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NURS 40030 Mental health System Notes

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Mental Health System – Treatment Settings & Severe Mental Illness in the Community Notes. *Essential Study Material!!

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  • September 12, 2024
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  • 2021/2022
  • Class notes
  • Prof. shannon
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anyiamgeorge19
Menta Health System – Treatment Settings & Severe Mental Illness in the Community
o Social workers – can run group therapy
Course Objectives: 1, 2, 4, 5 Class OBJECTIVES: o Counselors – do all the therapy work
 Discuss the changing focus of care in mental health with o Occupational/Recreational/Art/Music/Dance
concepts of case management in community mental Therapists
health nursing o Mental Health technicians – aides of the mental
 Define the Roles of specialized psychiatric care providers health community. Specially trained on how to
 Discuss primary, secondary, and tertiary prevention of observe patients and notify the nurse if they notice
mental illness in the community & the role nursing plays anything.
in prevention  Patient centered medical homes (Group Homes) &
 Identify treatment alternatives for care for seriously Community Mental Health Centers
mentally ill & homeless mentally ill within the o Coordinate care – psychiatric case managers
community o Extended hours/services
o Emergency services/Outpatient services (211 is the
Deinstitutionalization – the root of where our mentally ill are
emergency number for psych)
living as a homeless population
 Psychiatric Home Care
o Must be homebound
 Intensive Outpatient Programs (IOP) – about 3 or 4 hrs a
day, 3x a week. Pt comes to the hospital and spend a few
hrs w the doctor then sees a group. /Partial Hospitalization
Programs (PHP) – longer days (full 8 hr day), doing the
same programs.
o Intermediate from inpatient & outpatient care
 Mobile Mental Health Units/Telephone crisis counseling
– text crisis for suicide or 211.
 Emergency Care – first screen medical issues, then
evaluated by psych.
o Goal = Triage (severity & urgency) & Stabilization
First antipsychotic med Thorazine first came out around 1947-
(resolution of crisis)
1951. Prior to this med, patients were in institutions and not
treated well. People who lived most of their life in the – Emergency Department – hopefully, psychiatric
institution were simply dumped to the streets or live back w specialty area
their families. – Mobile crisis team – in the field
– Inpatient Care Settings:
Stigma & Challenges in accessing/navigating care system o Crisis stabilization/Observation units
 How to seek care? o General Hospital & Private Hospital (free standing)
 Hidden/embarrassment o State Hospital
 Anosognosia (you don’t believe you are sick) – Most severe (violent or hard to control)
o Nonadherence – don’t recognize that their issues are – Forensic – court related (committed a crime but
a problem. Non-compliant as they don’t see an issue also severely mentally ill). Jail where people can
or a problem. get tx for their psychiatric issues.
 Motivation/anergia – esp those w major depression. No o Pediatric/Geriatric (dementia, Alzheimer’s)/Veteran
energy to seek care and plan the finance. Care Centers (PTSD, addiction, depression, anxiety)
 Somatic confusion (means body) – think that there is o Prisons
something wrong w your physical body and not your o Alcohol & Drug Use Disorder Treatment – dual
mind. Ex: anxiety disorders or panic attacks (think it is diagnosis. That other diagnosis is what causes
heart attack).
o Somatic Disorders Community Nursing / Public Health Intervention
 Treatment inadequacy/Medication side effects/Residual
symptoms

Continuum of Care
 Primary Care – realized through screening from the
person or by the provider. Then refer to therapy
 Specialized psychiatric care providers
o Psychiatrists
– Meds
o Psychiatric-mental health advanced practice nurses
– NP/CNS – some do meds
o Psychologists – master or doctorates in psychology
and do most of the therapy.

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