Mental health nurses' contributions to community mental health care: An Australian study

Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses’ experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care

Strengthening of district mental health services in Gauteng Province, South Africa

In response to the Life Esidimeni tragedy, the Gauteng Department of Health established a task team to advise on the implementation of the Health Ombud’s recommendations and to develop a mental health recovery plan. Consistent with international human rights and South African legislation and policy, the plan focused on making mental healthcare more accessible, incorporating a strategy to strengthen district mental health services to deliver community-based care for people with any type and severity of mental illness. The strategy included an organogram with three new human resource teams integrated into the district health system: a district specialist mental health team to develop a public mental health approach, a clinical community psychiatry team for service delivery, and a team to support non-governmental organisation governance. This article discusses the strategy in terms of guiding policies and legislation, the roles and responsibilities of the various teams in the proposed organogram, and its sustainability

Recovery practice in community mental health teams: national survey

Background There is consensus about the importance of ‘recovery’ in mental health services, but the link between recovery orientation of mental health teams and personal recovery of individuals has been underresearched. Aims To investigate differences in team leader, clinician and service user perspectives of recovery orientation of community adult mental health teams in England. Method In six English mental health National Health Service (NHS) trusts, randomly chosen community adult mental health teams were surveyed. A random sample of ten patients, one team leader and a convenience sample of five clinicians were surveyed from each team. All respondents rated the recovery orientation of their team using parallel versions of the Recovery Self Assessment (RSA). In addition, service users also rated their own personal recovery using the Questionnaire about Processes of Recovery (QPR). Results Team leaders (n = 22) rated recovery orientation higher than clinicians (n = 109) or patients (n = 120) (Wald(2) = 7.0, P = 0.03), and both NHS trust and team type influenced RSA ratings. Patient-rated recovery orientation was a predictor of personal recovery (b = 0.58, 95% CI 0.31–0.85, P50.001). Team leaders and clinicians with experience of mental illness (39%) or supporting a family member or friend with mental illness (76%) did not differ in their RSA ratings from other team leaders or clinicians. Conclusions Compared with team leaders, frontline clinicians and service users have less positive views on recovery orientation. Increasing recovery orientation may support personal recovery

Aggressive Outreach to Homeless Mentally Ill People

Historically, people with chronic mental illnesses have been particularly at risk for homelessness. In 1984, the Connecticut Department of Mental Health (DMH) articulated policy to insure housing for mentally ill persons. One facet of that policy is to increase mental health services to homeless people. The Greater Bridgeport Community Mental Health Center has addressed this need through the formation of the Homeless Outreach Team (HOT). This article describes the development, organization, clinical work, and future of HOT. The team is run jointly by the Mental Health Center (funded through DMH) and Family Service-Woodfield, a United Way-funded agency that provides case management services. Members of the team identify homeless mentally ill persons at local soup kitchens, homeless shelters, and through a network of community contacts. HOT functions by taking clinical services into the community, offering supportive interventions as accepted by its clients. Its success is reflected in numbers of persons housed, psychiatrically stabilized, and participating in rehabilitative services either at the Mental Health Center or through other providers in the community. Several clinical vignettes illustrate HOT\u27s work

Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study

Background:The implementation of primary care for mental health is often insufficient, whichleaves its mark on staff. A team-based approach of mental healthcare prevents poor staff mor-ale. A community health centre (CHC), therefore, set up a project promoting interprofessionalcollaboration with a mental health team (MHT).Objectives:This study aimed to understand how an MHT would influence staff morale in a pri-mary care setting, aiming to formulate some recommendations for future projects.Methods:In 2017, interviews and a focus group discussion were conducted among the staff ofa CHC. Using a qualitative approach, we aimed to unravel contextual factors and mechanismsthat determine the effect of an MHT on staff morale.Results:The project relieved the burden of the patient encounters and staff members felt morevaluable to patients. Underlying mechanisms were recognition, altered attitudes towards patientsand role clarity. Facilitating factors were intercultural care mediators and a positive team atmos-phere, whereas inhibiting factors were inefficient time management and communicative issues.Conclusion:Our study elucidated mechanisms and the contextual factors by which an MHT ingeneral practice improves staff morale

Health and Wellness Projects in New Mexico Native Communities: An Activity Resource Kit

The Indian Health Service initiated the mental health program to assist American Indian tribes in dealing with problems of mental health on Indian reservations. Mental health programs on Indian Reservations are intended to be community-based. In addition, the community model is intended as a means of ensuring that mental health program practitioners treat individuals from an holistic standpoint; that is, to involve families and other community resources in treating individuals with various disorders. This evaluation provides information from four Areas: 1) Phoenix; 2) Portland; and 3) Navajo. The evaluation attempted to gauge the attitudes and perceptions of individuals in terms of suitability of treatment, personnel and Tribal involvement, community involvement, and planning features of the mental health programs. The evaluation used two separate questionnaires to survey two groups: 1) patients and 2) health advisory board members. The sample size for the patients was 69, far short of the desired 200. The evaluation team reported numerous problems associated with the patient survey. Chief among these problems was the reluctance on the part of the mental health units to participate fully in the study. Participation by advisory board members was minimal, with only 11 individuals responding. The study team decided to interview only those individuals who had direct contact or involvement with mental health programs. The study found that the mental health program was achieving some of the goals that were initially developed. However, the study felt that the mental health program, as a whole, lacks the community orientation that is to be the basis for operations and service delivery. Although referrals come from a number of different sources, problem-solving was on a one-to-one basis, rather than utilizing a combination of resources such as community resources, families, or other Tribal entities. Three patient groups-children, adolescents, and men--were not well-represented in the survey and this requires attention. The most striking feature of the board survey was their desire to have more training that will enable them to become more informed about their duties and about the nature of the mental health programs. The survey indicated that board members could not adequately express either the particular nature of mental health programs, or the philosophy of community upon which the mental health program is generally based. The evaluation team advised that Tribal leaders are highly concerned about the loss of tribal autonomy and control. The effectiveness of any program, be it mental health or otherwise, is ultimately measured by its abilities to draw upon the history and culture of the Indian community which it serves and to devise appropriate strategies for meeting identified needs

Law Enforcement\u27s Assistance to the Mental Health Community

Mental health calls are an overwhelmingly consistent part of the law enforcement profession. With the lack of resources for the mental health community, law enforcement officers are becoming the contingency strategy. Relationships between the law enforcement and mental health communities are becoming imperative for every community. While developing these relationships, law enforcement officers can begin to develop response teams to handle mental health calls for service. Bringing on board clinical and non-clinical professionals from the mental health community can provide different intervention and therapy programs. Basic ethical principles, accepted in culture, include but are not limited to respect, honesty, and loyalty. Law enforcement officers can overcome a current issue plaguing communities and the profession by using the basic level of ethical principles and implementing them in a specialized team for mental health calls

Bringing together coproduction and community participatory research approaches: Using first person reflective narrative to explore coproduction and community involvement in mental health research

Background A growing literature explores the coproduction of research knowledge. Barriers to coproduction in mental health research have been identified, especially for the people from marginalized communities. There is an established body of participatory research that has potential to inform coproduction in mental health research. Objectives To explore and articulate how learning from community participatory approaches to research enable barriers to knowledge coproduction to be overcome in mental health research. Setting An evaluation of a primary care mental health service, led by an experienced survivor researcher, supported by a health service researcher and involving a team of community co‐researchers. Design Cycles of reflective writing (first‐person narrative) by the authors, and feedback from the co‐researcher team, on their experiences of undertaking the evaluation were used to explore the ways in which community actors, including those from marginalized communities, might be meaningfully involved in producing research knowledge about mental health services. Results A space was created where community co‐researchers, including those from traditionally marginalized communities, felt safe and empowered to move beyond essentialized “service user” identities and bring a range of skills and expertise to the evaluation. There was meaningful rebalancing of power between traditional university and community roles, although the issues around leadership remained complex and more could be done to explore how our different experiences of race and mental health shape the research we do. Conclusions Potential was demonstrated for participatory research approaches to inform coproduction of knowledge in mental health research that fully reflects the diversity of identity and experience

Estia Centre 10 Years

In 2009, the Estia Centre celebrates a decade of working \ud towards making sure the mental health needs of people \ud with learning disabilities are met – through specialist \ud clinical services, research, and a programme of training \ud and education for both support workers and mental \ud health professionals. \ud \ud Despite government efforts of recent years, people \ud with learning disabilities are still marginalised. Those \ud with mental health problems and more complex needs \ud are even more socially excluded: they are much less likely \ud to be given the chance to speak for themselves and much \ud less likely to be given choices. Many people with learning \ud disabilities and mental health problems are placed in \ud residential or specialist treatment centres far from their \ud local community: historical lack of state investment has \ud led to a growth of independent providers of services \ud and a dearth of specialist public sector alternatives. \ud Based on Guy’s Hospital campus at London Bridge, the \ud Estia Centre is part of South London and Maudsley NHS \ud Foundation Trust (SLaM). Members of the Estia team work \ud in SLaM’s clinical services and at the Institute of Psychiatry \ud (IoP),King’s College London, SLaM’s academic partner. \ud There is also a dedicated team at the Centre responsible \ud for organising a large portfolio of training, offered \ud routinely to staff in social care and mental health services \ud in south London, and also available on request to staff \ud working in services around the UKand in other countries. \ud \ud The work of the Estia Centre has been inspirational to \ud clinicians and policy makers around the world. Over the \ud years, the Estia team has shared skills and experience \ud through long-standing collaborations and consultancy \ud work, helping to shape and develop specialist mental \ud health services for the benefit of people with learning \ud disabilities and their families

MODEL PELAYANAN KESEHATAN BERBASIS PARTISIPASI MASYARAKAT UNTUK MENINGKATKAN PELAYANAN KESEHATAN JIWA PADA MASYARAKAT SETEMPAT

Community-Based Participatory research is very important, because this study is the needs of local community that is facilitated by the researchers to bridge the gap between knowledge and practice of health and improve public health conditions through community involvement and social action. In this study, the local community has a significant mental health problem, then I trained community as mental health workers included how to take care of suffering from mental illness people in community life. The purpose of this research is to increase mental health workers (cadres) knowledge periodically through training and mental health care practices that were assisted by a team of researchers. The number of participants in the beginning of the study 30 people then selected 10 people who have the best value and the most skilled. Analysis of the level of knowledge and skills of cadres periodically used repeated measure ANOVA.The results of the study showed that (1) differences mental health worker knowledge of each period significantly by the results of tests of between-subjects effects 189.476 with a P value of .00 (2) The level of knowledge of the most effective after they were given skill training with Wilk lambda value of 248.71 by P value 0.00. Thus, it can be concluded the repetition of skills training impact to the level of knowledge of mental health workers. This program is recommended for the sustainability of the health department's involvement in funding and as a strategic conduction audience.Keywords: community participation, mental health workers knowledge, community mental health services