Psychiatric Care and Mental Health in the Community Presentation

Chapter 24 Vulnerability in Community Populations: An Overview Basic Concepts • Risk • Vulnerability • Special needs – At risk • Vulnerable populations – Vulnerable families Web of Causation • Schematic model – Shows interrelationship among multiple factors that contribute to choices made by individuals, families, and communities that affect their health status – Factors commonly associated with vulnerability: • • • • • Disadvantaged socioeconomic status Lifestyle behaviors Low self-esteem Feelings of powerlessness Disenfranchisement Poverty and Historical Perspectives • Society’s attitude • Two common themes – Strong work ethic – Religious/moral beliefs • Industrial Revolution • Public assistance programs • Shift from federal government to state to private sector Cultural and Policy Perspectives • Cultural perspectives – Meaning of poverty • • • • Impoverished Persistent poverty Neighborhood poverty Underclass poverty • Policy perspectives – Poverty index – Near poor Health-Related Perspectives • • • • High rate of infant mortality High morbidity and mortality Complex health problems Physical limitations secondary to chronic illness • Trauma-induced injuries • Death by violence Community Perspectives • High proportion of underrepresented ethnic groups • Single mothers • High rate of unemployment • Low level of education • Low wages • Violence • Discrimination • Communicable diseases • Premature death Vulnerable Populations with Special Needs • Disenfranchised • Uninsured and underinsured – Medically indigent/working poor • • • • Children and adolescents Elders Underrepresented ethnic groups Women Nursing Considerations • Access to care • Acceptable services for vulnerable patients in diverse settings – Know the community – Schedule clinic visits at convenient times – Have bilingual nurses available – Staff members who reflect cultural, racial, ethnic background of persons who use the facility – Sensitivity – Nonjudgmental attitude Considerations • Ethical and legal • Patients’ strengths and resources – Hardiness – Support networks • Nursing roles – Psychiatric Care and Mental Health in the Community Presentation

Advocate and activist – Case manager – Educator and counselor – Collaborator and partner – Researcher • Name DQ Rubric 2019 • • Description Rubric Detail Levels of Achievement Criteria Proficient Competent Novice Introduction and quality of discussion’s Argument Weight 60.00% 100.00 % It is consistent with application in research related to its context. Clarity of ideas. Comprehensive, indepth and wide ranging. 70.00 % The topic has a partially weak association to clarity of ideas and related topic. Relevant but not comprehensive. 15.00 % Unable to address any part of the question and/or topic. Little relevance/some accuracy. Objectivity of Tone, overall quality & Review of Literature in APA 6th format within past 7 years Weight 10.00% 100.00 % Tone is consistent, addressed professionally and objectively. Evidence in literature supports arguments. 70.00 % The tone is not consistently objective. Some observations, some supportive evidence used. 15.00 % No objectivity in tone. No evidence of literature review provided. Lacks evidence of critical analysis, poor to no use of supportive evidence. Grammar / Writing Skills Weight 7.50% 100.00 % Excellent mechanics, sentence structure and organization with no grammatical mistakes. 70.00 % Some grammatical lapses , uses emotional responses in lieu of relevant points. 0.00 % Poor grammar, weak communication, lack of clarity. Peer Reply #1 Weight 7.50% 100.00 % Demonstrates an exceptional ability to analyze and synthesize student work, asks meaningful extending questions. 70.00 % Some ability to meaningfully comment on other students work and ask meaningful questions. 0.00 % No peer response Peer Reply #2 Weight 7.50% 100.00 % 70.00 % 0.00 % No Peer response Levels of Achievement Criteria Overall APA Use Weight 7.50% Proficient Competent Demonstrates an exceptional ability to analyze and synthesize student work, asks meaningful extending questions. Some ability to meaningfully comment on other students work and ask meaningful questions. 100.00 % Demonstrates an exceptional ability to apply 6th edition APA standards. 70.00 % Some ability to to apply 6th edition APA standards. i.e. use of in-text citation, reference structure, quoting,etc. Novice 0.00 % No adherence to 6th edition APA standards. Running head: PSYCHIATRIC CARE AND MENTAL HEALTH Patricia Martin Florida National University Nursing Department BSN Program NUR 4636 – Community Health Nursing Prof. Eddie Cruz, RN MSN December 4, 2019. 1 PSYCHIATRIC CARE AND MENTAL HEALTH 2 Abstract This paper examines psychiatric care and mental health in the Community. It starts by giving basic concepts of community mental health. Three concepts are discussed; social determinants of health, risk, and vulnerability. It proceeds to give biological, social and political factors that affect mental health. It also describes the types of evidence-based treatment for mental disorders. Lastly, the paper ends by looking at the roles of nurses in community mental health. PSYCHIATRIC CARE AND MENTAL HEALTH 3 Concepts of Community Mental Health The term Mental health has three connotations in epidemiology. The term is used positively to refer to a state of psychological wellbeing. Psychological wellbeing is viewed as the ability of an individual to harmoniously interact with others in a community set up, and constructively contribute or participate in positive changes in his/her social or physical environment (Pilgrim, 2017, p. 3). Second, mental health is used as a prefix of mental health services. Pilgrim (2017) notes that before World War II, the term psychiatric services was mostly used to refer to mental health services (p. 4). Mental health services/facilities included hospitals, clinics, and asylum. Presently, the community mental healthcare as a service is considered part of the wider system of providing mental healthcare. The third connotation of mental health is the negative prefix to imply mental problem/illness. The term is euphemistically used to soften the use of stigmatizing terms such as bipolar disorder or schizophrenia (Pilgrim, 2017, p. 4). Karen and Janes in the book ‘Community Health Nursing: Caring for The Public’s Health’ discussed three basic concepts of mental health. These concepts are social determinants of health, risk, and vulnerability (Lundy & Janes, 2016, p. 578). Social Determinant of Health The social determinants of health refer to the social and physical environment in which an individual lives. Social and physical environment factors such as the type of houses, economic status, neighborhood, and work environment affect one’s mental PSYCHIATRIC CARE AND MENTAL HEALTH 4 health (Lundy & Janes, 2016, p. 660). Psychiatric Care and Mental Health in the Community Presentation

Lack of or inadequate access to resources affects individuals or communities negatively. The population living in slums is at higher likely to suffer from mental illnesses than the wealthy class. Risk The concept of risk in mental health is a health condition brought about by a combination of several factors such as a person’s genetic makeup, lifestyle and social determinants (Lundy & Janes, 2016, p. 578). An individual from a family lineage of people with history for mental disorders is at high risk of developing a mental problem. Vulnerability A vulnerable population is a group or individuals who are likely to develop mental health problems due to exposure to the risk environment. They include special population groups such as the elderly, uninsured and underinsured, underrepresented ethnic groups, children and adolescents who become pregnant. Risk environment may include poverty, lifestyle, low self-esteem, and disenfranchisement. Importance of Community Mental Health Promotion in Special Populations Special populations are incapacitated to access medical services. Therefore, there is a need for intervention to alleviate the suffering that may not be superfluous. Authorities can reach to such populations in various ways including admitting them into hospital wards and asylum. However, the community mental health promotion is preferred in less severe mental health cases. The concept aims at attending the patients at PSYCHIATRIC CARE AND MENTAL HEALTH 5 their normal residential locality (World Vision, 2015). That helps in minimizing costs and giving timely services. Biological, Social, And Political Factors Associated with Mental Illness Mental illness can be a result of numerous factors. These factors are broadly classified into biological, social and political categories. Biological Factors Biological factors that can lead to mental health include genetic makeup (Lundy & Janes, 2016, p. 578). For instance, a variation in genetic makeup can render a person susceptible to mental illness compared to others (Lundy & Janes, 2016, p. 580) Social Factors Social factors including poverty, lifestyle and low self-esteem increase the risk of developing mental illness (Lundy & Janes, 2016, p. 579). Poverty affects the health of people of all ages. Sometimes, individuals in the perceived affluent class in society may be suffering from the effects of poverty. Political factors These are factors that mostly relate to governance and administration. Political factors that may contribute to mental illness include disenfranchisement and feeling of powerlessness (Lundy & Janes, 2016, p. 579). Marginalized groups in the society may PSYCHIATRIC CARE AND MENTAL HEALTH 6 lose hope in a political system that has no provision for their active inclusion in governance. The feeling of exclusion from government and policy development may impact a marginalized race or ethnic group negatively. Different Types of Evidence-Based Treatment for Mental Disorders Psychotropic Medication Management Psychotropic medication, also referred to as psychodynamic medication, is a psychiatric disorder management method for administering drugs to change the function of the brain (Leggett, Pepin, Sonnega, & Assari, 2016, p. 957). An example of psychotropic medication is Lithium which is used to suppress feelings of depression. There are risks associated with this type of mental disorder management. However, for immediate effective results, especially in acute cases where the patient is experiencing severe emotional and behavioral disturbances, its use is recommended. Community Case Management Community case management is a system of service delivery to patients within their locality (World Vision, 2015). Local community members are trained and supervised to give medical services to the patients (Sadak, Wright, & Borson, 2016, p. 631). The system aims at providing timely and effective services to the patients. Crisis Intervention PSYCHIATRIC CARE AND MENTAL HEALTH 7 Crisis intervention is an immediate intervention undertaken to prevent the occurrence of major destruction. It is an emergency first aid for mental health (Debra Umberson, Donnelly, Xu, Farina, & Garcia, 2019). It is taken to contain the effects of certain negative happenings that can destabilize the mind. For instance, in the incidence of a road accident, the survivors may suffer from trauma. It is, therefore, necessary for the victims to receive immediate counseling to prevent prolonged trauma. Role of Mental Health Nurses in The Community Nurses develop and coordinate interventions to reach vulnerable individuals, families, and communities exposed to mental health problems. Effective interventions are developed by assessing the risk factors facing a vulnerable population and identifying local resources available to address the predicament of the population (Lundy & Janes, 2016). Psychiatric Care and Mental Health in the Community Presentation

Moreover, special nursing roles such as case manager, educator, counselor, partner, and researcher attend to the real problem (Lundy & Janes, 2016). Depending on intervention and the stage intervention, the role changes. That is, a nurse will assume a certain role depending on the case he is addressing. For instance, when addressing a lifestyle-caused mental health problem, the nurse will act as a teacher to give education on the benefit of adopting a healthy lifestyle. PSYCHIATRIC CARE AND MENTAL HEALTH 8 Conclusion Mental health is a complex sector of the broader medical service. In most cases, mental illness is a result of a combination of many factors. The affluent in the society may at times depict mental illness similar to the poor. Such complex scenarios make psychiatric care intricate. PSYCHIATRIC CARE AND MENTAL HEALTH 9 References Debra Umberson, P. D., Donnelly, R., Xu, M., Farina, M., & Garcia, M. A. (2019). Death of a Child Prior to Midlife, Dementia Risk, and Racial Disparities. The Journals of Gerontology, gbz154. doi:https://doi.org/10.1093/geronb/gbz154 Leggett, A., Pepin, R., Sonnega, A., & Assari, S. (2016). Predictors oNew Onset Sleep Medication and Treatment Utilization Among Older Adults in the United States. The Journals of Gerontology, 71(7), 954-960. doi:10.1093/gerona/glv227 Lundy, K. S., & Janes, S. (2016). Community Health Nursing: Caring for the Public’s Health (3rd ed.). Burlington: Jones & Bartlett Learning. Retrieved from https://archive.org/stream/communityhealthn0000lund Pilgrim, D. (2017). Key Concepts in Mental Health (4th ed.). London: Sage Publications Ltd. PSYCHIATRIC CARE AND MENTAL HEALTH 10 Sadak, T., Wright, J., & Borson, S. (2016). Managing Your LovOne’s Health: Development of a New Care Management Measure for Dementia Family Caregivers. Journal of Applied Gerontology, 37(5), 620-643. World Vision. (2015). What is CCM/ iCCM? Retrieved from https://www.wvi.org/health/integrated-community-case-management-iccm Running head: PSYCHOLOGICAL HEALTH Psychological health Roxana Tejera Florida National University Nursing Department BSN Program NUR 4636-Community Health Nursing Prof. Eddie Cruz, RN MSN December 4, 2019 1 PSYCHOLOGICAL HEALTH 2 Psychological health Introduction Mental health is an essential aspect of the WHO’s definition of health, and it represents the emotional, social, and psychological wellness of people. Mental health is a source of emotional stability, positive self-concept, fulfilling interpersonal relationships, and effective coping behaviors. Mental illness is a pervasive problem in communities with biological, political, and social aspects that require nurse-led evidence-based approaches. Community mental health concepts Some mental health concepts include risk, vulnerability, and special needs. Risks factors increase people’s vulnerability to mental health disorders. Examples of risk factors include a history of psychological health issues, stressful life incidences, medical conditions, trauma, and child abuse/neglect. Individuals with a history of mental problems are vulnerable to mental illnesses (Silveira & Rockman, 2016). Stressful incidences such as financial difficulties and unstable marriages can also lead to mental health disorders. Vulnerability represents the factors that hike one’s chances of developing mental disorders. The risk factors identified above are examples of circumstances that elevate one’s susceptibility to mental illnesses. According to chapter 24, lifestyle behaviors, low self-esteem, socio-economic status, and disenfranchisement, are some of the factors associated with mental illness vulnerability. Examples of populations with special needs include senior persons, adolescents, children, ethnic minorities, and women. The significance of psychological health promotion PSYCHOLOGICAL HEALTH 3 The development of psychological health is essential in the community. The promotion aims at strengthening communities to ensure mental disorders do not occur, and, therefore, promote wellbeing. Also, mental health promotion checks to see the development of individual skills that help to strengthen people in the wake of pervasive mental health illnesses. It provides equality and advocates for the creation of a healthy environment, which allows people with special needs to acquire necessities. Biosocial and political factors Several biological factors can lead to mental illness. Some of the elements are genetic. For instance, some children are born with brain tumors, which affect brain functioning and lead to persistent mental illness (Lebowitz and Ahn, 2014). Psychiatric Care and Mental Health in the Community Presentation

Diseases, such as syphilis, have also been identified to cause mental illness if they are not treated early enough. Some of the diseasecausing microorganisms attack the brain, and the result is mental illness. Social factors also cause mental illness. Factors such as segregation and discrimination, for instance, tend to cause loneliness among individuals. Separation causes depression, and it may lead to mental illness. Poverty also contributes to mental illness due to the stress that results from unpaid debts and unsatisfied basic needs. Physical, sexual, or emotional abuse may also cause mental health disorders. Furthermore, people can develop mental illnesses after exposure to traumatic experiences, such as the death of a loved one. There are political factors that have been identified to contribute to the occurrence of mental illness. Political violence, for instance, contributes to a higher level of stress in communities. Lack of adequate social amenities may also cause psychological problems. Political ethnicity and tribalism are also significant contributors to psychological problems. Evidence-based interventions PSYCHOLOGICAL HEALTH 4 Psychotropic medication management includes the use of psychotropic drugs, which change of balance the chemical compounds in the brain called neurotransmitters. Examples of neurotransmitters include dopamine, norepinephrine, and serotonin. Reducing or increasing the concentration of these chemical compounds may improve health outcomes for people with mental health problems. Community case management makes use of community health workers such as nurses to provide community-level curative treatments or interventions for everyday health problems, including mental illnesses. Case management offers customized mental health interventions based on patients’ biopsychosocial needs. The primary focus of these interventions is to reduce hospitalizations. As such, the approach used traditional mental health services. Examples of such services include strengthening social relationships and the provision of socioeconomic needs, such as housing, transportation, and employment. Mental health crisis intervention provides immediate and short-term assistance to patients of mental health illnesses (Murphy et al., 2015). An example of crisis approach is the use of psychotropic drugs and family therapy. Role of nurses Mental health nurses are critical in society. They often work with susceptible populations, and they promote mental health among them. The nurses heed to calls by society regarding psychological issues, and they make sure that cases of mental illness are managed and controlled. Also, these nurses develop community-wide strategies to counter mental diseases. They also play a crucial role in mental health education and creating awareness about mental illnesses in their communities. Mental health nurses are also essential in carrying research within the community to identify the causes of mental illness. The investigations carried also help in the identification of social needs relevant to psychological disorders. Through research, too, nurses get to know PSYCHOLOGICAL HEALTH 5 how to avail social needs, thereby averting mental issues. Mental health nurses, therefore, act as activists in campaigning and advocating for the provision of resources to the community as a way to reduce depression. Conclusion Mental illness is big health issue