Innovative models of care in psychiatric nursing practice in india and abroad
-
Upload
sayadwad-institute-of-higher-education-and-research -
Category
Healthcare
-
view
63 -
download
5
Transcript of Innovative models of care in psychiatric nursing practice in india and abroad
![Page 1: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/1.jpg)
INNOVATIVE MODELS OF CARE IN PSYCHIATRIC NURSING PRACTICE IN
INDIA AND ABROAD
By:- Firoz Qureshi Dept. Psychiatric Nursing
![Page 2: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/2.jpg)
1. INTRODUCTION
Innovation in psychiatric nursing practice started in the United States in the early 1960s with federal legislation authorising funds to build community mental health centres and to staff them
![Page 3: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/3.jpg)
The major aim was to provide mental health nursing care in the community and reduce census in psychiatric hospitals.
![Page 4: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/4.jpg)
In India, integration of mental health care with primary health care was considered as a primary method from the time of move towards the goal of “Health for All by the year 2000 AD (1978).
![Page 5: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/5.jpg)
2. TRADITIONAL APPROACHES
![Page 6: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/6.jpg)
2.1 Mental Hospital
Nurses to guard the patients, attend to the basic needs, assist in chemo and physical therapy, behaviour therapy, psychosocial therapy and organise activity therapies.
![Page 7: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/7.jpg)
2.2 General Hospital Psychiatric Units (GHPU)
The first GHPU was established in 1933 at Calcutta with most of the units starting incollaboration with neurology and named as “Neuropsychiatric clinics”. Nurses provided bothgeneral and psychiatric nursing care.
![Page 8: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/8.jpg)
2.3 Community care programmes
Mental Health care services were provided by public health nurses (PHN) and by multipurpose health workers (MPHW) working in community utilizing the available care & appropriate resources.
![Page 9: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/9.jpg)
3. INNOVATIVE APPROACHES
Institutional neurosis is an outcome of long incarceration of individual in an institution. Stigma arising out of admission in mental hospitals leads to social isolation and rehospitalisation. To manage the social and vocational inadequacies besides clinical disability, innovative approaches are required.
![Page 10: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/10.jpg)
3.1 Participation of the family in the treatment at Hospital
Dr. Vidyasagar, the then Superintendent of Amritsar Mental Hospital in 1950s, started taking the family into the hospital campus and they lived with patient in separate tents
![Page 11: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/11.jpg)
3.2 Home Care programme
The first experiment was reported from Chandigarh. A nurse was trained in making assessment of the patient, interview the relatives, counsel them regarding the illness and caring for the ill member of the family and dispensing the drugs.
![Page 12: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/12.jpg)
3.3 Foster Care
Patients were allowed to stay with families where psychiatrists would check periodically. Group of psychiatric patients live with their families, were given subsidiary of Rs. 5/- per family member
![Page 13: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/13.jpg)
3.4 Partial Hospitalization
• Although facility is there but not fully explored.
![Page 14: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/14.jpg)
It was started in Madras in 1962 and the patientswould either come to the hospital during day time for various therapeutic procedures and go back to their homes in the night or during the day they go for work and return to hospital at night.
3.4.1 Day and a night hospital:
![Page 15: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/15.jpg)
It provides occupational and recreational outlets. The creative talents of the patients are brought out by use of pottery, carpentry and cooking. Counselling & guidance are also given to clients attending the day care.
3.4.2 Day centre
![Page 16: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/16.jpg)
Voluntary agencies run these centres and itis for caring the chronic mentally ill as an aftercare service.
3.4.3 Half way homes/ Hostels in the community
![Page 17: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/17.jpg)
It give semi-sheltered life. Residents of these homes are drawn for various wards. Family visits them periodically. Nurses monitor their medical compliance and financial management
3.4.4 Quarter way homes/Ward-Hostels
![Page 18: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/18.jpg)
The group of patients 6-8 at a time, stay for a period of one month with almost no hospital supervision during the period. It is to facilitate their discharge into the community subsequently.
3.4.5 In association with camps in rehabilitation homes run by agencies
![Page 19: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/19.jpg)
Patient after receiving treatment & having onlyresidual defects are placed in voluntaryorganisations for shelter less to bring them into the mainstream of the society.
3.4.6 Placement of chronic mentally ill
![Page 20: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/20.jpg)
Adopt individual patients and visit them frequently
3.4.7 Friends of NIMHANS
![Page 21: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/21.jpg)
Some of the parents of chronic schizophrenics have formed a registered association to offer after care facility in the community for extended stay of chronic mentally ill, in small groups.
3.4.8 Association for sheltering mentally ill:
![Page 22: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/22.jpg)
3.4.9 Therapeutic community: is a democratic system in
hospital
![Page 23: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/23.jpg)
3.5 Community Leaders
Community leaders were oriented to health andmental health to use them as facilitators of mentalhealth care activities.
![Page 24: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/24.jpg)
4 sessions for 6 batches, 30 leaders from 10 villages to share mental health knowledge to other villagers, to identify needy patients and refer to the centre, to discuss with family members and to maintain continued contact with mental health agencies for consultation.
3.5 Community Leaders (cont…)
![Page 25: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/25.jpg)
3.6 Parents and relatives of patients
Parents and relatives of patients were assistedto form “Self-Help Group” in the care andmanagement of their wards.
![Page 26: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/26.jpg)
3.7 Traditional Healers
All the persons suffering from psychosis & epilepsy, detected during a survey carried out in villages aroundthe rural mental health centre attached to NIMHANS,had consulted traditional healers, while, only few had, in addition, gone to any modern healing centres.
![Page 27: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/27.jpg)
3.8 Training of lay volunteers
Training of lay volunteers who belong to the samesocio-economic class and the same community asthe patient and hence knew the problem in livingwhich the patient had
![Page 28: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/28.jpg)
3.9 Integrated Child Development Services (ICDS)
Nurses visited Anganwadi centres and trained Anganwadi workers for developing mental healthcare services for children in rural, urban slums and tribal areas.
![Page 29: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/29.jpg)
3.10 Student volunteers
Students of the National Service Schemes ofcolleges were used for providing recreational therapy to psychiatric patients.
![Page 30: Innovative models of care in psychiatric nursing practice in india and abroad](https://reader035.fdocuments.us/reader035/viewer/2022062822/5880ef1b1a28ab0d358b7413/html5/thumbnails/30.jpg)
4. CONCLUSION
While surveying the pattern of innovative approaches in psychiatric nursing practice, it wasfound that nurses play an important role in the general hospital psychiatric unit, in the mental hospitals and in community