Menta Health System – Treatment Settings & Severe Mental Illness in the Community
o Social workers – can run group therapy
Course Objectives: 1, 2, 4, 5 Class OBJECTIVES: o Counselors – do all the therapy work
Discuss the changing focus of care in mental health with o Occupational/Recreational/Art/Music/Dance
concepts of case management in community mental Therapists
health nursing o Mental Health technicians – aides of the mental
Define the Roles of specialized psychiatric care providers health community. Specially trained on how to
Discuss primary, secondary, and tertiary prevention of observe patients and notify the nurse if they notice
mental illness in the community & the role nursing plays anything.
in prevention Patient centered medical homes (Group Homes) &
Identify treatment alternatives for care for seriously Community Mental Health Centers
mentally ill & homeless mentally ill within the o Coordinate care – psychiatric case managers
community o Extended hours/services
o Emergency services/Outpatient services (211 is the
Deinstitutionalization – the root of where our mentally ill are
emergency number for psych)
living as a homeless population
Psychiatric Home Care
o Must be homebound
Intensive Outpatient Programs (IOP) – about 3 or 4 hrs a
day, 3x a week. Pt comes to the hospital and spend a few
hrs w the doctor then sees a group. /Partial Hospitalization
Programs (PHP) – longer days (full 8 hr day), doing the
same programs.
o Intermediate from inpatient & outpatient care
Mobile Mental Health Units/Telephone crisis counseling
– text crisis for suicide or 211.
Emergency Care – first screen medical issues, then
evaluated by psych.
o Goal = Triage (severity & urgency) & Stabilization
First antipsychotic med Thorazine first came out around 1947-
(resolution of crisis)
1951. Prior to this med, patients were in institutions and not
treated well. People who lived most of their life in the – Emergency Department – hopefully, psychiatric
institution were simply dumped to the streets or live back w specialty area
their families. – Mobile crisis team – in the field
– Inpatient Care Settings:
Stigma & Challenges in accessing/navigating care system o Crisis stabilization/Observation units
How to seek care? o General Hospital & Private Hospital (free standing)
Hidden/embarrassment o State Hospital
Anosognosia (you don’t believe you are sick) – Most severe (violent or hard to control)
o Nonadherence – don’t recognize that their issues are – Forensic – court related (committed a crime but
a problem. Non-compliant as they don’t see an issue also severely mentally ill). Jail where people can
or a problem. get tx for their psychiatric issues.
Motivation/anergia – esp those w major depression. No o Pediatric/Geriatric (dementia, Alzheimer’s)/Veteran
energy to seek care and plan the finance. Care Centers (PTSD, addiction, depression, anxiety)
Somatic confusion (means body) – think that there is o Prisons
something wrong w your physical body and not your o Alcohol & Drug Use Disorder Treatment – dual
mind. Ex: anxiety disorders or panic attacks (think it is diagnosis. That other diagnosis is what causes
heart attack).
o Somatic Disorders Community Nursing / Public Health Intervention
Treatment inadequacy/Medication side effects/Residual
symptoms
Continuum of Care
Primary Care – realized through screening from the
person or by the provider. Then refer to therapy
Specialized psychiatric care providers
o Psychiatrists
– Meds
o Psychiatric-mental health advanced practice nurses
– NP/CNS – some do meds
o Psychologists – master or doctorates in psychology
and do most of the therapy.
o Social workers – can run group therapy
Course Objectives: 1, 2, 4, 5 Class OBJECTIVES: o Counselors – do all the therapy work
Discuss the changing focus of care in mental health with o Occupational/Recreational/Art/Music/Dance
concepts of case management in community mental Therapists
health nursing o Mental Health technicians – aides of the mental
Define the Roles of specialized psychiatric care providers health community. Specially trained on how to
Discuss primary, secondary, and tertiary prevention of observe patients and notify the nurse if they notice
mental illness in the community & the role nursing plays anything.
in prevention Patient centered medical homes (Group Homes) &
Identify treatment alternatives for care for seriously Community Mental Health Centers
mentally ill & homeless mentally ill within the o Coordinate care – psychiatric case managers
community o Extended hours/services
o Emergency services/Outpatient services (211 is the
Deinstitutionalization – the root of where our mentally ill are
emergency number for psych)
living as a homeless population
Psychiatric Home Care
o Must be homebound
Intensive Outpatient Programs (IOP) – about 3 or 4 hrs a
day, 3x a week. Pt comes to the hospital and spend a few
hrs w the doctor then sees a group. /Partial Hospitalization
Programs (PHP) – longer days (full 8 hr day), doing the
same programs.
o Intermediate from inpatient & outpatient care
Mobile Mental Health Units/Telephone crisis counseling
– text crisis for suicide or 211.
Emergency Care – first screen medical issues, then
evaluated by psych.
o Goal = Triage (severity & urgency) & Stabilization
First antipsychotic med Thorazine first came out around 1947-
(resolution of crisis)
1951. Prior to this med, patients were in institutions and not
treated well. People who lived most of their life in the – Emergency Department – hopefully, psychiatric
institution were simply dumped to the streets or live back w specialty area
their families. – Mobile crisis team – in the field
– Inpatient Care Settings:
Stigma & Challenges in accessing/navigating care system o Crisis stabilization/Observation units
How to seek care? o General Hospital & Private Hospital (free standing)
Hidden/embarrassment o State Hospital
Anosognosia (you don’t believe you are sick) – Most severe (violent or hard to control)
o Nonadherence – don’t recognize that their issues are – Forensic – court related (committed a crime but
a problem. Non-compliant as they don’t see an issue also severely mentally ill). Jail where people can
or a problem. get tx for their psychiatric issues.
Motivation/anergia – esp those w major depression. No o Pediatric/Geriatric (dementia, Alzheimer’s)/Veteran
energy to seek care and plan the finance. Care Centers (PTSD, addiction, depression, anxiety)
Somatic confusion (means body) – think that there is o Prisons
something wrong w your physical body and not your o Alcohol & Drug Use Disorder Treatment – dual
mind. Ex: anxiety disorders or panic attacks (think it is diagnosis. That other diagnosis is what causes
heart attack).
o Somatic Disorders Community Nursing / Public Health Intervention
Treatment inadequacy/Medication side effects/Residual
symptoms
Continuum of Care
Primary Care – realized through screening from the
person or by the provider. Then refer to therapy
Specialized psychiatric care providers
o Psychiatrists
– Meds
o Psychiatric-mental health advanced practice nurses
– NP/CNS – some do meds
o Psychologists – master or doctorates in psychology
and do most of the therapy.
