Community psychiatric nurses have a vast amount of responsibilities and roles within the mental health sector. They are a registered nurse that have undergone specialised training in mental health who work within the community. Some can be attached to general doctor surgeries, within the prison system, mental health units, homes and even the homeless and/or community mental health centres to name a few. They may also have their own practices. They not only work with the patient they also work with and along side the families educating them to understand and cope with the patients illness.
A CPN teach the patient not only understanding the illness but also how to cope with the illness. They will also look at the medication the patient may be taking and assess this or assist on what medication the patient should be taking. Their roles vary and include counselling the patient. Teaching the patient how to manage anxiety. A CPN would teach patients strategies on how to cope with short term problems but will also work with severe mental health problems which require continued support over a long period of time.
They work with individuals and families but they also work within groups and communities to assess mental health needs, develop diagnoses and plan then implement and evaluate nursing care. They can assist patients with self-care activities, health teaching, crisis intervention and case management. Helping patients with practical problems. CPN’s are often qualified to deliver different types of therapy including behaviour therapy. Their roles include offering emotional support to both the patient and family and help the patient explore ways of living with their illness.
CPN’s keep regular contact with the patient and assesses any changes in their mental health and the patients day to day needs. They can also request an urgent opinion from a psychiatrist if they feel that the patients condition requires this. It is hard to define what roles CPD’s perform as their roles are being rapidly defined. Psychologists Psychologists have specialised training but they are not medical doctors and can not prescribe drugs to the patients. They deal with the way the mind works.
They normally undertake psychological talking treatments with patients. Psychologists may work within a hospital or community working directly with mental health problems. They help patients deal with problems ranging from short term personal issues to severe chronic conditions. Psychologists will interview the patient, perform diagnostic tests, then provide either/and individuals, family and group psychotherapy. Through interviews and different tests they perform on a patient they will find patterns that will help them understand and predict their behaviour.
They will identify and diagnose behavioural, emotional and/or mental disorders while working with individuals, couples and families and help them implement changes to their behaviour. They design behaviour modification programs and help the patient implement this program. Psychologists collaborate with physicians and/or social workers to help treat their patients. Their role is to assess and help patients manage and alleviate their mental distress, to promote better health. There are a number of different styles of therapy that psychologists may use but they will choose the type that best addresses the patients problems.
Common types of therapy may include behavioural, cognitive, cognitive-behavioural, interpersonal or a combination of a few therapy styles. Psychologists evaluate, plan, develop and implement mental health programs to promote subjective well being and personal development. They help patients with gaining a new view or perspective on the situations in their lives. They focus on helping their patients challenge their long-held beliefs and thought patterns. Encouraging patients th think about things in nee, healthier ways that help lead to improved mental health.
Psychologists teach patients new coping strategies during difficult stressful times in their lives. They conduct therapeutic interviews and provide counselling. They offer a confidential, non-judgemental place to talk and learn copying strategies for achieving better mental health. Social Workers Social workers within the mental health sector require further study and have had to have completed the necessary post-qualifying requirements. Once this is done they are qualified to involuntarily detain a patient under the mental health act.
They are normally employed by social services. They have a distinctive role within multi-agency settings. They work with the patient and their families. They work with the patient with mental health problems to help identify and realise their own needs. Working with the families and explaining to the family what their needs are and how to accommodate them while still having a life themselves. Social workers are also there for patients and families that may have had a negative experience within the mental health services and make it a positive experience.
People with mental health problems can feel isolated and have problems sustaining and preserving social contacts and social networks, it is a social workers role to coordinate and monitor care plans so that this does not happen. They are often responsible for managing and budgeting the complete care package, this also may include organising work retraining and/or housing problems and ensuring tha the patient and family are fully advised on all benefits that they are able to receive.
Depending what the patient and family require they may have to organise day centres that the patient can go to and give the family a break while knowing that they are safe and having fun doing activities in. or they may have to organise respite care for a while for the patient so the family can go on a holiday or just have a longer break for any reason. Or if the family feel that the patient would benefit from residential care it is the responsibility of the social worker to organise this and make it an easier experience for both the patient and their family. The social worker has a commitment to working as part of multidisciplinary teams.
Social workers have to be able to provide practical help, counselling and advocacy on the patients behalf while providing emotional support where needed. They promote independence and self direct support by providing their care programmes. Social workers responsibility is to form relationships with people in the mental health sector and assist them to live more successfully. Analyse three types of advocacy and evaluate their importance. Citizen Advocacy Citizen advocates are usually run by groups which are generally not connected to service provider agencies.
Citizen advocates are volunteers who form a long term relationship with the partner which leads to a more personal relationship. They help the partner that is normally socially excluded. Citizen advocates do not have a problem getting heard and they help people with mental health illness who do find it hard to be heard. The citizen advocate becomes their voice when they feel that they are not getting heard and also teach them how to speak up for themselves and get heard. With a citizen advocate they help their partner identify specific problems they have and how to overcome these problems.
The citizen advocate has to be a good listener and can communicate with different people in different ways. They can help the partner with attending meetings, making phone calls and writing letters. They can also help the partner socialise and get to know more people so that they do not feel so excluded and isolated within their community. The citizen advocate does not make the partners choices or influence them but they do identify the partners choices and decisions and discusses the issues with them and help them come to a decision. The citizen advocacy is one to one and the advocate loyalty is to the advocacy alone.
The advocacy relationships are based on trust and confidentiality. So as you can see the citizen advocacy is so important for someone within the mental health sector so that they will always have someone on their side who will listen to them and act for them to help their lives be less complicated and more importantly not so lonely a place to live. Peer advocacy Peer advocacy is support from someone with experience using the mental health services. Peer advocates will then draw on their own experiences within the mental health services to help the partner they are working with.
They are volunteers as the same as the volunteers in citizen advocacy, eventhough now there are also paid workers within survivor run schemes. Peer advocacy is a partnership between advocate and the people in mental health which are seeking wellness, focusing on fulfilling their tasks and achieving their goals. The peer advocate helps their partner develop skills and confidence to self advocate in the future. Because the peer advocate has experienced the same problems as their partner they can use language and common themes to build trust and understanding. They can work with the partner and alongside their families.
The advocate will work with their partner in an unjudgemental way. Their partner may be more inclined to listen to them than say a family member, especially if it is regarding something they don’t want to do because they know that the advocate has had to go through the same things and has come out the other side. The advantage of peer relationship os that the advocate is independent. It is their job to represent the partners wishes without putting their own personal opinion forward. They want to recognise the potential of self-empowerment and self expertise im each person seeking wellness.
They say that people who have gone through the same experiences as the person that they are helping have a better understanding thank someone who has not experienced some of their problems they are trying to help with. They can show their partner empathy. They can experience an equal relationship with the person that they are helping. So as you can see this can only be a win- win relationship and can only help the partner feel confident in the advocate knowing that they have gone through some of what they are going through at the time.
Crisis Advocacy Crisis advocacy is to support the partner through a crisis but are not intended to have a long term basis. The advocate could already be a citizen advocate as well. The crisis advocate could also work alongside peer, self or citizen advocacy and are needed for extra support in dealing with a particular problem, this could be employment, financial matters or education to name a few. This support may be needed because issues arise that need special expertise that the other advocate may not possess.
Crisis advocacy is all about providing an immediate response to an urgent situation that the partner is facing. The crisis advocacy support would continue until the crisis has been solved and has ended. The support would be supplied as quickly as possible so that the crisis can be stopped. A crisis is a situation that could cause long term damage and pain to the partner. The crisis advocate makes a commitment to the partner and they show loyalty to them at all times. The crisis advocate is the best insurance against the partners best interest being compromised.
In some instances where they feel that the partner is unable to make decisions in the crisis they may seek legal statues and become their temporary guardian. This is in extreme cases where they could be in a situation which could jeopardise their lifestyle. So again the crisis advocacy can only benefit the partner and would make the partner feel confident that it would not matter what issues may arise that there is always someone that is qualified to help even though it may not be there regular advocate, and the help support will be given as quick as possible.
So the partner does not have to stress about anything and can use all of their energy is ensuring a better lifestyle and a more independent lifestyle. Analyse the importance of community health teams. Community health teams are also known as CMHT’S. They look after people within the mental health system with serious mental health problems, in the age bracket of 18-64 years of age. The child and adolescent mental health services are also known as CAMHS they work with people aged between 0-18 years of age.
Both teams are made up from a core group of professional, some which we have already looked at earlier. CMHT’S will normally having a base where they work out from and can see service users there. They also work in a range of places which may include, G. P. surgeries, outpatient clinics, hostels, day centre clinics and they will also see people in their own homes. A CMHT’S is made up from around 8-16 mental health professionals which would include psychiatrists, clinical psychologists, social workers, day centre staff, vocational therapists and outreach workers to name a few.
They will each know how the others work and will also tackle problems together. As you can see they are made up from a number of different professional backgrounds, all of them aim to develop a respectful, helpful and trusting relationship with the service users and help them to become more independent. There are many things that can cause mental health problems, stress past relationships, past experiences and physical and mental illness like schizophrenia, eating disorders, depression, severe personality disorders to name a few.
CMHT’S will offer screening, assessment, intervention and then a care plan to service users. Some service users with severe mental health problems may also need help with benefits, housing, emotional problems, relationship problems, getting their self confidence back or just something that they would find rewarding and useful to do. Not one person could help with all of these issues plus maybe more, hence the team are made up from different professionals with different knowledge and skills so that they can help all the service users together.
The service user may be seen in a group, by themselves, sometimes with their friends and families depending which setting would be more beneficial to them. The service user will not normally have to be seen by the entire team, they may see a couple of different professionals to begin with so that they can be assessed then they will normally just see one person at a time, even though all of the team members would understand the service users distress that goes with mental health issues. The CMHT’S can work together with the service user to find answers to their current problems, develop their strengths and be someone they can talk to.
They will also work with the service user keeping an eye on any changes in their behaviour, feelings and what they are thinking. They discuss between the team whether medication is needed and if so organise this with their G. P. One of the team members that the service user would work closely with would be their key worker or care coordinator, which are normally social workers or nurses. This would be a very helpful and supportive partnership and they would make sure that the service users have a very clear plan about how they are going to be helped.
They would discuss the entire plan with the service user and would make sure that everyone was working together properly. The key worker gets to know the service user and learn about their difficulties and see how they see their problems. As stated the key worker would work on the service users care plan and make sure that the different parts of their help and treatment are written down in their care plan. They would make sure that the service user was aware of who should be doing what, their strengths, what should be done to help them recover and any risks involved.
All members of the CMHT’S have to keep the service users information confidential the sane way as your G. P. has to and would only discuss your information with other members of the team to ensure best possible care to the service user. They will also have to speak to the service users G. P. or any other doctor they may be seeing, again to ensure pest possible care for the service user. They may also take an advocate with them when they go and see the CMHT’S staff. they ca help the service user ask questions and get their message across to the professionals if they feel that they can not do this.
They are not normally part of the mental health team but are employed by a voluntary organisation or another part of the health services. The CMHT’S are not only there for the service users but also there for their families. Their family often need support and many teams hold regular support groups for them. Families also normally want to help the service user and the CMHT’S member would ask the service user how much, if any, information they would like the family to know about their mental health problems before discussing any of their needs with the family.
So as you can see the CMHT’S are not only for the service user but also there to help the families cope with living with someone with mental health issues. As stated the CAMHS work with children between the ages of 0-18 years of age, with concerns with behaviour and emotional well being. They are normally referred by their G. P. The CAMHS work very closely with child protection and welfare agencies, G. P’s, the child’s school (if they attend one), youth and family services and adolescent mental health services.
The CAMHS are made up from a number of professionals some of these may include a psychiatric nurse, CAMHS nurses, O. O, psychiatrist, family therapist and a play therapist. The CAMHS provide a range of services beginning with initial intake to provide advice, information that they require and screening of the service user. They undertake assessment and treatment of children and adolescents with serious emotional disturbances, whose condition is considered detrimental to their growth and development and or where there are difficulties in the child or adolescents social and family environment.
Emotional disturbances and behaviour may present in a variety of ways. Symptoms may include severe anxiety, nightmares, attention deficit, bed wetting, language problems, temper tantrums and sever attachment problems to name a few. Mental health can vary from time to time and in severity and tends to mainly affect behaviour and emotions. Some mental health issues are quite manageable like hyperactivity and anxiety but others may become mental disorders where the child or adolescent could harm themselves or others around them.
The CAMHS would assess the child or adolescent and work as a team to offer support and a care plan depending on severity. The CAMHS also offers specialist clinics and special assessments. The medical professional would normally assess that the child or adolescent are able to enjoy personal relationships, develop a sense of right and wrong, play and learn and develop emotionally and intellectually, if they are having difficulty doing this (as long as a disability does not stop them from doing these) it normally means that there are signs that their mental health is not at its best.
The service user may be seen by themselves or within a group therapy session depending on which way is more beneficial to them. The CAMHS are also there for the service user’s family and offer family and group therapy and parent or care support so that they can learn to live with a child or adolescent with mental health issues. The CAMHS is a multidisciplinary mental health service that ensures effective assessments, treatments and support for the child or adolescent and their families.
They ensure that the children and young people have access to mental health promotion, tackling attachment and parenting issues and training and support to front-line professionals. The CAMHS were set up to promote the psychological well being and the mental health of children and adolescents and to offer assessments and treatments. Each community health team ensures that all service users and their families realise that mental health is just as important to everyone as their physical health.