Rehabilitation groups

“Rehabilitation groups” refers to community-based organizations which substantially rely on the work of volunteers to assist people with disabilities towards functional independence. One may differentiate between rehabilitation groups and clinical healthcare services by categorizing clinical services as being predominantly concerned with treatments designed to lower symptoms and cure ill health. Alternatively, rehabilitation groups focus their attention on delivering programs designed to assist people in regaining “functional independence” with or without the ongoing presence of symptoms. Common programs rehabilitation groups deliver are described as including but not being limited to the following: • Mental health rehabilitation: assisting people with lived experience of mental illness towards social and emotional wellbeing. • Drug and alcohol rehabilitation: facilitating recovery from abuse of and dependency on psychoactive substances such as alcohol and other drugs. • Physical health rehabilitation: improving physical and/or neurocognitive functions that have been diminished by ongoing effects of disease or injury. Major themes of communication influence rehabilitation groups and there are connections between the daily work of rehabilitation groups and the theoretical paradigms that influence them. Theoretical paradigms include social disability theory, recovery-oriented care, person-centered care, and cultural materialism

Mouse to man, a mental health recovery journey

What is mental health recovery? Is it about getting rid of symptoms? Is it about relationships? Or being able to get a job? When I look back at my recovery, I realize that for me it has been an ongoing process of growth and development. In the description that follows, I have tried to provide a sense of the journey I have been on. It may sound funny, but while I have experienced great difficulties due to mental ill health, and although I have had some pretty poor interactions with services, I would not change my journey. I think this is because I have had so many valuable experiences and learnt so much about myself along the way

Perceptions of hospital-based Registered Nurses of care and discharge planning for people who are homeless : a qualitative study

Background: Links among homelessness, poor health and frequent hospitalisation are familiar to health services worldwide. Despite this, limited research has explored hospital-based Registered Nurses’ perspectives of homelessness healthcare. Aim: This study explored the perspectives of hospital-based Registered Nurses, regarding provision of person-centred care for people who are homeless. Methods: Interviews were conducted with twelve Registered Nurses working in a tertiary metropolitan hospital. Interview transcripts were analysed using a deductive thematic approach guided by Deci and Ryan's self-determination theory (SDT). Findings: Five themes emerged regarding provision of person-centred care for people who are homeless. First, people who are homeless frequently access the hospital as a safe place. Second, nurses often perceive homeless health problems as multifaceted and difficult to manage. Third, stigma creates a barrier to the delivery of hospital-based homelessness healthcare. Fourth, it is important to provide people who are homeless with a sense of choice. Fifth, there is a lack of suitable discharge options and connection between the hospital and community services. Discussion: If care pathways within a hospital are not designed to adequately address the complex needs of people who are homeless, they are vulnerable to frequent re-admissions and extended lengths of stay. A non-judgmental attitude and providing a sense of choice are important approaches for hospital-based Registered Nurses when working with people who are homeless. Conclusion: Hospital-based homelessness healthcare presents many challenges. The perceptions of Registered Nurses provide insight into the daily experience of caring for people experiencing homelessness within a hospital setting

Australia's first mental health nursing charity : ROAM communities

ROAM communities is Australia’s first dedicated mental health nursing charity. Established in 2005, we are dedicated to helping people overcome mental illness in the community, avoiding hospitals, jails and homelessness

Experiences of hospitalised homeless adults and their health care providers in OECD nations : a literature review

Problem: Throughout the world people who are homeless experience high rates of hospitalisation. Nurses who work in hospitals have the potential to improve outcomes for this group. To date, a review of qualitative literature pertaining to hospital-based nursing for people who are homeless has been lacking. Aim: To synthesize findings of contemporary qualitative studies related to hospital-based nursing care for people who are homeless in Organisation for Economic Cooperation and Development (OECD) nations. Design: A systematic database search was conducted in mid-2017 using search terms: homeless*, hospital* and nurs*, combined by the Boolean operator ‘AND’. Inclusion and exclusion criteria that mandated publication year, language, method, quality, participants, and setting were applied. 341 abstracts were screened for relevancy resulting in the final inclusion of 8 qualitative and 2 mixed method studies. Findings: Three overarching themes emerged; (1) Homelessness challenges rigid approaches to hospital-based care (2) Stigma impedes healthcare for people who are homeless (3) Hospitals can provide a platform to address homelessness. Discussion: Delivering flexible, non-stigmatising nursing in a way that empowers people experiencing homelessness challenges hospitals around the globe. Research is needed to explore local approaches and subgroups within the homeless population. Conclusion: Experiences of homelessness vary across nations and between cities necessitating local solutions. Within hospitals, if nurses can provide flexible, non-stigmatising care, they have potential to make a huge difference both the lives of individuals who are homeless and in the wellbeing of society as a whole

Disclosure of confidential information by mental health nurses, of patients they assess to be a risk of harm to self or others : an integrative review

There is a duty of confidentiality on the part of mental health nurses when they handle confidential patient information. Nonetheless, it may be necessary to disclose confidential information of a patient if the patient is assessed as being a risk to self or others, to protect the patient or others from harm. However, disclosing information inappropriately may constitute a breach of confidentiality. There is a paucity of information on how mental health nurses understand the rules of confidentiality when deciding to withhold or disclose confidential information in these circumstances. An integrative review of the literature was undertaken to explore the disclosure of confidential information by mental health nurses when they assess a patient as being a risk of harm. The findings indicate the rules of confidentiality are not well understood, or are not adhered to by mental health nurses. Risk assessments were found to underpin deliberations to withhold or disclose confidential information of a patient, despite risk being difficult to predict with any certainty. For risk assessment, mental health nurses were noted to prefer their unstructured clinical judgement over actuarial methods; and defer to their clinical intuition over scores of a structured risk assessment instrument, when making structured clinical judgement‐backed decisions in this area of their practice. Gaps in the literature that may be addressed by future empirical research were revealed during this integrative review

Decision-making processes of a nurse working in mental health, regarding disclosure of confidential personal health information of a patient assessed as posing a risk

Background: Nurses working in mental health routinely face difficult decisions regarding confidentiality and disclosure of patient information. There is public interest in protecting patient confidentiality, and there is a competing public interest in disclosing relevant confidential information to protect the patient or others from harm. However, inappropriate disclosures may constitute a breach of confidentiality. Despite the gravity of this situation, there is a paucity of literature to guide nurses’ decision-making processes regarding confidentiality and disclosure. Aim: To examine decision-making processes of a nurse working in mental health, regarding disclosure of personal health information of a patient assessed as posing a risk. Methods: Qualitative interpretivist approach using thematic analysis of data derived from an instrumental case study of NK v Northern Sydney Central Coast Area Health Service 2010, a Civil and Administrative Tribunal matter in New South Wales, Australia. Findings: Three important legal concerns relevant to nurses’ decision-making processes are illuminated. Firstly, for risk assessment there was an emphasis on a static notion of dangerousness. Secondly, rules of confidentiality and disclosure were not adequately observed. Thirdly, confidential information was disclosed without valid justification. Discussion: Inappropriate decision-making processes that may lead to a breach of patient confidentiality were evident in the findings. Gaps in understanding nurses’ decision-making processes pertaining to confidentiality and disclosure of patient information that may be addressed by future research were also revealed. Conclusion: Future research that addresses gaps in understanding nurses’ decision-making processes identified by this instrumental case study would provide greater guidance for nurses when making decisions regarding confidentiality and disclosure related to risk

The use of social environment in a psychosocial clubhouse to facilitate recovery-oriented practice

Background: Recovery-oriented language has been widely adopted in mental health policy; however, little is known about how recovery practices are implemented within individual services, such as psychosocial clubhouses. Aims: To explore how recovery practices are implemented in a psychosocial clubhouse. Method: Qualitative case study design informed by self-determination theory was utilised. This included 120 h of participant observation, interviews with 12 clubhouse members and 6 staff members. Field notes and interview transcripts were subject to theoretical thematic analysis. Results: Two overarching themes were identified, each comprising three sub-themes. In this paper, the overarching theme of ‘social environment’ is discussed. It was characterised by the sub-themes, ‘community and consistency’, ‘participation and opportunity’ and ‘respect and autonomy’. Conclusions: Social environment was used to facilitate recovery-oriented practice within the clubhouse. Whether recovery is experienced by clubhouse members in wider society, may well depend on supports and opportunities outside the clubhouse