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Chapter 09 Care Coordination and Continuity in Health Care Settings and the Community Powerpoint

Mental Health Care in the Community - PowerPoint PPT Presentation

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Mental Health Care in the Community

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Mental Health Care in the Community Chapter 5 – PowerPoint PPT presentation

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Title: Mental Health Care in the Community

1
Mental Health Care in the Community

  • Chapter 5

2
Continuum of Care

  • Ongoing clinical treatment and care matched with
    intensity of professional health services
  • Care provided over time
  • Facilitates stability, continuity and
    comprehensive services
  • Achieve the highest level of functioning possible
    within the context of the illness and in the
    least restrictive environment

3
Coordination of Care

  • Integration of appropriate services
  • Services tailored to clients strengths and
    limitations
  • No duplication of services
  • Collaboration among services
  • Case management, often by a nurse

4
Generalist Case Management Services

  • Brokerage service
  • Does not necessarily provide the needed services
  • Links the individual with the services
  • Patients are usually outpatients with high-level
    service use.
  • Staff-to-patient ratio is about 130.

5
Case Management Services

  • Therapeutic tool in providing clinical services
    or as a brokerage system for coordinating care
  • Goal To act as a patient advocate by increasing
    access through coordinated efforts

6
Nurse as a Case Manager

  • Community knowledge necessary
  • Special training in psychopharmacology, therapies
    and psychosocial rehabilitation
  • Skills needed include
  • collaboration
  • teaching
  • management
  • leadership
  • group
  • research

7
Components of CareInpatient Care

  • Crisis Interventions
  • Acute Inpatient Care
  • Partial Hospitalization
  • Residential Services
  • Respite Residential Care
  • In-home Mental Health Care
  • Outpatient Care

8
Other Services

  • Outpatient Detoxification
  • In-home Detoxification
  • Assertive Community Treatment
  • Psychiatric Rehabilitation
  • Clubhouse Model
  • Relapse Prevention
  • Alternative Housing Arrangements
  • Board-and-care homes

9
Assertive Community Treatment

  • Interdisciplinary team approach that provides a
    comprehensive range of treatment, rehabilitation
    and supportive services
  • Goal To reduce recurrences of hospitalization
  • Core elements include
  • interdisciplinary team responsible for a small
    group of patients (110)
  • assertive outreach treatment to patients ADLs,
    grocery shopping, etc.
  • treatment plan of care
  • ongoing treatment and support

10
Alternative Housing Arrangements

  • Personal Care Homes
  • Board-and-care Homes
  • Therapeutic Foster Care
  • Supervised Apartments
  • Clubhouse Models
  • Relapse Prevention After-care Programs

11
Managed Care

  • Efforts to coordinate patient care efficiently
    and cost-effectively
  • Goals To increase access to care and provide the
    most appropriate level of services in the least
    restrictive environment
  • Typical services provided
  • utilization management
  • care management
  • employee assistance program

12
Managed Care

  • Public and private collaboration
  • Role of nurse
  • Maximize time with patient.
  • Focus on teaching social skills and prevention of
    relapse.
  • Teach self-reliance, and create empowering
    environments.
  • Provide crisis intervention and case management.

13
Psychiatric Rehabilitation

  • Reintegration of persons with mental illnesses
    into the community
  • Focus on increased functioning of persons with
    mental illness
  • Structured program emphasizes acquiring skills
    such as communication or vocation skills.

14
Psychiatric RehabilitationRole of Nurse

  • Adapt to the changing needs of persons with
    mental illness.
  • Match the symptoms with an accurate diagnosis,
    and engage the patient in an appropriate trial of
    medication.
  • Monitor target symptoms.
  • Assess and educate on compliance issues, lab
    work, environment and lifestyle.

15
Discharge Planning

  • Begins when an individual enters the setting
  • All activities recorded
  • Discharge Checklist
  • Text Box 5.2

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