeutic relationship is…
- 18. “any power or function exercised under the Act must be exercised so that a person’s liberty and rights are affected only if there is no less restrictive way to protect the person’s health and safety or to protect others”
- 19. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care
- 20. Midwives General Nurses Mental Health Nurses
- 22. Case Management “is a delivery of care that coordinates and links various health care and social services to clients and their families who have complex health needs that involve ongoing care” Funnell, Koutoukidis & Lawrence (2005)
- 23. Case Management “is about participation in the consumer’s environment” “believing unconditionally in the person’s ability to recover and work as if their recovery is a reality “ Glover (2005)
- 24. Community MHN Roles Assessment e.g. mental state assessment, risk assessment Planning e.g. goal setting Linking e.g. joining in with social/sporting or… activities Monitoring & Advocacy e.g. ongoing assessment, Evaluation e.g. checking on goals and plans
- 25. establish, build and maintain a therapeutic relationship with consumer “phatic chat” & mental state assessment administration of medication – efficacy + side effects counselling therapy Community MHN Roles
- 26. linking consumer with services & social activities advocating for consumer assisting with life style choices education linking with families/carers Community MHN Roles
- 27. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care
- 28. Recovery Model Self empowerment Sense of being in control Maintaining hope Abandoning the ‘victim’ role (Muntez & Frese III,2001)
- 30. Creating relationships of safety Encouraging the person to have a sense of control Engaging with curiosity Attending to self-esteem and self-identity Attending to language and meaning Tapping into the person’s own capacity for self-knowing Facilitating self-help and personal responsibility External environments that facilitate recovery Essentials of recovery- informed practice Elder, Evans, & Nizette (2013) pp 21-25
- 31. Strengths Model Consumer strengths Consumer abilities and resources Consumer and community potentials (Fossey, cited in Dowling et al,2001)
- 32. Psychosocial Rehabilitation The goal is “to facilitate and support people with mental illness to live, learn, work, play and relate to others within their local community” (Farhall etal,2001)
- 33. Comparison of Approaches to Care Aspect of Care Psychosocial Rehabilitation Medical Model Focus wellness, health disease, disorder, illness Basis abilities disabilities Setting nature, familiar institutions Relationship adult-adult expert-patient Decision making partnership expert prescribes treatment (Table adapted from Sundeen 2001)
- 36. Today’s Presentation Context of Community Mental Health Care Therapeutic Relationships vs Involuntary Treatment Roles of the Community Mental Health Nurse Models of Community Mental Health Care