Discuss about the Modelling Mental Health Services with Principles of Primary Health Care.
This paper will first discuss the underlying principles of PHC. It will then go forward to address the administration of psychiatric services to the community, which is one of the nurses’ roles in PHC. While discussing mental services, the paper will evaluate the way the current delivery of mental health care balances with the principles of PHC.
For the sake of a substantial definition of PHC, this paper will define PHC as socially convenient, universally available, scientifically reliable level care. This care originates from the health administrations and frameworks with a flexible workforce containing multidisciplinary groups. At that point, these groups are sustained by incorporated referral structures.
From this definition, it is then clear that PHC cannot be an independent domain with a health care sector, and it is from this purpose it accommodates the effort of community mental health nurses (CMHN). While this paper will center attention on mental health systems, it is no doubt that all health professionals need to understand the entire concept of PHC and the extent which the utilization of its principles can prevent and improve mental health. In (World Health Organization [WHO], 2015) PHC principles are accessibility, equity and Justice, education and use of appropriate technology, community participation and intersectoral collaboration, culturally safe environment, health promotion and illness prevention.
By looking at equity, it’s worth noting that mental disorders do not only affect the ill person. There is also the community where the patients come from. Another thing to understand is that this community has its perception regarding mental disorders (Poreddi, Reddemma, Ramachandra & Math, 2013). Following this, CMHN come in to reduce the stigma associated with mental disorders. It’s more of restoring the patients and their family dignity, and that is what the principle of equity and justice entail (Azetsop & Ochieng, 2015). In offering social justice, CMHN usually employ the concept of dignity which is interlinked with social justice. Since social justice means equality with the notion of rendering equal privileges and opportunities in the society, (Tee, Brown & Carpenter, 2012) states that mental health nurses help restore dignities to the mentally ill persons by treating them as well as educate the community to accommodate them.
Like other patients, accessibility to mentally ill patients means being able to acquire quality treatment (Tee, Brown & Carpenter, 2012). When there are mental health services in PHC, more people manage to receive those services. For instance, people consider PHC as the one closest place to run. Having psychiatrist in the PHC ensures development in physical accessibility of mental health nurses, and it saves people the traveling costs.
With CMHN, mental health education has become a primary requirement among the consumers. Knowledge is a vehicle for fostering teamwork, and it soothes the adaptation process of living with the illnesses (Tee, Brown & Carpenter, 2012). For example, psycho-education is a valuable therapeutic strategy to support the clients in handling their illness. Consumers who understand their treatment are collaborative, and they engage in actions that promote their recovery. Furthermore, (Happell, Bennetts, Platania-Phung & Tohotoa, 2015) found that when mental health consumers start communicating with CMHN about their feelings, they receive advice that comfort which contributes to positive health outcomes.
On the side of technology, digital media and resources like online forums, emails, websites and blogs among others are now universal in the society (Goss, Anthony, Stretch & Nagel, 2016). One of the characteristics of technology integration in mental health is the technology based-assessment (TBA) and technology-assisted care (TAC) (Goss, Anthony, Stretch & Nagel, 2016). TBA involves interventions like recovery support, treatment, relapse prevention, etc. On the other hand, TAC in mental health helps in transcending geographic boundaries enabling CMHN to reach an enormous number of consumers (Goss, Anthony, Stretch & Nagel, 2016). In particularly, TAC helps CMHN to improve early access to care, engage patients online and undertake medication follow ups online.
Community involvement means involving the patients or their care givers in expressing their views or engaging them in the decision-making process (Lawn, 2015). The involvement includes sharing their feelings, information, and adhering to health workers’ instructions. Currently, CMHN view community participation as mainstream in their expectation and care practice (Lawn, 2015).
With community engagement, CMHN assists the consumers to improve the quality of their lives at different levels. At a personal level, CMHN allows the consumers to have an input into their treatment and the services (Lawn, 2015). At the organizational level, CMHN accommodates the users’ contributions to health agencies or organization (Lawn, 2015). The consumers also participate in the discussion that aims to improve the community and make it a more inclusive environment for mentally ill persons. At the policy level, CMHN welcomes the consumers to work in the policy agencies or accommodates their inputs in the policy development (Lawn, 2015).
In CMHN, intersectoral collaboration means maintaining a relationship with various community sectors (Subodh & Nebhinani, 2016). Some of these are the health management sectors, social services, education, transportation, local government, etc. For example, a collaboration between CMHN, and tobacco control sectors can come up with legislation, or a policy empowers the CMHN to launch quit-smoking programs.
A good definition of culture is the collection of values, beliefs, and knowledge inherited through generation. On the other hand, cultural sensitivity would mean being open to the manners in which people and their lifestyle shape health and their health behaviors (Yearwood & Hines-Martin, 2016). Therefore, cultural safety is an approach that encompasses an exploration to reflect on and understand one’s own culture and the way it interacts with other cultures.
In CMHN, cultural safe environment is a tool for upholding equity, and for bringing empowerment to the people. CMHN systems respond to articulating cultural competence within all stages of service delivery (Yearwood & Hines-Martin, 2016). The overall interrelationship gives cultural competence a different classic definition. The concept identifies competence as a set of unified attitudes, policies, and behaviors that empower the CMHN systems to function effectively within a cross-cultural setting. With the help CMHN, the integrated society understands the impacts of mental disorders on the social health and their health care systems (Yearwood & Hines-Martin, 2016). Also, CMHN helps the society to utilize the community health services.
Despite that CMHN goes to the extent of compulsory assessment when an ill person objects the assessment, it’s also easier to see that the outcome is for the benefit of the society (Procter, Hamer, McGarry, Wilson & Froggatt, 2013). The entire activity is for the good of the community as it eradicates what would have been a critical disease (Procter, Hamer, McGarry, Wilson & Froggatt, 2013). Therefore, CMHNs are sometimes forced to use their professional judgments in maintaining the safety of the bigger society.
In CMHN, Health promotion is a practice that centers its focus on the components of mental health. In (Tee, Brown & Carpenter, 2012), this emphasis endeavors to maintain people’s health or even make it better. In other words, promotion of mental health attempts to enhance the society’s capacity to accomplish psychosocial well-being and assist consumers in handling their adversities.
On the other hand, CMHN prevention of illnesses administers the various causes of mental diseases, and the steps that people can take to avoid the risk to those diseases (WHO, 2015). By looking at mental diseases prevention, CMHN looks at the three areas of prevention. One of these is the primary prevention. This one targets the entire population while examining the multiple determinants of mental illnesses. The other one is the secondary prevention. This one comprises of early detection of the disorder and its intervention, and also targets the entire population (Tee, Brown & Carpenter, 2012). Lastly, the tertiary prevention. This one administers the entire community for the process of recovery and reduction of the risks (WHO, 2015).
Practically, CMHN facilitates the developmental programs and undertake timed achievement goal plans for health promotion. In the same way, they evaluate their progress on the main developmental programs. Besides, they focus their attention and funding to those important programs of mental health promotion and disease prevention (Tee, Brown & Carpenter, 2012). Moreover, while undertaking their programs, they keep in mind the gender and the age of those who are at risk of critical mental health problems.
Conclusion
The integration of mental health system into PHC offers CMHN nurses with an opening to advocate for the rights of mentally ill persons. This also saves the patients costs and brings equity of access to care to the community. Through education and technology integration, mentally ill persons get a chance to enjoy the benefits of education and technology as other patients. Above all, CMHN help to restore the dignity of the patients and assist them to acquire a space in the society as other persons.
References
World Health Organization [WHO]. (2015). WHO global strategy on integrated people-centred health services 2016-2026. Placing People and Communities at The Centre Of Health Services. Retrieved from https://africahealthforum.afro.who.int/?-documents-
Yearwood, E., & Hines-Martin, V. (2016). Routledge handbook of global mental health nursing (1st ed.). Taylor & Francis.
Tee, S., Brown, J., & Carpenter, D. (2012). Handbook of mental health nursing (1st ed.). London: Hodder Arnold.
Subodh, B., & Nebhinani, N. (2016). Promoting mental health: Need for international collaboration. Indian Journal of Social Psychiatry, 32(3), 287. https://dx.doi.org/10.4103/0971-9962.193272
Procter, N., Hamer, H., McGarry, D., Wilson, R., & Froggatt, T. (2013). Mental health (1st ed.). Cambridge University Press.
Poreddi, V., Reddemma, K., Ramachandra, & Math, S. (2013). People with mental illness and human rights: A developing countries perspective. Indian Journal of Psychiatry, 55(2), 117. https://dx.doi.org/10.4103/0019-5545.111447
Lawn, S. (2015). Integrating service user participation in mental health care: what will it take? International Journal of Integrated Care, 15(1). https://dx.doi.org/10.5334/ijic.1992
Happell, B., Bennetts, W., Platania-Phung, C., & Tohotoa, J. (2015). Exploring the Scope of Consumer Participation in Mental Health Nursing Education: Perspectives from Nurses and Consumers. Perspectives in Psychiatric Care, 52(3), 169-177. https://dx.doi.org/10.1111/ppc.12113
Goss, S., Anthony, K., Stretch, L., & Nagel, D. (2016). Technology in mental health (2nd ed.). Charles C Thomas Publisher.
Azetsop, J., & Ochieng, M. (2015). The right to health, health systems development and public health policy challenges in Chad. Philosophy, Ethics, And Humanities in Medicine, 10(1), 1. https://dx.doi.org/10.1186/s13010-015-0023-z
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