UNIT-VII (COMMUNITY MENTAL HEALTH)

COMMUNITY MENTAL HEALTH

*”Community Mental Health is the process of increasing the level of mental health among people in the community and reducing the number of people with mental disorders.”

*Community mental health is the appropriate application of knowledge to the population and community to prevent mental disorders, promote and maintain mental health and rehabilitation.

IMPORTANCE OF COMMUNITY MENTAL HEALTH

*Essential to promote and maintain family mental health through preventive and promotional interventions.

*Helps to use their strengths to provide essential competencies for positive mental health and enhance the prospects of people in the community.

*Help family members to identify various stressors and educate them about coping methods.

*Helps family members recognize how social, cultural, and situational factors affect behavior and how they may affect the behavior of individuals in the family.

*Educates people in the community to monitor their mental health and that of the community as a whole.

*Community mental health services help remove stigma from people.

*Provides psychosocial support and rehabilitation services.

SCOPE OF COMMUNITY MENTAL HEALTH

•DAY HOSPITALS /CENTERS

*In this the patient is provided with appropriate treatment, services and the patient is allowed to go home at the end of the day, the family feels relief for a few hours a day and coping energy is developed for the rest of the time when the patient is at home. The patient develops discipline and routine.

•NURSING HOME

*Nursing home is a part of mental health services for mentally ill patients, family members etc. Hospitals provide various types of care to persons with mental disabilities.

•HALFWAY HOUSE/ SOBER HOUSE

*Also called a recovery home, it is a transition facility for mental patients who no longer need the full services of a hospital but require supervision for medicine and domestic equanimity.

• SUICIDE PREVENTION CENTER

*Suicide Prevention Center reduces the incidence of suicide. The incidence of suicide is very high in psychiatric mood disorders like depression.

•FOSTER HOMES

• A home where the patient can recover from mental illness among his family members where the patient gets an environment like his own home.

•GROUP HOMES

*These Homes may belong to hospitals where patients with recovering mental illness are fully recovered.

The former lives with the patient, they try to give each other moral, emotional and social support.

•SELF HELP GROUPS

*Self-help groups for mental health are voluntary associations of people who wish to overcome mental illness. Self-help groups provide mutual support to members and help them find solutions to problems they face in their lives with mental illness or drug abuse. .

COMMUNITY MENTAL HEALTH NURSING

Community mental health nursing is the application of psychiatric nursing knowledge to promote and maintain the mental health of people in the community, to help in early diagnosis and care, and in the rehabilitation of clients after mental illness.

PURPOSE OF COMMUNITY MENTAL HEALTH NURSING

• To provide preventive activities to the population aimed at improving mental health.

*Providing prompt intervention.

*Helping people develop a sense of self-worth and independence.

• Social and psychological factors affecting human interaction should be identified and changed.

*To develop new approaches for primary preventive activities.

• Providing mental health education and conducting mental health assessment.

PRINCIPLES OF COMMUNITY MENTAL HEALTH NURSING

*Community mental health nursing is distinguished by a unique conceptual framework of clinical processes and intervention strategies.

*Community mental health nursing should consider the social setting and situations where family members experience stress and problems and should be based on the potential and ability for promotion of mental health and prevention of mental disorders.

• Community mental health nursing uses a holistic approach to deal with people in the community which is related to the concept of mind, body and spirit.
• Community mental health nursing provides a special type of mental health services
• Community mental health nursing focuses on targeted population, social and community network.

*Community mental health nursing focuses on the interrelationships created in group form as they interact in activities of daily life.

Attitude, Stigma and Discrimination relates to mentally ill

•Mental illness is uncommon

In fact many mental health conditions like Anxiety, Depression etc are actually called Common Mental Disorders. Rather it is quite normal.

•Mental illness is caused by supernatural forces and is the result of a curse or possession by an evil spirit.

Many people do not consider mental illness as an illness, but believe that the patient or family has been possessed by a spirit or curse due to past sins or past birth misdeeds. This belief is more prevalent among rural and illiterate people than urban and educated people.

•Mental illness is shameful.

There is a feeling that mental illness is shameful. Due to this attitude, there are many people who do not seek professional help. As a result, when they finally seek professional help, it is too late. Help should be sought without any shame or hesitation.

•People with mental illness exhibit strange behavior.

Patients in mental hospitals and clinics are often treated as eccentrics who spend their time exhibiting useless odd behaviors such as arm wringing.

•Mentally ill people are dangers.

Most people with mental illness are not violent. In cases where violence occurs, the incident usually results from the same causes as in the general population, such as feeling threatened or due to excessive use of alcohol and/or drugs. Even in these cases, they can be brought under control as effective medication/counseling is available.

•Patients discharged from mental hospitals are often viewed with suspicion

Some public opinion studies show that discharged patients are not allowed to live. Many people do not accept people with mental illness to have a normal relationship or even after recovery, to employ them or accept them as neighbors.

•Mental illness is contagious.

Mental illness is neither contagious nor contagious and does not spread from one person to another. The fear that it is contagious is a major misconception that leads people to view it with suspicion.

• People with mental illness cannot contribute or are not positive. It is believed that people with mental illness have nothing positive to contribute.

•Marriage can remove mental illness

It is wrong to believe that a person with mental illness will get better after marriage. A patient who has recovered can marry and lead a normal life like any other person.

•People themselves are responsible for mental illness

Mental illness can happen to anyone, be it a person living in poverty or a rich person. It can also be genetic or inherited. No one chooses to live in mental illness. And people are not responsible for mental illness themselves.

• Most families have a history of at least one person with a mental illness. If there is a person with mental illness in the family, other family members are afraid of getting mental illness.
• People with mental illness are lazy and ineffective. In reality, it is the mental illness that makes a person incapable of working effectively or ineffective. Half of the people who leave the job due to disability actually suffer from psychosomatic disorders.

People with mental illness can do low level jobs but are not suitable for really important or responsible posts.

People with mental illness, like everyone else, have the ability to function at any level based on their own abilities, experiences and motivation.

Only Weak People Suffer From Mental Illness.

This disorder is mainly caused due to chemical imbalance in brain. Mental illness is not only weak or weak people, it can happen to anyone.

• Taking medicine can help. Medicines can help with relief, but it’s a long process (may take several years), and different medications work for different people, so it’s difficult to determine the right treatment for everyone.
• Mental illness is caused by normal stress of life. Stress is normal in everyday life and necessary for learning and developing life skills. They do not cause mental illness. For some people, severe and persistent stress increases the risk of developing mental illness.

•Old Person (old people) suffer from mental illness like depression.

In reality, the lowest incidence of severe mental disorder is seen in old people. It is wrong that only old people get depression.

•Electroconvulsive therapy (ECT) is an inappropriate method of treatment.

ECT is less painful and effective for the treatment of schizophrenia and major depression. ECT is not an inappropriate method of treatment.

• A person with mental illness cannot lead a normal, productive life. Many individuals with mental illness can lead productive and fulfilling lives because of the availability of effective treatment approaches to maintain a variety of mental health conditions.

PREVENTION OF MENTAL ILLNESS

1.Primary Prevention

*Primary Prevention Efforts to prevent mental disorders by strengthening individual, family and group coping skills are called primary prevention.

•Individual Centered Intervention

• Mother should be given prenatal care and educated about irradiation and medicine and their side effects.

*Training programs for physically and mentally handicapped children like blind, deaf, mute and mentally subnormal children etc.

• Counseling parents of physically and mentally handicapped children. Parents should accept the child and give them emotional support.

*Teachers and parents should be educated regarding child’s growth and development.

• Family Centered Intervention

*Parents should be consulted regarding appropriate discipline measures.

• To promote open health communication in the family.

•Mental Health Education

*Organizing community health education program through film shows, flash cards and appropriate audio-visual aids related to prevention of mental illness and promotion of mental health in the community.

2. Secondary Prevention

*Secondary prevention targets people who show early symptoms of mental health disorders and recover through treatment.

Early Diagnosis:

Screening of at-risk population and case finding through periodic examination and monitoring of clients.

Early Reference:

People should be educated to refer these cases to appropriate hospitals as soon as they notice the initial symptoms of mental illness.

Training Of Health Personnel:

Health personnel should be provided with orientation courses for case detection during their routine work.

•Crisis Intervention: If crisis is not dealt with, it can lead to suicide or mental disorders. Providing timely guidance to a person can help him deal with a crisis situation better.

3. Tertiary Prevention

*Tertiary prevention helps people with mental illness to reduce the severity, discomfort and disability associated with their illness.

*Family members should be actively involved in the treatment function so that effective follow-up can be done.

*Occupational and recreational activities should be organized in the hospital.

*Community health nurse and mental health organization should have continuous communication regarding follow-up of discharged patient.

*Nurses working with families must have a healthy attitude towards members with mental illness.

*Rehabilitation is successful only when the relationship between mental health care providers and community agencies is good.

ROLE OF NURSE IN MENTAL HEALTH PROGRAM AND PSYCHIATRIC CARE IN COMMUNITY

*Nurses play a vital role in community health services.

•Assessment And Screening

*They perform initial assessment and screening to identify mental health problems in patients.

•Treatment planning

*Nurses collaborate with other health care workers to develop individualized treatment plans for patients with mental conditions.

• Medication Administration

Nurses administer medication as prescribed and monitor the patient for any adverse reaction or side effect.

•Therapeutic Intervention

Nurses provide therapeutic interventions such as counseling, psychoeducation, and behavioral therapy to patients to manage their mental health.

•Monitoring And Evaluation

They continuously monitor the patient’s progress and assess the effectiveness of treatment interventions, adjusting the plan as needed.

•Advocative Role

Nurses play the role of advocate for the rights and needs of persons with mental conditions in the health care system and society at large.

•Education And Support

They educate patients and their families about mental health conditions, treatment and coping strategies, offering support throughout the rehabilitation process.

•Prevention And Health Promotion

Nurses engage in activities to promote mental well-being and prevent mental health problems through health education and early intervention.

•Collaboration And Coordination

Nurses collaborate with multidisciplinary teams including psychiatrists, psychologists, social workers and other health care workers to provide comprehensive care for patients with mental health problems.

•Research Work

They contribute to research aimed at advancing knowledge and understanding of mental health conditions and improving access to mental health services and reducing stigma.