what is acute care for mental health?
care for patients with severe mental illness
what kinds of settings are used for acute mental health care?
medical hospital - patient with mental health needs also has medical needs
emergency rooms
inpatient psych units
mental health admission criteria
- unable to meet own basic needs
- significant decline in health
- unable to meet community care goals
- risk of harm to self or others
mental health admission goals
- prevention of further harm
- stabilization
- therapeutic care
- discharge to community care
what is a voluntary commitment?
patient comes to facility on purpose and chooses to be admitted, retains right to apply for release at any time
what is temporary emergency admission?
patient is unable to make decisions regarding care
length of stay can vary
what is involuntary commitment?
admitted for indefinite period
requires sign-off by 2 providers
what is long-term involuntary commitment?
imposed by court order
ranges from 6-180 days
nursing responsibilities in acute mental health care
manage unit
milieu - safe environment
what to remove from mental health patient environment
remove unnecessary cords, electronic and BP cuff
remove IV poles
remove sharps container from the room
remove unnecessary items from the walls or have them bolted down
remove doorknobs or accessibility poles that could be used to hang oneself, along with sheets
remove anything that could be a projectile - metal trays etc
make sure light fixtures cannot be broken and used for harm to self or others
mental health unit safe items
- bed bolted to the floor
- sheets tear easily
- lights embedded to the wall and lightbulbs covered
- soft flexible pencils
- shower head comes straight out from wall, completely smooth
- slide door hook, no handle
what is primary mental illness prevention?
removal of risk factors helps to prevent mental health problems from occuring
what is secondary mental illness prevention?
early detection of mental illness
what is tertiary mental illness prevention?
period after mental health crisis occurred
rehabilitation
prevention of further problems
risk factors for developing mental illness
genetic predisposition
homelessness
unemployment
discrimination and racial injustice
family conflict
stressful life events
poverty
protective attributes against mental illness
resilience - ability to secure resources for support, regulate one’s emotions, and optimism
positive relationships
examples of primary mental illness prevention
- stress reduction resources on a college campus
- resources to prevent burnout
- support for parents
- extracurriculars to form healthy friendships
examples of secondary mental illness prevention
- annual PCP visit screening for depression and anxiety
- school teachers can notice signs and help family find resources
- suicide hotlines
examples of tertiary mental illness prevention
- therapy and follow up appointments
- medication adherence
- rehab facilities
what is community care?
- community based setting outside of hospital
- goal is to stabilize and improve mental functioning
- promotes social activities and independence
what is partial hospitalization?
- intense short-term treatment
- patient goes home every night
- police are called if patient does not come in every day
what is community residence?
- long term housing with mental and medical care
- case manager is involved to help prevent re-hospitalization
- goal is to transition patients to live on their own
- teach patients how to manage medications and interventions
Assertive care team
- nontraditional case management by IP team
- used for patients with history of noncompliance: multiple admissions, multiple relapses, incarceration
- helps with social, medical, and psych needs
role of nursing in community care
- link acute care to community care
- ensure med compliance
- monitor patients for decompensation
- provide education
- communicate with patient’s healthcare team
