Extending the accessibility of home nursing care for patients with mental illness will greatly improve their health and well being. A psychiatric home care nurse (PHCN) can assist patients with a primary diagnosis of mental illness; in particular, those with a history of not following their treatment plan, those who require frequent hospitalization, those who are otherwise unable to socially function or those who cannot adequately care for themselves will acquire considerable benefit. It is the intention of this project to holistically improve outpatient client-care by providing regular PHCN support to mentally ill patients, thereby offering a substitution for the level of inpatient care received during hospitalization; and as a means to assist or supplement family participation. As such, the paper will act as a project proposal to implement effective psychiatry home care while outlining the potential services to be offered, and surveying similar ongoing community initiatives related to the project. By installing the PHCN program, we hope to offer a bridge to facilitate semi- or fully independent patient living.
Psychiatric home care is expected to provide continuous and comprehensive treatment which meets a wide selection of issues, including medication and treatment, housing, psycho-social skills training, education, health promotion and work rehabilitation [Rice, 2006].
[...] As such, mental health patients can receive home nursing care consistent with the outlined proposal which pre-exists in fourteen CCACs across Ontario. By expanding on the work already performed therein, this project can increase the availability of home nursing care to patients with mental disorders in the province. Home care is able to expand the medical treatment options available to long term health needs experienced by patients. It is a supportive measure which, when used in conjunction to the primary care of a physician, assists in improving the quality of treatment and life of a patient. [...]
[...] Encouraging the promotion of social skills by home care nurses can include the recommendation that patients join “community alliances” such as accessing mental health resources in the forms of group counseling centers, or locations promoting workplace or social assistance. Effecting the transition toward positive social interaction will facilitate the recovery of patients with mental illness to an acceptable quality of life by preventing further social isolation and withdrawal, and community- based mental health organizations are positive sites to engage in this sort of activity without the unnecessary fear of social stigma. [...]
[...] The Centre for Addiction and Mental Health (CAMH) provides numerous inpatient and outpatient mental health services for patients in the Greater Toronto Area and Southern Ontario. As the primary location for mental health and addiction treatment in Toronto, its collection of resident physicians, psychiatrists and nurses are able to perform primary health care from assessment to treatment options. Coordinating psychiatric home nursing care with CAMH will allow this project to closely offer outpatient home care in tandem with the services offered at the hospital. [...]
[...] Since PCHN may be the only link these patients have with their physicians for some considerable length of time, they need to make adequate responses and engage in patient and family education concerning the side-effects or other issues surrounding the specific prescribed medication. In fact, nurses are frequently called upon to inject fluphenazine decanoate (Prolixin) or haloperidol decanoate (Haldol) on an intermittent schedule every four to six weeks as many patients are noncompliant with visiting the mental health centre for regular injections or lack someone who has assumed the responsibility of getting them to the facility [Rice, 2006]. [...]
[...] request home care services and are generally ambivalent to the project. According to Rice, patients suffering from depression and schizophrenia are the two presently leading categories of mentally ill clients benefiting from home care [Rice, 2006]. As such, an overview of their nursing requirements and characterizations as mental illnesses will be outlined. The DSM IV-TR defines a major depressive episode as five or more of the following symptoms over two weeks: depressed mood most of the day; diminished interest or pleasure in activities; significant weight loss or gain; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness; recurrent thoughts of death, suicide ideation without a plan, or a suicide attempt or a specific plan for committing suicide [Rice, 2006.] Conversely, schizophrenia is classified as a thought disorder in the DSM IV-TR. [...]
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