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Introduction Of Mental Health And Wellbeing In Integrated Care
The identified case scenario refers to the mental health field which states the story of a service user who has been diagnosed with Schizophrenia and further breakdown at the age of 25. Presently she is at home care under medication called Risperidone and afraid of weight gain and isolation. The following essay is intended to address the integrated care approach for the identified service user along with identifying the effectiveness of current practices under the same care approach. This is followed by addressing the nursing care approach in terms of addressing stigma in regards to the integrated care process.
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Discussion
Requirements of integration care approach for relevant client group
Background for integration care and related terms
The identified service user left home at the age of 16 while travelling emotionally and financially and suffered psychotic breakdown at the age of 19 and that time she was admitted to hospital under the implementation of mental Health act (Ncbi.nlm.nih.gov, 2023a). According to this legislation, in the case of a crisis of an individual at serious harming or risk capabilities, the section 135 warrant can be employed by the hospital authorities and police in order to be taken to a place of safety and assessed individuals by mental health professionals and doctors (Nhs.uk, 2023). However, she has also been discharged from the hospital and sent back home under the medication called Risperidone (Jester et al. 2023). The use of clinical global impression CGI scale is considered to be a major measurement for the identification of severity and change in patients if they have been discharged from hospital and given intensive treatment at home with identified disease conditions (Ncbi.nlm.nih.gov, 2023b). The government of the UK has collaborated with the NHS and launched the “NHS Long-Term Plan” for improving and expanding mental health and its associated services in the global world (Gov, 2023). Along with that, with the help of this plan, the service user was able to overcome the negative impact of Schizophrenia (Drugs, 2023). Therefore, the identified service user is afraid to consume the medication and starts doing self-medication with alcohol. This factor is responsible for raising side effects of the medicine in the nervous system, such as dizziness, sleepiness and difficulty concentrating on subjects with a reduced level of thinking or judgement (Drugs, 2023). These impacted the patient to be antisocial and changed her appetite.
Relevant policy and guidelines
The open-door policy is considered a significant safe while dealing with psychological and psychosocial intervention and sheds light on the use of routine-based psychotherapies as the part of mainstream treatment for Schizophrenia adult patients (Nice.org.uk, 2023). In order to manage the right treatment for a specific patient group, this is also accompanied by actions at service level and in conjunction with home therapy (Nimh.nih.gov, 2023). This factor is followed by using pharmacological management in terms of identifying anti-psychotic based pass treatment response as well as electro convulsive therapy to control side effects and non-pharmacological policy for improving psychoeducation and psychosocial interventions (Ncbi.nlm.nih.gov, 2023c). The government of the UK has taken support from the “Community Mental Health Teams” (Nhs, 2023). The prime goal of this team is to provide daily treatment and support at the time of ensuring that an individual has as much independence as possible. Therefore, taking support from this team, the service user is able to improve her health status and lead a normal lifestyle in the future.
Effectiveness of current practice in integrated care
Relevant therapeutic processes and interventions
The major emphasis on the current interior causes to address the area of managing identified disease refers to the use of treatment setting and modification to shoot the patients requirement in case of therapeutic process. The intervention procedure at the service level has been proposed by the “NICE Guideline 2009” and it has an aim. The prime aim of this intervention process is to enhance treatment procedures at the time of modifying the accurate utilisation of patient care and medication in the form of quick tranquilization (Nice.org.uk, 2023). On that note, it is followed by analysing intervention procedures at the time of managing the process of self-treatment and providing support as vocational rehabilitation for encompassing acute admission and community-dependent treatment process. Therefore, it would be helpful for the service user to treat her health condition by maintaining the aforementioned guidelines and leading a healthy and normal lifestyle (Faulkner et al. 2022). In order to improve the treatment process and to modify the use of medicinal products in the form of rapid sedatives, a service level intervention process is proposed in the 2009 NICE guidelines (Nice.org.uk, 2023). In this context, a review of the intervention procedure is then undertaken while offering peer support and assistance managing self-sufficiency with vocational rehabilitation in order to cover both community-based treatment and acute admission (Nice.org.uk, 2023).
Based on the case scenario, it has been observed that the service user and her family members are worried about the side effects of a drug named as Risperidone. Along with that, the service user is worried about to gain weight rapidly which is also a major side effect of this drug. For this reason, the service user and her family would not allow to take or receive any kind of treatment that is provided to her. On the other hand, it refers to participation of a psychosis team in an early intervention service for disease identified which results in reduced treatment delay and improved overall outcome. This intervention will be effective for the long term in terms of influencing patient recovery rates and providing care to less socioeconomically affected patients (Nice.org.uk, 2023).
The provision of emergency care to a patient has been launched by the “NICE Guideline 2006” at the time of providing different types of crisis-oriented treatments for reducing the negative impact of acute psychotic disorders and assisting all patients by providing standard care (Nice.org.uk, 2023).
Identified areas of good practice in integrated care
The main aim of Schizophrenia treatment is to provide effective medication and patient care and it is provided to adults as best practices. It is also improving the entire understanding of an effective treatment procedure and better management of this disease in a community as well. It has been followed through several suggestions in terms of enhancing “Community-dependent Interventions” in rehabilitating all patients from their health disorders (Leach et al. 2022). To improve the Community Based Intervention, a number of ways could be proposed to assist patients with diagnosed disease groups in rehabilitation (Leach et al. 2022). The implementation of the treatment plan and the effective improvement of the different aspects of the disease while functioning in patients with the identified disease are the clinical practice in the Community care setting for the identified disease. In addition to this, while using the available resources for delivery and evaluation of appropriate treatment it is also necessary to administer therapeutic interventions in a community setting not later than 9 to 12 months (Matscheck and Piuva, 2022). Apart from that using cognitive behavioural therapy by implying supportive psychotherapy and psychoeducation impact the patients to lower the effect of relapse alongside reduction of re-hospitalisation rate and stabilising mental state in medium term (6 weeks to 3 months) as well as long term (more than three months to 1 year) (Vives?Espelta et al. 2022). Clinical assessment is one of the good practices of nurses which can be considered in this case. Also, clinical assessment should be oriented with weight gain measurement at a regular interval which can provide a graphical representation of weight gain with continued taking Risperidone. Nice guideline for obesity can be followed by the nurse in order to ensure the client is becoming obese (Nice, 2023). Nice provided Body Mass Index measurement can be taken into account for this case to ensure further progression of overweight chronic disease. In this case, in the area of integrated care nurses must focus on improvement of health and reduce the progression of schizophrenia. According to Garmy et al. (2021), nurses help in reducing anxiety by helping people to calm their mind. Hence, in this case also, as good nursing practices in the area of integrated care of schizophrenia, a patient nurse must prepare a calm environment for the patient which reduces hallucination and may reduce triggering point.
Potential barriers to integration of care
The potential challenge regarding caring for individuals with schizophrenia refers to the emotional draining and physically exhausting process while supporting the patients and waiting for the outcome without any resources (Kaur et al. 2022). Alternatively, the fact that there is no valid method for determining a patient's current medical condition and his or her health requirements affects recovery rates (O'Grady et al. 2022). Barriers involved in the treatment of schizophrenic patients who are taking Risperidone are mediationalside effects. Therefore, continuous follow-up is required (Frisch and Rabinowitsch, 2019). In addition, as she is a mental patient she is required to provide mental support. For nurses, it is difficult to provide continuous mental support which may create a barrier for the development of integrated care for this patient. Stigma can be another barrier while treating a patient with schizophrenia. Due to stigma, patients may be unable to communicate with others. Hence, nurses must recognise it and need to be attentive in these cases. In the provided case scenario it can be stated that weight gain is a self stigma which is patent suffering which can cause problems in integrated care implementation.
Considered reasons why the client group within the scenario may not receive high quality care from service providers
Many individuals who are diagnosed with psychotic disease or behaviourism generally remain in contact with their parents and informal care gives us siblings, partners or children by using home care settings (Mishu et al. 2022). Furthermore, the absence of patient engagement and financial support does not guarantee that a long-term commitment to supporting and advocating patients' needs will be fulfilled. Service providers must need to take the patient's condition and increasing weight gain as first priority as weight gain may cause a distress in patient.
Role of nurses to address stigma
Forms of stigma that may affect the client group and their carers
The prevalence of high perceived stigma regarding the patients suffering from Schizophrenia refers to 62.6% (Ncbi.nlm.nih.gov, 2023e). The most common stigma in regards to the identified disease refers to the violent and chaotic behaviour along with labelling the care group with harmful words. The caregivers also face such stigma in the form of caring process, attitude as well as coping strategies in order to deal with the identified disease conditions (Adu et al.2022). Addressing stigma is necessary in order to deliver high quality healthcare service and to achieve optimal health (Nyblade et al. 2019). In this case mental health treatment is a priority rather than gaming weight. Hence, nurses must address the importance of continuing to take Risperidone. On the other hand, as opioid by Liu et al. (2022), Risperidone is used to treat Schizophrenia patients and prolonged treatment with this causes weight gain in patients. Therefore, Risperidone is causing weight gain and nurses must address the side effects of this drug to patients.
Potential impact of stigma on the integration of care
In addition to the presence of public stigma, the primary impact on the treatment process comes from self-stigma as well as institutional stigma (Hernandez-Fernandes et al. 2022). This includes the intentional and unintentional limitation of opportunities for people with health conditions and the reduction of funding compared to other healthcare issues. Self-stigma may affect the client of the taken case scenario. Self-stigma helps in changing the reaction of people by empowering them in the mental health system (Drapalski et al. 2021). Additionally, using self-stigma nurses can promote mental health improvement. This stigma will ensure the patient safety concern for mental health patients. Nurses are able to reduce the stigma by developing a trustworthy nurse-client relationship.
Role of nurses to play a part in addressing stigma
Nurses are accountable to educate people with the importance of getting treatment with the aim of improving the overall health condition. In addition, building a nurse-led alliance to convince, communicate and educate the population regarding the reduction of stigma and wellbeing of mental health (Sreeram et al. 2022). The development of structures and regulatory changes is followed by the elimination of stigmatisation. In this case, a nurse can focus on developing the relationship with the patient and can also help in influencing people to continue to take the Risperidone. Also by building trust, nurses can also concentrate on reduction of weight.
Conclusion
In terms of concluding the overall essay, it can be stated that the essay has identified the case study two in terms of continuing the discussion and successfully addressed integration care approach along with policies and regulations in order to treat patients with Schizophrenia. This is followed by discussing client group needs along with practice of care approached intervention in terms of treating patients with schizophrenia. Moreover, the subject of stigma and its effects as well as the role of nurses in educating people was also discussed in this paper with a view to reducing their impact on these patient groups.
References
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