14 Pages
3392 Words
Introduction Of Mental Health And Wellbeing In Integrated Care
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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.
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. As per this legislation, in case of emergency of an individual at serious risk or harming capabilities the section 135 warrant can be employed by police and hospital authorities in order to be taken to a place of safety and assessed individuals by mental health professionals and doctors (Nhs.uk, 2023). The treatment process which is impactful while engaging individuals who are experiencing mental illness refers to the providence of recovery-oriented care in terms of prioritising autonomy as well as empowerment and respect for the person receiving service (Ncbi.nlm.nih.gov, 2023a). This also includes providing a person-centred care which includes shared decision-making and appropriate treatment approach in order to focus on the individual's unique goal and life circumstances. This also involves diagnosing her with disease conditions and providing her with a long-term in-patient care process (Jester et al. 2023). The diagnosed disease condition for the identified service user refers to Schizophrenia and it can be defined as a mental disorder that destructs and individuals thought process perceptions along with emotional responsiveness and social interactions (Nimh.nih.gov, 2023). This also includes typical persistence symptoms and impacts the patients with psychotic symptoms such as hallucinations, delusions and thought disorders (Vita et al. 2022). However, she has also been discharged from the hospital and sent back home under the medication called Risperidone. In case of discharge and providing intensive home treatment for the identified disease conditions, the use of clinical global impression (CGI) scale is considered a significant measurement to identify severity and changes among patients (Ncbi.nlm.nih.gov, 2023b). It also includes regular medications along with comorbid drugs and cuts down on alcohol which improve the overall condition. Using medication such as Risperidone is capable of reducing symptoms of Schizophrenia for both long and short term while having improved individual response (Modesti et al. 2023). However, the drug has severe side effects including feeling sleepy the entire day, having issues with body movement, constant headache and gaining weight as well as a change in appetite (Drugs, 2023). Therefore, the identified service user is afraid to consume the medication and starts doing self-medication with alcohol. This factor has an impact on elevating nervous system side effects of the medicine in the form of dizziness, drowsiness and difficulties in concentrating on subjects alongside impairment in thinking and 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). This also includes service level interventions along with the home treatment process with the aim of managing proper treatment for the identified patient group. 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). Other policy initiatives refer to the move from in house care process to hospital to community care with the help of mental health service providers and did you see the adverse impact of cost in patient setting. This helps in providing non acute care and early detection programs with the aim of reducing drug effect on patients and managing their treatment plan to control psychotic symptoms (Nice.org.uk, 2023).
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 (Faulkner et al. 2022). The service level intervention process is proposed by NICE guideline 2009 with the aim of improving treatment procedure while modifying the use of medication in the form of rapid tranquilization (Nice.org.uk, 2023). This is followed by reviewing the area of intervention process while providing peer support and managing self-treatment in the form of vocational rehabilitation to encompass community-based treatment and acute admission. In addition, the 2014 guideline emphasises on care providers' experience in the case of physical healthcare setting to manage psychosis and schizophrenia by identifying risk of an individual's mental state and advising treatment and management of symptoms in adults (Nice.org.uk, 2023).
On the other hand, early intervention service in case of identified disease refers to the participation of the psychosis team while reducing the delay of treatment process and improving the overall outcome. In the long term process this intervention is effective while influencing the recovery rate of patients and providing care for lower socioeconomic groups (Nice.org.uk, 2023). As this intervention invests in reducing delay in treatment it can be implied for promoting recovery and reducing relapse of episodes of psychosis in the local area and community healthcare programs (Ogden et al. 2022).
In the case of crisis resolution and home treatment teams, the providence of urgent assessment is focused on follow up process and visits from the professional team in terms of managing a smooth home care process for the patients (Nice.org.uk, 2023). This was introduced by the NICE guideline 2006 while providing any type of crisis-oriented treatment for acute psychotic episodes and helping patients with standard care.
Identified areas of good practice in integrated care
Best practices regarding schizophrenia treatment among adults aim towards increasing the overall understanding of effective treatment procedure as well as better management of the disease within the community. This is followed by suggesting several ways in order to improve the community-based intervention while rehabilitating patients of the identified disease group (Leach et al. 2022). The clinical practice in the community care setting regarding the identified disease refers to the implementation of treatment agenda while effectively improving different disease aspects while functioning of patients with identified disease. Apart from that, clinical interventions are required to imply within 9 to 12 months in the community setting while using sufficient resources with the aim of delivery and evaluating adequate treatment (Matscheck and Piuva, 2022). This is followed by proper recognition and support from service managers with the aim of strategic collaboration using resources and time efficient intervention process while treating this disease. 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).
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). It also includes lack of insight in regards to the identification of suitable intervention processes along with preference for alternative care. However, identifying the severity of the disease while calculating financial constraints are a few examples that creates issues with the implementation of care intervention for the identified disease patient group (Rodolico et al. 2022). Apart from that, difficulties in communication distress stigmatising belief regarding the disease conditions and isolating patients without associating them impact adversely on recovery rate of patients. On the other hand, the absence of valid methods while determining the present health conditions of a patient as well as their health requirements impact on the recovering rate (O’Grady et al. 2022). This is followed by absence of multi-disciplinary team engagement while careful organisations of roles and functions in order to treat patients with schizophrenia.
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. However, the experience of informal care towards treatment of psychosis disease are not enough to deal with symptoms and cause high levels of distress and unsupportive behaviour (Ncbi.nlm.nih.gov, 2023e). In addition, the providence of long-term commitment towards supporting and advocating the requirement of a patients are not met due to the absence of patient engagement and financial support. In the case of the identified case study, the patient has not received the similar support from her informal caregivers and that led her to be antisocial and unmet need of treatment (Mishu et al. 2022).
Role of nurses to address stigma
Forms of stigma that may affect the client group and their carers
For the patients suffering with Schizophrenia and recovering from psychotic disease, stigma in regards to the clinical form refers to social exclusion along with impacting relationships with families and friends as well as growing cases of discrimination (Ran et al. 2022). 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). This is followed by the stigma of undesirable behaviour, danger and violence are common forms that are associated with both the patients and the carers.
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). The self-stigma impacts the patients by increasing negative thoughts along with internalised shame and looking down on themselves regarding their own mental health conditions. On the other hand, the institutional aspect addresses the systematic approach in regards to the policies of the government as well as private organisations (Bila and Carbonatto, 2022). This includes intentionally and unintentionally limiting opportunities for the people with disease conditions as well as lower funding in comparison with other healthcare issues. Apart from that, increasing discrimination for the patients with psychotic disorders impacts the patients to lower that standard of care process and reduces the job opportunities and socialising (Xanthopoulou et al. 2022). On the other hand, media representation on the disease conditions impacts the patients with negative, unapproachable and violent behaviour which leads to delaying in treatment process. This impacts the patients with reduced hope, lower self-esteem as well as difficulties with social relationships, increasing psychotic behaviour and reduced the chance of continuing treatment (Bila and Carbonatto, 2022).
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). This is followed by the development of structural and regulatory changes while eliminating stigma. Developing a culture across stigma with the practitioners and students while including education, tools and resources for improving the conditions as well as the creation of resource-based compendium programs while reducing stigma for addressing these (Wenzel et al. 2022).
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. On the other hand, this essay also discussed stigma, its impact and nurse's role to educate people while reducing the impact of stigma of the identified patient group.
References
- Adu, J., Oudshoorn, A., Anderson, K., Marshall, C.A. and Stuart, H., 2022. Experiences of familial stigma among individuals living with mental illnesses: A meta?synthesis of qualitative literature from high?income countries. Journal of Psychiatric and Mental Health Nursing.
- Bila, N.J. and Carbonatto, C.L., 2022. Culture and help-seeking behaviour in the rural communities of Limpopo, South Africa: unearthing beliefs of mental health care users and caregivers. Mental Health, Religion & Culture, 25(6), pp.543-562.
- Drugs. 2023., “Risperidone and Alcohol/Food Interactions” Available at: https://www.drugs.com/food-interactions/risperidone.html#:~:text=You%20should%20avoid%20the%20use,impairment%20in%20thinking%20and%20judgment. [Accessed on 21st April 2023]
- Faulkner, S.M., Drake, R.J., Ogden, M., Gardani, M. and Bee, P.E., 2022. A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders. Plos one, 17(6), p.e0269453.
- Hernandez-Fernandes, R.H., Sordi-Carrara, B., Andrade-Vidigal, B.A., Barbosa-Martins, A.L., Jennifer-Bobbili, S. and Arena-Ventura, C.A., 2022. Stigma experienced by people with mental illness in South America: an integrative review. Revista Cuidarte, 13(2).
- Jester, D.J., Thomas, M.L., Sturm, E.T., Harvey, P.D., Keshavan, M., Davis, B.J., Saxena, S., Tampi, R., Leutwyler, H., Compton, M.T. and Palmer, B.W., 2023. Review of major social determinants of health in schizophrenia-spectrum psychotic disorders: I. clinical outcomes. Schizophrenia bulletin, p.sbad023.
- Kaur, V., Lindinger-Sternart, S. and Grey, B., 2022. Public policy issues affecting integrated health care: Challenges, opportunities, and implications for clinical mental health counselors. Journal of Mental Health Counseling, 44(1), pp.49-67.
- Leach, M.J., Climstein, M., Fryer, G., Ziaian, T., Lauche, R., Kumar, S. and Agnew, T., 2022. Developing a needs-based integrative service delivery model to deliver best practice care for chronic nonspecific low back pain. European Journal of Integrative Medicine, 53, p.102153.
- Matscheck, D. and Piuva, K., 2022. Integrated care for individuals with mental illness and substance abuse–the example of the coordinated individual plan in Sweden. European Journal of Social Work, 25(2), pp.341-354.
- Mishu, M.P., Faisal, M.R., Macnamara, A., Sabbah, W., Peckham, E., Newbronner, L., Gilbody, S. and Gega, L., 2022. A qualitative study exploring the barriers and facilitators for maintaining oral health and using dental service in people with severe mental illness: perspectives from service users and service providers. International Journal of Environmental Research and Public Health, 19(7), p.4344.
- Modesti, M.N., Arena, J.F., Palermo, N. and Del Casale, A., 2023. A Systematic Review on Add-On Psychotherapy in Schizophrenia Spectrum Disorders. Journal of Clinical Medicine, 12(3), p.1021.
- Ncbi.nlm.nih.gov. 2023a., “Treatment engagement of individuals experiencing mental illness: review and update” Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780300/ [Accessed on 21st April 2023]
- Ncbi.nlm.nih.gov. 2023b., “The outcomes of home treatment for schizophrenia” Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465209/ [Accessed on 21st April 2023]
- Ncbi.nlm.nih.gov. 2023c., “Clinical Practice Guidelines for Management of Schizophrenia” Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310098/ [Accessed on 21st April 2023]
- Ncbi.nlm.nih.gov. 2023d., “Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care”Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792827/ [Accessed on 21st April 2023]
- Ncbi.nlm.nih.gov. 2023e.,“Understanding the needs of carers of people with psychosis in primary care” Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979915/ [Accessed on 21st April 2023]
- Nhs.uk. 2023., “Mental Health Act” Available at: https://www.nhs.uk/mental-health/social-care-and-your-rights/mental-health-and-the-law/mental-health-act/. [Accessed on 21st April 2023]
- Nice.org.uk. 2023., “Psychosis and schizophrenia in adults” Available at: https://www.nice.org.uk/guidance/cg178/evidence/full-guideline-490503565 [Accessed on 21st April 2023]
- Nimh.nih.gov. 2023., “Schizophrenia” Available at: https://www.nimh.nih.gov/health/statistics/schizophrenia#:~:text=Schizophrenia-,Definition,be%20both%20severe%20and%20disabling. [Accessed on 21st April 2023]
- O’Grady, M.A., Neighbors, C.J., Randrianarivony, R., Shapiro-Luft, D., Tempchin, J., Perez-Cubillan, Y., Collymore, D.C., Martin, K., Heyward, N., Wu, M. and Beacham, A., 2022. Identifying the physical and mental healthcare needs of opioid treatment program clients. Substance Use & Misuse, 57(7), pp.1164-1169.
- Ogden, M., Gardani, M. and Bee, P.E., 2022. A mixed methods expert opinion study on the optimal content and format for an occupational therapy intervention to improve sleep in schizophrenia spectrum disorders.
- Ran, M.S., Wang, Y.Z., Lu, P.Y., Weng, X., Zhang, T.M., Deng, S.Y., Li, M., Luo, W., Wong, I.Y.L., Yang, L.H. and Thornicroft, G., 2022. Effectiveness of enhancing contact model on reducing stigma of mental illness among family caregivers of persons with schizophrenia in rural China: A cluster randomized controlled trial. The Lancet Regional Health-Western Pacific, 22, p.100419.
- Rodolico, A., Bighelli, I., Avanzato, C., Concerto, C., Cutrufelli, P., Mineo, L., Schneider-Thoma, J., Siafis, S., Signorelli, M.S., Wu, H. and Wang, D., 2022. Family interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. The Lancet Psychiatry.
- Sreeram, A., Cross, W.M. and Townsin, L., 2022. Anti?stigma initiatives for mental health professionals—A systematic literature review. Journal of Psychiatric and Mental Health Nursing, 29(4), pp.512-528.
- Vita, A., Barlati, S., Bellomo, A., Poli, P.F., Masi, G., Nobili, L., Serafini, G., Zuddas, A. and Vicari, S., 2022. Patterns of care for adolescent with schizophrenia: a delphi-based consensus study. Frontiers in psychiatry, 13, p.571.
- Vives?Espelta, J., Burjalés?Martí, M.D. and Ferré?Grau, C., 2022. Nurses’ views and practices on parental mental illness: An integrative review. International Journal of Mental Health Nursing, 31(1), pp.8-24.
- Wenzel, C., Melrose, S., Lane, A. and Kent-Wilkinson, A., 2022. Clinical instruction in mental health nursing: Students’ perceptions of best practices. International Journal of Nursing Education Scholarship, 19(1).
- Xanthopoulou, P.D., Mbanu, J., Chevalier, A., Webber, M. and Giacco, D., 2022. Social Isolation and Psychosis: Perspectives from People with Psychosis, Family Caregivers and Mental Health Professionals. Community mental health journal, 58(7), pp.1338-1345.