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Susan T. is the director of the community mental health service agency- Healthy Minds. Healthy Minds seeks to prevent exacerbations of mental illness through the team care, case management, outreach, and a variety of rehabilitation models. Healthy Minds sees clients of all ages and socioeconomic levels who suffer from serious and persistent illnesses. In the beginning, Healthy Minds served as a follow-up service for patients seen at the local psychiatric hospital; however, services have expanded to reach out to all people in the community.

Nurse Susan is coordinating an in-service for all nurses newly hired to work at Healthy Minds. The purpose of the in-service is to orient novices to their role as community mental health nurses, to educate them about aspects of mental health that affect community services, and to inform them about other possible referral services in the area that are available for their clients.

Use this case study to answer the following questions:

1) How can the nurse as an educator enhance mental health care?

2) What factors related to mental illness may influence a community's resources? Be specific.

3) What self-help groups or other community services are available to clients with mental illness and mental health problems in your area? (Hint- one resource might be Alcoholics Anonymous).

Answer 1

1)a.Task shifting: Nurses with specialized training in mental health could bolster the mental health workforce. Shifting the care of uncomplicated patients who require straightforward clinical decision-making to such nurses, working under the supervision of psychiatrists, could be a huge help where psychiatrists are few and their geographic distribution doesn’t match the need for them.

b. Integration with primary care. Another way to increase access to mental health care involves adding front-line practitioners and screening processes within primary care practices, the places where patients most often interact with the health care system. We can build capacity by having primary care nurses flag patients for further evaluation by psychiatrists. These practitioners can screen more patients, implement straightforward first-line treatments, and maintain consultation and referral options to psychiatrists embedded in primary care offices. This structure, known as collaborative care, consistently demonstrates better mental health outcomes than standard management in primary care settings.

C. Nurses work outside hospitals and visit clients in their own homes, out-patient departments or GP surgeries. They can help you to talk through problems and give practical advice and support. They can also give medicines and keep an eye on their effects. Nurse therapists have had extra training in particular problems and treatments, such as eating disorders or behaviour therapy.

They can help by:

• working with you to keep an eye on any changes in your behaviour, feelings and thinking
• being someone to talk to
• developing your strengths
• working to find answers to your current problems
• helping you to become more independent.

2) It is clear that mental illness imposes a heavy burden in terms of human suffering,
social exclusion, stigmatization of the mentally ill and their families and economic
costs. Unfortunately, the burden is likely to grow over time as a result of ageing
of the global population and stresses resulting from social problems and unrest,
including violence, conflict and natural disasters.

The disability resulting from mental illness effects community resources, The cost of disability has three components :
• the direct cost of welfare services and treatment, including the costs of disabili-
ty benefits, travel and access, possible medication, etc;
• the indirect cost to those who are not directly affected (carers);
• the opportunity costs of income foregone as a result of incapacity.

DISABILITY Psychiatric Social and cultural exclusion and stigma Denial of opportunities for economic, social and human development Vulnerability to poverty and ill-health Poverty Reduced participation in decision-making, and denial of civil and political rights Deficits in economic, social and cultural rights Source: United Kingdom Department for International Development. Disability, Poverty and Development, February 2000 (modified)

3)

1.Alcoholics Anonymous:

AA group stands out to make its members to "stay sober and help other alcoholics achieve sobriety. AA is nonprofessional, self-supporting, and apolitical. Its only membership requirement is a desire to stop drinking. The AA program of recovery is set by TWELVE STEPS.

Members remain anonymous in public media, altruistically help other alcoholics, and that AA groups avoid official affiliations with other organizations.

AA membership has since spread internationally "across various countries holding different beliefs and values", including geopolitical areas resistant revolutionary movements.

2.TOPS:

Its a self help group which sponsor research and foster support groups in human body weight control.Most members refer to the organization simply as "TOPS" Stands for "Take Off Pounds Sensibly."

In response to the need to assist overweight and obese people to lose weight by setting up a support group system.They also created an incentive for club members who reach and maintain their weight at their goal level to stay in the club as KOPS (Keeps Off Pounds Sensibly) members—giving them extra recognition to help encourage other members in the club.

TOPS dont have any particular weight-loss plan & welcomes people into the membership even if they are actively involved in any weight-loss plan. Club meetings emphasize nutrition, exercise, motivation, behavior modification and wellness education focused on supplementing a member's effort to manage his or her weight.

3.

Cancer support group :

This is a group for people affected by cancer to share their experiences and emotions with others in similar situations.The experience of people diagnosed with cancer varies from one person to another, but it offers a good support system in order to cope throughout the different stages of the process.